TEACH FOR NURSES LESSON PLAN
Chapter 13: Skin, Hair, and Nails
CHAPTER OBJECTIVES
1. Relate the anatomic structures of the skin to its functions.
2. Describe the significant differences between the skin of the very young, the older adult, and the healthy adult.
3. Cite examples of health care implications presented by skin alterations.
STUDENT RESOURCES
understand
• Textbook Chapter 13
• Sherpath for Medical-Surgical Nursing*
• Animations (Evolve website)
• Answer Keys: Study Guide & Lab Manual
13-2
apply
• Case Studies (Evolve)
synthesize
• SimChart*
• Simulation Learning System*
INSTRUCTOR RESOURCES
before class
• Nursing Curriculum Standards (below)
in class
• PowerPoint Presentations (Evolve)
after class
• Test Bank (Evolve)
• HESI Practice Tests*
* Sold separately from textbook.
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
STRUCTURE AND
FUNCTION
SKIN
Figure 13.1 displays the
three layers of skin.
Review the basal cell layer,
the horny cell layer, and
• Activity: Using a copy of the picture of the skin provided in the text, have students label the
structures of the skin.
13-3
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
Explain how collagen
prevents the skin from
tearing.
Discuss how sebum oil
lubricates the skin and
hair, connecting the excess
production during puberty
to adolescent acne.
FUNCTION OF THE SKIN
DEVELOPMENTAL
COMPETENCE
Demonstrate the
protective and adaptive
qualities of the skin.
• Group Activity: Simulate erythema. Working in pairs or trios, have each student slap his or her left
hand and compare its tone with that of the right hand. Students may need especially good lighting to
note the difference between the two hands, but there will be a noticeable difference. This exercise
underscores the need for good lighting. A change will occur regardless of each student’s basic skin
13-4
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
melasma.
Discuss what factors affect
the hair and skin of the
aging adult.
SUBJECTIVE DATA
chronic diseases.
Choose one of the
questions in this section
and elaborate on both
problems and solutions for
the subject matter.
• Small Group Activity: Assign students to prepare a presentation on the use of sunscreen that is
directed toward adolescents or designed for a group of new mothers. Be sure they explain the
differences in the SPF of various products.
OBJECTIVE DATA
INSPECT AND PALPATE
THE SKIN
Discuss how to integrate
the skin examination into
the complete physical
examination and the
regional examination;
cover Table 13.1.
• Online Activity: Have students search the Internet for a skin assessment instrument. Have them
critique the instrument for completeness.
• Activity: In the clinical area, assign students to patients from various ethnic groups and have them
complete an assessment, including the submission of a completed history and description of findings.
Students might complete this assignment singly or in pairs.
13-5
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
Figures 13.3 and 13.4 give
examples of common
benign pigmented areas.
Explain the difference
between hypothermia and
hyperthermia and how
they affect the skin.
Cherry (senile) angiomas
may be seen in Figure
13.8. Discuss what creates
these angiomas. Table 13.7
shows pattern injury,
hematoma, and
contusions.
13-6
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
THE HAIR
INSPECT AND PALPATE
THE NAILS
HEALTH PROMOTION AND
PATIENT TEACHING
how to inspect the hair for
texture, distribution,
lesions, or lice. Discuss
care for both dandruff and
Figures 13.14 through
13.16 give examples of
linear bands and what to
look for when depressing
the nail and checking for
capillary refill.
Using Figure 13.32,
demonstrate how to do
skin self-examination.
noticed in themselves.
• Small Group Activity: Divide students into pairs or trios to complete a history, examination, and
documentation of an examination of the hair, skin, and nails. One student may be the patient, one
may conduct the examination, and one may read the text to guide the examiner. Rotate roles as time
13-7
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
how to teach acne care to
adolescents while making
them aware that acne
usually is a temporary
condition.
IN-CLASS/ONLINE CASE STUDY
J.P. is a 45-year-old man who presents to the outpatient clinic with two swollen toes on his right foot. He does not recall injuring his foot.
Subjective Data
Pain level is a 6/10 location = right foot, throbbing
Works as a truck driver
Objective Data
Vital signs: T 37 P 80 R 14 BP 120/68
+2 edema great toe and second toe, right foot, warm to touch
+ pulses
+2 capillary refill
Questions
1. What other assessments should be included for this patient?
2. From the readings, what is the most probable cause of the edema?
3. What are two known nursing diagnoses?
4. What would be included in the nursing care plan?
5. What interventions might be included in the plan of care for this patient?
13-8
Answers
1. The assessment should include the onset, location, duration, characteristics, aggravating factors, related symptoms, treatment by the
NURSING CURRICULUM STANDARDS
QSEN/NLN COMPETENCIES
• Patient-Centered Care/Human Flourishing
NURSING CONCEPTS
The following conceptual themes and specific concepts match those presented in Giddens, J. F. (2017). Concepts for nursing practice (2nd ed.).
St. Louis: Elsevier. The specific exemplars chosen and listed below for each concept have been tailored specifically to correspond to the Jarvis
textbook.
A full Concept-Based Curriculum Map covering the entire book can be found in the “Download by Resource Type” folder on Evolve.
THEME: Personal Preferences
• Concept: Culture
13-9
• Concept: Tissue Integrity
o Exemplar: The Aging Adult
BSN ESSENTIALS
• Essential IX: Baccalaureate Generalist Nursing Practice
ANSWERS TO QUESTIONS IN THE STUDY GUIDE
Note: Answers to these questions can be found on Evolve site. Click here.