A nurse is caring for a client who has systemic lupus erythematosus (SLE).

The client asks why she has to have her blood drawn so often.

Which of the following responses should the nurse make?

These are normal inflammatory responses to the vaccine.

The tetanus vaccine protects people from the bacteria that cause tetanus, a serious disease that causes muscle stiffness and spasms.

The vaccine stimulates the body’s immune system to produce antibodies against the bacteria.Sometimes, this immune response can cause mild symptoms such as pain, redness, swelling, fever, headache, or tiredness.

These are not signs of an infection or an allergic reaction, but rather the body’s way of building immunity.

Choice A is wrong because an allergic reaction to the vaccine would cause more severe symptoms such as hives, swelling of the face or throat, difficulty breathing, or shock.

These symptoms would usually occur within minutes or hours of getting the vaccine and require immediate medical attention.

Choice C is wrong because these are not signs of an active infection with tetanus.

Tetanus is a rare but potentially fatal disease that causes muscle spasms and paralysis.

It is caused by bacteria that enter the body through wounds or cuts.The symptoms of tetanus usually appear several days or weeks after exposure and include lockjaw, stiffness of the neck and abdomen, difficulty swallowing, fever, sweating, and seizures.

The tetanus vaccine prevents the disease by creating immunity before exposure.

Choice D is wrong because these are not adverse effects of preservatives in the vaccine.

Preservatives are substances that prevent contamination and spoilage of vaccines.The most common preservative used in tetanus vaccines is thimerosal, a mercury-based compound that has been proven to be safe and effective.

There is no evidence that thimerosal causes autism or any other health problems.

Some people may have a sensitivity to thimerosal or other ingredients in the vaccine, but this is very rare and would cause an allergic reaction as described in choice A.

“We need to monitor your kidney function because SLE can cause glomerulonephritis.” Glomerulonephritis is kidney inflammation caused by SLE that can damage the filtering units of the kidneys called glomeruli.SLE is an autoimmune disease that can affect various organs and tissues, including the kidneys.About half of the people with lupus experience kidney involvement, which can lead to kidney failure if not treated.

Therefore, it is important to monitor the kidney function of people with SLE.

Choice B is wrong because SLE does not cause hepatic necrosis, which is the death of liver cells.SLE can cause inflammation of the liver, but this is less common and less severe than kidney involvement.

Choice C is wrong because SLE does not cause hypothyroidism, which is a condition where the thyroid gland does not produce enough thyroid hormones.

SLE can affect the thyroid gland, but this is rare and usually does not affect the thyroid function.

Choice D is wrong because SLE does not cause diabetes mellitus, which is a condition where the body cannot regulate blood sugar levels.

SLE can cause inflammation of the pancreas, but this is uncommon and usually does not affect the insulin production.