Hair Nail is a thin, flexible, elongated, fiber Are thin plated keratinized composed of dead keratinized epidermal cells cells that grow out in columnar fashion Warmth Shield the distal ends of the Functions Protection fingers and toes Sensation Hair Follicle Nail Matrix -site where each hair shaft arises -site where the growth occurs -site where hair growth occurs Nail Body -has nerve endings -extends over the nail bed -has an arrector pili -appears pink because of blood Hair Bulb supply in the underlying dermis Structures -site where new cells produced Lunula -nourished by dermal blood -“moon-shaped” crescent vessel -appears on the nail body over the thickened nail matrix Cuticle -protects the root and sides of each nail Hair Growth (Cyclic) - scalp hair typically has an active phase of about 4 years -resting phase of a few months Hair Color -determined by the amount of melanin produced in the hair follicle Hair Type and Distribution Characteristi a) Vellus – A pale, fine, short cs strand grows over the entire body except lips, nipple, palm, soles of the feet, labia minora, penis b) Terminal – darker, coarser and longer found in the eyebrows and scalp *vary in developmental stages: axillae, pubic region, legs, face and chest

RISK DIAGNOSIS ACTUAL DIAGNOSIS Risk for Impaired Skin Integrity Impaired Skin Integrity Risk for Imbalance body temperature Disturbed Sleep Pattern Risk for Infection Disturbed Body Image Risk for Impaired Nail Integrity Ineffective Helath Maintenance Risk for Altered Nutrition: Less than Deficient Fluid Volume Body requirements

HAIR Normal Findings Abnormal Findings INSPECTION Inspect for -Natural Hair Color -Patch Gray Hair (nutritional general color *may vary with culture and age deficiencies) and -Copper-Red Hair (severe condition malnutrition) Scalp -clean and dry -Excessive Scaliness (dermatitis) -sparse dandruff -Raised Lesion (infections or INSPECTION tumor growth) AND Hair PALPATION -smooth and firm -Dull, dry hair (hypothyroidism Inspect and *vary with age and culture and malnutrition) Palpate for -Fine vellus (covers the entire -Excessive generalized cleanliness, body except soles, palms, lips, (infection, nutritional deficiency, dryness or nipples) hormonal disorders, thyroid or oiliness, parasites -Symmetric male patter balding liver diseases, drug toxicity, and lesions hepatic or renal faiure, at 1-inch chemotherapy) interval -Patchy Hair Loss (Systemix Lupus Erythematosus) - on females (Cushing’s Disease) NAIL INSPECTION Nail -Clean and manicured -Dirty, broken, jagged fingernails grooming (poor hygiene, client’s hobby or and occupation) cleanliness -pink tones -Pale or Cyanotic (hypoxia and -dark skinned: pigmented streaks anemia) Nail color -Splinter Hemorrhage (trauma) and -Beau’s lines (acute illness) markings -Yellow discoloration (fungal infections, ) -160 -Nail pitting (psoriasis)

-Clubbing (hypoxia) Shape of Early =180 nails *Schamroth Late >180 Technique – -Spoon Nails/ Concave (iron ‘diamond’ deficiency Anemia also called Koilonchyia) INSPECTION AND -hard, immobile -Thickened toe nails (decreased PALPATION Dark skinned: thickened nails circulation) Palpate nail -older client: thickened yellow, -Spongy (early indication of to assess brittle because of decreased clubbing) texture and circulation to extremities -Onychauxis (thick and consistency -smooth and firm overgrown) *note -nail plate firmly attached to the - ( and whether nail nailbed Infection) plate is attached to -pink tones returns immediately - (Detachment of nail bed after blanching (less than 2 secs) nailplate from nailbed, Infection/Trauma -Greater than 2 secs capillary Refill (Respiratory or CVD)