A client is admitted to the medical unit during an exacerbation of systemic lupus erythematosus (SLE). It is most important to report which assessment finding to the healthcare provider?
Joint pain.
Low grade fever.
Muscle atrophy.
Hematuria.
The Correct Answer is D
A. Joint pain is a common symptom of systemic lupus erythematosus (SLE) and, while it may indicate an exacerbation of the disease, it is not the most critical finding to report.
B. A low-grade fever can signify an infection or increased disease activity but is generally not as urgent as changes in renal function or systemic involvement.
C. Muscle atrophy is a concern over time but does not pose an immediate threat to the client’s health compared to acute changes in kidney function.
D. Hematuria is significant in SLE as it can indicate renal involvement, such as lupus nephritis, which can lead to severe complications. This finding requires prompt reporting and assessment to prevent further renal damage and manage potential complications effectively.
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Correct Answer is B
Explanation
A. Latent hepatitis C is not an absolute contraindication for peritoneal dialysis, and patients with this condition can often undergo dialysis with appropriate precautions.
B. Crohn's disease with a history of colectomy poses a risk for peritoneal dialysis due to potential intra-abdominal adhesions and infection, which can complicate the procedure and increase the risk of peritonitis.
C. A history of nephrotic syndrome does not contraindicate peritoneal dialysis; patients with nephrotic syndrome may still be candidates depending on their overall kidney function and health status.
D. Type 2 diabetes mellitus is a common condition among patients needing dialysis and does not preclude the use of peritoneal dialysis, as long as blood sugar levels are managed effectively.
Correct Answer is A
Explanation
A. The elevated heart rate and respirations suggest the client may be experiencing hypoxia, especially following a thoracotomy. Administering oxygen will help improve oxygen saturation levels and address potential respiratory distress.
B. While pain management is essential, the immediate concern is ensuring adequate oxygenation.
C. Administering IV fluids may be necessary but is secondary to ensuring the client's oxygenation.
D. Encouraging the client to splint and cough is important for preventing complications but does not address the immediate issue of vital signs indicating possible respiratory compromise.