Más contenido relacionado


systemiclupuserythematosus-180816062414 (1).pdf

  1. Presented by Monika Devi Msc(N)1st year HCN ,SRHU Systemic Lupus Erythematosus
  2. Definition • Systemic lupus erythematosus is an autoimmune disease of the body's connective tissues. • Autoimmune means that the immune system attacks the tissues of the body. Attacks parts of the cell nucleus. • Between the ages of 15 and 40, although it can show up at any age.
  3. Systemic Lupus Erythematosus
  4. Pathogenesis  A healthy immune system produces proteins called antibodies and specific cells called lymphocytes.  That help fight and destroy viruses, bacteria, and other foreign substances that invade the body.  In lupus, the immune system produces antibodies against the body's healthy cells and tissues.
  5. Cont.. • These antibodies, contribute to the inflammation of various parts of the body and can cause damage to organs and tissues. • Lupus can affect :- -joints, skin, kidneys, heart, lungs, blood vessels, and brain.
  6. Pathogenesis
  7. Causes  The exact causes is not known.  Inherited genes, viruses, ultraviolet light, and drugs may all play some role.  Genetic factors increase the tendency of developing autoimmune diseases
  8. Cont..  Hormones play an important role in the expression of SLE.  A genetic mutation  Drug-induced lupus.
  9. Types Of Lupus Erythematosus 1. Discoid lupus erythematosus :- is a chronic skin disorder, red, raised rash appears on the face, scalp, or elsewhere. The rash may last for days or years . 2. Sub acute cutaneous lupus erythematosus:- refers to skin lesions that appear on parts of the body exposed to sun. The lesions do not cause scarring.
  10. Cont… 3. Drug-induced lupus :- is a form of lupus caused by medications. Many different drugs can cause drug induced lupus. 4. Neonatal lupus :- is a rare disease that can occur in newborn babies of women with SLE .
  11. Cont.. 5. Sjögren's syndrome is an autoimmune disorder in which immune cells attack and destroy the exocrine glands that produce tears and saliva. Secondary sjogren’s syndrome 1. Dry eyes 2. Dry mouth
  12. Clinical Manifestation • The symptoms of SLE come on in waves, called flares or flare-ups. • general discomfort, extreme fatigue, fever, and weight loss at some point.
  13. Common Symptoms of Lupus 1. Painful or swollen joints and muscle pain 2. Unexplained fever 3. Red rashes, most commonly on the face 4. Chest pain upon deep breathing 5. Unusual loss of hair 6. Pale or purple fingers or toes from cold or stress .
  14. Cont.. 7. Sensitivity to the sun 8. Swelling (edema) in legs or around eyes 9. Swollen glands 10. Extreme fatigue
  15. Malar Rash • This is a "butterfly shaped" red rash over the cheeks below the eyes and across the bridge of the nose. • It may be a flat or a raised rash. • The rashes are made worse by sun exposure.
  16. Raynaud’s Phenomenon • Is commonly found in lupus. • Reaction of distal digits to cold or emotion, in which the skin color changes from white to blue to red.
  17. Maculopapular Eruption
  18. Vasculitic Skin Lesion
  19. Alopecia
  20. Mouth Ulcer • Painless sores in the nose or mouth
  21. Different Symptoms In Different Body Systems
  22. Diagnostic studies  Complete blood count (CBC) –Erythrocyte sedimentation rate (ESR) –Urinalysis –Blood chemistries –Antinuclear antibody test (ANA) –Other autoantibody tests (anti-DNA  Skin biopsy  Kidney biopsy
  23. Complication  Blood clots and inflammation of blood vessels.  Pericarditis  Heart attack  Stroke  Memory change  Behavioral changes  Seizures
  24. Treatment 1. A conservative regimen of physical and emotional rest is required. 2. protection from direct sunlight. 3. A healthful diet. 4. prompt treatment of infections. 5. Pregnancy must be planned for times when the disease is under control, and the patient is on allowable medications.
  25. Medication 1-NSAIDs:  Non steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. 2- Anti-malarials:  (Plaque nil) It may be used alone or in combination with other drug.  hydroxychloroquine, quinacrine (available compounded), chloroquine  Used in lupus over 50 years  Mildest immunosuppressant  Very safe, risk of retinal toxicity low  Eye exam once year
  26. Cont.. 3. Corticosteroid:- 4- Immunosuppressive : -  For some patients whose kidneys or central nervous system are affected by lupus, such as cyclophosphamide (Cytoxan)  Restrain the overactive immune system by blocking the production of immune cells.
  27. Other Therapy 1. Plasma exchange 2. Intravenous Immunoglobulin 3. Stem cell transplantation 4. Immune therapy
  28. Nursing Management 1. Minimize appearance of lesions. 2. Alleviate discomfort 3. Minimize fatigue. 4. Maintain weight at optimal range 5. Teach the patient to recognize fever and signs and symptoms of infection. 6. Maintain joint function and increase muscle strength.
  29. Cont.. 7. Recognize anemia and develop a plan of care 8. Minimize episodes of bleeding. 9. Minimize incidence of infection. 10. Educate the patient about immunizations 11. Educate patient nutritional status.
  30. NURSING DIAGNOSIS 1. Impaired skin integrity related to inflammation as evidence by skin rash. INTERVENTION 1. Wear protective eyewear. 2. Wear a wide-brimmed hat and carry an umbrella.3 3. Wear maximum protection sunscreen (SPF 15 or above) in the sun. Sunbathing is contraindicated. 4. Avoid ultraviolet ray.
  31. Nursing Diagnosis 2. Acute pain related to inflammation as evidence by Verbalized complaint of joint pain or stiffness. INTERVENTION  Assess for the signs of joint inflammation (warmth, redness, swelling) or decreased motion  Encourage the use of ambulation aids when pain is related to weight-bearing.  Encourage the use of nonpharmacological measures of pain control such as relaxation, distraction, or guided imagery.  Consult an occupational therapist for the proper splinting of affected joints.
  32. Nursing Diagnosis 3. Imbalance nutrition: less than body requirement related to poor appetite. INTERVENTION  Monitor calorie intake, weight.  Provide menu suggestion for high protein & calorie foods  Give high protein and calorie diet.  Provide liquid and frequent diet.  Plan periods of rest after food intake.
  33. Nursing Diagnosis 4. Deficient knowledge about self-management to be performed at home. INTERVENTION  Teach the patient about self-care.  Give strong message to stop smoking  Advise the patient to take regular treatment  Teach about exercise.
  34. Summary
  35. Reference  Systemic lupus erythematosus Lewis’s medical surgical nursing assessment and clinical practice second edition.  Systemic lupus erythematosus Brunner and suddartha’s medical surgical nursing twelfth edition.  Systemic lupus erythematosus, www.Medicine.  Systemic lupus erythematosus en.m wikipedia .org.  Systemic lupus erythematosus,