Question

A client with systematic lupus erythematosus has been admitted to a medical unit. Emergency room diagnostic exams are assessed by the nurse. Which exam result indicates the most negative affect? A. Heart ejection fraction of \(25 \%\) B. \(\mathrm{HCT}\) of \(38 \%\) C. Scant proteinuria D. Resolving pleural effusion

Short answer

A) Heart ejection fraction of \(25 \% \) B) HCT of \(38 \% \) C) Scant proteinuria D) Resolving pleural effusion Answer: A) Heart ejection fraction of \(25 \%\)

Step-by-step solution

Understanding Option A

A heart ejection fraction of \(25 \%\) refers to the percentage of blood being pumped out of the heart with each heartbeat. A normal value ranges between \(50 \%\) and \(70 \%\). An ejection fraction of \(25 \%\) indicates that the heart is unable to pump enough blood, which can lead to heart failure and other complications in a person with SLE.

Understanding Option B

\(\mathrm{HCT}\), or hematocrit, measures the percentage of red blood cells in a person's blood. A \(\mathrm{HCT}\) of \(38 \%\) is slightly below the normal range for adults, which is \(40 \%\) to \(50 \%\) for men and \(36 \%\) to \(48 \%\) for women. A low \(\mathrm{HCT}\) may indicate anemia, which can affect the oxygen-carrying capacity of the blood, but it is not as serious as low ejection fraction in a person with SLE.

Understanding Option C

Scant proteinuria refers to the presence of small amounts of protein in the urine, which is common in clients with SLE due to kidney involvement. Although proteinuria is an indicator of kidney damage, scant proteinuria suggests that the kidney damage is mild.

Understanding Option D

Resolving pleural effusion refers to the clearing or improvement of excess fluid built up around the lungs, due to inflammation or other causes. This indicates that the client's pleural effusion is likely getting better, which is a positive sign in a person with SLE.

Determining the Most Negative Effect

After evaluating all the options, we can see that Option A (heart ejection fraction of \(25 \%\)) has the most negative effect on the client's health with SLE, as it indicates a significantly reduced heart function and can lead to serious complications like heart failure.