A client with systemic lupus erythematosus (SLE) tells the nurse ...

[AEWBW]

A client with systemic lupus erythematosus (SLE) tells the nurse that she is afraid that her husband will leave her because her skin is disfigured with lesions.
 
  Which of the following interventions does the nurse plan to teach this couple to minimize skin infections associated with SLE? 1. Avoid sun exposure between 3:00 p.m. and 5:00 p.m.
   2. Avoid swimming in a pool or the ocean
   3. Use sunscreen with an SPF of 15 or greater
   4. Remain indoors on sunny days

Question 2

The white blood cell count (WBC) of a client with systemic lupus erythematousus (SLE) shows a shift to the left. Which of the following is a priority nursing diagnosis for this client?
 
  1. Ineffective Health Maintenance
   2. Impaired Skin Integrity
   3. Ineffective Coping
   4. Ineffective Protection

[yuyiding]

Answer to Question 1

3. Use sunscreen with an SPF of 15 or greater

Rationale:
The nurse teaches the couple that the client may live normally with a few extra precautions. There is a relationship between sun exposure and infection, so the client is taught to use sunscreen with an SPF of at least 15and to avoid the sun between 10:00 a.m. and 3:00 p.m. The client may swim but should reapply sunscreen after swimming. The client does not need to stay indoors on sunny days.

Answer to Question 2

4. Ineffective Protection

Rationale:
All identified diagnoses are appropriate for a client with SLE. However, the results of the laboratory test demonstrates an increased risk for infection. A shift to the left in a WBC differential indicates an increased number of immature cells, suggesting infection, and is therefore the priority for the nurse.

[AEWBW]

Excellent

[Dominic]

TYSM