A client is diagnosed with systemic lupus erythematosus (SLE). What symptom would the nurse expect to see?

Choice A reason: This is not the highest priority client because a urinary tract infection (UTI) is a common and treatable condition that affects the lower urinary system, such as the bladder or urethra. A fever of 38.5°C and flank pain can indicate that the infection has spread to the upper urinary system, such as the kidneys, which can cause pyelonephritis. Pyelonephritis is a serious but not lifethreatening complication that requires antibiotic therapy and hydration. The nurse should monitor the client's vital signs, urine output, and pain level and administer the prescribed medication and fluids.

Choice B reason: This is not the highest priority client because a deep vein thrombosis (DVT) is a blood clot that forms in a deep vein, usually in the lower extremities. A positive Homans' sign and edema in the affected leg can indicate that the clot is causing inflammation and obstruction of the blood flow. DVT is a serious but not lifethreatening complication that requires anticoagulant therapy and compression therapy. The nurse should monitor the client's vital signs, leg circumference, and pain level and administer the prescribed medication and stockings.

Choice C reason: This is the highest priority client because a myocardial infarction (MI) is a heart attack that occurs when the blood flow to a part of the heart muscle is blocked, causing tissue damage or death. Chest pain and shortness of breath can indicate that the client is experiencing acute cardiac ischemia, which can lead to cardiac arrest or heart failure. MI is a lifethreatening emergency that requires immediate intervention and treatment. The nurse should activate the rapid response team, monitor the client's vital signs, electrocardiogram, and oxygen saturation, and administer the prescribed medication and oxygen.

Choice D reason: This is not the highest priority client because a stroke is a brain attack that occurs when the blood flow to a part of the brain is interrupted, causing tissue damage or death. Slurred speech and facial droop can indicate that the client is experiencing acute neurological impairment, which can affect their communication and facial expression. Stroke is a serious but not lifethreatening complication that requires prompt evaluation and treatment. The nurse should monitor the client's vital signs, neurological status, and glucose level and administer the prescribed medication and fluids.

Choice A reason: The main side effect of acetaminophen is gastrointestinal (GI) bleeding is not a teaching that the nurse should include in the education, because it is incorrect and misleading. Acetaminophen is a pain reliever and fever reducer that is commonly used for osteoarthritis, but it does not have antiinflammatory properties. Acetaminophen does not cause GI bleeding, unlike NSAIDs, which can irritate the stomach lining and increase the risk of ulcers and bleeding. The main side effect of acetaminophen is liver damage, which can occur if the dose is exceeded or if the drug is combined with alcohol or other hepatotoxic substances.

Choice B reason: You should not take more than 4000 mg of acetaminophen a day is a teaching that the nurse should include in the education, because it is correct and important. Acetaminophen has a maximum daily dose of 4000 mg for adults, which should not be exceeded to avoid the risk of liver damage or overdose. Acetaminophen can be found in many overthecounter and prescription products, such as cold and flu remedies, cough syrups, or combination analgesics. Therefore, the client should read the labels carefully and keep track of the total amount of acetaminophen they are taking from all sources.

Choice C reason: Nonsteroidal antiinflammatory drugs (NSAIDs) are very safe and have no side effects is not a teaching that the nurse should include in the education, because it is incorrect and misleading. NSAIDs are a group of drugs that have antiinflammatory, analgesic, and antipyretic effects, and that are commonly used for osteoarthritis. However, NSAIDs are not very safe and have many side effects, such as GI bleeding, ulcers, kidney damage, cardiovascular events, allergic reactions, or interactions with other drugs. Therefore, the client should use NSAIDs with caution and under the supervision of the provider.

Choice D reason: The most common adverse effect of nonsteroidal antiinflammatory drugs (NSAIDs) are liver failure and tinnitus is not a teaching that the nurse should include in the education, because it is incorrect and misleading. Liver failure and tinnitus are not the most common adverse effects of NSAIDs, but rather rare and serious ones. Liver failure can occur in some cases of NSAID overdose or hypersensitivity, while tinnitus can occur in some cases of NSAID toxicity or high doses. The most common adverse effects of NSAIDs are GI bleeding, ulcers, or irritation, which can affect up to 15% of the users.