The nurse is reviewing with a pregnant client the skin changes that she might experience during gestation. What should the nurse include in this discussion? Select all that apply

1. Linea nigra
2. Spider nevi
3. Psoriatic lesions
4. Striae gravidarum
5. Melasma gravidarum


1, 2, 4, 5
Explanation:
1. Changes in skin pigmentation occurring during pregnancy are thought to be stimulated by increased estrogen, progesterone, and α-melanocytic–stimulating hormone levels. The skin in the middle of the abdomen may develop a pigmented line, the linea nigra, which usually extends from the pubic area to the umbilicus or higher.
2. Vascular spider nevi, small, bright-red elevations of the skin radiating from a central body, may develop on the chest, neck, face, arms, and legs. They may be caused by increased subcutaneous blood flow in response to elevated estrogen levels.
3. Psoriatic lesions are not typically associated with pregnancy.
4. Striae gravidarum, or stretch marks, may appear on the abdomen, thighs, buttocks, and breasts. They result from reduced connective tissue strength because of elevated adrenal steroid levels.
5. Changes in skin pigmentation occurring during pregnancy are thought to be stimulated by increased estrogen, progesterone, and α-melanocytic–stimulating hormone levels. Melasma gravidarum, also known as the "mask of pregnancy," a darkening of the skin over the forehead and around the eyes, may develop. Melasma is more prominent in dark-haired women and is aggravated by exposure to the sun.

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