Final answer:
The nurse should teach the patient about the risk for type 2 diabetes, as the dark skin pigmentation in skinfolds can be a sign of acanthosis nigricans associated with insulin resistance. Education on diabetes management and lifestyle changes should be prioritized.
Step-by-step explanation:
The nurse should teach the patient about the risk for type 2 diabetes. Darker skin pigmentation in skinfolds, especially when coupled with a high BMI, can be indicative of acanthosis nigricans, which is associated with insulin resistance, a risk factor for type 2 diabetes. This condition can present as velvety, hyperpigmented areas in skinfolds and indicates that the patient could be at higher risk for developing diabetes or may already have it undiagnosed.
Due to the patient's BMI of 40 kg/m2, the patient falls into the obese category, which comes with an elevated risk for several conditions, including type 2 diabetes. Considering this patient's potential health risks, the nurse should focus on education concerning the signs, symptoms, risks, and management of diabetes. This would include discussions on lifestyle changes such as diet alterations, increased physical activity, and regular blood glucose monitoring.
A visual examination would suffice to differentiate the pigmentation from that caused by a possible fungal infection, which would look different and may require antifungal treatment. However, given the strong association between acanthosis nigricans and diabetes, it is critical to address the potential underlying insulin resistance first.