The nurse provides care for a client admitted one hour ago with the diagnosis of salicylate toxicity. The client has an arterial pH of 7.32. Which finding does the nurse expect to observe?

Choice A reason: Initiates the fibrinolytic process in the arteries is not a role of inflammation in the development of atherosclerosis, but a protective mechanism against it. Fibrinolysis is the breakdown of blood clots by enzymes such as plasmin. It prevents the formation of thrombi that can occlude the arteries and cause ischemia.

Choice B reason: Decreases highly sensitive C-reactive protein (hsCRP) levels is not a role of inflammation in the development of atherosclerosis, but an indicator of it. hsCRP is a marker of systemic inflammation that is produced by the liver in response to cytokines. It is elevated in patients with atherosclerosis and correlates with the risk of cardiovascular events.

Choice C reason: Damages the endothelium of the arteries is the main role of inflammation in the development of atherosclerosis. Endothelial injury exposes the subendothelial layer to the blood, which triggers the adhesion of monocytes and platelets. Monocytes differentiate into macrophages and engulf oxidized low-density lipoproteins (LDL), forming foam cells. Foam cells accumulate in the intima and form fatty streaks, which are the earliest lesions of atherosclerosis.

Choice D reason: Causes diffuse arterial vasoconstriction is not a role of inflammation in the development of atherosclerosis, but a consequence of it. Atherosclerosis narrows the lumen of the arteries and reduces the blood flow to the tissues. This causes ischemia, which stimulates the release of vasoconstrictors such as angiotensin II and endothelin. Vasoconstriction further worsens the ischemia and increases the blood pressure.

Choice A reason: Hepatomegaly is not the expected finding because it is a condition where the liver is enlarged, which can be caused by various factors, such as infections, tumors, or cirrhosis. Hepatomegaly is not a common manifestation of systemic lupus erythematosus, which is an autoimmune disease that causes inflammation and damage to various organs and tissues in the body.

Choice B reason: Abdominal cramping pain is not the expected finding because it is a symptom that can be caused by various conditions, such as irritable bowel syndrome, appendicitis, or diverticulitis. Abdominal cramping pain is not a specific manifestation of systemic lupus erythematosus, although some clients may experience abdominal discomfort due to gastritis, pancreatitis, or peritonitis, which are possible complications of the disease.

Choice C reason: Whitish patches on the tongue are not the expected finding because they are a sign of oral candidiasis, which is a fungal infection that affects the mouth and throat. Oral candidiasis can be caused by various factors, such as weakened immune system, antibiotic use, or diabetes. Oral candidiasis is not a typical manifestation of systemic lupus erythematosus, although some clients may have oral ulcers, which are painful sores that appear on the lips, gums, or tongue.

Choice D reason: Arthritis with papular rash is the expected finding because it is a characteristic manifestation of systemic lupus erythematosus, which affects the joints and the skin. Arthritis is a condition where the joints are inflamed, causing pain, stiffness, and swelling. Arthritis can affect any joint in the body, but it is more common in the hands, wrists, and knees. Papular rash is a type of skin rash that consists of small, raised bumps that are red or purple. Papular rash can appear on any part of the body, but it is more common on the face, especially on the cheeks and the bridge of the nose. Papular rash is also known as malar rash or butterfly rash, because of its shape and location.