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Sle ppt
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2.
3. PRESENTED TO: PRESENTED BY:
Ms. SIMRANJIT KAUR AMANDEEP KAUR
ASSIT. PROFESSOR Msc. Nsg. 1st Year
(MED.-SURG. NURSING Roll No. 1915703
4.
5. The immune system is a complex system that
is responsible for protecting us against
infections and foreign substances.
6. The immune system is closely tied to
The lymphatic system,
With B and T lymphocytes within lymph
nodes.
Tonsils and
The thymus gland
7.
8. THYMUS GLAND
containing glandular tissue and producing several
hormones, is much more closely associated with
the immune system than with the endocrine
system.
The thymus serves a vital role in the training and
development of T-lymphocytes, an extremely
important type of white blood cell.
9. T-CELLS
(also known as Thymocytes cells) or T
lymphocytes are a type of lymphocyte (in turn, a
type of white blood cell) that play a central role in
cell-mediated immunity.
They are called T cells because they mature in the
thymus.
11. BONE MARROW
In addition, the bone marrow contains
hematopoietic stem cells, which give rise to the
three classes of blood cells that are found in the
circulation:
white blood cells (leukocytes),
red blood cells (erythrocytes), and
platelets (thrombocytes).
12. SPLEEN
It acts as a filter for blood as part of the
immune system.
Old red blood cells are recycled in the spleen,
and
platelets and white blood cells are stored there.
The spleen also helps fight certain kinds of
bacteria that cause pneumonia and meningitis.
13.
14. INTRODUCTION:
The word “lupus” comes from the latin word “for
wolf” –means- “ to reflect the mask like
appearance”, that client have when they have a
lupus facial rash.
The rash is red and thus the word erythematosus,
meaning reddened, was added to describe the
disease.
15. “Chronic multisystem inflammatory disease.
Associated with abnormalities of immune system.
Results from interactions among genetic,
hormonal, environmental, and immunologic
factors”.
16. Affects the
Skin
Joints
Serous membranes
Renal system
Hematologic system
Neurologic system
17.
18. SLE affects 2 to 8 persons per 100,000 in United
States
Most cases occur in women of childbearing years
Women are 10 times more likely to develop SLE
than man.
Most clients with lupus have the systemic type,
but a small percentage have the type that affect
only the skin , a condition called “DISCOID
LUPUS ERYTHEMATOSUS”.
19. Discoid lupus is not life threatening.
SLE can be life threatening -progressive
systemic inflammatory disease that can cause
major body organ and system failure.
Although this definition seems similar to the
definition of rheumatoid arthritis; one
distinct difference exists, client with SLE
typically have more body organ development
earlier in their disease than the clients with
R.A.
20.
21. Etiology is unknown
Most probable causes
Genetic influence
Hormones
Environmental factors
Certain medications
22. Immune system alteration
Antinuclear antibodies ,antibodies to
ribonucleoprotein (smith antigen)
Abnormalities in both B- cells and T-
cells(overactive).
Production of antibodies to self and non-self
antigen.
26. Ranges from a relatively mild disorder to
rapidly progressing, affecting many body
systems
Most commonly affects the skin/muscles,
lining of lungs, heart, nervous tissue, and
kidneys
55. INFECTION
Increased susceptibility to infections
Fever should be considered serious
Infections such as pneumonia are a common
cause of death
56.
57. No specific test
SLE is diagnosed primarily on criteria relating
to patient
history,
physical examination,
laboratory findings
58. Tissue biopsy:- skin lesions can be biopsied
and examined microscopically for signs of
inflammation.
ESR- to detect systemic inflammation.
Antinuclear antibody titers- to detect the
presence of abnormal antibodies, sometimes
called LE cells.
59. CBC :-(Hb., TLC, DLC,RFT,LFT, Platelets
count): to get valuable information of the
general state of health.
Anti-DNA & Anti-smith antibodies: to detect
the titres of anti-(double standard) dsDNA
Antibodies. Increased level sugest SLE.
(ELISA- enzyme-linked immunosorbent
assay).
60. Urinalysis: to check for protein & cells, signs of
possible kidney damage.
X-Ray of affected joints: to see the condition.
Chest X-Ray: to find the systemic involvement.
