A nurse is providing care for a client who is experiencing an acute exacerbation of systemic lupus erythematosus. Which of the following findings should the nurse anticipate?

An hCG level of 30,000 IU/L is significantly elevated and may suggest a molar pregnancy, especially when values are higher than expected for gestational age. In a molar pregnancy (hydatidiform mole), trophoblastic tissue proliferates abnormally, producing excessive hCG. This level, in combination with normal hemoglobin and hematocrit, makes other causes like spontaneous or induced abortion less likely.

Key Takeaways:

• Extremely elevated hCG levels can indicate gestational trophoblastic disease (molar pregnancy).
• Molar pregnancy is a nonviable pregnancy characterized by abnormal trophoblast proliferation.
• Normal hemoglobin and hematocrit reduce the likelihood of current bleeding or miscarriage.

A. Use short sentences when communicating with the client. In a panic level of anxiety, the client has impaired concentration, perception, and understanding. Using short, simple sentences helps the client process communication more easily and reduces cognitive overload.
B. Tell the client to sit alone in a private place and reflect on the situation. A client in a panic state may feel unsafe or overwhelmed when left alone. Supervision and a calm presence are essential until the anxiety level decreases.
C. Encourage the client to talk about his feelings. Clients in a panic state are often unable to verbalize or reflect on their emotions clearly. Talking about feelings is more appropriate once the anxiety has decreased to a moderate level.
D. Have the client journal about what is happening to him. Journaling requires organized thought and concentration, which is not possible during a panic-level anxiety episode. It may be useful later, during a lower level of anxiety.