A pregnant client tells her nurse that she is worried about the blotchy, brownish coloring over her cheeks, nose, and forehead. The nurse can reassure her that this is a normal condition related to hormonal changes. What is the correct term for this integumentary finding?

A. Emptying surgical drains is an important part of postoperative care and should be performed as instructed to prevent fluid accumulation and infection. This activity is safe and encouraged.

B. Progressive arm exercises are recommended to maintain shoulder mobility and prevent stiffness or lymphedema. These exercises should be done gradually according to the nurse’s instructions.

C. Lifting less than 2 lbs is safe and typically recommended early in the postoperative period to avoid strain on the surgical site.

D. Wearing clothing with tight sleeves on the operative side should be avoided because tight clothing can restrict circulation, increase swelling, and elevate the risk of lymphedema. Patients are advised to wear loose, comfortable clothing to support proper healing and reduce complications.

A. Melasma, also called the “mask of pregnancy,” is characterized by irregular, blotchy, brownish patches on the face, typically over the cheeks, nose, forehead, and upper lip. It occurs in response to hormonal changes during pregnancy, specifically elevated estrogen and progesterone, which increase melanocyte activity and melanin production in sun-exposed areas. Melasma is more common in women with darker skin tones and those with a family history of hyperpigmentation. It is considered a benign and reversible condition, often improving several months postpartum, though it may persist in some cases. Preventive strategies include limiting sun exposure, using broad-spectrum sunscreen, and wearing protective clothing, as ultraviolet light can worsen pigmentation.

B. Palmar erythema refers to reddening of the palms due to increased estrogen levels and enhanced peripheral vasodilation. While it is a normal pregnancy change, it does not affect the face and therefore does not describe the blotchy facial pigmentation observed in melasma.

C. Linea nigra is a dark vertical line that appears along the midline of the abdomen, extending from the pubic area to the umbilicus or higher. It develops from hormonal stimulation of melanocytes in the abdominal midline and is unrelated to facial hyperpigmentation.

D. Striae gravidarum, commonly called stretch marks, appear as reddish-purple streaks on the abdomen, breasts, hips, or thighs due to rapid skin stretching combined with hormonal effects on connective tissue. They are not blotchy brown patches on the face.