Lupus: Hallmark sign - butterfly rash on face
Lupus: Indication of flare - Fever and fatigue
*also assess BUN function
*c reactive protein remains
... [Show More] normal
Lupus: Interventions - -Falls precautions
-treat pain with tylenol and NSAIDS (monitor kidney function)
-AVOID SUNLIGHT
-REPORT FLARE IMMEDIATELY
-clean skin with mild soap and pat dry and apply lotion
Lupus: medical management - -hydroxychloroquine(anti-malarial) decreases
absorption of UV light
Scleroderma - inflammatory, autoimmune connective tissue disease
Scleroderma: Hallmark Sign - Hard, leather-like edematous skin
Late: esophageal dismotility
Scleroderma: Assess - Swallow safety--esophageal dysmotility (ASPIRATION)
O2
circulation
skin
Scleroderma: Interventions - aspiration precautions (keep HOB at 60 degrees
during meals and after)
skin protection measures
small frequent meals--avoid caffeine and alcohol
-avoid spices, caffeine and pepper
fibromyalgia: S/sx - extreme fatigure
GI symptoms
dysuria
blurred vision
forgetfulnessfibromyalgia: Assess - pain level
extreme fatigue
GI symptoms
Fibromyalgia: Interventions - NSAIDS
Nuerontin (gabapentin)
Lyrica (pregabalin)
SNRI and tricyclic antidepressants (amitriptyline)
promote sleep and low impact exercise (stretching, walking, swimming, rowing,
water exercise)
Lyme Disease: Hallmark sign - stage 1: "bulls eye rash" and flu-like symptoms
Stage 2: facial paralysis, carditis, meningitis
Lyme Disease: Assess - Skin
history of tick bites
Lyme Disease: Interventions - prevention!
Insect repellant with DEET
early stage--doxycycline antibiotics ORAL
late stage--Iv antibiotics (ceftriaxone)
avoid tall grass
wear light colored clothing
have pets wear tick collars
Allergic Reaction Priority - STOP THE INFUSION/ELIMINATE the trigger, then
STOP the immune response
Give Epi
maintain airway
Latex allergy: risks - -frequent use of latex condoms
-healthcare workers
-allergy to avocados, bananas, and some nuts
Anaphylactic shock - AIRWAY--give epi IV or IM STAT and intubate if needed
BREATHING--apply O2; mechanically ventilate
CIRCULATION--monitor for distributive shock; give fluidsEpinephrine Auto-injector teaching - always carry 2 devices
inject by "stabbing" into top of thigh with pants on (AVOID pockets)
call 911 immediately--patient still needs to be monitored
keep epi in cool dark place.
Immunocompromised Patient - -Do not drink anything that has been sitting out
-take temp at least once per day
-clean toothbrush once weekly in diswasher or bleach solution
-do not eat raw foods; salad, cottage cheese
-do not scoop litter boxes
-no plants or soil exposure
-antibacterial soap
-AVOID reptiles
HIV: Assess - CD4 count
ELISA test once per year for at risk patients
HIV: Interventions - PREVENTION:
-condoms
-PreP (truvada) must take 4 consecutive days in a row before protected; cant miss
more than one dose in a row
-needle safety
-post exposure prophylaxis-start cART within 24-36 hours of exposure
HIV: Nutrition - high calorie
high protein
low fat
small frequent meals
thrush--treat with anitfungal
HIV tx: HAART/cART - DOES NOT CURE
Does not prevent secondary/opportunistic infections
MUST TAKE 90% of the time --otherwise resistance will occur [Show Less]