During a skin assessment, which finding should the nurse report immediately?
Explanation & Rationale
Rationale: A. This is a critical finding that indicates possible pressure injury (pressure ulcer) or tissue ischemia. Non-blanching means that when pressure is applied, the area does not turn white, which is a hallmark sign of compromised perfusion and potential skin breakdown. Immediate reporting is necessary to prevent further tissue damage and initiate interventions such as pressure relief, wound care, and close monitoring. B. This is an old, healed injury and is considered normal in the context of a skin assessment. It does not indicate current skin compromise and does not require urgent reporting. C. Freckles are benign pigmented skin lesions. They are normal variations in skin pigmentation and do not indicate acute pathology or require immediate reporting. D. While dry skin should be addressed to prevent discomfort or cracking, it is not an urgent finding. It can be managed with routine skin care and moisturizer, and does not require immediate intervention.