Care of the Lupus Patient
Central Nervous System Manifestations continued...
Objective: Assist Patient in Identifying
Family and Community Support Services
Assess patient's support network. Discuss
alternatives for strengthening supports.
Anticipate family concerns. Seek out the
family to answer their questions and to provide support. Include significant
others in patient care as appropriate.
Help family identify potential coping
skills, environmental supports, and community services for dealing with
chronically ill people.
Encourage patient and family members to
consider professional counseling.
Objective: Minimize Potential for
Assist patient and family in identifying
and removing potentially dangerous items in the environment.
Involve family members in planning of
patient's care and safety measures.
Assess patient's ability to safely
administer own medications.
Gastrointestinal (GI) problems
are common and range from vague complaints of anorexia to life-threatening
bowel perforation secondary to mesenteric arteritis. Anorexia, nausea,
vomiting, and diarrhea may be related to the use of salicylates, NSAIDs,
antimalarials, corticosteroids, and cytotoxic drugs.
SLE patients who present with
acute abdominal pain and tenderness need immediate, aggressive, and
comprehensive evaluation to rule out an intra-abdominal crisis. Ascites, an
abnormal accumulation of fluid in the peritoneal cavity, is found in about 10%
of SLE patients. Pancreatitis is a serious complication occurring in
approximately 5% of SLE patients and is usually secondary to
Mesenteric or intestinal
vasculitis are life-threatening conditions that may have complications of
obstruction, perforation, or infarction. They are seen in more than 5% of
patients with SLE. Abnormal liver enzyme levels are also found in about
one-half of SLE patients (usually secondary to medications). Active liver
disease is rarely found.
Alteration in GI function related to drug
therapy or disease process
Objective: Minimize Complications from
Assess patient for GI problems at each
Monitor laboratory results.
Suggest measures that may increase
comfort, such as throat lozenges, saline rinses, or small, frequent
Instruct patient to immediately report any
sudden or severe abdominal pain, shortness of breath, or epigastric pain to
Refer patient to dietitian.