A client with systemic lupus erythematosus (SLE) is being treated ...

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A client with systemic lupus erythematosus (SLE) is being treated with immunosuppressant drugs and corticosteroids. When providing teaching for this client, which topics are appropriate for the nurse to include?
 
  Select all that apply.
  A) Avoid large crowds.
  B) Don't get a flu shot.
  C) Use contraception to prevent pregnancy
  D) Refrain from taking aspirin products.
  E) Report signs of infection to the healthcare provider.

Question 2

The nurse is caring for a client who is hospitalized due to an exacerbation of systemic lupus erythematosus (SLE). The nurse is reviewing the client's lab work and finds the white blood cell count (WBC) is shifted to the left.
 
  Based on this information, which is a priority nursing diagnosis for this client?
  A) Risk for Infection
  B) Ineffective Health Maintenance
  C) Ineffective Individual Coping
  D) Risk for Impaired Skin Integrity

[Edwyer]

Answer to Question 1

Answer: A, C, D, E

Crowds may increase exposure to infection. Annual influenza vaccination is recommended but clients with significant immunosuppression should not receive live vaccines. Immunosuppressive drugs may increase the risk of birth defects. Aspirin products may increase the risk of bleeding. Chills, fever, sore throat, fatigue, or malaise should be reported.

Answer to Question 2

Answer: A

All identified diagnoses are appropriate for a client with SLE. However, the shift to the left in the WBC count indicates an increased risk for infection. A shift to the left in a WBC differential is indicative of a large number of immature cells, suggesting infection. Therefore, the priority diagnosis is Risk for Infection.