A client with rheumatoid arthritis who is started on hydroxychloroquine should be educated about the most serious adverse effect to monitor.

A client with rheumatoid arthritis who is started on hydroxychloroquine should be educated about the most serious adverse effect to monitor.

• A. Hepatotoxicity
• B. Tinnitus
• C. Nephrotoxicity
• D. Retinal damage

Answer: (D)

Hydroxychloroquine carries a risk of retinal toxicity that can cause irreversible damage to the retina and permanent vision loss. This makes retinal damage the most serious adverse effect to monitor. While other adverse effects can occur, they are less likely to cause permanent disability, and often are less common. The risk of retinal toxicity increases with long-term use and higher daily doses, and early changes may not affect vision yet, so baseline eye exams and ongoing screening are essential. Patients should be taught to report any new visual symptoms promptly, such as blurred vision, blind spots, or changes in color vision. Regular eye testing using visual field testing and imaging (like OCT) can detect early toxicity, allowing dose adjustments or discontinuation to prevent progression.

Hydroxychloroquine carries a risk of retinal toxicity that can cause irreversible damage to the retina and permanent vision loss. This makes retinal damage the most serious adverse effect to monitor. While other adverse effects can occur, they are less likely to cause permanent disability, and often are less common. The risk of retinal toxicity increases with long-term use and higher daily doses, and early changes may not affect vision yet, so baseline eye exams and ongoing screening are essential. Patients should be taught to report any new visual symptoms promptly, such as blurred vision, blind spots, or changes in color vision. Regular eye testing using visual field testing and imaging (like OCT) can detect early toxicity, allowing dose adjustments or discontinuation to prevent progression.