ASSESSING THE HAIR AND NAILS

IMPLEMENTATION
Life span Considerations: HAIR

INFANTS: it is normal for infants to have either very little or a great deal of body and scalp hair
CHILDREN: As puberty approaches, axillary and pubic hair will appear
ELDERS: There may be loss of scalp, pubic, and axillary hair. Hairs of the eye brows, ears and nostrils
become bristle-like and coarse.

Prior to performing the procedure,

1. Perform handwashing, and sanitize hand
Hand washing technique:

2. Introduce yourself to the client and identify client’s identity, explain what you are going to do, why it
is necessary, and how the client can cooperate. and secure client consent
How to Identify Clients name?
Patient wrist band
Ask patient Full name
Patient Bed. Number/room

3. Gather the necessary equipment.

Equipment:
Millimeter Ruler, Examination
gloves, Magnifying glass
Equipment: Clean Gloves
4. Provide Privacy,
Draw curtain for privacy before performing a procedure,

5. Provide safety environment to both patient and nurse, include:

Sharp injuries
Exposure to blood pathogens
Lifting injuries
Lack of PPE

6. Raise bed side rails

To prevent patient from risk for fall
1. Wash hands
2. Introduce yourself to the client
and identify client’s identity.
Explain what you are going to do,
why it is necessary, and
how the client can cooperate.
3. Gather the necessary equipment.
4. Provide Privacy
PROCEDURE/ASSESSMENT NORMAL FINDINGS DEVIATIONS FROM
NORMAL
Inspect the evenness of growth Evenly distributed hair Patches of hair loss
over the scalp (ex. Alopecia)
Inspect Hair thickness or Thick hair Very thin hair (hypothyroidism)
thinness
Inspect Hair texture and Silky, resilient hair Brittle hair (hypothyroidism);
oiliness. Excessively oily or dry hair.

Note presence of infections or No infection or infestation Flaking sores, lice, nits (louse
infestations by parting the hair eggs), and ringworm.
in several areas, checking
behind the ears and along the
hairline at the neck.
Inspect amount of body hair Variable Hirsutism (abnormal hairiness)
in women; naturally absent or
space leg hair (poor circulation)
Document finding in the client record using forms or checklists supplemented by narrative notes when
appropriate by narrative notes when appropriate.

IMPLEMENTATION

Life span Considerations: NAILS

INFANTS: Newborns nails grow very quickly, are extremely thin, and tear easily.
CHILDREN: Bent, Bruised, or ingrown toenails may indicate shoes that are too tight.
Nail biting should be discussed with family member.
ELDERS: The nails grow more slowly and thicken
Longitudinal bands commonly develop, and the nails tend to split, Bands across the nails may indicate
protein deficiency; and spoon-shaped nails, iron deficiency.
Toenails fungus is more common and difficult to eliminate (although not dangerous to health)
PROCEDURE/ASSESSMENT NORMAL FINDINGS DEVIATIONS FROM
NORMAL
Inspect fingernails plate shape to Convex curvature; angle of nail Spoon nail (figure B); clubbing
determine its curvature and plate about 160’(see figure A) (180’ or greater) Figure C and
angle D)
Excessive thickness or thinness
or presence of grooves or
furrows; beau’s lines (figure E);
Discolored or detached nail-
often due to fungus.
Inspect fingernail and toenail Highly vascular and pink in Bluish or purplish tint (may
bed color. light-skinned clients; dark- reflect cyanosis); pallor (may
skinned clients may have brown reflect poor arterial circulation)
or black pigmentation in
longitudinal streaks
Inspect tissues surrounding Intact epidermis Hangnails; paronychia
nails. (inflammation)

Perform blanch test of capillary Prompt return of pink or usual Delayed return of pink or usual
refill: color color (may indicate circulatory
Press two or more nails between (generally less than 4 seconds) impairment)
your thumb and index finger;
look for blanching and return of
pink color to nail bed.
Document finding in the client record using forms or checklists supplemented by narrative notes when
appropriate by narrative notes when appropriate.

FIGURE (A)

FIGURE (B)

FIGURE (C)