IndexNursing ProcessNursing DiagnosesInterventionsConclusionReferencesLupus, Latin for wolf, was the term chosen by physicians in the early 19th century to describe a relatively rare condition characterized by a distinct rash on the face. The erythema, or redness, was combined with the wolf's description to coin the current term for the disease known as systemic lupus erythematosus. This disease has since been characterized by diagnostic difficulties, unpredictable progression, and periods of remission and exacerbation. For all its mysteries, there remain interventions that can help patients lead high-quality lives while living with lupus. Understanding the disease process is critical to providing high-quality nursing care to patients with systemic lupus erythematosus. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay Systemic lupus erythematosus (SLE) is one of three types of lupus that is distinguished from both discoid lupus (which affects only the skin) and drug-induced lupus, which is often reversed after stopping the drug agent in question (Bauer, 2013). Brown (2006) describes the disease as “…a chronic autoimmune disease of unknown etiology characterized by inflammation that can lead to multisystem damage.” This unknown cause makes SLE particularly frustrating, as risk factors remain ambiguous in relation to known pathophysiology. Genetic, environmental, and hormonal influences could attribute to an individual's likelihood of developing SLE. For example, Bauer (2013) found that “estrogen metabolism is an indicator of susceptibility to Lupus because pregnancy increases the frequency of flares and flare episodes may be synchronized with the menstrual cycles of many patients.” Currently recognized risk factors include female sex, childbearing age, and a family history of SLE. Other factors are possible, but appear to offer a weaker correlation than cause and effect. Because SLE is classified as an autoimmune disease, it follows similar patterns to diseases with widespread inflammation, many of which are rheumatic in nature. In Lupus, normal tissues are mistaken for foreign bodies. In other words, the typical reaction of antibody formation as a response to a virus or a bacterium instead occurs starting from healthy tissue. The resulting formation is an autoantibody, which in turn accumulates in tissues (Bauer, 2013). These autoantibodies subsequently become significant for diagnostic purposes. However, in terms of physiology, the exact reasons for the widespread connective tissue inflammation (or rheumatic nature) of SLE remain a mystery. As stated previously, diagnosing lupus is a unique challenge for healthcare providers. There are many reasons: SLE can go into remission for long periods, prompting patients to avoid medical intervention. Additionally, tests for lupus can be ambiguous at best, high in cost, and the disease's symptoms tend to mock other autoimmune conditions. For example, recognizable symptoms include malaise, prolonged fever without infection, anemia, rash on the cheeks and nose, and arthritis. Many confuse the rash with rosacea and may not seek medical help for other symptoms until more serious complications occur. When lupus is left untreated or poorly managed, complications can quickly arise. These include psychiatric abnormalities such as psychotic episodes or personality changes,inflammation of the heart (pericarditis, endocarditis or myocarditis), inflammation of the blood vessels (vasculitis), often nephritis and possible kidney failure (Bauer, 2013). It is therefore important that people not only seek medical help when the first signs of lupus appear, but also that a diagnosis is made using advanced testing if necessary. Tests for lupus include a complete blood count, urinalysis, ESR, C-reactive protein test, and ANA titer (Bauer, 2013). These findings look for anemia, urine casts indicating renal dysfunction, general inflammation, and autoimmune etiology. It should be noted that many tests will be positive for most lupus patients, but will also test positive for other diseases, making the process involved for both the doctor and the patients. Tests that most accurately isolate a diagnosis of lupus may be positive for only a small percentage of SLE patients. It is important for patients to understand that lupus is a chronic condition and that treatments will vary and may require frequent changes. Bauer (2003) explains treatment goals as symptom-centered, often geared towards reducing exacerbations. The first-line treatment for mild to moderate lupus is the use of NSAIDs (Brown, 2006). These drugs are generally well tolerated, but patients should still be advised that they are at increased risk of bleeding and that they should take them with food. Another course of treatment, generally for moderate to severe lupus with multisystem involvement, is the use of corticosteroids. These drugs completely reduce/eliminate the inflammatory immune response in the body and come with a number of side effects. Monitoring blood pressure, weight, or changes in skin integrity is vital. Teach patients to never stop using these medications without tapering them with the doctor's order. Because of their steroid-sparing effects, Ferenkeh-Koroma (2012) mentions antimalarial drugs or a chemotherapeutic agent such as methotrexate as an alternative option during a lupus flare. These treatments may be helpful in reducing steroid use and are still able to reduce widespread inflammation caused by lupus. Nursing Process Nursing care for lupus is significant as it helps patients maintain quality of life and keep symptoms to a minimum. The initial nursing assessment for an individual with lupus or suspected of having lupus should include questions regarding activity level to assess fatigue and the impact it may have on the individual; including their mood and quality of life. Other questions should address diet and exercise routines, the patient's understanding of tests and prescribed medications, and then a physical evaluation. In a patient with SLE you should notice physical changes such as mucosal abnormalities, paleness, skin lesions or rashes, or joint discomfort or malaise. Changes in vital signs may only occur in connection with individualized flare-ups of the disease. Low-grade, long-lasting fever is common in lupus patients and should be evaluated frequently. Other specific assessments will vary depending on your individual lupus case. For example, someone who suspects valvultis should be asked about abdominal pain. Nursing Diagnoses A nursing care plan for a patient with SLE might include diagnoses such as activity intolerance or fatigue related to the common lack of energy, risk of infection with many therapies, or impotence related to the incurable and unpredictable nature of chronic lupus, 35(11), 54-60.