Alright, in this video, I'm going to talk about systemic lupus erythematosus, or SLE.
So if you're following along with cards, I'm on card number 12.
SLE is a chronic inflammatory disorder of the connective tissue and it causes widespread
inflammation as well as tissue damage.
Now, keep in mind as I go through this information, I'm talking about systemic lupus and not discoid
lupus, which primarily just affects the skin.
So in terms of the pathophysiology behind this disorder, systemic lupus is an autoimmune
disorder which results in the production of antinuclear antibodies, or ANA.
And this results in inflammation and damage to many organs in the body, including the
skin, the lungs, the kidneys, and the heart.
And just like other autoimmune disorders, lupus is characterized by periods of exacerbations
as well as periods of remission.
In terms of the risk factors, women are much more likely to get lupus.
Onset of the disease usually occurs between the ages of 20 and 40.
And race also plays a role, so African Americans, Asians, and Native Americans are at higher
risk for getting lupus.
Signs and symptoms of systemic lupus include fatigue, joint pain, fever, a butterfly rash
across the face.
So that's one of the hallmark symptoms of this disorder, as well as Raynaud's phenomenon.
So with Raynaud's, you have vasospasming, so decreased blood flow to the extremities,
to the fingers.
So those fingers become pale, numb, and cold.
So if you Google Raynaud's, you'll see lots of pictures of pale fingers and you can imagine
that they're probably numb and cold, too.
Other symptoms include anemia, pericarditis, which is inflammation of the membrane that
surrounds the heart, as well as lymphadenopathy, so enlarged lymph nodes.
In terms of the labs and how we would diagnose this condition, patients who have lupus will
usually have a positive ANA titer and they will also have decreased serum complement,
so decreased C3 and C4.
In addition, they'll have decreased red blood cells, white blood cells, and platelet counts.
And then, if their kidneys become involved at some point, then we would see an increase
in BUN and creatinine as well.
In terms of treatment, NSAIDs can be used but we also usually provide immunosuppressants
to patients with lupus because it is an autoimmune disorder and we're trying to suppress that
immune system.
So medications that fall within this class include prednisone as well as methotrexate.
Hydroxychloroquine is also an effective medication for lupus.
So hydroxychloroquine is actually a medication used for malaria but it is also used for autoimmune
disorders such as lupus.
And then, the provider may also prescribe a topical steroid cream for the rash on the
face, for that butterfly rash.
In terms of nursing care, in addition to providing these medications, you're going to really
monitor for complications, including renal failure.
And then you're going to provide some important teaching to your patient.
So some of those key teaching points include avoiding UV and sun exposure to prevent skin
damage.
Also, the patient needs to really prevent infection, so they should avoid sick people
and really protect themselves from getting infection.
And then they need to take frequent rest periods as well because of that side effect of fatigue
associated with systemic lupus.
Okay, so that's it for lupus.
When I come back on my next video, we will talk about scleroderma.
Thank you so much for watching!