Integument

Definition

The integument (integumentary system) comprises the skin and its accessory structures: hair, nails, sebaceous and sweat glands. It is the body's largest organ by surface area and serves protection, thermoregulation, sensation, excretion, and vitamin D synthesis.

Skin Layers

• Epidermis: Outermost; avascular; contains keratinocytes, melanocytes.
• Dermis: Connective tissue; blood vessels, nerves, hair follicles, glands.
• Hypodermis (subcutaneous): Fat, connective tissue.

Nursing Assessment

Inspect for color, lesions, moisture, temperature, turgor, edema, integrity. Palpate for texture and masses. Special populations: assess darker skin in natural light; assess mucous membranes, palms, soles, and sclera for color changes.

Common Conditions

Pressure injuries, dermatitis, cellulitis, psoriasis, herpes, skin cancer.

NCLEX Relevance

Assess skin integrity on every patient. Risk factors: immobility, incontinence, malnutrition.