Assessment of the skin, hair and nails

Good day everyone. I am Hannah J. Oleranjoy, student nurse from ISUA Chaga Main Campus, BSN 1-2. Today, I will be performing a return demonstration on the assessment of skin, hair, and nails.

But prior to that procedure, I am going to first perform hand hygiene and put on PPE if necessary. After that, we can now proceed to the assessment.

So, good day, ma'am. I am Hannah Ola, your student for today. Can you please confirm your name, age, and birthday?

My name is Aryan Lesser Arnarendo. My birthday is December 11, 2009, and I'm 12 years old.

Okay, if there are any curtains and doors in the room, we have to close them to provide privacy. After that, we have to explain the procedure to the patient.

So, how do you want me to call you, ma'am?

I am, so ma'am Aryan, I am here to assess your skin, your hair, and your nails. But before that, can I ask your consent? Is it okay for me to touch those parts of your body?

Yes.

Okay, we do this to ensure that everything is normal, and if there are any abnormalities, we are going to note them to prevent any further complications.

I assure you, ma'am, that everything I gather here will be kept completely confidential between you, me, and that attending physician.

So, I have already explained the procedure to you, ma'am, and I will be handing you this patient done for you.

Okay, so after this, we can now proceed to the first part of the assessment.

The first thing I need to do is to take note of any distinctive odor emanating from the skin of my client. I don't smell any distinctive odor, so let's proceed to the inspection.

The first thing I need to inspect is the generalized color variations. So, I request you to raise your hands like this.

Okay, we are trying to look here for any signs of pallor, cyanosis, jaundice, erythema, and edema.

As I am assessing your skin, I observe that your skin color is brown, which is normal. The next thing I am going to inspect is your skin integrity.

I observe that there is no skin breakdown, and your skin integrity is good.

Lastly, for the inspection, I'm going to inspect for any primary, secondary, and muscular emissions. We are trying to look here for any scars, scratches, and lesions.

I don't see any skin lesions, and that's great.

So, after I inspect the skin, I am now going to proceed to palpation.

The first thing I need to palpate is the texture of your skin using the pulpar surface of my three middle fingers, starting from the base next to the arms and to the lower extremities and to the feet.

As I am assessing, I observe that your skin is smooth and firm.

Now, let's go to the temperature and moisture of your skin. For this, I am going to use the dorsal part of my hand because this is more sensitive to temperature.

I observe that you have a normal temperature, and the moisture of your skin is not overly dry and not overly moist.

Next, I will palpate for the mobility and turgor of your skin by pinching up your skin over the sternum.

I can see that you have good skin mobility, and it looks like your skin quickly returns to normal, which means there are no signs of skin turgor.

Lastly, for the palpation, I'm going to palpate for edema. In this case, I'm going to apply pressure on your skin.

I assess that your skin is smooth, and your skin quickly returns to normal. That means there are no signs of edema.

I am now going to palpate for the thickness of your skin with my fingerprints.

As I am assessing your skin, I observe that your skin is thin and firm over most of your body, except the palms, the soles of your feet, the knees, and your elbows, which is normal.

Now, let's go to the hair assessment.

For this, I am going to inspect your hair and scalp for color. I am going to inspect for the amount and distribution, and I will inspect and palpate for thickness, texture, oiliness, lesions, and parasites.

So, I will just inspect your hair.

As I am assessing your hair, I can see that your hair color is black, and you have smooth and thin hair. You have a clean and dry scalp, and there are no signs of hair loss. Your hair is evenly distributed.

In addition to that, I don't see any scars, scratches, excessive dryness, excessive oiliness, or parasites on your hair, which is great.

So, after the hair assessment, we can now proceed to the nail assessment.

For this, I am going to inspect for the cleanliness and grooming of your nails, inspect for the amount and markings, and inspect for the shape of your nails.

I observed that you have clean and groomed nails. You have normal nails, and there are no markings along the nails, which is good.

Can you do this one?

Okay, I see that you have a normal nail shape because it is at 106 degrees between your skin and the nail bed.

Next, I am going to palpate for your capillary refill. For this, I will apply pressure on your nails.

I observe that you have a fast capillary refill because the color immediately returns to normal when applying pressure. That means you have a fast capillary refill.

So, that's all for the skin, hair, and nail assessment.

Lastly, I'm going to perform hand hygiene again.

Okay, wait for a while, and I will just note the other information.

Thank you very much, ma'am, for your cooperation. Before I end, let me go back and review the information I gathered, and if there are any mistakes, then please correct me.

So, for the skin, there is no distinctive odor from the skin. You don't have any signs of pallor, cyanosis, jaundice, erythema, or edema. Your skin color is brown, your skin integrity is good and intact, and there are no skin breakdowns.

You don't have any skin lesions. Your skin is smooth, and you have a normal temperature. The moisture of your skin is not overly moist and not overly dry, with no signs of fever.

Your skin is thinner over most of your body. You have good skin mobility and no presence of turgor or edema.

For the hair and scalp, your hair is black, thin, and smooth. You have a clean and dry scalp, there is no pattern of hair loss, and your hair is evenly distributed.

I don't see any scars, lesions, dryness, oiliness, or parasites on your hair.

Lastly, for the nails, your nails are groomed and clean, with no white spots along the nails. Your nail shape is normal, and you have fast capillaries.

Did I miss anything else? Is there any specific concern that you want me to give attention to?

Okay, if none, thank you very much. I will now go back to the nursing station and record this on my chart.

So, wait for a moment; your doctor will be here soon.

Again, I am Nurse Anna, and if you need anything, I will just be there.