NURS 6512 Wk 8 Assignment Assessing the Skin, Hair, Nails
SKIN, HAIR AND NAILS
Skin pink, warm, dry and elastic. No lesions or excoriations noted. Old appendectomy scar right lower abdomen 4 inches long, thin, and white. Sprinkling of freckles noted across cheeks and nose. Hair brown, shoulder length, clean, shiny. Normal distribution of hair on scalp and perineum. Hair has been removed form legs, axillae. Nails form 160 degree angle at base, are hard, smooth, and immobile. Nailbeds pink without clubbing. Cuticles smooth, no detachment of nailplate. Hands well-manicured with clear enamel.
HEAD AND NECK
Head symmetrically round, hard, and smooth without lesions or bumps. Face oval, smooth, and symmetrical. Temporal artery elastic and nontender. Temporomandibular joint palpated with full range of motion without tenderness. Neck symmetric with centered head position and no bulging masses. C7 is visible and palpable with neck flexion. Has smooth, controlled, full range of motion of neck. Thyroid gland nonvisible but palpable when swallowing. Trachea in midline. Lymph nodes nonpalpable.NURS 6512 Wk 8 Assignment Assessing the Skin, Hair, Nails
EYE AND EAR
Acuity by Snellen chart O.D. 20/20, O.S. 20/20. Visual fields full by confrontation. Extraocular movements smooth and symmetric with no nystagmus. Evelids in normal position with no abnormal widening or ptosis. No redness, discharge, or crusting noted on lid margins. Conjunctiva and sclera appear moist and smooth. Sclera white with no lesions or redness. No swelling or redness over lacrimal gland. Cornea is transparent, smooth, and moist with no opacities, lens is free of opacities. Irises are round, flat, and evenly colored. Pupils are equal in size and reactive to light and accommodation. Pupils converge evenly.
Ears are equal in size bilaterally. Auricles are aligned with the corner of each eye. Skin smooth, no lumps, lesions, nodules. No discharge. Non tender on palpation. Small amount of moist yellow cerumen in external canal. Whisper test : patient repeats 2 syllable word.
MOUTH, THROAT, NOSE, AND SINUS
Lips pink, smooth, and moist without lesions. Buccal mucosa pink, moist, and without exudates. Stensen/s ducts visible with no redness or swelling. 32 white to yellowish teeth present. Gums pink without redness or swelling. Protrudes geographic tongue in midline with no tremors. Equal bilateral strength in tongue. Ventral surface of tongue smooth and shiny pink with small visible veins present. Frenulum in midline. Soft palate smooth and pink. Tonsillar pillars pink and symmetric.
Nose somewhat large but smooth and symmetric. Able to sniff through each nostril. Nasal septum slightly deviated to the left, but does not obstruct airflow. Inferior and middle turbinates dark pink, moist, and free of lesions. No purulent drainage noted. Frontal and maxillary sinuses are nontender to palpation and percussion.
THORAX AND LUNG
Respirations 18/minute, relaxed and even. Anteroposterior less than transverse diameter.
Chest expansion symmetric. No retraction or bulging of interspaces. No pain or tenderness on palpation. Tactile fremitus symmetric. Percussion tones resonant over all lung fields. Vesicular breath sounds auscultated over lung fields. No adventitious sounds present.NURS 6512 Wk 8 Assignment Assessing the Skin, Hair, Nails
BREASTS AND LYMPHACIC
Bilateral breasts moderate in size, pendulant, and symmetric. Breast skin pale, pink with light brown areola. Nipples everted bilaterally. Free movement of breasts with position changes of arms and hands. No dimpling, retraction, lesions, or inflammation noted. Axillae free of rashes or inflammation.
No masses or tenderness noted on palpation. Bilateral mammary ridge present. No discharge noted from nipples. Axillary ( central, posterior, or anterior) and lateral arm lymph nodes nonpalpable. Demonstrates appropriate technique for BSE.
HEART AND NECK VESSELS
Carotid pulse equal bilaterally, 2+, elastic. No bruits auscultated over carotids. Jugular venous pulsation disappears when upright. Apical impulse palpated in the fifth ICS at the left MCL. Apical pulse- 70 beats/minute, regular rhythm, S1 heard best at the apex, S2 heard best at the base.
ABDOMEN
Skin of abdomen is free of striae, scars, lesions, or rashes. Umbilicus is midline and recessed with no bulging. Abdomen is flat and symmetric with no bulges or lumps. No bulges noted when patient raises head. No peristaltic movements seen. Soft clicks and gurgles heard at a rate of 15 per minute. Percussion reveals generalized tympany over all four quadrants. No tenderness or guarding in any quadrant with light palpation. Umbilicus and surrounding area free of masses, swelling, and bulges.
MALE GENITALIA
pubic hair growth pattern is normal for adult male: pubic hair and base of penis are free of excoriation and infestation. Circumcised penis is free of rashes, lesions, and lumps and is soft, flaccid and nontender on palpation. Glans is rounded, and free of lesions; urinary meatus is centrally located on glans; no discharge is palpated from urinary meatus. No masses or swelling noted in scrotum and left side hangs slightly lower than right side. Skin is free of lesions and appears rugated and darkly pigmented. Two descended testicles palpated. No swelling, tenderness,or masses palpated along the testicle. No bulges or masses palpated in inguinal or femoral canal.NURS 6512 Wk 8 Assignment Assessing the Skin, Hair, Nails
Over the last 10 years, numerous political drivers have paved the way for the development of new and innovative models of practice within the critical care environment. Many of these new models of practice required practitioners to perform detailed and comprehensive patient assessment. Within critical care, respiratory assessment is increasingly regarded as an essential element of a critical care practitioner’s profile. However, the assessment of other body systems has been adopted more slowly. This article argues that skin and nail assessment should be ascribed a high priority within practitioners’ scope of practice. The skin is the largest organ in the body. A wide range of diseases covering numerous pathologies and specialties manifest in changes in the skin and nails. There has been increasing realization and recognition that there is a connection between the skin and systemic disease. The skin and nails can therefore give valuable diagnostic clues to underlying disease. This article offers practitioners an opportunity to develop and augment their knowledge and understanding of skin and nail assessment and its application to the critically ill patient.NURS 6512 Wk 8 Assignment Assessing the Skin, Hair, Nails