A 47-year-old female client is scheduled to see her dermatologist today. The nurse reviews recorded client data from February 1 to August 1.
Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided.
The nurse would be most concerned about
option choose:
Basal Cell Carcinoma, Squamous Cell Carcinoma, or Malignant Melanoma
especially related to the appearance of lesion #
1, 2, 3
. The nurse will educate the client on
wearing loose fitting clothing, limiting UV light exposure, or using oil based creams
Lesion #1: right upper cheek
(February 1) 2x2 mm, round nevus, uniform dark brown
(May 1) 2x3 mm, round nevus, uniform dark brown
(August 1) 2x3 mm, round nevus, uniform dark brown
Lesion #2: right top of foot
(February 1) 3x5 mm, oval nevus, uniform light brown, slightly raised
(May 1) 3x5 mm, oval nevus, regular border, uniform light brown, slightly raised
(August 1) 6x7 mm, oval nevus with curved and notched edges, primarily light brown with patch of dark brown/purple to left 1/3, slightly raised
Flow Sheet
Lesion #3: right shoulder
(February 1) 5x5 mm, rounded square nevus, dark-brown center with lighter brown perimeter
(May 1) 5x5 mm, rounded square nevus, dark-brown center with light-pink perimeter
(August 1) 5x5 mm, rounded square nevus, dark-brown center with light-tan perimeter
History & Physical
47-year-old Caucasian female.
Past medical history: hypertension and anemia.
Family medical history:
Father: type 2 diabetes mellitus, coronary artery disease, myocardial infarction. Mother: deceased at age 60 of melanoma. Sister: type 2 diabetes mellitus.
Personal/social history: Works as elementary school teacher, teaches swim lessons in the summer. Drinks 1 glass of wine most nights. Owns and uses tanning bed 2-3x/wk.
Nurses Notes
February 1: Initial visit. Referral from primary healthcare provider for assessment and treatment of lesions. Client voices that she is self-conscious of lesion to right cheek and right foot, and her sister keeps telling her to see the doctor about the lesion on her right shoulder (see flow sheet for measurements). She also has many scattered dark brown macules to upper back, shoulders, and upper arms.
May 1: Follow-up appointment. See flow sheet for documentation of lesions, no other changes to scattered lesions on upper body. Client comments that she is excited for 2-month extended stay with her sister in Florida.
August 1: Follow-up appointment. See flow sheet for documentation of lesions. Skin is overall pinker in color. Client tells the nurse that she just got back from Florida 3 days ago, speaks of extensive description of sister’s pool and condo in Florida, and tells the nurse that they sat by the pool every day.
