Lupus/Test 4

Question 1

Systemic Lupus Erythematosus:

Answer 1

A complex multisystem inflammatory disease of autoimmune origin affecting the connective tissues. Abnormalities of the immune system. It typically affects the skin, joints and serous membranes (pluera, pericardium) along with the renal, hematologic and neurologic systems. Characterized by variability and chronic unpredictable course is marked by alternating periods of exacerbations and remissions

Question 2

SLE affects

Answer 2

• 2-8 persons per 100,000 in US
• Most cases occur in women of childbearing years
• African, Asion, and native Americans three time more likely to develop than Caucasian

Question 3

Lupus etiology:

Answer 3

• unknown
• genetic influence suspected
• hormones
• environmental factors
• certain medications

Question 4

Common clinical manifestations:

Answer 4

• specific manifestations depend on which cell types or organs are involved
• variable in severity
• most commonly affected tissues are skin and muscle, lining of lungs, heart, nervous tissue and kidneys

Question 5

Common clinical manifestations:

Answer 5

• Specific manifestations depend on which cell types or organs are involved.
• variable in severity
• most commonly affected tissues are skin, muscle, lining of lungs, heart, nervous tissue and kidneys

Question 6

Common Clinical Manifestations:

Answer 6

• Skin-photosensitivity
• Musculoskeletal-polyarthralgia with morning stiffness
• Cardiopulmonary- tachypnea and cough, arrhythmias, accelerates coronary artery disease
• Infection- major cause of death, pneumonia, most common

Question 7

Diagnostic Studies: Classification criteria for diagnosis (4 or more present)

Answer 7

-malar rash
-discoid rash
-photosensitivity
-oral ulcers
-arthritis
-serositis; plueral or pericarditis
-renal disorder
-neurologic disorder
-hematologic disorder
-immunologic disorder
-antinuclear antibodies
not specific, but found in 99%

Question 8

Drug therapy:

Answer 8

• NSAIDs
• Steroid sparing drugs
• Antimalarials
• Corticosteroids
• Immunosuppressive drugs

Question 9

Steroid sparing drugs:

Answer 9

• Methotrexate

* screening liver, renal, pulmonary, and hemalogic testing

Question 10

Antimalarials

Answer 10

*hydroxychloroquine (Plaquenil)

Question 11

Corticosteroids:

Answer 11

for exacerbations and severe disease

Question 12

Immunosuppressive:

Answer 12

• cycloshospharmide

- azathioprine (Imuran)

Question 13

Nursing goals:

Answer 13

• prevention is not possible at this time
• promote a clear understanding of the disease, early diagnosis and treatment
• have satisfactory pain relief
• Comply with therapeutic regimen to achieve maximum symptom management
• Demonstrate awareness of and avoid activities that cause disease exacerbation
• Maintain optimal role function and positive self-image