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Module 4 > Lupus > Flashcards

Lupus Flashcards

1
Q

Lupus

A

Multisystem inflammatory autoimmune disease

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2
Q

Causes of lupus

A

Genetic influence
Hormones
Enviromental factors
Certain medications

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3
Q

Classifications

A

Systemic lupus erythematous
Discoidlupuslimited toskin
Drug induced lupus
Neonatal lupus

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4
Q

Discoid lupus

A

Round coin shape rashes
Limited to skin
Tend to be more to upper body

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5
Q

Risk factors

A

Women20-40 (child bearing yrs)
More common in African Americans, Asian Americans, Hispanics, native Americans than in whites

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6
Q

1 trigger of lupus

A

Sunlight

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7
Q

Other triggers of lupus

A

Ultraviolet light
Stress
Exposure to chemicals

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8
Q

Top 3 meds that cause lupus

A

Procainamide
Hydralazine
Quinidine

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9
Q

Flare ups are predictable t/f

A

False

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10
Q

Severity of SLE

A

Is extremely variable
Effects skin
Kidneys
Muscles
Lungs
Heart
Nervous tissue

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11
Q

3 main things SLE effects

A

Cardiopulmonary , neurologic, urinary

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12
Q

Cardiopulmonary s/s

A

Endocarditis
Myocarditis
Pericarditis
Pleural effusion
Pneumonitis
Raynaud’s phenomenon

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13
Q

Other s/s ofSLE

A

Fever of unknown origin, achy , extreme fatigue, weight loss, arthralgia

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14
Q

Integumentary problems SLE

A

Malar “butter fly “rash
Rash with sunlight exposure
Oral /nasopharyngeal ulcers
Discoid lesions

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15
Q

Musculoskeletal probs

A

Polyarthralgia with morning stiffness
Arthritis
Swan neck fingers
Ulcer deviation
Subluxation with hyperlaxity of joints
Increase risk of bone loss and fracture
Muscle pain

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16
Q

Cardiopulmonary s/s2

A

Dyspnea
Cough
Pleurisy
Raynauds
Dysrhythmias(fibrosis of SA &AV nodes)
Pericarditis

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17
Q

What do we get from pt every 3-6 month

A

A renal sample everytime they go to the doctor
Filter is damaged
And larger proteins molecules get through

Glomerulonephritis
And lupus nephritis
Also watch hypercoagability

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18
Q

Hyper-coagulability

A

Micro clots
Can effect vision and kidneys

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19
Q

After 2nd year of being diagnosed

A

Most pt may have kidney damage

If scarring and permanent damage pt can go into ESRD

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20
Q

Nervous system problems

A

Seizures
Peripheral neuropathy
Congnitive dysfunction
Psychiatric - depression and anxiety

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21
Q

Hematologic probs

A

Formation of antibodies against blood cells
Anemia
Leukopenia
Thrombocytopenia
Coagulation disorders

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22
Q

Anticoagulation therapy

A

Aspirin , plavix

23
Q

SLE are typically

A

Immunocompromised
Effect of immunosuppressive effect of anti inflammatory drugs

24
Q

ESR &&& CRP

A

monitor for treatment
Usually elevated , easy test and very inexpensive will be ran on a regular basis to see how pt is reacting to treatment

25
SLE is primarily diagnosed
Primarily on criteria relating to pt history , physical examination and laboratory findings
26
SLE diagnostic criteria “Soap brain MD”
Serositis(pleuritis, pericarditis) Oral ulcers arthritis Photosensitivity Blood disorder Renal disorder Ana + Immunologic disorder Neurologic disorder Malar rash Discoid rash
27
If pt has 4/11 on criteria soap brain md
Then it is highly likely they have lupus
28
Most common problems with SLE
Persistent pain(joints and muscles) Chronic inflammation Fatigue Possible loss of tissue integrity (from rashes) Self esteem decreased r/t body image
29
+Ana
Anti nuclear antibodies
30
Antimalarial drug/lupus
Hydroxychloroquine First drug of choice
31
Most of the RA drugs can be used to treat lupus but not all of them t/f
True
32
NSAIDS for lupus
For arthralgia feelings
33
Immunosuppressive drugs can also be combined with what to treat lupus
Hydroxychloroquine
34
Corticosteroids for lupus
In short intervals used only in flare ups
35
What are all drugs that a lupus can be on
NSAIDS Hydroxychloroquine Immunosuppressive Corticosteroids Anticoagulant
36
Uses for hydroxychloroquine
Discoid lupus or SLE RA Malaria
37
What does hydroxychloroquine do?
Reduce antibodies , reduce pain and inflammation , prevent lupus flares and prevent organ damage
38
Side effects of hydroxychloroquine
Hepatotoxicity Dysrhythmias (heart feels like skips a beat) Retinal damage
39
education for hydroxychloroquine
Eye exam every 6 months Call HCP -fever bleeding bruising vision changes (Will effect clotting ability)
40
What is the goal when treating lupus
Prevent exacerbation
41
How can we prevent exacerbation?
Maintain good nutrition Avoid exposure to infections Teach client about medications Avoid sunlight exposure CallHCP before taking immunizations Avoid pregnancy
42
What kind of immunizations can lupus pt take
Not live vaccines Flu, pneumonia
43
How can we monitor for adequate tissue perfusion?
Assess for impaired peripheral perfusion- are they developing s/s of neuropathy , color changes , vision changes etc Prevent injury to extremities Monitor for fluid retention(perfusion to kidneys)
44
Effective pain control
Encourage rest between activity Nsaids for arthritic pain Ice, heat, elevation Corticosteroids (flare up )
45
How can we monitor renal function in lupus
Monitor for edema, HTN , hematuria & UO \ BUN & creatine Monitor for utis& glomerulonephritis Assess for excess fluid volume (Daily weight)
46
What can we do when lupus starts showing s/s of CNS involvement (headache, inappropriate speech, difficulty concentration, memory loss)
Assess for mood change Encourage use of support groups& other resources
47
Lupus flares
Acute care May quickly become very ill Encourage pt to keep logs What worked, what didnt
48
What do we observe for in acute care
Fever pattern Joint inflammation Limitation of motion(monitor changes of ROM) Location and degree of discomfort Fatigue
49
Acute care nursing implantation
Monitor weight & I&O Collect 24 hour urine sample Assess neurologic status Visual problems , headaches Seizures Personality changes memory loss Explain nature of disease Provide emotional support
50
Pregnancy and lupus
Councel against pregnancy Be vigilant on BC If they want a baby OB and specialist need to communicate Some meds may impact placenta and blood vessels of placcenta
51
What happens during pregnancy and lupus
Sometimes people are better and sometimes flare ups are worse Miscarriage is a high risk and so is still born
52
What can happen in post pardon pt ?
Flare ups
53
How can I evaluate?
Use energy conservation techniques Lifestyle changes Adherence to medication Avoid /delay organ dysfunction Maintain positive thinking

Module 4 (47 decks)

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