By Mary Jo Goolsby, Laurie Grubbs
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Additional info for Advanced Assessment-Interpreting Findings and Formulating Different Diagnosis
As the history is obtained, a general survey is performed to determine the patient’s general status. Notice the posture, body habitus, obvious respiratory status, and whether the patient is guarding or protecting any area of the skin. The general survey should provide an indication of the patient’s overall skin condition, including color, visible lesions, moisture, and perspiration. As each section of skin is inspected and palpated, there are basic considerations. These include the skin’s color, moisture, texture, turgor, and any lesions.
A. Davis. 8 The Art of Assessment and Clinical Decision-Making development of a differential diagnosis that is based on an understanding of probability and prognosis. This means that conditions considered are those that most commonly cause the perceived cluster of data (probability), as well as conditions that may be less common, but would require urgent detection and action (prognosis). Several adages are frequently used when teaching health assessment, to encourage novice diagnosticians to always consider clinical explanations that are most likely to explain a patient’s situation.
An individual’s multiple lesions are similar in color. The margins are well discriminated. Itching is often present. It usually occurs in the warm months and in adolescents and young adults. Size ranges widely. Diagnostic Studies. Skin scrapings with potassium hydroxide solution reveal hyphae and spores. MILIA Milia occur in infants and are similar to epidermal inclusion cysts. Signs and Symptoms. Milia consist of 1–2-mm pearl-colored lesions scattered over a newborn infant’s face. They may involve the oral mucosa over the palate (Epstein’s pearls).