A nurse is teaching a female client who has a new diagnosis of systemic lupus erythematosus (SLE). The nurse should recognize the need for further teaching when the client identifies which of the following as a factor that can exacerbate SLE?

Choice A rationale:
Lymph nodes are small, bean-shaped structures that play a crucial role in the immune system. They filter lymph fluid, which carries white blood cells and other immune cells throughout the body.
When the body is fighting an infection or other immune challenge, lymph nodes often swell and become tender. This is because they are actively working to filter out pathogens and activate immune cells.
Palpation of the lymph nodes can provide valuable information about the patient's immune function. The nurse can assess for enlargement, tenderness, and mobility of the lymph nodes.
Lymph node assessment is a non-invasive, painless procedure that can be performed quickly and easily.
Choice B rationale:
Auscultation of the apical heart rate is important for assessing cardiovascular function, but it does not directly assess immune function.
While heart rate can be indirectly affected by certain immune conditions (e.g., fever), it is not a primary indicator of immune system activity.
Choice C rationale:
Palpation of the liver can provide information about liver size and consistency, but it does not directly assess immune function.
The liver plays a role in immune function by producing proteins that help fight infection, but its size and consistency do not necessarily reflect its immune activity.
Choice D rationale:
Percussion of the abdomen can be used to assess the size and location of abdominal organs, but it does not directly assess immune function.
While certain immune conditions may involve abdominal organs (e.g., splenomegaly), percussion is not a primary method for assessing immune function.

Choice A rationale:
Flu-like symptoms: These are common during the early stages of HIV infection, often within 2-4 weeks after exposure to the virus. They are a result of the body's immune system responding to the virus. Symptoms can include:
Fever Fatigue

Muscle aches

Headache Sore throat

Rash

Swollen lymph nodes
Night sweats: These are also common in early HIV infection and can be caused by the body's attempts to fight off the virus or by inflammation. They can also be a side effect of some HIV medications.

Choice B rationale:
Kaposi's sarcoma (KS): This is a type of cancer that is associated with HIV infection. It is caused by a virus called Kaposi's sarcoma-associated herpesvirus (KSHV). KS often appears as purple or red lesions on the skin or in the mouth. It can also affect other organs, such as the lungs and lymph nodes. However, it's not a common initial symptom of HIV infection. It usually develops in later stages of HIV when the immune system is severely weakened.

Choice C rationale:
Fungal and bacterial infections: People with HIV are more susceptible to infections because the virus weakens their immune system. However, fungal and bacterial infections are not typically among the initial symptoms of HIV infection. They usually occur in later stages of the disease when the immune system is more compromised.

Choice D rationale:
Pneumocystis lung infection (PCP): This is a serious lung infection that is caused by a fungus called Pneumocystis jirovecii. It is a common opportunistic infection in people with HIV, but it is not typically an initial symptom. It usually develops in later stages of HIV when the CD4 count (a measure of immune system health) is very low.