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
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.
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