ECG- to determine extra- articular involvement /
cardiac problems.
61. Prognosis is improved with
Earlier diagnosis
Earlier and better treatment regimens
Careful monitoring for organ involvement
62. DRUG THERAPY
NSAIDs-
(diclofenac sodium, Naproxen and oxaprozin )
Anti-malarial drugs-
(Chloroquine phosphate)
Steroid-sparing drugs
(Cyclosporine,methotrexate).
64. No way to prevent lupus.
But people who smoke may be more likely to
get lupus.
Avoiding smoking and perhaps other tobacco
products may decrease the risk.
65. Assess patient’s physical, psychologic, and
sociocultural problems with long-term
management of SLE.
Assess pain and fatigue daily.
Obtain subjective and objective data.
66. Acute pain related to inflammatory process
and inadequate comfort measures as evidenced
by complaints of joint pain.
Fatigue related to chronic inflammation and
altered immunity as evidenced by lack of
energy, inability to maintain usual routine.
67. Impaired skin integrity related to
photosensitivity, skin rash and alopecia as
evidenced by rash anywhere on body, butterfly
rash on face, hair loss, areas of ulceration on
fingertips complaints of urticaria.
Deficient knowledge related to lack of
exposure to an unfamiliarity with information
resources as evidenced by questions about
SLE.
Body image disturbance related to disease
condition.
68. 1) Uses energy conservation techniques.
2) Sets and complete priority activities.
3) Adapt lifestyle to energy level.
4) Avoid activities that cause disease
exacerbation (triggers).
5) Uses analgesics and non-pharmacologic
measures appropriately to control pain at an
acceptable level
69. Health promotion
Prevention of SLE is not possible
Promote early diagnosis and treatment
Acute intervention
During exacerbation, patient will become
abruptly, dramatically ill
Record severity of symptoms and response to
therapy
70. Observe for
Fever pattern
Joint inflammation
Limitation of motion
Location and degree of discomfort
Fatigability
71. Monitor weight and I&O
Collect 24-hour urine sample
Assess neurological status
Explain nature of disease
Provide support
72. Ambulatory and home care
Reiterate that adherence to treatment does not
necessarily halt progression
Minimize exposure to precipitating factors –
fatigue, sun, stress, infection, drug.
Teach energy conservation and relaxation
exercises
For joint problems, all the teaching for RA
related to joint protection, ROM, and
positioning to prevent contractures
73. Infertility can result from SLE treatment
regimen
SLE is associated with complications of
pregnancy
Pregnancy & post partum can cause
exacerbations of SLE
Women with serious SLE should be
counseled against pregnancy.
74. Counsel patient and family that SLE has
good prognosis
Physical effects can lead to isolation, self-
esteem, and body image disturbances
Assist patient in developing goals
75. Expected outcomes
Completion of priority activities
Verbalization of having more energy
Expression of satisfaction with pain relief
measures
Performance of activities of daily living
without pain
Limitation of direct exposure to sun and use
of sunscreen
76. No open skin lesions
Expression of satisfaction with activity level
Pacing of activities to match level of
tolerance
Expression of confidence in ability to manage
SLE over time and in home environment
77. Follow-up
Use of special cosmetics
Complementary or alternative therapies
should be discussed
Reproduction-avoid pregnancy
78.
79. Systemic Lupus Erythematosus (SLE) is a
chronic autoimmune disorder. It predominantly
affects younger women, but can occur in up to
20% of pts. 50 years of age or older. SLE
affects almost almost every system in the
body,with varying degrees of severity. The
mgt. is individualized and depends on
presenting symptoms.
80. BIBLIOGRAPHY
•Lippincott Manual of Nursing Practice. Of
Lippincott Williams & wilkins. Jaypee brothers
medical publishers (p) ltd. Edition-8th. P.1019-22.
•Brunner & suddarth’s text book of Medical-
Surgical Nursing.volume-3. By Janice L. Hinkle
& Kerry H. Cheever. Edition-13th. P.1070-1.
•INTERNET:-
www.ncbi.nlm.nih.gov>pubmedsystemiclupuseryt
hmatousus
81. Make a nsg. Care plan on patient with systemic
lupus erythematousus with nsg. Diagnosis
prioritiwise.