RN Nursing · Systemic Lupus Erythematosus · Practice question
A patient with SLE (Systemic Lupus Erythematosus) presents with new onset periorbital edema, hypertension, and reports urine that appears frothy. Urinalysis shows proteinuria. What is the nurse's priority action?
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Document findings
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Administer NSAIDs
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✓
Notify provider for possible nephritis
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Restrict fluids
Answer & explanation
Correct: Notify provider for possible nephritis
The clinical picture presented — periorbital edema, hypertension, frothy urine, and proteinuria in a patient with SLE — is the classic triad of lupus nephritis, a serious and common complication of SLE in which immune complex deposition damages the glomeruli. The priority nursing action is to notify the provider immediately so that further workup (serum creatinine, GFR, 24-hour urine protein, renal biopsy) and treatment can be initiated promptly. Early identification and treatment of lupus nephritis significantly affects renal outcomes. Simply documenting the findings without escalating is insufficient given the severity of the presentation. Administering NSAIDs is contraindicated because NSAIDs reduce renal perfusion and can worsen renal function in a patient already showing signs of glomerular injury. Restricting fluids without provider guidance is inappropriate and could be harmful depending on the patient's volume status; fluid management decisions require provider assessment and lab correlation. The nurse's role is assessment, communication, and advocacy — recognizing that these findings indicate a potentially serious complication requiring prompt provider evaluation and intervention is the cornerstone of appropriate clinical judgment in this scenario.
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