A nurse is assessing a client who reports a nevus that has increased in size and an irregularly shaped lesion that varies in color. These findings are consistent with which of the following medical diagnoses?

Choice A reason:

While explaining discharge instructions is an important part of patient education and ensuring safety after leaving the hospital, it is not the immediate priority. The nurse must first address any potential medical issues that could compromise the patient's health, such as circulation and nerve function in the affected limb.

Choice B reason:

Applying an ice pack to the casted leg can help reduce swelling and provide comfort to the client. This is often recommended for the first 24 to 72 hours after the cast is applied, especially if the cast is on a leg. However, this is secondary to assessing the neurovascular status of the limb.

Choice C reason:

Performing a neurovascular assessment is the priority action for the nurse. This assessment includes checking for sensation, warmth, capillary refill, pulses, and movement. It is crucial to identify any signs of compromised blood flow or nerve injury early to prevent further complications.

Choice D reason:

Providing reassurance to the client and parents is important for emotional support and can help alleviate anxiety. However, the nurse's immediate priority is to ensure the physical well-being of the client, which includes performing a neurovascular assessment to detect any urgent issues.

Choice A reason:
Urine-specific gravity measures the concentration of urine compared to water. It can indicate various conditions affecting the kidneys, but it does not provide a direct measure of renal function. It can be affected by hydration status and does not specifically reflect kidney damage or disease.

Choice B reason:
Blood urea nitrogen (BUN) levels can indicate kidney health; however, BUN can also be influenced by factors such as protein intake, hydration, and liver function. Therefore, while it is a useful test, it is not the most specific indicator of renal function in isolation.

Choice C reason:
Serum sodium levels are important for assessing electrolyte balance and can be affected by kidney function. However, changes in serum sodium are not specific to kidney function alone and can result from a variety of conditions.

Choice D reason:
Serum creatinine is a waste product from the normal breakdown of muscle tissue. As the kidneys are responsible for filtering out creatinine, its level in the blood is a good indication of kidney function. Elevated levels of serum creatinine may indicate impaired kidney function or kidney disease. In the context of SLE, where kidney involvement is common, serum creatinine is a crucial marker for monitoring renal function.