Audrey, a 45-year-old elementary school teacher, presents to her primary care provider with complaints of persistent fatigue, joint pain, and occasional low-grade fevers over the past six months. She reports that the pain is worst in the morning and improves slightly with movement. Upon further questioning, she mentions increased hair loss and a recent unintentional weight loss of five pounds. Physical examination reveals mild swelling in the metacarpophalangeal (MCP) joints, a facial rash across her cheeks and nose, and slight tenderness in her cervical lymph nodes.

Laboratory findings include:

• Elevated ANA (antinuclear antibodies)
• Mild anemia (Hgb: 10.8 g/dL)
• Elevated ESR (erythrocyte sedimentation rate)
• Mild proteinuria on urinalysis
• Her primary care provider suspects an autoimmune condition and refers her to a rheumatologist for further evaluation.

Based on the above information, answer the following questions:

• Based on Audrey’s symptoms and lab findings, discuss the possible autoimmune disorder affecting her immune system. Explain the underlying pathophysiology of this condition and how it leads to her clinical presentation.
• What additional subjective and objective data should be gathered to confirm the diagnosis and assess disease severity?
• Identify three health promotion strategies or lifestyle modifications that would be beneficial for Audrey. How would you educate her on managing her condition and preventing exacerbations?
• What members of the healthcare team should be involved in Audrey’s care, and how can a collaborative approach improve her health outcomes?

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