{"id":1119,"date":"2022-12-12T11:55:01","date_gmt":"2022-12-12T16:55:01","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/skin-inspection\/"},"modified":"2024-08-13T10:59:27","modified_gmt":"2024-08-13T14:59:27","slug":"skin-inspection","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/skin-inspection\/","title":{"raw":"Skin: Inspection","rendered":"Skin: Inspection"},"content":{"raw":"Inspection of the skin can be performed with the client sitting upright on the exam table or lying in a supine position. If you are doing a focused assessment, position the client so that you have the best visibility of the affected area. Use a bright light or a pen light if needed. Shadows and dark lighting may alter your visualization of the affected area and provide information about the elevation of a lump.\u00a0<\/span>\r\n\r\nIf you are doing a complete assessment, use a systematic approach and proceed [pb_glossary id=\"1462\"]cephalocaudally[\/pb_glossary] to ensure comprehensiveness. If the client has identified a specific concern, inspect that area first. If you are doing a complete assessment when the client has no specific concerns, inspect the face, arms\/hands, back, abdomen, chest, and legs\/feet. Always inspect the anterior <\/strong>and posterior side<\/strong>; for example, for the arms, ask the client to raise their hands\/arms in front of them with their palms facing down and then turn palms up so that you can inspect both sides. Similarly, for the legs, inspect the anterior and then have the client roll over so that you can inspect the posterior. You may need to seek assistance to reposition a client that is immobile or has difficulty moving.\u00a0<\/span>\r\n\r\nKeep in mind that the best control for comparison is the client\u2019s own body, so always compare bilaterally<\/strong>.\u00a0<\/span>\r\n
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Clinical Tip<\/strong><\/h2>\r\n<\/header>\r\n
\r\n\r\nCommonly overlooked areas for skin inspection include behind the knees, in [pb_glossary id=\"1460\"]skin folds[\/pb_glossary], <\/span>and between digits (fingers and toes). Other important areas to check are bony prominences (e.g., hips, spine, ankles), especially if the client has mobility issues. If the client is unable to reach these areas, encouraging family members to assist with checks can be helpful.\r\n\r\n<\/div>\r\n<\/div>\r\nSkin inspection involves the following steps:<\/span>\r\n
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  1. Inspect the skin for colour<\/strong> using both a generalized and localized approach. To visualize general colour, step back and take note of their general appearance; for a localized approach, inspect specific regions. Mucous membranes, palms, sclera, and regions around the mouth can all be telltale signs for centralized colour variations. Always examine distal extremities for discolouration. Table 4<\/strong> lists common colour variations. Skin colour varies widely from dark to light shades including black, brown, yellow, and white shades. These colours are affected by many factors. The biggest factor is how much [pb_glossary id=\"1478\"]melanin[\/pb_glossary] is produced by the body's melanocytes; this also affects hair and eye colour. Additionally, the circulating hemoglobin affects skin colour and the underlying connective tissue.<\/span><\/li>\r\n<\/ol>\r\n