The client states they are experiencing constipation. What tool would not be included in the assessment of this condition?

Choice A reason: Systemic lupus erythematosus (SLE) is an autoimmune disease where the immune system produces autoantibodies, such as anti-nuclear antibodies, that attack healthy tissues like joints, skin, kidneys, and other organs. This leads to chronic inflammation and tissue damage. B-cell hyperactivity and T-cell dysfunction drive this process, causing systemic effects. This statement is accurate, as autoimmunity defines SLE’s pathology, distinguishing it from non-autoimmune disorders.

Choice B reason: Most individuals with SLE survive due to improved treatments like immunosuppressive drugs, with over 90% surviving beyond 10 years. However, it can be fatal due to complications such as kidney failure, cardiovascular disease, or infections during severe flares. This statement is accurate, reflecting the disease’s manageable yet potentially lethal nature, especially with organ involvement.

Choice C reason: Family history is a known risk factor for SLE. Genetic predisposition, particularly HLA gene variants, increases susceptibility. First-degree relatives of SLE patients have a 5-10% higher risk of developing the disease compared to the general population. This statement is inaccurate, as genetics significantly influences SLE onset, making it a key risk factor.

Choice D reason: SLE is a chronic, progressive connective tissue disorder characterized by periods of flares and remission. It affects connective tissues like joints and skin, with progressive organ damage possible in severe cases. This statement is accurate, as SLE’s chronic nature and connective tissue involvement are central to its pathophysiology, often requiring long-term management.

Choice A reason: Humulin R (regular insulin) has an onset of 30-60 minutes and peaks at 2-3 hours. Taking a snack at 0900-0930, immediately after injection, is too early, as insulin action is minimal, and glucose from the meal may cause hyperglycemia before insulin peaks, making this timing inappropriate.

Choice B reason: Humulin R peaks at 2-3 hours (1100-1200 for a 0900 dose), when hypoglycemia risk is highest due to maximum glucose uptake. A snack or meal at 1100-1130 provides glucose to counter insulin’s peak effect, preventing low blood sugar, making this the most appropriate timing.

Choice C reason: By 1400-1430, Humulin R’s effect (duration 5-8 hours) is waning, reducing hypoglycemia risk. A snack at this time is less critical, as insulin’s glucose-lowering action is declining. This timing is less effective for preventing hypoglycemia compared to the peak action period at 1100-1130.

Choice D reason: At 1700-1730, Humulin R’s effect is nearly gone (duration 5-8 hours), making hypoglycemia unlikely from the 0900 dose. A snack this late is irrelevant to the insulin’s action, as glucose levels are stabilized, making this timing inappropriate for preventing hypoglycemia.