Integumentary Assessment Case Study

A 52 year old patient was referred to hospital for widespread tense, serous fluid filled blisters with an inflammatory base in the skin. Discuss the integumentary assessment for this patient?

Integumentary Assessment:

An examination of the integumentary requires some understanding of the structure and function of the system. There also needs to be an awareness of the appearance of the skin in healthy and diseased states.Prior to performing a physical assessment of the skin, a health history should be obtained. The following data should be gathered from the patient and/or family members when performing a health history about the integumentary system.

ASSESSMENT OF SKIN-SUBJECTIVE DATA

-Past health history-- indicates

biopsy, cosmetic surgery)

-Health practices related to integumentary system (ex. hygiene, sun protection).

i.Nutritional-metabolic pattern: indicates changes in the skin, hair, nails and mucous membranes and whether they are related to dietary changes.

ii.Elimination pattern-ask patient about conditions of the skin such as dehydration, edema, and pruritus

iii.Activity-Exercise pattern- environmental hazards (ex. carcinogens, allergens)

iv.Sleep-Rest pattern- disturbances in sleep caused by a skin condition

v.Cognitive-Perceptual pattern- patient 's perception of the sensations of heat, cold, pain, and touch.

vi.concept pattern- feelings related to the patient 's skin condition.

vii. Role-relationship pattern- how the skin condition affects relationships with family members, peers and work associates.

viii.Sexuality-reproductive pattern- effect of the patient 's skin condition on sexual activity

ix.Coping-Stress Tolerance pattern- the role that stress may play in creating or exacerbating the skin condition.

ASSESSMENT PROCEDURE OF INTEGUMENTARY SYSTEM.

-CLIENT PREPARATION

To prepare for the skin examination, ask the client to remove all clothing and jewelry and put on an examination

Keep in mind that some clients have sun tanned areas, freckles, or white patches known as vitiligo. The variations are due to different amounts of melanin in certain areas. A generalized loss of pigmentation is seen in albinism. Dark-skinned clients have lighter-colored palms, soles, nail beds, and lips. Freckle like or dark streaks of pigmentation are also common in the sclera and nail- beds of dark-skinned clients.

i. Inspect for Skin Integrity

Check skin integrity, especially carefully in pressure point areas (e.g., sacrum, hips, elbows). If any skin break- down is noted, use a scale to document the degree of skin breakdown.

ii.Inspect for Lesions

Observe the skin surface to detect abnormalities If you observe a lesion, note its location, distribution, and configuration.

-SKIN PALPATION

Palpate Skin to Assess