Module 11 AUTOIMMUNE & RHEUMATIC DISORDERS (SLE & RA)

Autoimmune disorder

Overactive immune system attacks own tissues

ANA test

Detects autoantibodies, used for SLE

Anti-dsDNA

Confirms SLE, monitors disease activity

Complement C3/C4

Low levels mean active autoimmune disease

ESR/CRP

Nonspecific markers of inflammation

Rheumatoid factor

Blood test for rheumatoid arthritis

Anti-CCP antibodies

Diagnostic for rheumatoid arthritis

SLE

Chronic autoimmune disease with fibrin deposits in vessels/organs

SLE cause

Unknown, no cure

SLE triggers

Medications, stress, genetics, UV light, pregnancy

Malar rash

Butterfly rash on face, sign of SLE

Photosensitivity

Skin reaction to sunlight, seen in SLE

Palmar erythema

Redness of palms, seen in SLE

SLE skin care

Mild fragrance-free soap, avoid sun/UV

SLE fatigue care

Diet high in protein, vitamins, iron; energy conservation

SLE pain meds

Corticosteroids, salicylates, NSAIDs

Plasmapheresis

Removes autoantibodies and immune complexes

SLE renal monitoring

Watch for proteinuria, red cell casts, BUN/creatinine

Rheumatic disease

Autoimmune/inflammatory disease of joints, muscles, soft tissue

Rheumatic disease pattern

Flare-ups alternating with remission

Rheumatoid arthritis

Chronic systemic disease destroying joint connective tissue

RA pathology order

Synovitis, pannus, joint disappears, bony ankylosis

RA morning stiffness

Lasts more than 30 minutes

RA joint pattern

Bilateral, symmetrical joints

RA diagnostic tests

Elevated ESR/CRP, positive rheumatoid factor, joint imaging changes

NSAIDs (RA)

Ibuprofen, decreases inflammation

DMARDs

Methotrexate, hydroxychloroquine, suppress immune system

Biologic response modifiers

Abatacept, adalimumab, for severe RA

RA surgery

Arthroplasty (joint replacement), synovectomy, arthrodesis

RA nursing care

ROM exercises, balance rest/activity, pain management, assistive devices

Osteoarthritis vs RA

OA is degenerative and asymmetrical; RA is autoimmune and symmetrical