Incorporating Skin Color into Patient Assessment and Healthcare

Your 75-year-old patient has shortness of breath. You’re unsure how to diagnose central cyanosis in nursing homes, knowing his skin is naturally dark.

The dark tan of her skin makes it difficult to see the bruising.

A patient with a dark skin tone arrives in the emergency room after a sexual assault. The labia minor is suspected to have been abraded. Even when applying a contrast medium, it is difficult to detect the injury by health care providers because of the surrounding color. Nurse education particularly, LPN classes at community college is a better option for understanding the skin color appropriate for ethnicity nursing, as it provides valuable clinical experiences & clinical practice.

The largest organ of the body is the skin. The hue of your skin is a vital sign of your general wellness. It can also be used to assess skin breakdown and healing. For example:

• Pallor can indicate anemia.
• Cyanosis can be a sign of hypoxemia.
• Burn care is influenced by the extent of redness on the skin.
• Understanding skin color variations is essential for detecting pressure ulcers and staging them.

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This article discusses skin color assessment and the role that skin color plays in the nursing profession concerning competent care. It also explains the importance of color awareness for healthcare providers instead of blindness.

Constitutive Vs. Facultative Skin Color

Constitutive skin color is determined by genetics and does not change with exposure to ultraviolet light (UV) or hormones. It’s usually seen in areas with little to no sun exposure, like the underside of an upper arm.

The opposite is true for facultative skin colors caused by exposure to UV light or other environmental factors. Tanning, for example, alters the composition of the melanin in your skin and increases the amount and the size of the melanin produced. So, the skin of facultative skin will be darker than that of constitutive skin.

Why Does “The Color Seeing” May Risk a Person’s Existence?

Skin color can cause disparate health care outcomes in health care for many reasons. These include discrimination and poor access to healthcare. Health disparity can emerge when sincere medical workers are color “blind”–that is, they overlook a patient’s skin color because they feel it will help them deliver an equal standard of clinical care to all patients despite their skin color. This approach, however, limits the importance of skin color concerning health. It also limits the ability of health care professionals to provide personalized nursing care.

Forensic Implications

Researchers who studied forensic sexual assault exams found that black patients (women) were less likely to suffer genital injuries after rape than white women. The researchers suggested that the reported difference in injury prevalence was not related to race but rather to reduced visibility of injuries in dark-skinned women (compared to lighter-skinned) or to actual differences in skin property depending on skin color. The study also showed that dark-skinned females suffered fewer injuries after sexual relations than lighter-skinned counterparts.

Cultivating Color Awareness

Color awareness, unlike color blindness, acknowledges the importance of skin color to health. It also recognizes that many people on the skin color spectrum may not wish to be treated like they are colorless or raceless. This is because a large part of their identity comes from their color. Applying color awareness in health assessment allows healthcare professionals better to manage darker skin tones conditions for patients of all skin colors and reduce disparities by the practical nurse.

Skin Color Assessment Methods

Fitzpatrick’s scale is the most common method of assessing skin color. It was created to classify skin types during a study on UV dosing for psoriasis treatments. (See the box beneath.) This scale’s latest version categorizes skin into six different types depending on how it reacts to sun exposure. This scale is not very useful in nursing assessment because it focuses on sun exposure and the fact that dark-skinned individuals fall into one main category.

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Recommendations to Assess Dark-skinned Patients

Use natural light to assess the patient’s skin instead of fluorescent lights, which can alter the actual color of the skin and create the illusion that it is bluish.

The color of the skin is essential for detecting cyanosis. A person is said to be cyanotic if their arterial blood contains five g/dL unoxygenated hemoglobin. Central cyanosis, or cyanosis of lips, mucous membranes, nail beds, and tongue, occurs when arterial saturation drops below 85% for patients with normal hemoglobin. However, In a practical nursing program near me (United States) at an LPN school, nursing students can learn how to detect cyanosis effectively through nursing practice.