Assignments, Chapter 11, Skin, Hair, and Nails Assessment
Written Assignments
1. A 61-year-old presents to the clinic today with itching of the head and
Learning Objective
2 scalp. He states that he has a rough and scaly area on the crown that flakes when he scratches his scalp.
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After initial clinical assessment and diagnosis of seborrhea, make a list of health promotion measures and risk reduction factors related to scalp infection for this patient.
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Make a list of teaching opportunities for health promotion and risk reduction related to the skin, hair, and nails.
2. Write a description of chronic seborrhea using correct medical terminology.
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Group Assignments
1. A middle-aged adult is being examined by the nurse practitioner today in the clinic. The patient has an oval-shaped, solid tan area on her right cheek. She
Learning
Objective(s)
3, 5 routinely uses a tanning bed during the winter months. The patient’s mother was diagnosed with a melanoma 6 months ago. She asks the nurse if this spot on her right cheek is cancer.
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A group of students will gather pictures of examples of melanomas and differentiate the normal from the abnormal findings.
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Discuss the physical assessment findings with the other students in Skills

Lab and include the location, size, distribution, and configuration of the skin lesion.
2. Nine months ago, a 62-year-old patient had bariatric surgery. She returns to the surgeon for another postoperative visit, reporting significant hair loss.
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What is the normal hair distribution for the older adult?
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What measures can the patient take to determine healthy hair distribution?
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What vitamins are intrinsic to normal hair?
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Clinical Assignments
1. An older adult patient has a 6 × 8 cm skin ulcer on his right lateral ankle above the medial malleolus. Wound margins are irregular with some pallor at the edges. The wound is of partial thickness, with 80% beefy red and 20% yellow. Large fibrinous exudates are on the dressing. The skin on the left leg is hyperpigmented and ruddy. Some flaking is present. There is no hair on
Learning
Objective(s)
3 the left leg. Edema is 3+, with capillary refill of 4 seconds. The patient has full range of motion of the legs, with strength 2+ and slightly decreased.
While his wound is being cleaned and dressed, he reports that drainage from the wound bed leaks on his bedsheets during the night. He says that his right ankle is swollen and tender. He is worried that he has lost the hair around the right ankle.

Document the subjective data that describes the wound area.
2. During Skills Lab, practice assessing skin turgor, temperature, color, and 4

moisture with older adult volunteers from the community nursing home.
Collect objective data.
3. A young adult female has been going to the nail salon for more than 1 year. She has had artificial nails applied without experiencing a problem.
Today, she is visiting the clinic with a nail on her right index finger that is inflamed and painful. Over the last 3 weeks, her nail has become discolored and thickened; the artificial nail has become dislodged from the right index finger. A moderate amount of thick, yellow, odiferous drainage exudes from beneath the nail.
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What subjective information is available from the given scenario?
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What is the objective information?
4. Linda, a 70-year-old black woman, is on the telemetry unit today. She has been admitted with a diagnosis of angina. Linda has a history of Type 2 diabetes. During today’s assessment, the nurse notices that the patient’s left heel is ulcerated and has foul-smelling, yellow drainage.
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Individualize assessment of the integumentary system, considering the patient’s condition, age, gender, and culture.

Use integumentary assessment findings to identify diagnoses and to initiate a plan of care.
Web Assignments
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8, 9
1. Using Web research, identify the structures and functions of the integumentary
Learning
Objective
1

system. Possible URLs include the following: http://www.innerbody.com/anatomy/integumentary http://www.pennmedicine.org/health_info/body_guide/reftext/html/skin_sys_fin.html
2. Using Web research, identify variations of skin lesions. Possible URL includes http://www.healthline.com/health/skin-lesions
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