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concerns regarding this system, or if she has skin issues she would like to discuss. An over-all examination is done first to ask more specific questions. By doing so, it allows the nurse to focuson particular issues, and obtain detailed information that may be related to the type of skin, nail or hair problem identified by the patient. It is entirely possible to be visually assessing while conversing with the patient. Palpation of the skin is done last to evaluate skin temperature or other abnormals that may be identified by laying hands on the skin (Jensen,2015).The assessment for Tina revealed what she referred to as “zits” and is scattered pustules on her face. She states that this is better since starting the birth control, but is still problematic forher. Acanthosis nigricans is a skin condition that Ms. Jones also expresses concern over but, feelsit is not getting worse since starting the birth control. One of the identified findings is related to scattered pustules on her face, which is called acne. It is quite common for women who may present with acne involving their lower face and neck to associate the concern with a premenstrual flare, and they typically benefit from hormonal therapies such as the birth control Tina started somewhat recently (Garber, 2017). This condition is evident, and the treatment is helping since Ms. Jones stated her skin had improved after beginning the birth control pill.Acanthosis nigricans is the second concern noted by Ms. Jones and observed in the assessment. This condition commonly presents with thickened, velvety to verrucous type, grey-
ANALYSIS AND HEALTH PROMOTION7browned and hyperpigmented plaques on the skin. It is common to appear on the side and back of the neck and in the axillae area. This skin condition can be linked with patients who are diabetic, obese, and frequently have polycystic ovarian syndrome (Sander, 2016). This condition is also quite pronounced in Ms. Jones, yet she feels as though it has not worsened since starting the birth control.At the conclusion of the exam, if desired, a referral to a dermatology specialist will be arranged to determine if other best practices exist for Ms. Jones. It is common for one to experience humiliation and embarrassment with visible skin issues. Assisting this patient in improving her skin problems, can have many positive effects on her. Additionally, a simple homeskin care regime will be offered to this patient as well. She will receive education for washing her face twice a day with a gentle synthetic type detergent cleanser as recommended by UptoDate (2016) with her fingers, in a gentle motion, avoiding an aggressive scrubbing, and will then rinse her skin with warm water. She will be advised against picking her acne, as this may exacerbate infection and scarring (Graber, 2016).HEENT Assessment.While gathering the data related to Tina’s head, eyes, ears, nose, and throat the nurse utilized the skills of inspection, palpation, and auscultation. Ms. Jones is asked first about concerns associated with HEENT and if she has concerns. The question is asked so the nurse can focus on areas identified by the patient as concerning for her. Tina, however, did