Objectives Develop a plan of care for the skin, hair, and nails Demonstrate docu

Objectives
Develop a plan of care for the skin, hair, and nails
Demonstrate documentation of the skin, hair, and nails assessment findings
Explain how to conduct a physical assessment of the hair, skin, and nails
Assignment Overview
In this writing assignment, you will review a case scenario and submit an assignment providing information on how you would conduct a focused physical assessment of the client based on the presenting complaints. You will document your findings from the focused history and physical assessment data elicited and develop a nursing plan of care for this client.
Step 1
Scenario
Benito Jaramillo is a 41-year-old Hispanic male in excellent health. He presents to the Primary Care Clinic today because of a mole his partner noticed on his back.
You perform the following assessment:
Onset: When you asked Benito about any problems with his skin, he tells you he has never really noticed any problems with his skin, but his partner Greg has been telling him he should get this growth on his back checked out.
Duration: You asked him how long he has had the growth, and he tells you he has had it for about six months, but Greg told him it has been getting larger in the past couple of months.
Characteristics: You asked Benito if it itches or bothers him in any way and he tells you no, but it has been oozing a little bit of fluid he noticed on his t-shirt. You asked him what the mole looks like, and Benito tells you it is a dark color and oddly shaped. He has had a hard time looking at it very well in a mirror because of where it is located.
Aggravating or alleviating factors: None.
Other background information: Benito is a competitive triathlete, often spending many hours a day training outside. He does not wear sunscreen because he believes his dark skin protects him from the sun. He also vacations often with his partner Greg, and they go to places like Hawaii for windsurfing and relaxing on the beach.
You perform the following assessment:
Skin: You first examine the lesion following the established guidelines of A, B, C, D, E:
A—Asymmetrical Shape: You observe the lesion is not round and is irregular in shape.
B—Irregular Border: You observe there is no clear border and, in fact, the lesion has several notched areas.
C—Changes in Color: You observe the lesion is red on half and purplish black on the other half.
D—Diameter: You measure the lesion and find it is 8 mm at its largest diameter.
E—Evolving: Benito confirms it has been getting larger over the last several months.
Diagnosis and treatment: You suspect melanoma and refer Benito to the dermatologist. A biopsy determines it is a Stage II melanoma, and Benito goes for more surgery to remove the lesion.
Step 2
You are precepting a student nurse today who is taking her assessment class. She is learning about focused history and assessment skills. In your paper, discuss the following items:
Write a detailed explanation describing what you would say to the student, explaining the assessment conducted and the findings. Discuss the skin assessment you performed and any additional assessments you would perform. What are other factors related to the probable diagnosis you would be concerned about with this client?
Explain how you would document your findings in the medical record.
Develop your plan of care. Identify one to two nursing diagnoses and one to two nursing interventions related to those diagnoses. The interventions need to be evidence based. Cite the references used in your plan in correct format. As a minimum the textbook and any article you are asked to read should be used as evidence, next level would be peer reviewed articles after that well known web sites for example CDC or the AHA. Avoid blogs or obscure web sites. Never cite or utilize Wikipedia.
Identify what client education should be done for Benito, given his background and presenting illness. Describe your teaching strategy and how you will evaluate the effectiveness of the educational intervention.