{
  "name": "Systemic Lupus Erythematosus",
  "slug": "systemic-lupus-erythematosus",
  "url": "https://nursingplex.com/care-plans/systemic-lupus-erythematosus",
  "category": "Basic Nursing & General Care Plans",
  "summary": "Autoimmune multi-system inflammation with flares; focus on fatigue, skin, renal function and infection risk from immunosuppression.",
  "nursing_diagnoses": [
    "Fatigue",
    "Acute pain",
    "Impaired skin integrity",
    "Risk for infection"
  ],
  "overview": [
    "Systemic lupus erythematosus is a chronic autoimmune disease in which immune complexes deposit in connective tissue throughout the body, producing inflammation of skin, joints, kidneys, serous membranes, blood cells and the nervous system. It follows a relapsing–remitting course of flares and quiet periods.",
    "It affects women of childbearing age far more often than men, and sunlight, infection, stress, pregnancy and certain drugs commonly trigger flares. Lupus nephritis is the leading cause of serious morbidity, so renal monitoring is central to long-term care.",
    "Nursing care focuses on flare prevention, protecting the kidneys, managing fatigue and pain, monitoring immunosuppressive therapy, and helping the patient adapt to an unpredictable illness with visible skin changes."
  ],
  "key_facts": [
    {
      "label": "Hallmark rash",
      "text": "The malar 'butterfly' rash spares the nasolabial folds and worsens with sun exposure."
    },
    {
      "label": "Key labs",
      "text": "ANA is sensitive but not specific; anti-dsDNA and anti-Smith are more specific, and low complement (C3/C4) suggests active disease."
    },
    {
      "label": "Renal warning",
      "text": "Proteinuria, hematuria, rising creatinine or new hypertension may signal lupus nephritis."
    },
    {
      "label": "Sun protection",
      "text": "Broad-spectrum SPF 30+ daily and protective clothing reduce both rash and systemic flares."
    }
  ],
  "nursing_priorities": [
    "Identify and reduce flare triggers, especially UV exposure and infection.",
    "Monitor renal, hematologic and cardiopulmonary involvement.",
    "Manage pain, joint stiffness and fatigue.",
    "Support safe use of steroids, hydroxychloroquine and immunosuppressants.",
    "Address body image, fertility and psychosocial impact."
  ],
  "assessment": {
    "subjective": [
      "Reports of joint pain and morning stiffness",
      "Complaints of profound fatigue not relieved by rest",
      "Reports of photosensitivity and rash after sun exposure",
      "Chest pain worse with breathing (pleuritis/pericarditis)",
      "Concerns about appearance, hair loss or fertility"
    ],
    "objective": [
      "Malar or discoid rash, oral ulcers, alopecia",
      "Symmetric joint swelling and tenderness without erosion",
      "Fever, lymphadenopathy or pericardial friction rub",
      "Proteinuria, hematuria, elevated creatinine or edema",
      "Anemia, leukopenia, thrombocytopenia; positive ANA, anti-dsDNA; low complement"
    ],
    "related_factors": [
      "Autoimmune immune-complex deposition",
      "Ultraviolet light exposure",
      "Infection, physical or emotional stress",
      "Hormonal changes and pregnancy",
      "Drug-induced lupus from hydralazine, procainamide, isoniazid"
    ]
  },
  "goals": [
    "The client will report reduced pain and improved joint mobility.",
    "The client will remain free of infection during immunosuppressive therapy.",
    "The client will maintain stable renal function and blood pressure.",
    "The client will describe flare triggers and daily sun-protection measures."
  ],
  "interventions": [
    {
      "title": "Monitor disease activity",
      "points": [
        "Assess joints, skin, temperature and weight at each contact.",
        "Review urinalysis, creatinine, CBC, complement and anti-dsDNA trends.",
        "Monitor blood pressure and edema for renal involvement.",
        "Auscultate for rubs and assess for pleuritic chest pain."
      ]
    },
    {
      "title": "Manage symptoms",
      "points": [
        "Give NSAIDs, hydroxychloroquine, corticosteroids or immunosuppressants as ordered.",
        "Apply warm compresses for stiffness and encourage low-impact exercise and rest cycles.",
        "Use mild cleansers and moisturizers for skin; avoid harsh products.",
        "Teach energy conservation and structured pacing for fatigue."
      ]
    },
    {
      "title": "Prevent complications",
      "points": [
        "Emphasize infection precautions, hand hygiene and up-to-date vaccinations before immunosuppression.",
        "Arrange annual eye exams for hydroxychloroquine retinopathy screening.",
        "Monitor for steroid effects: hyperglycemia, hypertension, osteoporosis, mood changes.",
        "Counsel on planned pregnancy during remission and cardiovascular risk reduction."
      ]
    }
  ],
  "patient_teaching": [
    "Wear sunscreen and protective clothing daily, even on cloudy days.",
    "Report fever, new rash, foamy urine, swelling or chest pain promptly.",
    "Never stop corticosteroids abruptly.",
    "Balance activity and rest, and keep all rheumatology follow-up appointments."
  ]
}