Lupus/Rheumatoid Arthritis

Front

The 26-year-old female client is complaining of a low-grade fever, arthralgias, fatigue, and a facial rash. Which laboratory tests should the nurse expect the HCP to order if SLE is suspected?

Back

Complete blood count and antinuclear antibody tests.

Answer explanation

No single laboratory test diagnoses SLE, but the client usually presents with moderate to severe anemia, thrombocytopenia, leukopenia, and a positive antinuclear antibody.

Front

The nurse is developing a care plan for a client diagnosed with SLE. Which goal is priority for this client?

Back

The client will have no deterioration of organ function.

Answer explanation

SLE can invade and destroy any body system or organ. Maintaining organ function is the primary goal of SLE treatment.

Front

The nurse is admitting a client diagnosed with R/O SLE. Which assessment data observed by the nurse support the diagnosis of SLE?

Back

Pericardial friction rub and crackles in the lungs.

Answer explanation

SLE can affect any organ. It can cause pericarditis and myocardial ischemia as well as pneumonia or pleural effusions.

Front

The nurse enters the room of a female client diagnosed with SLE and finds the client crying. Which statement is the most therapeutic response?

Back

“I see you are crying. We can talk if you would like.”

Answer explanation

The nurse stated a fact, “You are crying,” and then offered self by saying “Would you like to talk?” This addresses the nonverbal cue, crying, and is a therapeutic response.

Front

The nurse is assessing a client with cutaneous lupus erythematosus. Which intervention should be implemented?

Back

Dry the skin thoroughly by patting.

Answer explanation

The skin should be washed with mild soap, rinsed, and patted dry. Rubbing can cause abrasions and skin breakdown.

Front

The nurse is caring for clients on a medical floor. Which client should be assessed first? Options: The client diagnosed with SLE who is complaining of chest pain., The client diagnosed with MS who is complaining of pain at a “10.”, The client diagnosed with myasthenia gravis who has dysphagia., The client diagnosed with GB syndrome who can barely move his toes.

Back

The client diagnosed with SLE who is complaining of chest pain.

Answer explanation

Chest pain should be considered a priority regardless of the admitting diagnosis. Clients diagnosed with SLE can develop cardiac complications.

Front

What is SLE and how did I get it?

Back

This is an autoimmune disease that may have a genetic or hormonal component.

Answer explanation

There is evidence for familial and hormonal components to the development SLE. SLE is an autoimmune disease process in which there is an exaggerated production of autoantibodies.

Front

The client diagnosed with an acute exacerbation of SLE is being discharged with a prescription for an oral steroid which will be discontinued gradually. Which statement is the scientific rationale for this type of medication dosing?

Back

Tapering the dose allows the adrenal glands to begin to produce cortisol again.

Answer explanation

Tapering steroids is important because the adrenal gland stops producing cortisol, a glucocorticosteroid, when the exogenous administration of steroids exceeds what normally is produced. The functions of cortisol in the body are to regulate glucose metabolism and maintain blood pressure.

Front

Which signs and symptoms are shared by rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE)?

Back

Joint stiffness and pain

Answer explanation

Joint stiffness and pain are symptoms occurring in both diseases.

Front

The client diagnosed with RA is being seen in the outpatient clinic. Which preventive care should the nurse include in the regularly scheduled clinic visits?

Back

Recommend the flu and pneumonia vaccines.

Answer explanation

RA is a disease with many immunological abnormalities. The clients have increased susceptibility to infectious disease, such as the flu or pneumonia, and, therefore, vaccines, which are preventive, should be recommended.