Which of the following dietary recommendations should the nurse include for a client with SLE?

Follow a high-sodium diet to prevent fluid loss.

Avoid calcium and vitamin D supplements to prevent kidney stones.

Eat a low-fat, high-fiber diet with fruits, vegetables, and whole grains.

Increase red meat intake to improve anemia.

Answer and Explanation

The Correct Answer is C

A. Follow a high-sodium diet to prevent fluid loss: Clients with SLE are at risk for hypertension and renal involvement, including lupus nephritis. Excess sodium can worsen fluid retention, edema, and blood pressure control. Sodium restriction is often recommended rather than increased intake.

B. Avoid calcium and vitamin D supplements to prevent kidney stones: Clients with SLE are at increased risk for osteoporosis due to chronic inflammation and long-term corticosteroid use. Calcium and vitamin D are commonly encouraged to support bone health. Avoidance is not routinely indicated unless specific contraindications exist.

C. Eat a low-fat, high-fiber diet with fruits, vegetables, and whole grains: SLE is associated with chronic inflammation and increased cardiovascular risk. A diet rich in fiber, antioxidants, and healthy fats supports cardiovascular health and helps manage dyslipidemia. This dietary pattern also supports immune function and overall metabolic health.

D. Increase red meat intake to improve anemia: While anemia may occur in SLE, increasing red meat intake is not routinely recommended due to its saturated fat content. Anemia management depends on the underlying cause, such as chronic disease or iron deficiency. Dietary changes should be targeted rather than generalized.

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Correct Answer is B

Explanation

A. Diabetic ketoacidosis: Diabetic ketoacidosis results from insulin deficiency and is associated with type 1 diabetes mellitus or severe insulin deficiency states. Hypothyroidism does not directly impair insulin metabolism to the extent required to precipitate ketoacidosis. The pathophysiology of these conditions is unrelated.

B. Myxedema coma: Severe hypothyroidism can progress to myxedema coma, a life-threatening emergency characterized by hypothermia, bradycardia, hypotension, hypoventilation, and altered mental status. It often occurs in older adults or after stressors such as infection or cold exposure. Early recognition is critical due to high mortality.

C. Thyroid storm: Thyroid storm is a complication of severe hyperthyroidism rather than hypothyroidism. It involves excessive thyroid hormone activity with hyperthermia, tachycardia, and agitation. This condition represents the opposite end of the thyroid dysfunction spectrum.

D. Addisonian crisis: Addisonian crisis is associated with acute adrenal insufficiency and cortisol deficiency. While autoimmune conditions can coexist, severe hypothyroidism alone does not directly cause adrenal crisis. Monitoring focuses on thyroid-related complications instead.

A. Administering a nebulized beta-adrenergic B. Positioning the client in prone position C. Initiating oxygen therapy D. Providing immediate rest for the client

Correct Answer is A

Explanation

A. Administering a nebulized beta-adrenergic: Beta-adrenergic bronchodilators, such as albuterol, are first-line treatment for acute asthma exacerbations. They rapidly relax bronchial smooth muscle, relieve airway constriction, and improve airflow, addressing the underlying cause of respiratory distress. Prompt administration is critical to prevent respiratory failure.

B. Positioning the client in prone position: Positioning can improve comfort and ease of breathing slightly, but it does not directly relieve bronchospasm or improve oxygenation to the same extent as bronchodilator therapy. It is supportive, not priority.

C. Initiating oxygen therapy: Oxygen can help maintain adequate oxygen saturation during an exacerbation, but it does not treat the primary problem of airway constriction. Oxygen is adjunctive to airway-opening interventions.

D. Providing immediate rest for the client: Rest can reduce oxygen demand and anxiety, but it does not address airway obstruction. While supportive, it is not the most urgent intervention in acute asthma.

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Which of the following dietary recommendations should the nurse include for a client with SLE?

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