A nurse is caring for a client with systemic lupus erythemat… | 마이메르시 MyMerci
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문제

A nurse is caring for a client with systemic lupus erythematosus (SLE) who is experiencing a flare-up. Which nursing intervention should be the priority?

해설
Energy conservation and activity pacing are priority interventions during SLE flare-ups to manage fatigue and prevent joint stress. Other options like vigorous exercise, heat therapy, or high-dose vitamin D are not appropriate as they may exacerbate symptoms or lack evidence.
같은 주제 다음 문제A 52-year-old female client with systemic lupus erythematosus (SLE) is admitted to the med…

심화 해설

Clinical Judgment This question assesses the nurse's prioritization in managing an SLE patient's acute flare-up. The key is to connect the "flare-up" situation with the presented symptoms (joint pain, fatigue, butterfly rash) to identify the problem that is most debilitating and poses the most immediate risk. During a flare-up, the immune system is overactive, causing systemic inflammation and fatigue. In this context, Fatigue is not just a symptom; it is a major factor that impairs daily function, hinders recovery, and where excessive activity can trigger further exacerbation. Therefore, conserving energy and preventing exhaustion becomes the top priority in flare-up management. Memory Tip: Remember: Prioritize Pacing in Flares. The core nursing care during an SLE flare-up is Rest and Energy conservation. KR vs US: In Korea, there is a tendency to give general advice like 'get plenty of rest' for managing fatigue in SLE patients. In contrast, the US NGN/CJMM emphasizes systematically teaching Energy Conservation Techniques and analyzing the patient's daily activities to establish an individualized activity-rest plan. This is an approach focused on enhancing the patient's self-management abilities.

임상 시나리오

Clinical Practice Guide: SLE Flare Management

During an SLE flare, the body undergoes a systemic inflammatory response that can affect multiple organs, including the skin, joints, kidneys, and central nervous system. Profound fatigue is a hallmark symptom, driven by cytokine release and increased metabolic demand. Nursing care prioritizes reducing this physiological burden to prevent organ damage and promote recovery.

Energy Conservation and Pacing: Teach the client to break daily tasks into smaller components with planned rest periods. Prioritize essential activities and delegate non-essential ones. This reduces metabolic stress and helps modulate the overactive immune response. Encourage the use of assistive devices if needed to minimize joint strain.

Activity Management: Vigorous exercise is contraindicated during a flare as it increases inflammation and fatigue. Instead, recommend gentle range-of-motion exercises to maintain joint function without overexertion. Activity should be gradually increased as the flare subsides.

Thermal Modalities: Heat therapy may provide comfort for stiff, non-inflamed joints but should be avoided over actively inflamed or swollen areas to prevent worsening of inflammation. Cold packs may be used for acute joint pain and swelling.

Medication and Supplement Guidance: Administer prescribed corticosteroids and immunosuppressants as ordered to control inflammation. Vitamin D supplementation is important for bone health in SLE patients on long-term steroids but is not an acute intervention during a flare. Monitor for signs of organ involvement, such as renal or neurological changes.

Patient Education: Educate the client on recognizing early signs of a flare, adhering to medication regimens, and balancing rest with activity. Emphasize the importance of stress reduction and adequate sleep to support immune regulation.

핵심 개념

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