ADH Ex2 NUR 4585: SLE, Gout & Fibromyalgia Nursing Care

What is systemic lupus erythematosus (SLE)?

An autoimmune disorder where the immune system attacks healthy tissue, causing inflammation and possible organ involvement.

What are common symptoms of SLE?

Fatigue, malaise, anemia, joint pain, swelling, malar rash, photosensitivity, and cognitive changes.

What medications are typically used to manage SLE?

Hydroxychloroquine, NSAIDs, corticosteroids, and immunosuppressants like methotrexate or azathioprine.

What is the significance of the malar rash in SLE?

It is a characteristic skin manifestation of systemic lupus erythematosus.

What laboratory test is commonly positive in SLE?

Antinuclear antibody (ANA) test.

What does a positive anti-double-stranded DNA (anti-dsDNA) test indicate?

It is more specific for SLE and may correlate with disease activity.

What are the signs of renal involvement in SLE?

Decreased urine output, proteinuria, hematuria, and dark or foamy urine.

What is the role of urinalysis in evaluating SLE?

It helps assess renal function and detect proteinuria or hematuria.

What is drug-induced lupus?

A form of lupus associated with certain medications that often improves after stopping the drug.

What is the primary concern when a patient with SLE reports cognitive changes?

It may indicate central nervous system involvement, which can be serious.

What are common clinical manifestations of gout?

Sudden, intense joint pain, redness, warmth, swelling, tenderness, and limited range of motion.

What is the gold-standard diagnostic test for gout?

Synovial fluid analysis showing needle-shaped, negatively birefringent monosodium urate crystals.

What are tophi in the context of gout?

Deposits that may form in chronic or recurrent gout, often visible under the skin.

What is the importance of monitoring blood pressure in SLE patients?

To assess for potential organ involvement, particularly renal and cardiovascular systems.

What lifestyle modifications should be encouraged for SLE patients?

Sun protection and minimizing UV exposure.

What role do corticosteroids play in SLE management?

They are used for flares or significant disease but require monitoring for glucose levels and infection risk.

What is the relationship between SLE and organ involvement?

SLE can affect multiple organ systems, necessitating comprehensive monitoring beyond joint symptoms.

What are the potential side effects of long-term corticosteroid use?

Increased risk for osteoporosis and infection.

Why is it important to monitor for infection in SLE patients receiving immunosuppressive therapy?

Immunosuppressive therapy increases the risk of infections due to reduced immune response.

What symptoms should SLE patients be taught to report immediately?

Decreased or foamy urine, increasing edema, chest pain or dyspnea, fever, and new neurologic symptoms.

What is the typical age of onset for systemic lupus erythematosus?

It is commonly diagnosed in women between the ages of 15 and 44, but can occur at any age.

What is the difference between SLE and discoid lupus?

Discoid lupus primarily affects the skin, while SLE can affect multiple organ systems.

What are common laboratory findings in SLE?

Positive ANA, anti-dsDNA, decreased complement levels (C3 and C4), and possible anemia or leukopenia.

What is the significance of ESR and CRP in SLE?

They are markers of inflammation that can indicate disease activity.

What is the recommended nursing care during an SLE flare?

Address pain and fatigue, balance activity with rest, and administer prescribed therapy.

How does fibromyalgia differ from SLE?

Fibromyalgia involves widespread musculoskeletal pain without inflammation or organ damage.

What are the first-line medications for acute gout flares?

NSAIDs such as naproxen or indomethacin.

When is colchicine most effective for gout?

When started early, ideally within 12 to 24 hours.

What are common adverse effects of colchicine?

Diarrhea and nausea.

What should be used when NSAIDs or colchicine are contraindicated?

Corticosteroids.

What is the goal serum uric acid level when using allopurinol or febuxostat?

Below 6 mg/dL.

Should long-term urate-lowering medication be stopped during an acute flare?

No, it should not be stopped.

What does probenecid do in gout management?

Increases renal uric acid excretion.

What lifestyle changes are recommended for gout self-management?

Encourage 2 to 3 L of fluid daily, promote a healthy weight, and limit certain foods and drinks.

What is fibromyalgia characterized by?

Widespread musculoskeletal pain, fatigue, sleep disturbance, cognitive changes, and heightened sensitivity.

Does fibromyalgia cause joint or tissue destruction?

No, it does not.

What neurochemical changes are associated with fibromyalgia?

Increased substance P and decreased serotonin and norepinephrine.

What are common clinical manifestations of fibromyalgia?

Widespread pain, severe fatigue, nonrestorative sleep, cognitive difficulty, and mood changes.

How is fibromyalgia diagnosed?

Clinically, based on history and symptom pattern.

What is the primary goal of fibromyalgia management?

To reduce symptoms while improving function and quality of life.

What types of exercise are recommended for fibromyalgia patients?

Regular low-impact aerobic exercise.

What medications are commonly used for fibromyalgia?

Analgesics, antidepressants (SNRIs, TCAs), and anticonvulsants (gabapentin, pregabalin).

What is the role of duloxetine in fibromyalgia treatment?

It is an SNRI that increases serotonin and norepinephrine in the CNS.

What should be monitored when prescribing pregabalin?

Dizziness, somnolence, peripheral edema, and weight gain.

What distinguishes SLE from gout and fibromyalgia?

SLE is a chronic autoimmune inflammatory disease.

What is the distinguishing feature of gout?

Deposition of monosodium urate crystals in joints and tissues.

What is a key characteristic of fibromyalgia?

Altered central pain processing without an inflammatory process.