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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
Q

SLE is primarily diagnosed

A

Primarily on criteria relating to pt history , physical examination and laboratory findings

26
Q

SLE diagnostic criteria
“Soap brain MD”

A

Serositis(pleuritis, pericarditis)
Oral ulcers
arthritis
Photosensitivity

Blood disorder
Renal disorder
Ana +
Immunologic disorder
Neurologic disorder

Malar rash
Discoid rash

27
Q

If pt has 4/11 on criteria soap brain md

A

Then it is highly likely they have lupus

28
Q

Most common problems with SLE

A

Persistent pain(joints and muscles)
Chronic inflammation
Fatigue
Possible loss of tissue integrity (from rashes)
Self esteem decreased r/t body image

29
Q

+Ana

A

Anti nuclear antibodies

30
Q

Antimalarial drug/lupus

A

Hydroxychloroquine

First drug of choice

31
Q

Most of the RA drugs can be used to treat lupus but not all of them t/f

A

True

32
Q

NSAIDS for lupus

A

For arthralgia feelings

33
Q

Immunosuppressive drugs can also be combined with what to treat lupus

A

Hydroxychloroquine

34
Q

Corticosteroids for lupus

A

In short intervals used only in flare ups

35
Q

What are all drugs that a lupus can be on

A

NSAIDS
Hydroxychloroquine
Immunosuppressive
Corticosteroids
Anticoagulant

36
Q

Uses for hydroxychloroquine

A

Discoid lupus or SLE
RA
Malaria

37
Q

What does hydroxychloroquine do?

A

Reduce antibodies , reduce pain and inflammation
, prevent lupus flares and prevent organ damage

38
Q

Side effects of hydroxychloroquine

A

Hepatotoxicity
Dysrhythmias (heart feels like skips a beat)
Retinal damage

39
Q

education for hydroxychloroquine

A

Eye exam every 6 months
Call HCP -fever bleeding bruising vision changes
(Will effect clotting ability)

40
Q

What is the goal when treating lupus

A

Prevent exacerbation

41
Q

How can we prevent exacerbation?

A

Maintain good nutrition
Avoid exposure to infections
Teach client about medications
Avoid sunlight exposure
CallHCP before taking immunizations
Avoid pregnancy

42
Q

What kind of immunizations can lupus pt take

A

Not live vaccines

Flu, pneumonia

43
Q

How can we monitor for adequate tissue perfusion?

A

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
Q

Effective pain control

A

Encourage rest between activity
Nsaids for arthritic pain
Ice, heat, elevation
Corticosteroids (flare up )

45
Q

How can we monitor renal function in lupus

A

Monitor for edema, HTN , hematuria & UO \
BUN & creatine
Monitor for utis& glomerulonephritis
Assess for excess fluid volume
(Daily weight)

46
Q

What can we do when lupus starts showing s/s of CNS involvement (headache, inappropriate speech, difficulty concentration, memory loss)

A

Assess for mood change
Encourage use of support groups& other resources

47
Q

Lupus flares

A

Acute care
May quickly become very ill
Encourage pt to keep logs
What worked, what didnt

48
Q

What do we observe for in acute care

A

Fever pattern
Joint inflammation
Limitation of motion(monitor changes of ROM)
Location and degree of discomfort
Fatigue

49
Q

Acute care nursing implantation

A

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
Q

Pregnancy and lupus

A

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
Q

What happens during pregnancy and lupus

A

Sometimes people are better and sometimes flare ups are worse

Miscarriage is a high risk and so is still born

52
Q

What can happen in post pardon pt ?

A

Flare ups

53
Q

How can I evaluate?

A

Use energy conservation techniques
Lifestyle changes
Adherence to medication
Avoid /delay organ dysfunction
Maintain positive thinking

Module 4 (47 decks)

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