A nurse is assessing a client who has tuberculosis and recently began taking ethambutol. The nurse should identify which of the following findings as an adverse effect of this medication?

Rationale:
A. "I'm concerned because I'm so tired all the time.": Fatigue is a common manifestation of SLE caused by chronic inflammation, anemia, or medication effects. While it impacts daily function, it is not an immediate threat compared to signs of infection, which can become life-threatening quickly in immunosuppressed clients.

B. "I feel like I'm isolated from all my friends now.": Emotional concerns like isolation are important in managing chronic illness, but they are not urgent physical issues. Addressing psychosocial health is necessary, but it does not take precedence over symptoms that may indicate infection or disease flare.

C. "I've had a fever the last couple of days.": Fever is a priority concern in clients with SLE as it may signal an active infection or disease flare. Immunosuppressive therapy increases the risk of severe infections, which can rapidly worsen if not treated promptly, making this the most urgent issue.

D. "I have a lot of questions about this disease.": Education is vital for long-term disease management and patient empowerment. However, it is not an immediate priority when signs of acute illness, such as fever, are present and require prompt clinical attention.

Rationale:
A. Hypernatremia: While mild hypernatremia can occur in severe dehydration, it is not a defining or consistent feature of type 1 diabetes. Electrolyte imbalances may vary depending on hydration and glucose levels.

B. Decreased serum osmolality: In type 1 diabetes, serum osmolality is typically increased due to hyperglycemia and the osmotic effect of glucose in the bloodstream, which draws water out of cells and into the vascular space. A decrease would be inconsistent with the expected metabolic state.

C. Ketones in the urine: Ketones in the urine are a hallmark of type 1 diabetes, especially when insulin is deficient. Without insulin, the body breaks down fat for energy, producing ketones as a byproduct, which can be detected in the urine during diabetic ketoacidosis.

D. Hypoglycemia: Hypoglycemia is a complication of diabetes management, often resulting from too much insulin or missed meals. It is not a presenting manifestation of newly diagnosed type 1 diabetes, which typically presents with hyperglycemia and related symptoms.