Physical Observations.

Observe the skin under good, natural light.

Any abnormal skin condition should be described as to its location, color, and size and how it feels to the patient.

The following skin observations should be checked upon admission and daily thereafter:

• Cleanliness.
• Odor. May be caused by sweat secreted by the sweat glands; by abnormal conditions, such as infection or kidney disease; or by bodily discharges (urine, feces) that need to be cleaned.
• Texture. Smooth and elastic or dry and rough; nutritional deficiencies can influence skin texture.
• Color. Reddened areas that could indicate pressure, cyanosis (bluish tinge) or jaundice (yellowish tinge).
• Temperature. Hot skin could mean fever; cold skin could mean poor circulation.
• Sensitivity. Pain, tenderness, itching, or burning.
• Swelling (edema). Stretched or tight appearing; usually begins in the ankles or legs or any other dependent part; may be associated with injury.
• Skin lesions. Rashes, growths, or breaks in the skin.

Observations may begin at the head (scalp) and proceed to the feet in a systematic manner.

Psychosocial Observations.

Problems in this area may be related to the patient’s present problems.

The time of the patient’s bath may be a good time to find out more about the patient’s psychosocial needs.

Remember that the patient’s nonverbal communication may tell you much about the way he/she is feeling.