W#4 Health Assessment (Peer replies)

Reply Posts

Respond to your peers’ post and include the following:

· Insight on a solution to an identified peer challenge.

· Resources that may be helpful related to your peers’ post.

POST # 1 AYME

(Ayme’s initial Post)

Reflect on the focus area or system(s) for the week.

· What challenges might you anticipate in completing this assessment?

· What differences might you anticipate when assessing patients across the lifespan?

· Share findings from scholarly resources that help in the performance of this assessment.

The focus areas of assessment over the week included the skin, hair, and nails. These areas are seemingly too external that they may be considered to have minimal information to inform the diagnostic and care planning processes. However, the cardinal rule in assessment is that every system and area is as important as the other and may inform the point of separation especially in differentia diagnosis where differences are too minimal but still critical. Notably, the skin should be considered as a critical organ considering that it is the largest organ occupying up to 16% of the entire body weight (Jensen, 2018). When assessing the skin, inspection is usually the first-line procedure. The inspection helps in identifying skin lesions and growth. Skin coloration and skin integrity can be identified via observation. However, the challenge with skin assessment is that the variations in attributes from one age-matched group to the other are extremely wide. In essence, the skin of a healthy infant is significantly different from that of a healthy elderly adult. In elderly adults, for instance, dry skin may be attributed to reduced mobility, low fluid intake, and general drooping of the skin due to age-related factors (Dains et al., 2020). The elderly adult will still be considered healthy with no significant health issues. However, dry and drooping skin in an infant is likely to be interpreted as emergency dehydration and the infant may require extensive monitoring. 

   Inspection of the hair focuses on identifying the overall distribution of axillae, pubic hair, and scalp. In hair assessment, the distribution of hair, scalp, and axilla tends to decline with age with less hair, fewer axillae, and extended scalp (Jarvis, 2019). This interpretation of hair is less complex as compared to nails and skin. In nail inspection, the shape, cleanliness, and color are the informing factors. Nails are also critical in informing peripheral blood circulation via refill patterns/rate. The challenge with using nails as a primary determinant in peripheral blood circulation is that it varies across the lifespan and experience may be necessary for ensuring age-appropriate interpretation (Bickley, 2017). Older adults while healthy may display slower capillary refill and this may be considered normal due to inevitable decline in the functional status of muscles with age. However, a slower capillary rate in an infant may be informative of poor or compromised blood circulation (Harding, 2019). 

References

Bickley, L. (2017). Bates' guide to physical examination and history taking (12th ed.). New York: Lippincott, Williams & Wilkins. ISBN-13: 978-1469893419 

Dains, J.E., Baumann, L.C., & Scheibel, P. (2020). Advanced health assessment and clinical diagnosis in primary care (6th ed.). Boston: Elsevier.

Harding, M. M. (2019). Assessment: Integumentary System. Lewis's Medical-Surgical Nursing E-Book: Assessment and Management of Clinical Problems, Single Volume, 395.

Jarvis, C. (2019). Physical Examination and Health Assessment E-Book. Elsevier Health Sciences.

Jensen, S. (2018). Nursing health assessment: A best practice approach. Lippincott Williams & Wilkins.