Reference no: EM133709363

Question

Diagnostic Results Antinuclear antibody (ANA) Positive (Negative) Erythrocyte sedimentation rate (ESR) 38 mm/hr (up to 20 mm/hr) Hemoglobin 10 g/dL (12 to 18 g/dL) Hematocrit 35% (37% to 52%) WBC count 10,500/mm* (5,000 to 10,000/mm?) Platelet count 100,000/mm* (150,000 to 400,000/mm3) Echocardiogram: Position, size, and movement of the cardiac valves and heart muscle wall are all as expected. Directional flow of blood within the heart chambers within expected reference range Physical Examination Client's first visit: Client presents with rash and cutaneous plaques on scalp, face, and neck, areas of hyperpigmentation also noted. Butterfly rash present on cheeks. Client reports progressive fatigue, despite increasing rest periods. Client reports joint tenderness. 1 edema noted. Client denies chest pain or discomfort. $1 S2 noted on auscultation. No pericardial friction rub or murmurs noted. Chest clear on auscultation. Client denies shortness of breath, cough, or congestion. Bowel sounds present in all four quadrants. Denies any gastrointestinal issues. Reports urinating with no difficulty. congestion. 155085. Bowel sounds present in all four quadrants. Denies any gastrointestinal Reports urinating with no difficulty. Laboratory tests. Urinalysis to check for proteinuria Echocardiogram to assess heart function screening tor osteoporosis with baseline bone mineral density test Begin medication therapy with.