Final Prep - Musculoskeletal - Systemic Lupus Erythematosus (SLE) Flashcards

Patho

autoimmune disease
risk factors:
being a woman ethnicity family Hx
smoking

Sx

most common:
fatigue joint pain rashes mouth
ulcers hair loss
other Sx:
H/A fever anemia edema (feet, legs,
hands, eyes) pleurisy abnormal blood clotting
Reynaud's phenomenon seizures

Dx Criteria

Any Combo of >= 4 of Criteria = SLE Likely

malar or discoid rash photosensitivity oral
ulcers arthritis serositis renal d/o
neurologic d/o hematologic d/o: anemia, leukopenia,
lymphopenia, thrombocytopenia, immunologic d/o, antinuclear
antibodies

Dx / Labs

CBC 24hr urine ANA PT/PTT
skin or kidney biopsy anti-dsDNA histone
antibodies phospholipid antibodies Ross-A &
La/SS-B antibodies Sm target protein in the cell nucleus
antibodies

Meds

NSAIDS corticosteroids antimalarials: HCQ,
chloroquine, quinacrine cyclophosphamide
mycophenolate motefil belimumab

Complimentary Alternative Tx

acupuncture meditation biofeedback
herbal Tx

Nursing Interventions

Hx & physical exam manage exacerbations
seizure precautions monitor fluid status
maintain skin integrity promote coping &
self-esteem discuss reproductive issues

Pt Teaching

sunscreen, hats, long-sleeves, avoid sun if possible
flu & pneumonia vac (no live vac w/ immunosuppressants)
oral contraceptive pill maybe contraindicated hormone
therapy: trigger flares inc. risk of bleed/bruise if
anticoagulant ther. pregnancy plan inc. risk of
ischemic heart disease exercise = good inc. risk
of infection be aware of Sx