Nursing role in educating patients with systemic lupus erythematosus (2nd part ) بالانجليزية
Providing a thorough education to patients about SLE is crucial. This includes explaining the disease's nature, treatment options, drug adherence, and the significance of routine follow-up visits with medical professionals. The patient needs assistance in better understanding his condition and how it affects his physical and psychological state to accept oneself. Accepting the patient for who he is, how he looks, and the changes brought on by the illness are crucial components of psychological health.
In the course of treating systemic lupus erythematosus, nursing can be helpful, particularly when the condition is at its worst. As a result of the nurse's ability to prevent SLE exacerbations, educate patients coping mechanisms for managing their symptoms in daily life, and offer comprehensive health education about lifestyle modifications that promote self-management. Lifestyle changes including stress management, quitting smoking, eating healthy nutrition, maintaining an appropriate body weight, avoiding excessive sun exposure, exercising and resting enough, and getting enough sleeping patterns are also crucial.
For nutrition: Anti-inflammatory foods such as fish, veggies, fruit, whole grain bread, oats, beans, legumes, seeds, and tofu should be promoted. Proinflammatory cytokines produced by fat and overweight people can exacerbate SLE. So, they should consult a nutritionist to assist patients in making healthy eating choices. However, the patient's diet may need to change depending on how the lupus has affected their body. For example, patients with fever and active lupus may need to consume more calories; patients with elevated cholesterol or triglyceride levels may need to follow a special diet; and patients experiencing swelling (oedema) in their lower legs or feet may need to reduce their intake of salt and sodium. Extra vitamins, such as calcium and vitamin D, are required also due to the lack of sun exposure and may help improve the disease outcomes.. Other recommendations include, avoiding foods lucerne and garlic because they contain an amino acid that might trigger the immune system to go into overdrive and exacerbate lupus symptoms. For patients with mouth ulcers, practise proper oral hygiene and use lip balms and mouthwash on a regular basis. Painful chewing can be lessened with dietary management, such as eating softer food during oral flare-ups and snacking frequently.
Regarding exercise: Exercise interventions can reduce some SLE symptoms and enhance aerobic fitness. SLE patients can safely participate in exercise training with physician approval, but patients who are (a) exposed to UV light, (b) taking analgesics or corticosteroids, or (c) having cardiopulmonary involvement should take cautions. These patients should also take frequent rest due to the side effects of fatigue associated with lupus.
In terms of stress management, the most significant variables that have been linked to improving the psychological and physical conditions of SLE patients are stress and anxiety when coping strategies are adopted. Therefore, behavioural and psychological coping strategies, as well as coping mechanisms that people employ to manage, tolerate, or lessen stressful situations, can be beneficial to patients with SLE. This could be achieved by altering certain behaviours and increasing awareness of his illness. Alternatively, nurses can improve patients' quality of life by simply listening to their concerns and anxieties, trying to understand the psychological and psychosocial implications of SLE, and helping patients find coping mechanisms by referring them to self-help groups or counsellors. So, it is necessary to offer the required assistance, emotional support, and rehabilitation that improve the quality of life.
When it comes to joint care, the primary objective is to reduce pain to a manageable level. This can be achieved in a number of ways, such as by applying heat or cold to the affected joints, supporting the affected joints with pillows, blankets, or splints (if prescribed by a physician), getting as much rest as possible for the affected joints, and keeping them elevated to minimise swelling. The second objective is to preserve joint function and build muscle strength by using the following methods: avoid exerting any weight on a severely inflamed joint; take warm baths or showers to reduce stiffness; avoid strenuous activity; and avoid any activity that increases the affected joint's pain, swelling, tenderness, or heat.
Identification of Raynaud's phenomenon triggers and recommendations for symptom relief, such as the use of heat packs and gloves, should be made. For the person, alopecia or receding hairlines can be traumatising. For these patients, psychological support could be required, and the nurse should look into the possibilities of wigs, hats, and scarves to make patients feel less self-conscious. Since their immune system is weaker and more vulnerable to foreign invaders when using immunosuppressants, it is crucial for this patient to avoid infection. They ought to stay away from ill persons, take precautions against contracting illnesses, get vaccinations as recommended, wearing a N95 mask if taking immunosuppressive medications.
Concerning the section about sun exposure, patient should protect himself from the sun by donning sunglasses, wide-brimmed hats, and applying sun protection factor greater than or equal to 30, as their skin is more vulnerable to burns. For minimising skin rash, it is recommended to stay out of the sun, covering arms and legs, wearing a hat, steer clear of the sun at its strongest hours. This is typically between the hours of 10 a.m. and 4 p.m., particularly in the summer.
Ultimately, individuals who have received glucocorticoid therapy ought to receive instruction on bone health and fracture avoidance techniques. In order to determine the risk of stroke, coronary disease, and heart failure, it is imperative that hypertension be identified in SLE patients. As such, routine blood pressure checks, as well as weight and cholesterol monitoring, should be carried out. Monitoring for complications, such as renal failure, as well is a crucial part of nursing care for patients with lupus.
References
Justiz Vaillant, A.A., Goyal, A., & Varacallo, M. (2024). Systemic lupus erythematosus. In: StatPearls
[Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK535405/
Sedrak, M.W., Mohamad, Z.A., Abo-ElNoor, E.I.,& Abd-Elall., H.A. (2020). Effect of nursing
education on knowledge and self care for patient's with systemic lupus erythematosus. Assiut
Scientific Nursing Journal, 8 (23).
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