A nurse is assessing a client who has a new diagnosis of systemic lupus erythematosus (SLE). The nurse should identify which of the following as a cutaneous manifestation of SLE?

A. Fibromyalgia: Fibromyalgia is characterized by widespread musculoskeletal pain, fatigue, and tender points, but it does not cause bony nodules or joint deformities. The presence of Heberden’s nodes is not associated with this condition.

B. Osteoarthritis: Heberden’s nodes are bony enlargements of the distal interphalangeal joints commonly seen in osteoarthritis. They result from cartilage degeneration and bone remodeling, and are a hallmark sign of osteoarthritic joint changes.

C. Rheumatoid arthritis: Rheumatoid arthritis primarily affects the proximal interphalangeal and metacarpophalangeal joints with symmetric inflammation. Nodules in RA are typically subcutaneous, not bony, and Heberden’s nodes are not characteristic.

D. Systemic lupus erythematosus: SLE can cause joint pain and swelling, but it does not lead to Heberden’s nodes or osteoarthritic bony changes. Joint involvement in SLE is typically non-erosive and inflammatory rather than degenerative.

A. Avoid foods high in sodium: While limiting sodium may benefit clients with hypertension or fluid retention, sodium restriction does not directly prevent biliary colic or reduce gallbladder irritation. It is not the primary dietary focus for cholecystitis.

B. Avoid foods high in fat: High-fat foods stimulate the gallbladder to contract, which can trigger pain in clients with chronic cholecystitis or biliary colic. A low-fat diet helps minimize gallbladder stimulation and reduces the frequency and severity of colicky episodes.

C. Include foods high in starch and proteins: While adequate protein and complex carbohydrates are part of a balanced diet, emphasizing starch and protein alone does not specifically prevent biliary colic. The key is limiting fat intake rather than increasing these macronutrients.

D. Include foods high in fiber: Fiber supports gastrointestinal health and regularity but does not directly influence gallbladder contractions or prevent biliary colic. While generally healthy, high-fiber intake is secondary to fat restriction in managing cholecystitis.