Care of the Lupus Patient
Central Nervous System Manifestations continued...
Objective: Develop Plan for Patient to
Perform ADL Appropriately and Independently
Assess and document
patient's mental status to determine her or his capabilities:
- general appearance
- unusual body movements
- speech patterns and word use
- alertness and orientation to time, place,
- memory of remote and recent
- perception of self and
- affect and emotional stability
- ability to solve problems
- presence of depression
Support patient's need to
maintain some control over daily activities and decisions:
- encourage patient to plan and participate
in daily routines
- set aside time to develop trust and
rapport with patient, and be consistently truthful (patients are keenly aware
of inconsistencies in information provided)
General CNS Lupus
- Visual defects
- Nystagmus (involuntary movement of the
- Ptosis (paralytic drooping of the
- Papilledema (edema in the optic
- Facial palsy
- Impaired long- and short-term
- Difficulty in conceptualizing,
abstracting, generalizing, organizing, and planning information for problem
- Difficulties in personal and extrapersonal
- Altered visual-spatial
- Selective attention
- Difficulties in pattern recognition, sound
discrimination and analysis, and visual-motor integration
- Affective disorder
- Mood swings
- Hypomania or mania (especially with
Rare CNS Manifestations
- Movement disorder
Encourage patient to discuss
effects of SLE on her or his personal life and coping methods. Allow
expressions of fear and anger.
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.