Lupus

Question 1

An autoimmune inflammatory disease can involve many systems or organs.

Answer 1

Lupus

Question 2

Which system is not affected by lupus?

a) Reproductive
b) Musculoskeletal
c) Renal
d) Nervous

Answer 2

a)

All the systems affected by Lupus:

• Integumentary
• Musculoskeletal
• Circulatory
• Respiratory
• Renal
• Nervous

Question 3

What are some aggravating factors of Lupus?

Answer 3

• Prolonged, severe stress
• Fatigue
• Poor diet
• Viral infections
• Prescription drug-induced
• Environmental
• Hormonal

Question 4

Who Gets Lupus?

Answer 4

• Women > Men 8:1

- Age 15-45 (most common in 20s-30s)

Question 5

Phases of Healing: Lupus

Answer 5

• Flare-ups
• Chronic
• Remission

Question 6

• Joint pain
• Muscle pain
• Severe fatigue
• Flu-like symptoms
• Sudden unexplained weight loss or weight gain
• Depression
• Spindliform joints
• Symmetrical involvement
• Skin bruising
• Skin rash (Malar KA butterfly, or discoid)
• Mucous membrane ulcers of mouth, throat or nose
• Unusual reaction to sunlight
• Swelling of legs and feet
• Chest pain
• Neurological conditions: migraine-like headaches, confusion, memory loss, visual disturbances, peripheral neuropathies

Answer 6

Clinical Manifestations of Lupus

Question 7

• NSAIDs: Naproxen for mild cases
• Corticosteroids: prednisone
• Antimalarial: Hydroxychloroquine (Plaquenil)
• Immunosuppressive medications: methotrexate, cyclophosphamide, Benlysta, Imuran, mycophenolate mofetil

Answer 7

Lupus Medications

Question 8

• MD diagnosis
• What position do you sleep at night? How many pillows, elevated? Are your fluids restricted? (renal – restricted to 800 ml/day)
  frequency of attacks
• Most recent flare-up
• Current symptoms
• ADL’s affected
• Treatments
• Meds
• Surgery (to improve stability of jts)

Answer 8

History Questions for Lupus to Rule Out Serious Complications

Question 9

Test according to joint(s) affected and according to state of inflammation

• Flare-up: AROM
• Non-flared: test based on symptoms

Answer 9

Assessment for Lupus

Question 10

• As they pertain to organ involvement
• As they pertain to meds
• Exposure to any form of infection

Answer 10

Lupus Contraindications

Question 11

Generally:

• Positioning: considerations around joint comfort, breathing difficulties, abdominal pain
• Stress reduction
• Rhythmic techniques

Specifically:

• During flare-up – stay away from site, no circulatory intent on-site, minimum pressure, Grade 1 distraction.
• Chronic/Remission stage – clinical picture varies based on symptom picture

Other forms of treatment: Lavender, chamomile essential oils may be added as anti-inflammatory and pain reducer

Answer 11

Treatment for Lupus

Question 12

• Hot hydro between flare-ups

- Cool/cold during flare-ups on site

Answer 12

Hydrotherapy for Lupus

Question 13

• Gentle stretching
• Painfree strengthening
• Diaphragmatic breathing
• Naturopath – improve immune system
• Lupus Foundation of Ontario

Answer 13

Lupus Selfcare