RISK FACTORS Cause of Lupus is unknown, A familial association suggests genetic predisposition.

Environmental factors, susceptibility to certain viruses, an immune system dysfunction with production of auto antibodies, Hormonal abnormality, Ultraviolet radiation, Drugs: hydralazine, hydrochloride ,procainamide hydrochloride, penicillin, isonicotinic acid hydrazide, chlorpromazine, phenytoin, and quinidine (can cause onset of lupus like symptoms and aggravate existing disease)

MEDICAL CONDITION A Systemic Lupus Erythemous/Anemia

ASSESSMENT DATA VS: T: 98.0 P: 54 RR: 18 BP: 128 / 78 Pain Num: 0/10 2 sat: 98% RBC: L 2.29 (4.0 5.90) m/cumm HGB: 7.9 L ( 13.8 16.9) LS Clear:LUQ, RUQ,LLQ,RLQ BS: active x 4 quads, No tenderness noted on liver or spleen upon palpation, Edema: R arm mild non pitting BLE: edema +2 pitting edema, minor ecchymosis on R wrist., No Skin rashes or lesions present, Active ROM , Hair loss, NO SLIV Total Urine output during shift: 650 Fluid intake: 480 Diet: renal ( pt ate 100%)

NURSING DIAGNOSIS Pain r/t Inflammation Alteration in comfort r/t edema and joint pain, peripheral nerve inflammation. PLANNING Pharmacologic therapy, adequate rest periods, PT program to maintain mobility, and ROM, observe pt for Renal failure

ETIOLOGY/PATHOPHYSIOLOGY Lupus Erythematosus is an auto immune disease that affects the connective tissue of the body. The course of the disease is variable and unpredictable, with episodes of remission and relapse. SLE is a multisystem inflammatory disease that affects any body system but primarily the Musculoskeletal, cutaneous, renal, nervous, and cardiovascular systems. The multi system nature of SLE places the patient at risk for multiple complications, and the disease is ultimately fatal. The survival or patients with SLE is about 90%@5 yrs. and 80% @ 10 years. The most common causes of death are renal failure and infections, followed by neurological and cardiovascular disorders. Therapy has reduced mortality for 20yr survival to 70% TEACHING Medication teaching Side effects Alternate forms of pain management Diet ROM exercises, mobility, freq rest periods, Use of protective skin barrier sunscreen, skin protection scalp Stress reduction Disease process Coping strategies Referral to support groups

MEDICATIONS Renagel 800mg P.O TID with meals Folic Acid 5mg P.O daily Cellcept 500mg P.O BID Lovenox 40 mg SC q Daily

INTERVENTIONS Analgesic administration, VS, Anxiety reduction, ROM exercises, Frequent rest periods, Pain assessment, Neuro checks, Pain management, Strict I&O, monitor lab values, Patient teaching, Assess patient for s/s of joint pain ,relaxation techniques, Amb with patient ad lib, Comfort measures to decrease pain: warm packs,

EVALUATION Pt had no c/o Pain r/t Inflammation Pt had no c/o Alteration in comfort r/t edema and joint pain, peripheral nerve inflammation.