D.W. is a 25-year-old married woman with three children under 5…

Question Answered step-by-step D.W. is a 25-year-old married woman with three children under 5… D.W. is a 25-year-old married woman with three children under 5 years old. She came to her physician 7 months ago with vague complaints of intermittent fatigue, joint pain, low-grade fever, and unintentional weight loss. Her physician noted small, patchy areas of vitiligo, and a scaley rash across her nose, cheeks, back, and chest at that time. Laboratory studies revealed that D. W. had:Positive antinuclear antibody (ANA) titerPositive anti-dsDNA testPositive anti-Sm testElevated C-reactive protein (CRP)Elevated erythrocyte sedimentation rate (ESR)Decreased C-3 and C-4 serum complementJoint x-ray films demonstrated joint swelling without joint erosion.D. W. was diagnosed with systemic lupus erythromatosus (SLE). Here initial treatment consisted of hydroxychloroquine 400 mg and prednisone 20 mg orally every day, bed rest, and ice packs. D.W. responded well and the steroid was tapered and discontinued. She was told she could report for follow-up every 6 months unless her symptoms became acute. D.W. resumed her job in environmental services at a large geriatric facility. What priority problems should be addressed in D.W.’s plan of care at the time of diagnosis?What signs and symptoms would the nurse teach the patient to report to HCP immediately?Twenty-eight months after diagnosis, D.W. seeks out her physician with complaints of puffy hands and feet, and increased fatigue. D.W. reports she has been working longer hours because of the absence of two of her fellow co-workers. Chart Review Laboratory Test Results   Sodium 129 mmol/L   Potassium 4.2 mmol/L   Chloride 119 mmol/L   Total CO2 21 mmol/L   Blood, urea, nitrogen 34 mg/dL   Creatinine 2.6 mg/dL   Glucose 123 mg/dL   Urinalysis 2+ protein *Which laboratory finding concern the nurse and why?*What further subjective data would the nurse want to collect from the patient?The physician orders cyclophosphamide 100 mg/m2/day orally in two divided doses. D. W. is 5ft. 4 inches tall and weighs 140 lbs. 5′ 4″ = 64 inches x 2.54cm/inch = 162.56 cm = 163 centimeters 140 lb. ? 2.2lbs/kg = 63.63 kg = 63.6 kg Using nomogram the nurse will find BSA = 1.65 m2 *Using the physician order, calculate the amount of drug needed per dose. Round to the nearest whole dose. __________ mg per dose*How much of the drug will D.W take each day? _____ mg per day*What support would the nurse offer to D.W. and her husband? Health Science Science Nursing Share QuestionEmailCopy link Comments (0)

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