Assessing Clients With Skin Problems

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Assessing the clients with skin problems include obtaining a detailed history as this may provide clues to forensic nursing diagnosis, with careful observation.

The general examination of the skin considers normal variants and general changes in the skin.
General changes can alter color (jaundice, cyanosis, pallor), turgor, thickness, temperature, and vascularity (purpura, petechiae, flushing).

Specific terminology is used to describe the characteristics of skin lesions (color, configuration, distribution, type of lesion, and the lesion pattern), which can then be documented

Begin a patient history using the patient’s own words regarding his/her own condition. This gives the nurse a sense of direction as to which triage questions to ask.

Examinations should be done in an orderly manner to insure important diagnostic clues are not missed. Don’t overlook hair, nails, and mouth.

Primary lesions are caused directly by the disease process. Pay attention to the shape, morphology, distribution, and quality of the lesion(s).

Some common descriptive terms of primary lesions are macule, papule, nodule, plaque, wheal, vesicle, bulla, pustule, cyst, comedo, and burrow.

Secondary lesions are the patient’s response to a disease process.

Some common descriptive terms of primary lesions are scale, crust, fissures, lichenification, erosion, ulcer, excoriation, scar, and atrophy.

Evaluate the distribution, shape, arrangement, and color of the lesion(s).

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