The nurse in the outpatient clinic is assessing a client with systemic lupus erythematosus (SLE). Which laboratory data is essential for the nurse to monitor to determine if the client is experiencing a complication?
The nurse in the outpatient clinic is assessing a client with systemic lupus erythematosus (SLE). Which laboratory data is essential for the nurse to monitor to determine if the client is experiencing a complication?
A. urine analysis
[38%]
B. hemoglobin A1C (HbA1C)
[10%]
C. thyroid-stimulating hormone (TSH)
[29%]
D. ammonia
[24%]
Statistics
Subject/Lesson
Subject
Adult Health
Lesson
Immune
Client Need
Test Plan
Reduction of Risk Potential
Related Topic
Potential for Alterations in Body Systems
Item Type
Item Type
Analysis
Explanation
Choice A is correct. A common complication associated with SLE is the development of lupus nephritis. Glomerular injury is seen in lupus nephritis because of the significant inflammation caused by this condition. The client with SLE should have routine urine analysis because evidence of lupus nephritis would consist of proteinuria and microscopic hematuria. Other laboratory testing pointing to lupus nephritis would be an elevated creatinine and decreased glomerular filtration rate. Lupus nephritis may be so aggressive that it may cause an individual to need a kidney transplant.
Choice B is incorrect. The hemoglobin A1C is not a routine laboratory test monitored for a client with SLE. This test is performed for a client with diabetes mellitus or to determine if a client has diabetes.
Choice C is incorrect. Thyroid problems may coexist with SLE, but thyroid problems, such as hypothyroidism, are not categorized as a complication; instead, it is a comorbidity.
Choice D is incorrect. Ammonia is a nitrogenous waste product that, in excess, may cause a client to develop encephalopathy. Liver problems are not as common with lupus compared to the insult it may cause to the kidneys.
Related Videos
2 Key Topics
Systemic Lupus Erythematosus
23.4 Autoimmune & Immune-Mediated Disorders
Additional Info
✓ SLE is a multisystem disease that is highly complex because of its multiorgan involvement.
✓ SLE may cause a client to develop complications such as lupus nephritis, pleuritis, anemia, pericarditis, myocarditis, and vasculitis.
✓ Lupus nephritis is a common complication and can be detected with routine urine analysis (UA). A UA that shows proteinuria and microscopic hematuria requires follow-up.
✓ Increased serum creatinine and decreased glomerular filtration rate also are concerning for lupus nephritis.
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