The patient with lupus often has special
nutritional needs related to medical
conditions that may arise during the
course of the disease. These conditions
include steroid-induced osteoporosis or
diabetes, cardiovascular disease, and
For the SLE patient to
maintain optimal health, the nurse must
work closely with the patient, dietitian,
and physician to develop a nutritional
plan specific to the patient's disease and
Potential Manifestations of Nutritional Problems
- weight loss or gain
- loss of interest in food
- dry, rough, scaly skin
- dull, dry, brittle, thin hair
- loss of lean muscle mass
- listlessness, apathy
- poor muscle tone
- constipation or diarrhea
- fatigue and lack of energy
- inflamed or bleeding gums
1. weight changes
3. alteration in nutritional
status due to drug therapy or
complications of SLE
Objective: Determine the causes of the
patient's altered nutritional status.
1. Conduct a physical assessment
of the patient, including weight,
height, and percentage of body
2. Assess the patient's nutritional
intake by asking her or him to
keep a food diary.
3. Assess the patient's current
medications and doses.
4. Determine dietary and
nutrient intake and vitamin/
mineral supplement intake,
food sensitivities (allergies
may provoke a flare), food
preferences, and experience with
fad diets to "cure" lupus.
5. Assess the patient for signs
and symptoms of SLEassociated
osteoporosis, diabetes, and
cardiovascular and kidney
6. Monitor laboratory values such
as hemoglobin, hematocrit,
serum ferritin, serum iron, total
cholesterol, HDL, LDL, VLDL,
triglycerides, and plasma protein
7. Assess the patient for signs and
symptoms of depression.
8. Assess the patient's knowledge of
nutrition and understanding of a
9. Assess the patient's ability to
purchase and prepare meals.
10. Assess the patient's activity level.
11. Assess the cultural,
socioeconomic, and religious
factors that may influence the
Objective: Educate patient about
healthful eating to prevent alteration in
1. Encourage the patient to
maintain a healthful diet, and
discuss nutritional claims of
"curing lupus", which are often
2. Provide the patient with
information on the basics of
a well-balanced diet and its
importance in a chronic disease
such as lupus.
3. Instruct the patient to take iron
supplements only if iron stores
4. Suggest vitamin and mineral
supplementation, if necessary.
5. Refer the patient to dietitian for
assistance in dietary planning
for serious conditions associated
Note: For additional information, see the Patient Information Sheet on Nutrition and Lupus..
Source: National Institutes of Health, U.S.Dept of Health and Human Services