How should a nurse document the presence of large red-blue and purple areas on a client's skin that do not blanch?

The most appropriate term for documenting large red-blue and purple areas on a client's skin that do not blanch is ecchymosis. Ecchymosis refers specifically to the occurrence of large areas of discoloration resulting from bleeding beneath the skin. These lesions typically have a purple or blue coloration and do not change color or become lighter when pressure is applied, which distinguishes them from other skin findings such as purpura.

Purpura generally describes smaller purplish spots or areas on the skin caused by bleeding, which can also not blanch. However, purpura typically refers to smaller lesions than those associated with ecchymosis.

Hematoma refers to a localized collection of blood outside of blood vessels, usually as a result of trauma, and may not necessarily describe the diffuse nature of the discoloration seen in the question.

Macules are small, flat, discolored areas of skin that do not have texture or elevation and typically refer to lesions that may or may not be vascular in nature, making them unsuitable for this scenario.

Thus, referencing large red-blue and purple areas that do not blanch aligns perfectly with the definition of ecchymosis, making it the correct choice for documentation in this context.