A nurse in a provider's office is caring for a client.

Exhibits

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

A. A decrease in blood pressure is the correct finding that indicates telmisartan has been effective. Telmisartan is an angiotensin II receptor blocker (ARB) used primarily to treat hypertension, and its effectiveness is typically measured by a reduction in blood pressure.

B. A respiratory rate of 16/min is within the normal range for adults and does not indicate the effectiveness of telmisartan, as the medication primarily affects blood pressure and not respiratory function.

C. A blood glucose of 110 mg/dL is within the normal range and does not directly reflect the effectiveness of telmisartan. While ARBs like telmisartan may have some effect on glucose metabolism, blood glucose levels are not the primary indicator of its effectiveness.

D. An increase in urinary output is not directly related to the effectiveness of telmisartan. While ARBs can have some mild diuretic effects, the primary expected outcome is a reduction in blood pressure, not an increase in urine output.

Rationale:

The client exhibits hallmark symptoms of Systemic Lupus Erythematosus (SLE), including a butterfly rash on the cheeks, alopecia, joint tenderness, and elevated ANA and ESR levels. These findings, combined with anemia and thrombocytopenia, are consistent with SLE, an autoimmune disorder characterized by systemic inflammation and tissue damage.

Multiple sclerosis is primarily a neurological condition and does not align with the client’s dermatological and hematological findings. Celiac disease is associated with gastrointestinal symptoms and gluten sensitivity, which the client denies. Type 1 diabetes mellitus involves hyperglycemia and insulin deficiency, which are not relevant to the presented symptoms.

Helping the client identify aggravating factors (e.g., sunlight exposure, stress) is crucial for managing SLE. Recommending low-impact exercises can help maintain joint mobility and reduce inflammation.

Monitoring adherence to corticosteroid therapy is essential since these medications are often used to control inflammation in SLE. Assessing for depression related to body image is important due to the physical manifestations of SLE, such as alopecia and hyperpigmentation, which may affect the client’s mental health.