A nurse is caring for a client who is at 22 weeks of gestation and reports concern about the blotchy hyperpigmentation on her forehead. Which of the following actions should the nurse take?
A.
Tell the client to follow up with a dermatologist
B.
Explain to the client this is an expected occurrence.
C.
instruct the client to increase her intake of vitamin D
D.
Inform the client she might have an allergy to her skin care products
The correct answer and Explanation is :
The correct answer is B. Explain to the client this is an expected occurrence.
The blotchy hyperpigmentation the client is experiencing is likely chloasma, also known as melasma or the “mask of pregnancy.” It is a common dermatologic condition that occurs during pregnancy, affecting many women, especially after the first trimester. This condition results from hormonal changes, specifically increased levels of estrogen and progesterone, which stimulate melanocytes in the skin to produce more melanin. This increased melanin leads to the appearance of darker patches on the face, particularly the forehead, cheeks, nose, and upper lip.
Explanation:
- Common in Pregnancy: Chloasma affects around 50% to 75% of pregnant women, particularly in those with darker skin tones. These pigment changes usually develop during the second trimester, around 16 to 24 weeks of gestation, making this client’s concern at 22 weeks entirely within the typical timeframe for its onset.
- Benign and Temporary: It is an entirely benign condition, posing no threat to the mother or the fetus. In most cases, the pigmentation fades after delivery when hormone levels return to normal, although it may persist in some women.
- Management and Prevention: While no specific treatment is required, prevention of further darkening can be achieved by minimizing sun exposure, as ultraviolet (UV) light exacerbates pigmentation. The nurse might advise the client to use broad-spectrum sunscreen and wear protective clothing or hats when outside.
Other answer choices:
- A (dermatologist referral) is not necessary for this common, benign condition.
- C (increase vitamin D intake) has no connection to chloasma.
- D (skin care allergy) is unlikely, as chloasma is hormonally induced, not related to allergies.