Overview

SLE affects the immune system, thus reducing the body's ability to prevent and fight infection. In addition, many of the drugs used to treat SLE also suppress the function of the immune system, thereby further depressing the ability to fight infection. The risk of infection parallels medication dosages and duration of treatment.

Patients with SLE who show signs and symptoms of infection need prompt therapy to prevent it from becoming life threatening. The most common infections involve the respiratory tract, urinary tract, and skin and do not require hospitalization if they are treated promptly. Other opportunistic infections, particularly Salmonella, herpes zoster, and Candida infections, are more common in patients with SLE because of altered immune status.

Potential Manifestations of Infection Respiratory tract infections sore throat sneezing fever productive or nonproductive cough runny nose malaise chills back and muscle pain dyspnea wheezing or rales nausea vomiting Urinary tract infections chills fever flank pain nausea vomiting urinary frequency dysuria hematuria Skin infections lesions redness swelling tenderness or pain

Potential Problems

1. Increased risk of infection

Nursing Interventions

Objective: Minimize incidence of infection.

1. Assess the patient's current medications, particularly those that promote susceptibility to infection such as corticosteroids and immunosuppressives.

2. Teach the patient to use good hand-washing and personal-hygiene techniques.

3. Teach the patient the signs and symptoms of infection and reinforce the importance of reporting them to the physician.

4. Encourage the patient to eat a balanced diet with adequate calories to help preserve the immune system.

5. Teach the patient to minimize exposure to crowds and people with infections or contagious illnesses

Objective: Educate the patient about immunizations.

1. Check the patient's current immunization status.

2. Teach the patient that infections can be minimized with immunizations.

3. Encourage the patient to consult her or his doctor before considering allergy shots or flu or pneumococcal vaccines; these medications may induce a lupus flare.

Note: For additional information, see the section on general manifestations of SLE. Also see the Patient Information Sheet on Fever and Lupus..



Source: National Institutes of Health, U.S.Dept of Health and Human Services