Week 7 - Systemic Lupus Erythematosus Flashcards
what is systemic lupus erythematosus
- chronic, multisystem inflammatory disease of autoimmune origin
what causes systemic lupus erythematosus (SLE) (4)
interactions among
- genetic
- enviro
- immunological
- hormonal factors
who does SLE effect more
- 10x more common in females than males
what is SLE characterized by (3)
- variability within and among persons
- chronic, unpredictable course
- marked w alternating periods of exacerbations and remissions
describe the symptoms of SLE (4)
- variable
- range from relatively mild to rapidly progressive
- no characteristic pattern
- any organ can be impacted
what tissues are most commonly effected by SLE (6)
- skin
- muscle
- lungs
- heart
- nervous tissue
- kidneys
what are the generalized complaints of SLE (5)
- fever
- weight loss
- arthralgia
- excessive fatigue
- pain
what are the dermatological manifestations of SLE(7)
- cutaneous vascular lesions
- butterfly rash on cheeks and bridge of nose
- discoid –> round, coin shaped lesions
- photosensitivity
- ulcers of oral or nasopharyngeal membranes
- alopecia
- dry, scaly scalp
what are the musculoskeletal manifestations of SLE (4)
- polyarthalgia with morning stiffness
- diffuse swelling
- joint and muscle pain
- increased risk of bone loss & fracture
what cardiopulmonary manifestations are associated w SLE (4)
- tachypnea
- cough
- dysrhythmias
- pleurisy & pleural effusion
what renal problems are associated w SLE (3)
- lupus nephritis
- mild proteinuria
- rapid, progressive glomerulonephritis
what nervous system manifestations are associated w SLE (7)
- generalized or focal seizures
- disorientation
- memory deficits
- psychiatric symptoms
- depression
- psychosis
- HA
what hematological manifestations are associated with SLE (4)
- anemia
- leukopenia
- thrombocytopenia
- coagulopathy –> either excessive bleeding or bloof clot formation
describe the relationship between SLE and infections
- causes increased susceptibility to infections
- infection is a major cause of death
which two symptoms are most commonly reported by pts to interfere w their QOL
- pain
- fatigue
what is a major challenge in treating SLE
- managing the acute phase while preventing complications of treatment that cause long-term tissue damage
what is included in collaborative care for SLE
- meds
describe an exacerbation of SLE
- during an acute exac, the pt can become abruptly and dramatically ill
- may need to be admitted to hospital
what should you assess/monitor for during an acute exac of SLE (10)
- S&S of infection
- I&O
- joint inflammation
- signs of AKI
- collect 24-hr urine samples for creatinine clearance and protein
- signs of bleeding
- neuro assessment
- extreme fatigue
- document the response to therapy
- peripheral neuropathy
- limitation of motion
- location and degree of pain/discomfort
what are some meds included in treatment for SLE (5)
- NSAIDs for mild disease
- corticosteroids for exacerbation and severe disease
- immunosuppressive meds
- steroid-sparing meds
- antimalarials
what should be included in the teaching plan for a pt with SLE & the caregiver (12)
- disease process
- med education
- pain mngmt strategies
- energy conservation & pacing techniques
- therapeutic exercise
- use of heat therapy for arthralgia
- avoid physical & emotional stress
- avoid exposure to individuals w infection
- avoid drying soaps, powders, household chems
- use sunscreen protection
- regular med & lab follow ups
- community resources and health care agencies
what is imp to teach pts regarding the disease process
- even strong adherence to the treatment plan cannpy guarantee against exac bc the course of the disease is unpredictable
what factors increase disease activity (6)
- fatigue
- sun exposure
- emotional stress
- infection
- drugs
- surgery
describe the relationship between SLE and pregnancy
- pregnancy should be planned when disease activity is minimal
describe the psychosocial impact of SLE (2)
- skin rashes, discoid lesions and alopecia can contribute to social isolation
- pain & fatigue interfere w QOL
