A nurse is caring for a 12-year-old client diagnosed with systemic lupus erythematous (SLE). The nurse should recognize which of the following as a common manifestation of SLE?

A. Tay-Sachs disease is a progressive disease process with a maximum life span of 18 to 20 years: While this statement describes a serious progressive disease, it is inaccurate for Tay-Sachs, as the infantile form typically results in death much earlier, usually by 4–5 years of age, not late adolescence.

B. Having Tay-Sachs disease means their child will never be able to have children of their own: Fertility is not a central concern in the infantile form of Tay-Sachs, and this factor is not a primary contributor to caregiver grief immediately after diagnosis.

C. Having Tay-Sachs disease means their child cannot play sports due to possible heart conditions: Tay-Sachs does not primarily affect cardiac function; restrictions on activities like sports are not the main cause of caregiver distress in this context.

D. Tay-Sachs is a progressive disease in which the child usually dies before years of age: The early-onset form of Tay-Sachs leads to progressive neurodegeneration, loss of motor and cognitive function, and death typically by 4–5 years. Awareness of this prognosis is a major factor contributing to the caregivers’ grief and emotional response.

A. Fixation on certain items or topics: Children with ASD often develop intense interests or focus on specific objects or topics, which is a characteristic behavior and should be included in parental education.

B. Frequent changes in routine: Children with ASD typically struggle with changes in routine and may become distressed when routines are disrupted, so frequent changes are not characteristic and should not be encouraged.

C. Display of self-harming behaviors such as head-banging: Some children with ASD may engage in self-injurious behaviors, including head-banging or biting, particularly during times of frustration or sensory overload.

D. Spontaneous and unpredictable behaviors: Behaviors in ASD are usually repetitive or predictable rather than spontaneous; unpredictability is not a defining characteristic.

E. Adhering to a rigid routine: A strong preference for sameness and strict adherence to routines is common in children with ASD and should be recognized by caregivers.

F. Avoidance of repetitive activities: Children with ASD typically engage in repetitive behaviors such as hand-flapping, rocking, or repeating words, so avoidance of these is not typical.