Lupus Health Center

Care of the Lupus Patient

Potential Manifestations of Infection

Respiratory Tract Infections

• Sore throat
• Sneezing
• Fever
• Productive or nonproductive cough
• Runny nose
• Malaise
• Chills
• Back and muscle pain
• Dyspnea
• Wheezing or rales
• Chills
• Nausea
• Vomiting

Urinary Tract Infections

• Chills
• Fever
• Flank pain
• Nausea
• Vomiting
• Urinary frequency
• Dysuria
• Hematuria

Skin Infections

• Lesions
• Redness
• Swelling
• Tenderness or pain

Nutrition

Overview

The patient with lupus often has special nutritional needs related to medical conditions that may arise during the course of the disease. These conditions include steroid-induced osteoporosis or diabetes, cardiovascular disease, and kidney disease. For the SLE patient to maintain optimal health, the nurse must work closely with the patient, dietitian, and physician to develop a nutritional plan specific to the patient's disease and manifestations.

Potential Problems

• Weight changes
• Anorexia
• Alteration in nutritional status due to drug therapy or complications of SLE

Potential Manifestations of Nutritional Problems

• Weight loss or gain
• Loss of interest in food
• Anorexia
• Dry, rough, scaly skin
• Dull, dry, brittle, thin hair
• Loss of lean muscle mass
• Listlessness, apathy
• Poor muscle tone
• Constipation or diarrhea
• Irritability
• Fatigue and lack of energy
• Inflamed or bleeding gums

Nursing Interventions

Objective: Determine the Causes of Patient's Altered Nutritional Status

1. Conduct a physical assessment of patient, including weight, height, and percentage of body fat.
2. Assess patient's nutritional intake by asking her or him to keep a food diary.
3. Assess patient's current medications and doses.
4. Determine dietary and nutrient intake and vitamin/mineral supplement intake, food sensitivities (allergies may provoke a flare), food preferences, and experience with fad diets to "cure" lupus.
5. Assess patient for signs and symptoms of SLE-associated conditions, including osteoporosis, diabetes, and cardiovascular and kidney disease.
6. Monitor laboratory values such as hemoglobin, hematocrit, serum ferritin, serum iron, total cholesterol, HDL, LDL, VLDL, triglycerides, and plasma protein levels.
7. Assess patient for signs and symptoms of depression.
8. Assess patient's knowledge of nutrition and understanding of a healthful diet.
9. Assess patient's ability to purchase and prepare meals.
10. Assess patient's activity level.
11. Assess cultural, socioeconomic, and religious factors that may influence patient's diet.

Objective: Educate Patient about Healthful Eating to Prevent Alteration in Nutritional Status

1. Encourage patient to maintain a healthful diet, and discuss nutritional claims of "curing lupus," which are often misleading.
2. Provide patient with information on the basics of a well-balanced diet and its importance in a chronic disease such as lupus.
3. Instruct patient to take iron supplements only if iron stores are depleted.
4. Suggest vitamin and mineral supplementation, if necessary.
5. Refer patient to dietitian for assistance in dietary planning for serious conditions associated with SLE.