一名有全身性紅斑性狼瘡（SLE）病史的病患因急性發作入院。下列哪項評估結果最能顯示可能發生了腎臟併發症？
A client with a history of systemic lupus erythematosus (SLE) is admitted with an acute flare-up. Which assessment finding is most indicative of a potential complication involving the kidneys?
- APositive antinuclear antibody (ANA) titer抗核抗體 (ANA) 效價陽性
- BMalar rash on the face臉部蝴蝶斑
- CElevated serum creatinine and protein in the urine✓ 正解血清肌酸酐升高及尿液中有蛋白質
- DGeneralized joint pain and stiffness全身性關節疼痛與僵硬
紅斑性狼瘡（SLE）是一種侵犯多系統的自體免疫疾病，其中「狼瘡性腎炎」（Lupus Nephritis）是致死與致殘的主要原因。血清肌酸酐（Creatinine）升高與蛋白尿（Proteinuria）是腎功能受損的最直接證據。選項 B（蝴蝶斑）和 D（關節痛）是 SLE 的常見臨床表現，但不屬於器官受損的危險併發症。選項 A（ANA 陽性）是用於診斷 SLE 的指標，而非監測急性併發症的指標。護理師應定期監測尿液分析與腎功能數值，以早期發現腎臟受損。
Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organ systems, with lupus nephritis being the leading cause of death and disability. Elevated serum creatinine and proteinuria are the most direct evidence of renal impairment. Options A (butterfly rash) and D (joint pain) are common clinical manifestations of SLE but are not signs of dangerous organ involvement. Option A (positive ANA) is a diagnostic marker for SLE rather than an indicator for monitoring acute complications. The nurse should regularly monitor urinalysis and renal function values to detect kidney injury early.
美國 NCLEX 考題常將蛋白尿視為狼瘡病患必須「立即回報」的項目；台灣臨床上對於 SLE 病患的照護，除了監測腎功能，還非常強調避免陽光曝曬（光敏感）的衛教，以預防病情發作。