MEDICAL CONDITION
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)
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
ETIOLOGY/PATHOPHYSIOLOG
A
Systemic Lupus Erythemous/Anemia Y
Lupus Erythematosus is an
auto immune disease that
ASSESSMENT DATA
affects the connective tissue
VS: T: 98.0 P: 54 RR: 18 BP: 128 / 78 Pain Num: 0/10
O2 of the body. The course of
the disease is variable and
sat: 98%
unpredictable, with episodes
RBC: L 2.29 (4.0 5.90) m/cumm HGB: 7.9 L ( 13.8 16.9)
of remission and relapse. SLE
LS Clear:LUQ, RUQ,LLQ,RLQ BS: active x 4 quads, No
is a multisystem
tenderness noted on liver or spleen upon palpation,
inflammatory disease that
Edema: R arm mild non pitting BLE: edema +2 pitting
affects any body system but
edema, minor ecchymosis on R wrist., No Skin rashes or
primarily the
lesions present, Active ROM , Hair loss, NO SLIV
Musculoskeletal, cutaneous,
Total Urine output during shift: 650
renal, nervous, and
Fluid intake: 480
cardiovascular systems. The
Diet: renal ( pt ate 100%)
multi system nature of SLE
places the patient at risk for
NURSING DIAGNOSIS
multiple complications, and
Pain r/t Inflammation
the disease is ultimately
Alteration in comfort r/t edema and joint pain,
fatal. The survival or patients
peripheral nerve inflammation.
with SLE is about 90%@5
yrs. and 80% @ 10 years.
PLANNING The most common causes of
Pharmacologic therapy, adequate rest periods, PT program death are renal failure and
to maintain mobility, and ROM, observe pt for Renal failure TEACHING
Medication teaching
Side effects
INTERVENTIONS Alternate forms of pain
Analgesic administration, VS, Anxiety reduction, ROM management
exercises, Frequent rest periods, Pain assessment, Neuro Diet
checks, Pain management, Strict I&O, monitor lab values, ROM exercises, mobility, freq
Patient teaching, Assess patient for s/s of joint pain rest periods,
,relaxation techniques, Amb with patient ad lib, Comfort Use of protective skin barrier
measures to decrease pain: warm packs, sunscreen, skin protection
scalp
Stress reduction
EVALUATION Disease process
Pt had no c/o Pain r/t Inflammation Coping strategies
Pt had no c/o Alteration in comfort r/t edema and joint pain, Referral to support groups
peripheral nerve inflammation.