A client with SLE at 39 weeks of gestation may need to discontinue which therapy?

The client with Systemic Lupus Erythematosus (SLE) at 39 weeks of gestation may need to discontinue salicylate therapy due to potential cardiovascular risks and possible complications for the neonate, especially close to the time of delivery. Salicylates, while anti-inflammatory, can interfere with platelet function and may lead to increased bleeding tendencies during labor and delivery.

In contrast, non-steroidal anti-inflammatory drugs (NSAIDs) might be used judiciously and under close supervision, as they can provide pain relief without significantly harming the pregnancy when used appropriately. Corticosteroids are often utilized to manage SLE symptoms and have a well-established safety profile during pregnancy, particularly in controlling disease flares and preventing complications. Immunosuppressants may be necessary for controlling severe SLE flares and while they do require cautious monitoring, some can be continued up to and during pregnancy if the benefits outweigh the risks to the mother and fetus.

Discontinuing salicylate therapy is particularly critical as the time of delivery approaches to mitigate risks associated with bleeding and potential complications for both mother and baby.