Essential things to look for in physical assessment of hair and nails

A certified nursing assistant, or a registered nurse, is normally entrusted with the responsibility of carrying out a physical assessment of a patient over a life span.  Adopting the cephalocaudal approach to record the findings from the various visible parts of the body, the nurse should make note of the normal and abnormal features of the various parts he or she assesses.

The nurses’ approach has to be a detailed one and look for more details than any normal person’s assessment of the various body parts.

As part of the assessment of a person’s hair, the nurse should look for:

  • Texture
  • Quantity
  • Distribution, and
  • Hygiene

As you can see, the approach of the nurse is quite different than the normal view of an ordinary person.  Similarly, in the case of nails, a nurse, under this approach, should look for:

  • Color of the nail beds
  • Consistency of the nails
  • Contour, and
  • Thickness

In assessment of the hair features, a great amount of variation both in texture and quantity is quite normal.  However, the nurse should make note of abnormalities such as brittleness, dryness or coarseness of the texture, and also whether the quantity of hair is dense or sparse.

Fair distribution of the hair across the region should be considered normal.  However, excessive hair growth in specific parts, such as chest or face of a female, can be Alopecia, and this abnormal feature should be taken note of.

The hygiene of the hair should also be assessed for presence of lice, dandruff, odor, and appearance.

As for the assessment of nails, excessive thickness of the nails might be a cause of fungal infection.  Smooth and flexible nature of the nails is considered normal, while transverse edges and brittleness might be abnormal and should be recorded by the nurse.

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