A nurse is providing care for a client who is experiencing an acute exacerbation of systemic lupus erythematosus. Which of the following findings should the nurse anticipate?
Diplopia
Fever
Esophagitis
Bradykinesia
The Correct Answer is B
A. Diplopia. Double vision (diplopia) is more commonly associated with neurological or ophthalmic disorders such as multiple sclerosis or cranial nerve dysfunction. It is not a typical manifestation of lupus exacerbations.
B. Fever. Fever is a common and expected finding during an acute exacerbation of systemic lupus erythematosus (SLE). It results from systemic inflammation and immune system activation, often indicating disease flare-up or potential infection.
C. Esophagitis. Esophagitis is more often linked to gastroesophageal reflux disease or infections, not systemic lupus. Although lupus can affect many organs, the esophagus is not a typical site of acute involvement in SLE exacerbations.
D. Bradykinesia. Bradykinesia, or slowness of movement, is a hallmark feature of Parkinson’s disease. It is not associated with SLE and would not be expected during a lupus flare.
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Related Questions
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"E"}
Explanation
- Tocolytic medication: Tocolytics are used to suppress preterm labor, which is not applicable for this postpartum client. There is no indication of uterine contractions needing suppression.
- Intravenous antibiotic: The client exhibits signs of postpartum endometritis—including fever, uterine tenderness, foul-smelling lochia, and a very high WBC count (33,000/mm³). These findings strongly support the need for IV antibiotics to treat the infection.
- Intrauterine tamponade balloon: This device is used for managing postpartum hemorrhage, which is not present in this case. The client’s lochia is moderate, not excessive, and her uterus is responding to massage.
- Kleihauer-Betke test: This test is used to detect fetal-to-maternal hemorrhage, particularly in Rh-negative mothers after trauma or potential placental separation. It is not relevant in the context of postpartum infection.
- Increase in daily fluid intake: The client is febrile and shows signs of systemic infection. Increased fluids support hydration, promote recovery, and help manage the effects of fever and infection, making this an appropriate supportive measure.
Correct Answer is C
Explanation
A. "You should make sure your partner takes the prescribed medication." While medication adherence is important, this response shifts the focus to advice-giving rather than exploring the partner’s emotions or current experience, which limits therapeutic communication.
B. "You did the right thing by bringing your partner in for treatment." Although supportive, this statement closes off the conversation and doesn’t invite the partner to share more about their feelings or the situation at home.
C. "Can you talk about what was happening with your partner at home?" This open-ended, therapeutic response encourages the partner to express their thoughts and emotions, facilitating a better understanding of the client’s condition and the impact it has had on the family.
D. "Why do you think your partner's symptoms are progressing so quickly?" Asking “why” can feel accusatory or put the partner on the defensive. It may also imply blame, which is not helpful in building trust or gathering therapeutic insight.
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