NURS 308 - Systemic Lupus Erythematosus

cutaneous lupus erythematosus (discoid lupus)

type of lupus: limited to the skin, causes no organ damage - the most common symptom is a circular-shaped, red, bumpy rash on various places on the body (commonly mistaken for psoriasis or eczema)

drug-induced systemic lupus

type of lupus: temporary lupus symptoms caused by drugs - when the drug is stopped, the symptoms go away

skin, joints, and serous membranes (pleura, pericardium); renal, hematologic, and neurological systems

*basically, every organ and system in the body can be affected by lupus - a multisystem disease

what organs in the body are affected by systemic lupus erythematosus?

women

_____ are 6x more likely to be affected by lupus

joint and muscle pain

often the first sign of systemic lupus erythematosus

no permanent joint damage

what is the difference between rheumatoid arthritis and systemic lupus erythematosus?

- joint & muscle pain

- joints may be inflamed & warm to the touch

- low-grade fever

- light sensitivity

- fatigue

- infection

- skin rash on areas exposed to sunlight (butterfly rash)

- discoid lesions

- oral & nasopharyngeal ulcers

- transient alopecia

- cardiopulmonary effects: pleurisy, arrhythmias, raynaud’s, pericarditis, hypertension, hypercholesterolemia, thrombi

- lupus nephritis

- GI effects: abdominal pain, nausea, vomiting, dysphagia, hepatitis, pancreatitis

- neuro effects: headaches, seizures, peripheral neuropathy, stroke

- hematologic effects: anemia, leukopenia, thrombocytopenia

clinical manifestations of systemic lupus erythematosus:

raynaud's disease

poor circulation to the fingers and toes, causing a white/blue discoloration and pain

lupus nephritis

a very serious complication of systemic lupus erythematosus that can lead to chronic kidney disease and end-stage renal disease

anemia - leukopenia (risk for infection) - thrombocytopenia (risk for bleeding)

hematologic effects of lupus:

spontaneous abortion (miscarriage) - stillbirth - intrauterine growth retardation (born small for gestational age)

pregnancy complications of systemic lupus erythematosus:

preconception counseling: pregnancy should be planned in advanced to address the issues and make the pregnancy as safe as possible

what should be done before a patient with systemic lupus erythematosus decides to get pregnant?

↑ anti-smith anti-nuclear antibody

the specific test for lupus - this test is only positive if the patient has lupus; however, not everyone with lupus tests positive

- prevention of flare ups: identify and avoid triggers

- cover up when in the sun

- no smoking

- regular exercise

- improve stress management skills

- get plenty of rest: may need up to 12 hours of sleep at night

patient teaching for a patient with systemic lupus erythematosus:

rest, prevent infection

what is the main focus for a patient with systemic lupus erythematosus?