NURS 190 – PHYSICAL ASSESSMENT MIDTERM STUDY GUIDE
Week 1: Skin, Hair, and Nails, Head, Neck, and Related Lymphatic Assessment
Physical assessment is an essential component of nursing practice that involves systematic collection and analysis of data related to a patient’s health status. It serves as the foundation for establishing a baseline and identifying any abnormalities or changes in a patient’s condition. This study guide focuses on the assessment of the skin, hair, and nails, as well as the head, neck, and related lymphatic system. The subjective and objective data collection techniques and assessment findings will be discussed in detail.
Subjective data refers to information collected directly from the patient, which includes their thoughts, feelings, and experiences. In a physical assessment, subjective data is always collected first to gain insights into the patient’s current health status. It helps in understanding the patient’s perception of their symptoms, pain levels, emotions, and overall health.
The following subjective data should be collected when assessing the skin, hair, and nails, as well as the head, neck, and related lymphatic system:
1. Pain: Ask the patient about any pain they may be experiencing in these areas. Note the location, intensity, quality, and any exacerbating or relieving factors.
2. Symptoms: Inquire about any specific symptoms the patient may have noticed, such as itching, rash, swelling, or changes in hair or nail texture.
3. Emotion: Assess the patient’s emotional state by asking about their level of concern, anxiety, or distress related to any skin, hair, or nail issues.
4. Health History: Obtain the patient’s general health history, focusing on any past or current medical conditions that may affect the skin, hair, nails, head, neck, or lymphatic system.
5. History of Illness and Injury: Gather information about any previous episodes of skin infections, wounds, burns, or head and neck injuries.
6. Family History: Ask the patient about any family history of skin disorders, hair loss, nail abnormalities, or lymphatic conditions.
7. Review of Systems: Conduct a thorough review of systems to identify any symptoms or changes related to other body systems that may be affecting the skin, hair, nails, head, neck, or lymphatic system. Pay particular attention to symptoms such as fever, weight loss, fatigue, or enlarged lymph nodes.
8. Social History: Obtain information about the patient’s lifestyle, occupation, hobbies, and habits that may influence the health of the skin, hair, nails, or lymphatic system. Determine if the patient has any exposure to environmental or occupational hazards, such as chemicals, radiation, or sunlight.
Objective data refers to measurable and observable findings obtained through physical examination techniques. These findings provide objective evidence to support or confirm the subjective data collected from the patient. In a physical assessment, objective data is collected through inspection, palpation, percussion, and auscultation.
When assessing the skin, hair, and nails, as well as the head, neck, and related lymphatic system, the following objective data should be collected:
1. Inspection: Visually examine the skin, hair, and nails for color, texture, moisture, lesions, rashes, scars, hair loss, nail deformities, and any observable abnormalities. Note any asymmetry, asymmetrical movements, or changes in size or shape of the head and neck.
2. Palpation: Use gentle touch to assess the skin’s temperature, moisture, texture, and turgor. Palpate the scalp for tenderness, lumps, or masses. Assess the lymph nodes in the head and neck for size, tenderness, mobility, and consistency.
3. Percussion: Percuss the skull and sinuses to assess for any dullness or abnormal sounds that may indicate underlying pathology.
4. Auscultation: Auscultate the carotid arteries for any abnormal sounds, such as bruits, and assess the thyroid gland for any audible bruits or abnormal masses.
In conclusion, the assessment of the skin, hair, and nails, as well as the head, neck, and related lymphatic system, involves the collection of subjective and objective data to gain a comprehensive understanding of the patient’s health status. Subjective data includes the patient’s perception of symptoms, pain, emotions, and health history. Objective data is obtained through various physical examination techniques, including inspection, palpation, percussion, and auscultation. By systematically collecting and analyzing these data, nurses can identify any abnormalities or changes in the patient’s condition, which will guide further assessment and intervention.