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to fail. NONCURABLE - Characterized by a flaring up and remission (so on and so on; stress may trigger) ▪ Many clients with SLE have some degree of kidney involvement. ← Systemic ← In the heart, more likely to have CHF; Lungs have scar tissue (COPD w/ no cig) Plural effusion, pneumonia; Renal and joint involvement (RA) ▪ Collaborative Management ▪ Physical assessment and clinical manifestations 1. Skin involvement ← Butterfly rash 1. Musculoskeletal changes 2. Systemic manifestations including pleural effusions or pneumonia and Raynaud’s phenomenon (peripheral vascular disease; when cold we all vasoconstrict, in cold room severe vasoconstriction –inadequate oxygen, anaerobic metabolism.. produce lactic acid; Assessments for Lupus ▪ Psychosocial results can be devastating. ▪ Laboratory ← Drugs- immunosuppresents (Prednisone); ← Cushing (moon face, buffalo hump); risk for infection; osteoporosis; methotrexate, cyclosporine; ▪ Skin biopsy (only significant test to confirm diagnosis) ▪ Anti-Ro (SSA) test (look for lupus antibodies) ▪ Complete blood count ▪ Body system functions (autoimmune… body destroying body) Progressive Systemic Sclerosis ▪ Referred to as systemic scleroderma, meaning hardening of the skin ▪ Diffuse cutaneous scleroderma ← Mobility problems; skin lesions ← Limited cutaneous scleroderma ← Clients have CREST syndrome: ▪ Calcinosis ▪ Raynaud’s phenomenon ▪ Esophageal dysmotility (lose of peristaslisis) ▪ Sclerodactyly (Thick webbing forming in between fingers) ▪ Telangiectasia (Spider looking blue veins along skin) ▪ Heart, lungs, etc – SYSTEMIC
Drug therapy with NSAIDs 5. and water exercise ← Heat. low dose ASA ▪ · More often seen in men ▪ Big toe hurts the worst. biking. rough feeling). etc 2. memory and thinking problems present in later stages ← Can be a cause of dementia Fibromyalgia Syndrome 1. Pain typically located at trigger points 3. chronic complications such as arthralgias. If not treated in early stages. rowing. resulting from the bite of an infected deer tick ← Wear repellent. CRI (Chronic Renal Insuff). Home exercises. Muscle relaxants 6. fatigue. ← Lyrica ← Gouty Arthritis ▪ · Disorder of Purine Metabolism with an excess of serum uric acid ▪ · Destructive inflammatory process ▪ · Risk factors: hypertension. thiazide diuretics. including walking. Physical therapy treatment 4. Reportable systemic infectious disease caused by the spirochete Borrelia burgdorferi. ETOH (esp beer). Massage. Tophi (gritty. Stages I and II 3.6 mg daily or bid ▪ · Probencid (excrete acid) 500 mg to 1000 mg daily and increased to 1500 mg to 2000 mg as needed &/or Allopurinol 100mg qd up to 800 mg daily (lower if CRI) ▪ · Low purine diet ▪ · Weight loss .▪ Hard and thick like leather. obesity. but we want to keep the pts in activity. Lyme Disease 1. long sleeves. swimming. Chronic pain syndrome. NOT an inflammatory disease 2. postmenopausal. even the bed sheet hurting. low in dairy. diet high in red meat & seafood. ▪ Drug therapy slows disease progression but is often unsuccessful. etc. may help. Indicates increase uric acid ▪ · In cancer patients when Rx initiated and large ‘cell’ kill (tumor lysis) anticipated Treatment for Gout ▪ · Prophylactic Colchicine 0.
· Life style modifications .