A nurse is providing teaching about self-care to an adolescent client who has been diagnosed with lupus.
Which of the following statements should the nurse include in their teaching?
When a flare-up occurs, you will likely feel better, but this is only temporary.
Triggers vary so much, so you may not be able to predict what will make your condition worse.
Hormonal changes may cause flare-ups.
You may feel very tired, but you need to resist the urge to sleep too much.
The Correct Answer is C
Systemic lupus erythematosus is a chronic autoimmune condition characterized by widespread inflammation and tissue damage. Knowledge of disease triggers, including the role of estrogen and physiological stress, is essential for educating adolescent clients on managing flares and maintaining stable health during puberty.
Choice A rationale
Flare-ups involve an exacerbation of symptoms such as joint pain, fever, and rashes, causing the client to feel significantly worse rather than better. Understanding the cyclical nature of the disease helps the client recognize when medical intervention is needed.
Choice B rationale
While triggers vary, many are highly predictable and manageable. Ultraviolet light exposure, emotional stress, and certain infections are well-known triggers that clients can learn to identify and avoid through careful monitoring and lifestyle adjustments.
Choice C rationale
Hormonal shifts, particularly during puberty or menstrual cycles, are known to influence lupus activity. Estrogen is thought to play a role in the immune response, making adolescents more susceptible to flares during these physiological changes.
Choice D rationale
Fatigue is a hallmark symptom of lupus caused by systemic inflammation. Clients are encouraged to balance activity with rest and should not resist the urge to sleep, as adequate rest is vital for managing the body's inflammatory response.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Managing a sickle cell crisis necessitates understanding the pathophysiology of vaso-occlusive events. Priority is placed on reversing sickling by improving perfusion and oxygenation. Knowledge of fluid resuscitation and pain management protocols is critical to prevent permanent tissue damage and complications.
Choice A rationale
Adequate pain management is essential during a crisis because the pain is severe due to tissue ischemia. Withholding analgesics is unethical and physiologically harmful, as uncontrolled pain can increase metabolic demands and worsen the overall clinical condition.
Choice B rationale
Physical exertion increases oxygen consumption and can worsen the sickling of red blood cells. During an acute crisis, the client should remain on bed rest to minimize metabolic demands and prevent further vaso-occlusive events in the peripheral vasculature.
Choice C rationale
Hydration reduces blood viscosity, which is vital for preventing the sickling of red blood cells (normal RBC lifespan is 120 days). IV fluids help dilute the concentration of sickle cells, improving blood flow through obstructed vessels and tissues.
Choice D rationale
Cold temperatures cause vasoconstriction, which further impairs blood flow and promotes sickling. Warm compresses are preferred because they promote vasodilation and improve circulation to the affected areas, whereas cold applications would increase the risk of localized tissue infarction.
Correct Answer is C
Explanation
This scenario requires applying knowledge of immunology and vaccine timing following the administration of blood products or immunoglobulins. Understanding how exogenous antibodies interfere with the replication of live-attenuated vaccines is crucial for ensuring effective immunization schedules in pediatric patients.
Choice A rationale
The rotavirus vaccine is a live-attenuated virus usually administered in early infancy. Since this child is older and having an annual exam, this vaccine is not typically indicated, regardless of the timing of the prior immunoglobulin treatment.
Choice B rationale
High-dose immunoglobulin treatment interferes with the immune response to the live MMR vaccine. Guidelines usually recommend delaying live vaccines for 8 to 11 months after IVIG to ensure the child can mount an appropriate endogenous antibody response.
Choice C rationale
The inactivated influenza vaccine does not contain live virus and is not affected by circulating antibodies from immunoglobulin therapy. It should be administered annually to children to provide protection against seasonal viral strains without requiring any delay.
Choice D rationale
Varicella is a live-attenuated vaccine. Similar to MMR, the exogenous antibodies from the 4-month-ago IVIG treatment will likely neutralize the vaccine virus before it can trigger a long-term immune memory, necessitating a longer delay before administration.
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