A nurse is reviewing the plan of care for a client who has systemic lupus erythematosus (SLE). The client reports fatigue, joint tenderness, swelling, and difficulty urinating. Which of the following laboratory findings should the nurse anticipate? (Select all that apply)

Positive ANA titer

2+ urine protein

Increased hemoglobin

Increased serum T3 and T4

Elevated BUN

Answer and Explanation

Correct Answer : A,B,E

A.   A positive antinuclear antibody (ANA) titer is a common finding in SLE. This test is often used as a screening tool for autoimmune diseases, and most patients with SLE will have a positive ANA. Therefore, this finding is expected.
B.   The presence of protein in the urine (proteinuria) is indicative of kidney involvement, which can occur in SLE due to lupus nephritis. Given the client's difficulty urinating and other symptoms, this finding would be anticipated.
C.   This statement is unlikely to be correct. In SLE, anemia is common due to various factors, including chronic disease, bone marrow involvement, or hemolysis. Therefore, an increased hemoglobin level would not be expected in this scenario.
D.   This finding is not typically associated with SLE. SLE is primarily an autoimmune disease affecting the connective tissues, and thyroid function tests (like T3 and T4) would not show increased levels unless there is an underlying thyroid disorder. Therefore, this finding is not expected in SLE.
E.   An elevated blood urea nitrogen (BUN) level may be anticipated, especially if there is kidney involvement due to lupus nephritis. Increased BUN can indicate impaired kidney function, which aligns with the client's symptoms of difficulty urinating.

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Correct Answer is A

Explanation

A. PT (Prothrombin Time) and INR (International Normalized Ratio) are tests primarily used to evaluate blood coagulation and the effectiveness of anticoagulant therapy. While they can provide some insight into a patient's overall health, they are not specific indicators of inflammation.
B. CRP is a protein produced by the liver in response to inflammation. It is a well-established marker for detecting acute inflammation and is commonly used in clinical settings to assess inflammatory conditions.
C. ESR measures how quickly red blood cells settle at the bottom of a test tube. An elevated ESR is a classic indicator of inflammation in the body and is commonly used in diagnosing various inflammatory conditions.
D. Procalcitonin is a biomarker that can indicate bacterial infections and systemic inflammation. It is increasingly used in clinical practice to assess the severity of infection and inflammation, particularly in cases of sepsis.

A. Show expected changes in white blood cell counts. B. Skin tests for tuberculosis may be falsely negative. C. Should receive influenza, pneumococcal, and shingles vaccinations. D. Higher risk for respiratory tract and genitourinary infections. E. Booster vaccinations are not likely needed as one ages. F. May not have a fever with severe infection.

Correct Answer is ["B","C","D","F"]

Explanation

A. While it's important for older adults to have regular blood tests to monitor their health, showing expected changes in white blood cell counts is not a specific risk factor for infections.
B. Skin tests for tuberculosis may be falsely negative in older adults due to a weakened immune response.
C. Older adults should stay up-to-date on their vaccinations, including influenza, pneumococcal, and shingles vaccinations, to help protect themselves against these infections.
D. Older adults are at increased risk for respiratory tract infections, such as pneumonia, and genitourinary infections, such as urinary tract infections.
E. Booster vaccinations are essential for older adults to maintain protection against diseases such as influenza, tetanus, diphtheria, and pertussis.
F. Older adults may not develop a fever in response to a severe infection. This can make it difficult to recognize the presence of an infection.

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A nurse is reviewing the plan of care for a client who has systemic lupus erythematosus (SLE). The client reports fatigue, joint tenderness, swelling, and difficulty urinating. Which of the following laboratory findings should the nurse anticipate? (Select all that apply)

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Correct Answer is A

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