Author Question: The nurse is caring for an African American patient who has a serum bilirubin of 6 mg/100 mL. What ... (Read 45 times)

storky111 · **on:** Jun 25, 2018

The nurse is caring for an African American patient who has a serum bilirubin of 6 mg/100 mL. What is the best way of assessing skin color changes in this patient?

1. Assess the sclera.
2. Assess the palms of the hands.
3. Assess the fingernails.
4. Assess the skin of the inner arms.

Question 2

The nurse is caring for an African American patient who has an ashen cast to his normally black skin. Which laboratory test results should the nurse review to determine a possible cause of the skin color change?

1. BUN
2. hemoglobin and hematocrit
3. bilirubin
4. oxygen saturation

fauacakatahaias · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 2
In patients with dark skin, yellowing is best assessed at the junction of the hard palate and the soft palate, or on the palms of the hands. Sclera may be yellow near the limbus; however, this can be confused with normal yellow eye pigmentation. Jaundice might be observed in the fingernails of a light-skinned patient. Jaundice is not assessed by looking at the skin of the inner arms.

Answer to Question 2

Correct Answer: 2
Decreased hemoglobin and hematocrit indicate anemia, which presents in black skin as dullness and an ashen gray cast. BUN levels are associated with kidney function; uremia may manifest as a yellowish green color in the sclera of the eye. An elevated bilirubin level is seen as yellowing of the skin especially evident in the palms of dark-skinned individuals. Decreased oxygen saturation presents as cyanosis or a bluish discoloration in nail beds in dark-skinned individuals.