A nurse is assessing a client who has systemic lupus erythematosus and is taking hydroxychloroquine. The nurse should report which of the following adverse effects to the provider immediately?

A. Blurred vision: Hydroxychloroquine can cause retinal damage, leading to blurred vision or other visual disturbances. It should be reported immediately to the provider for further evaluation and management, as it may indicate retinopathy, a potentially irreversible complication of the drug. B. Diarrhea: Diarrhea can be a mild side effect of hydroxychloroquine and is generally not a cause for immediate concern unless it becomes severe or persistent. It may not require urgent reporting unless other concerning symptoms are present. C. Fatigue: Fatigue is a common symptom of systemic lupus erythematosus (SLE) itself and is not typically associated with an immediate adverse effect of hydroxychloroquine. It can be managed, but it is not an urgent issue requiring immediate reporting. D. Pruritus: Pruritus (itching) can occur with hydroxychloroquine use but is not as serious as blurred vision. While it should still be monitored and managed, it is not an immediate emergency like potential retinal damage.