University of Northern Philippines

Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986
NCM 109 PEDIA

ACTIVITY 3
Systemic Lupus Erythematosus
By: Catherine A. Prado BSN II – B
Systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the immune system of the
body mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain, and other organs.
Causes
Lupus occurs when your immune system attacks healthy tissue in your body (autoimmune disease). It's
likely that lupus results from a combination of your genetics and your environment.
It appears that people with an inherited predisposition for lupus may develop the disease when they come
into contact with something in the environment that can trigger lupus. The cause of lupus in most cases,
however, is unknown. Some potential triggers include:
 Sunlight. Exposure to the sun may bring on lupus skin lesions or trigger an internal response in
susceptible people.
 Infections. Having an infection can initiate lupus or cause a relapse in some people.
 Medications. Lupus can be triggered by certain types of blood pressure medications, anti-seizure
medications and antibiotics. People who have drug-induced lupus usually get better when they
stop taking the medication. Rarely, symptoms may persist even after the drug is stopped.
Risk factors
Factors that may increase your risk of lupus include:
 Sex. Lupus is more common in women.

 Age. Although lupus affects people of all ages, it's most often diagnosed between the ages of 15
and 45.
 Race. Lupus is more common in African-Americans, Hispanics and Asian-Americans.
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Symptoms
Symptoms vary from person to person, and may come and go. Everyone with SLE has joint pain and
swelling at some time. Some develop arthritis. SLE often affects the joints of the fingers, hands, wrists,
and knees.
 Chest pain when taking a deep breath.

 Fatigue.
 Fever with no other cause.
 General discomfort, uneasiness, or ill feeling (malaise).
 Hair loss.
 Weight loss.
 Mouth sores.
 Sensitivity to sunlight.
 Skin rash: A "butterfly" rash develops in about half the people with SLE. The rash is mostly seen
over the cheeks and bridge of the nose. It can be widespread. It gets worse in sunlight.
 Swollen lymph nodes.
Other symptoms depend on which part of the body is affected:
 Brain and nervous system: Headaches, numbness, tingling, seizures, vision problems, and
personality changes
 Digestive tract: Abdominal pain, nausea, and vomiting
 Heart: Valve problems, inflammation of heart muscle
 Lung: Buildup of fluid in the pleural space, difficulty breathing
 Skin: Patchy skin color and fingers that change color when cold (Raynaud phenomenon)
 Kidney: Swelling in the legs
Complications
Inflammation caused by lupus can affect many areas of your body, including your:
 Kidneys. Lupus can cause serious kidney damage, and kidney failure is one of the leading causes
of death among people with lupus.
 Brain and central nervous system. If your brain is affected by lupus, you may experience
headaches, dizziness, behavior changes, vision problems, and even strokes or seizures. Many
people with lupus experience memory problems and may have difficulty expressing their
thoughts.
 Blood and blood vessels. Lupus may lead to blood problems, including anemia and increased risk
of bleeding or blood clotting. It can also cause inflammation of the blood vessels (vasculitis).
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 Lungs. Having lupus increases your chances of developing an inflammation of the chest cavity
lining (pleurisy), which can make breathing painful. Bleeding into lungs and pneumonia also are
possible.
 Heart. Lupus can cause inflammation of your heart muscle, your arteries or heart membrane
(pericarditis). The risk of cardiovascular disease and heart attacks increases greatly as well.
Other types of complications
Having lupus also increases your risk of:
 Infection. People with lupus are more vulnerable to infection because both the disease and its
treatments can weaken the immune system.
 Cancer. Having lupus appears to increase your risk of cancer; however the risk is small.
 Bone tissue death (avascular necrosis). This occurs when the blood supply to a bone diminishes,
often leading to tiny breaks in the bone and eventually to the bone's collapse.
 Pregnancy complications. Women with lupus have an increased risk of miscarriage. Lupus
increases the risk of high blood pressure during pregnancy (preeclampsia) and preterm birth. To
reduce the risk of these complications, doctors often recommend delaying pregnancy until your
disease has been under control for at least six months.
Prevention
 Limit your time in direct sunlight if sun exposure causes a rash. You should always wear a
sunscreen with an SPF of 70 or higher that blocks both UVA and UVB rays.
 Try to avoid medications, if feasible, that make you even more sensitive to the sun. Trusted
Source This includes the antibiotics minocycline (Minocin) and trimethoprim-sulfamethoxazole
(Bactrim), and diuretics such as furosemide (Lasix) or hydrochlorothiazide.
 Develop stress management techniques. Meditate, practice yoga, or get massages — whatever
helps calm your mind.
 Stay away from people who are sick with colds and other infections.
 Get enough sleep. Go to bed early enough each night to guarantee yourself seven to nine hours of
rest.
Medical and Nursing Management
 Nonsteroidal anti-inflammatory drugs (NSAIDs)

 Hydroxychloroquine (Plaquenil)
 Corticosteroids
 Immunosuppressive drugs such as azathioprine (Imuran), methotrexate (Rheumatrex),
cyclosporine (Sandimmune, Neoral), and mycophenolate mofetil (CellCept), cyclophosphamide
(Cytoxan) and tacrolimus (Prograf). Some are given by injection or intravenously.
 Biological agents such as belimumab (Benlysta), rituximab (Rituxan), TNF alpha inhibitors
(Enbrel, Humira,Cimzia, and others)
 Other biological agents now considered experimental, including those that
 block, interferon and other cytokines
 Encourage patient to maintain activity when the symptoms are mild or in
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 remission.
 Encourage patient to maintain activity and to allow for adequate rest.
 Support the patient’s self-image by encouraging good grooming.
 Explain the meaning of the chronic illness and coping strategies with the patient.

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University of Northern Philippines

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Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES

NCM 109 PEDIA

Systemic lupus erythematosus

 Sex. Lupus is more common in women.

 Chest pain when taking a deep breath.

Medical and Nursing Management

 Nonsteroidal anti-inflammatory drugs (NSAIDs)

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