Answer the following questions as you respond to the responses below
In this week’s reading topics, I have found that skin the skin assessment will likely be a challenging section for me in the future. Skin, hair and nails assessments can be very tricky due to the level of difficulty in differentiating between the different skin conditions. While I typically do frequent skin assessments in my current occupation, I do not go very in depth with my skin assessment, typically looking for any skin breakdown or excoriation during their hospital visit. This type of assessment in an outpatient setting done by a provider is very different from the type of assessment that I conduct currently. Also, there are many different skin conditions that look similar to others. This can include superficial basal cell carcinoma and actinic keratosis and squamous cell carcinoma in situ, as well as nodular basal cell carcinoma and sebaceous hyperplasia (Bickley, 2016). Though these skin conditions may look similar, further testing will be necessary in order to differentiate between the two, as treatment can be very different for each condition.
I have found through my reading that skin assessments in newborns can be particularly challenging, as there are many skin conditions that are common in newborns. Again, differentiating between these skin conditions can be challenging. It is important to distinguish between typical or benign skin conditions and more severe skin conditions or diseases in order to diagnose and treat at the earliest possible time (Kutlubay et al., 2017). After this course and through experience, I should be able to quickly diagnose many of these conditions in order to ensure that my patients get the necessary treatment. Though skin conditions can be challenging, I look forward to learning as much as I can in order to have the ability to provide high quality care to my patients across the lifespan
Some challenges I anticipate in conducting the skin and abdominal assessment are detecting irregularities in age related skin changes, identifying issues such as melanomas in a wide variety of skin tones and conducting an abdominal assessment on someone with excess abdominal girth. The process of aging presents many potential complications for integrity of skin for elders. In older adults and elderly loss of elasticity, dry skin, as well as reduced adipose tissue tend to make skin tears and lesions easier to occur, along with moisture related breakdown and pressure ulcer development as reported by Todd (2018). Sun exposure can increase melanoma risk, Bickley (2017) discusses how skin assessment as part of routine exam can help detect skin cancers earlier resulting in easier treatment.
When examining infants and young children it may be difficult to get them to stay still long enough to evaluate abdomen thoroughly. In examining patients with developmental delay or cognitive impairment it may be difficult to get cooperation from the individual due to fear or lack of understanding. Examining abdomen of obese patients can be difficult due to excess adipose tissue interference, Reuben (2016) reports that in patients with central obesity it can be difficult to detect enlargement of organs, and fluid during abdominal exam. Conducting a thorough abdominal assessment can reduce the need for unnecessary radiological investigations but can be difficult in obese patients as noted by Mealie, Ali & Manthey (2020).
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