When assessing a client who has systemic lupus erythematosus and is taking hydroxychloroquine, it is crucial to monitor for specific adverse effects, as some can be indicators of severe complications. Here's a breakdown of the potential adverse effects and which one warrants immediate attention:
1. Diarrhea: While diarrhea can be uncomfortable and bothersome, it is a common side effect of many medications, including hydroxychloroquine. However, it is not considered an immediate threat unless it is severe or persistent, potentially leading to dehydration and electrolyte imbalance.
2. Blurred vision: This is a significant adverse effect when taking hydroxychloroquine because it can indicate retinal toxicity. Retinal toxicity can lead to irreversible damage to the retina and vision loss if not addressed promptly. Therefore, blurred vision should be reported to the provider immediately.
3. Pruritus (itching): Pruritus is also a common side effect and usually not a cause for immediate concern. It can be uncomfortable, but it is typically not indicative of severe complications requiring urgent medical intervention.
4. Fatigue: Similar to diarrhea and pruritus, fatigue is a common symptom associated with both systemic lupus erythematosus and hydroxychloroquine use. While it can affect the client's daily life, it is generally not an emergency.
Since blurred vision can be an early sign of potentially serious retinal issues, the nurse should report this adverse effect to the provider without delay.
Answer: Blurred vision (2)
