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lOMoARcPSD|11969435Medsurg - Cardiac, Musculoskeletal, Cancer
Nursing Praxis and Professional Caring IV (Laurentian University)
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Downloaded by Henry Lionel (henry.lionel12@gmail.com)
, lOMoARcPSD|11969435
Theory (56)
Musculoskeletal Health Changes (13)
Systemic Lupus Erythematosus (SLE)
chronic multisystem inflammatory disease, associated with abnormalities of the immune
system
results from interactios among genetic, hormonal, environmental, and immunologic factors
progressive and can cause major organs and systems to fail (skin, joints, serous membranes,
renal system, hematological, neurological)
connective tissue and fibrin deposits collect in blood vessels on collagen fibers and on otgans,
leading to necrosis and inflammation in blood vessels, lymph nodes, GI tract, and pleura
etiology is unknown, but thought to be autoimmune reactions directed against DNA and
antivody response related to B and T cell hyperactivity
manifestations: range from mild to rapidly progressing which affect many systems
-most commonly affects skin, muscles, lining of lungs, heart, nervous tissue and kidneys
-butterfly rash*
-erythema*
-mucosal ulcers
-dry, scaly rash*
-inflammation of heart
-hematuria, glomulenephritis
-arthritis*
-joint swelling*
-anemia
-leukopenia
-splenomegaly
-thrombocytopenia
-stroke, seizures, peripheral neuropathy, psychosis
drug therapy
-NSAIDS (for arthritis and pain)
-antimalarial drugs (fatigue and skin/joint problems)
-steroid-sparing drugs (severe polyarthritis)
-corticosteroids
-immunosuppressive drugs (severe organ system disease)
nursing assessment
-physical, psychological, sociocultural problems with long-term management of SLE
-assess pain and fatigue daily
-monitor skin integrity and provide frequent oral care
-in and out
-signs of bleeding (bruising, petechiae, tarry stools)
-high vitamin and high iron diet
-avoid exposure to sunlight
evaluation
-verablization of having more energy
-expression of satisfaction with pain relief
-ADLs without pain
Downloaded by Henry Lionel (henry.lionel12@gmail.com)
, lOMoARcPSD|11969435
-limitation of direct exposure to sunlight, use of sunscreen
-no skin lesions
-expression of confidence in ability to manage SLE overtime in home environment
Myofascial Pain Syndrome
musculoskeletal pain and tenderness in one anatomic body region
pain is deep, aching, burning, stinging and stiff
referred to buttock, hand and head
diagnosis is made by palpation of trigger points
treatment- physio, massage, acupuncture, biofeedback, ultrasound therapy
teaching – good posture to prevent muscle tension
Fibromyalgia Syndrome
widespread, non-articular musculoskeletal pain and fatigue with multiple tender points
non-restorative sleep, morning stiffness, IBS, anxiety (may be genetic)
a disorder of central processing with neuroendocrine/neurotransmitter dysregulation
infectious triggers in ppl with Lyme disease and recent viral illness
physiological abnormalities
-increased levels of blood flow to thalamus
-dysfunction of HPA axis
-low levels of serotonin and tryptophan
-abnormalities in cytokine function
manifestations
-widespread burning pain, worsens and improves throughout day, difficult to relieve
-head or facial pain originated from stiff neck and shoulders
-fatigue
-temporomandibular joint dysfunction
-point tenderness varies, mainly: back of head, traps, shoulder blade, gluteal, greater
trochanter, knee, inner elbow, neck, second rib
-numbness and tingling in hands or feet
-restless leg syndrome
-IBS
-difficulty swallowing
-increased urinary frequency and urgency
-difficult mentstruation
cognitive effects
-difficulty concentrating
-memory lapses
-overwhelmed when dealing with multiple tasks
-migraines
-depression and anxiety
labs rule out other suspected disorders
muscle biopsy may reveal non-specific moth-eaten look or fibre atrophy
diagnosis is made if:
-pain is experienced in 11 of 18 tender points on palpation
-history of widespread pain for at least 3 months
Downloaded by Henry Lionel (henry.lionel12@gmail.com)
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