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 C
Explanation
A. Schedule the client for an aPTT test. An aPTT (activated partial thromboplastin time) test is used to monitor heparin therapy and is not relevant following an amniocentesis unless the client has a known bleeding disorder, which is not indicated here.
B. Collect a blood sample from the client for a direct Coombs test. The direct Coombs test is typically performed on newborns, not the mother, to detect antibodies attached to red blood cells. It is not a routine part of post-amniocentesis care.
C. Monitor the client for uterine contractions. After an amniocentesis, it is essential to monitor for signs of preterm labor, including uterine contractions. The procedure can irritate the uterus and potentially trigger contractions, especially at 34 weeks gestation.
D. Administer Rho(D) Immune globulin if the client is Rh positive. Rho(D) Immune globulin is given to Rh-negative clients after procedures like amniocentesis to prevent isoimmunization. It is not indicated for Rh-positive individuals.
Correct Answer is D
Explanation
A. Revise the current policy for catheter care. Policy changes should be based on evidence and root cause analysis. Revising the policy prematurely without identifying contributing factors may not address the actual causes of infection.
B. Schedule nursing staff training for infection control procedures. Education and training are important but should be guided by identified gaps. Implementing training without understanding the root cause may result in ineffective interventions.
C. Meet with providers to discuss measures to decrease the infections. While interdisciplinary collaboration is valuable, it should occur after gathering and analyzing relevant data. This ensures targeted, evidence-based recommendations.
D. Identify possible precipitating factors related to the infections. The first step in quality improvement is to investigate and assess contributing factors. This helps guide the most appropriate and effective interventions to reduce infection rates.
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