During assessment of a client diagnosed with severe anemia, the nurse notes pallor of the skin and mucous membranes. Which explanation is the best rationale for this finding?

Choice A reason: Blood clots in the peripheral blood vessels are not a cause of anemia, but a complication of it. They may occur due to increased blood viscosity, reduced blood flow, or hypercoagulability. They may cause tissue ischemia, pain, and necrosis.

Choice B reason: Decrease in bone marrow platelet production is not a cause of anemia, but a result of it. It may occur due to bone marrow suppression, infiltration, or destruction. It may cause bleeding, bruising, and petechiae.

Choice C reason: Increase in the number of circulating reticulocytes is not a cause of anemia, but a sign of it. Reticulocytes are immature red blood cells that are released from the bone marrow to compensate for the loss of mature red blood cells. They indicate a regenerative response to anemia.

Choice D reason: Redistribution of blood to the heart and brain is a compensatory mechanism for anemia. It occurs to maintain adequate oxygen delivery to the vital organs. It causes vasoconstriction and shunting of blood away from the skin and mucous membranes, resulting in pallor.

Choice A reason: Hepatomegaly is not the expected finding because it is a condition where the liver is enlarged, which can be caused by various factors, such as infections, tumors, or cirrhosis. Hepatomegaly is not a common manifestation of systemic lupus erythematosus, which is an autoimmune disease that causes inflammation and damage to various organs and tissues in the body.

Choice B reason: Abdominal cramping pain is not the expected finding because it is a symptom that can be caused by various conditions, such as irritable bowel syndrome, appendicitis, or diverticulitis. Abdominal cramping pain is not a specific manifestation of systemic lupus erythematosus, although some clients may experience abdominal discomfort due to gastritis, pancreatitis, or peritonitis, which are possible complications of the disease.

Choice C reason: Whitish patches on the tongue are not the expected finding because they are a sign of oral candidiasis, which is a fungal infection that affects the mouth and throat. Oral candidiasis can be caused by various factors, such as weakened immune system, antibiotic use, or diabetes. Oral candidiasis is not a typical manifestation of systemic lupus erythematosus, although some clients may have oral ulcers, which are painful sores that appear on the lips, gums, or tongue.

Choice D reason: Arthritis with papular rash is the expected finding because it is a characteristic manifestation of systemic lupus erythematosus, which affects the joints and the skin. Arthritis is a condition where the joints are inflamed, causing pain, stiffness, and swelling. Arthritis can affect any joint in the body, but it is more common in the hands, wrists, and knees. Papular rash is a type of skin rash that consists of small, raised bumps that are red or purple. Papular rash can appear on any part of the body, but it is more common on the face, especially on the cheeks and the bridge of the nose. Papular rash is also known as malar rash or butterfly rash, because of its shape and location.