Care of the Lupus Patient
Potential Manifestations of Infection
Respiratory Tract Infections
- Sore throat
- Productive or nonproductive cough
- Runny nose
- Back and muscle pain
- Wheezing or rales
Urinary Tract Infections
- Flank pain
- Urinary frequency
- Tenderness or pain
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
- Weight changes
- Alteration in nutritional status due to drug therapy or complications of
Potential Manifestations of Nutritional Problems
- Weight loss or gain
- Loss of interest in food
- Dry, rough, scaly skin
- Dull, dry, brittle, thin hair
- Loss of lean muscle mass
- Listlessness, apathy
- Poor muscle tone
- Constipation or diarrhea
- Fatigue and lack of energy
- Inflamed or bleeding gums
Objective: Determine the Causes of Patient's Altered
- Conduct a physical assessment of patient, including weight,
height, and percentage of body fat.
- Assess patient's nutritional intake by asking her or him to
keep a food diary.
- Assess patient's current medications and doses.
- 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.
- Assess patient for signs and symptoms of SLE-associated
conditions, including osteoporosis, diabetes, and cardiovascular and kidney
- Monitor laboratory values such as hemoglobin, hematocrit,
serum ferritin, serum iron, total cholesterol, HDL, LDL, VLDL, triglycerides,
and plasma protein levels.
- Assess patient for signs and symptoms of
- Assess patient's knowledge of nutrition and understanding of
a healthful diet.
- Assess patient's ability to purchase and prepare
- Assess patient's activity level.
- Assess cultural, socioeconomic, and religious factors that
may influence patient's diet.
Objective: Educate Patient about Healthful Eating to
Prevent Alteration in Nutritional Status
- Encourage patient to maintain a healthful diet, and discuss
nutritional claims of "curing lupus," which are often
- Provide patient with information on the basics of a
well-balanced diet and its importance in a chronic disease such as
- Instruct patient to take iron supplements only if iron
stores are depleted.
- Suggest vitamin and mineral supplementation, if
- Refer patient to dietitian for assistance in dietary
planning for serious conditions associated with SLE.