A nurse is providing discharge teaching to a client with a new diagnosis of systemic lupus erythematosus (SLE). Which client statement indicates understanding of the teaching?

A. This statement indicates a misunderstanding, as systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can damage the kidneys, heart, lungs, and joints. The type of lupus that only affects the skin is known as discoid lupus erythematosus (DLE). Understanding that SLE has systemic implications is crucial for the patient to monitor for diverse symptoms beyond dermatological changes. B. While low-grade fevers can occur during a lupus flare-up, they are not a normal daily expectation for a stable patient. A new or persistent fever may indicate an infection or an impending exacerbation of the disease, requiring immediate medical evaluation. Patients should be taught that fever is a significant clinical sign rather than a benign, everyday occurrence of the condition. C. Methotrexate is a disease-modifying antirheumatic drug (DMARD) frequently prescribed once weekly to manage the systemic inflammation and immune overactivity in SLE. This statement correctly identifies the standard dosing frequency and demonstrates that the patient understands their pharmacological regimen. Adhering to the weekly schedule is essential to achieve therapeutic effects while minimizing the risk of drug-induced toxicity. D. Patients with SLE are often highly photosensitive, and SPF 15 is generally considered insufficient protection against UV rays that can trigger systemic flares. Clinical guidelines typically recommend a broad-spectrum sunscreen with an SPF of at least 30 or 50, even on cloudy days. The statement fails to reflect the necessary level of sun protection required to prevent immune system activation.