Question

The assessment reveals that the client's abdomen is symmetrical with no masses, bulges, or pulsation of the abdominal aorta observed.

The nurse notes dark brown pigmentation on the abdominal area. Which action is most important for the nurse to perform next?

- Question the client to obtain more information.
- Make a note to consult a dermatologist.
- Document the finding as normal.
- Document the finding as abnormal.

Answer 1

The nurse should first question the client to obtain more information about the dark brown pigmentation, as it could be an indication of a condition like Addison's disease or a normal variation such as striae.

Step-by-step explanation:

Upon observing dark brown pigmentation on the client's abdominal area, the most important action for the nurse to perform next is to question the client to obtain more information. This step is crucial because the pigmentation could be normal variation or indicative of a condition such as Addison's disease, which is characterized by hyperpigmentation of the skin. Documenting this finding as normal without further inquiry may overlook a potentially significant health issue, whereas making a note to consult a dermatologist or documenting the finding as abnormal before gathering more details may be premature.

Additionally, the nurse should be aware of the ABCDE mnemonic for melanoma detection, where dark pigmentation with asymmetry, irregular borders, or varied color may warrant closer examination. The presence of dark pigmentation could also be related to physiological changes such as striae (stretch marks) due to the stretching of the dermis. Understanding these contexts will aid the nurse in conducting a thorough assessment and determining the appropriate follow-up actions.