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Individuals two Exam 1.docx

Individuals two Exam 1.docx - Individuals two Exam 1...

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Individuals two Exam 1 Systemic Lupus Erythmatosus (SLE): 3-4 questions Nursing Management: Nursing Diagnosis 1. Fatigue related to chronic in ammation and altered immunity 2. Impaired skin integrity related to photosensitivity, skin rash, and alopecia 3. impaired comfort related to illness-related symptoms, treatment-related side effects, and the potential for variable and unpredictable progression of the disease Goals 1) have satisfactory pain management, (2) adhere to the therapeutic regimen to achieve maximum symptom management, (3) dem- onstrate awareness of and avoid activities that exacerbate the disease, and (4) maintain optimal role function and a positive self-image. Interventions o Nursing interventions include accurately recording the severity of symptoms and documenting the response to therapy o ssess fever pattern, joint in ammation, limitation of motion, location and degree of discomfort, and fatigue o Monitor the patient’s weight and uid intake and output if corticosteroids are prescribed because of their fluid retention e ect and the possibility of renal failure o Collection of 24-hour urine samples for protein and creatinine clearance may be ordered o Observe for signs of bleeding that result from drug therapy, such as pallor, skin bruising, petechiae, or tarry stools. o Carefully assess the neurologic status. Observe for visual disturbances, headaches, personality changes, seizures, and for- getfulness. o Psychosis may indicate CNS disease or may be an effect of corticosteroid therapy. o Irritation of the nerves of the extremities (peripheral neuropathy) may produce numbness, tingling, and weakness of the hands and feet. Evaluation The expected outcomes are that the patient with SLE will • Use energy conservation techniques • Adapt lifestyle to energy level • Maintain skin integrity with the use of topical treatments • Prevent exacerbations with the use of sunscreens and limited sun exposure Pt. Education (Table 65-17) Include the following information in the teaching plan for a patient with systemic lupus erythematosus and the caregiver.
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• Names of drugs, actions, side effects, dosage, administration • Pain management strategies • Energy conservation and pacing techniques • Therapeutic exercise, use of heat therapy (for arthralgia) • Avoidance of physical and emotional stress • Avoidance of exposure to individuals with infection • Avoidance of drying soaps, powders, household chemicals • Use of sunscreen protection (at least SPF 15) and protective clothing, with minimal sun exposure from 11:00 AM to 3:00 PM • Regular medical and laboratory follow-up • Marital and pregnancy counseling as needed • Community resources and health care agencies Know the triggers: o stress o pregnancy o sun exposure or sunburn o hormones o contraceptives o menarche o certain drugs Diagnostics o No specific test is diagnostic for SLE, but a variety of abnormalities may be present in the blood.
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