Overview

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 kidney disease.

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 manifestations.

Potential Manifestations of Nutritional Problems weight loss or gain loss of interest in food anorexia dry, rough, scaly skin dull, dry, brittle, thin hair loss of lean muscle mass listlessness, apathy poor muscle tone constipation or diarrhea irritability fatigue and lack of energy inflamed or bleeding gums

Potential Problems

1. weight changes

2. anorexia

3. alteration in nutritional status due to drug therapy or complications of SLE

Nursing Interventions

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 fat.

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 conditions, including osteoporosis, diabetes, and cardiovascular and kidney disease.

6. Monitor laboratory values such as hemoglobin, hematocrit, serum ferritin, serum iron, total cholesterol, HDL, LDL, VLDL, triglycerides, and plasma protein levels.

7. Assess the patient for signs and symptoms of depression.

8. Assess the patient's knowledge of nutrition and understanding of a healthful diet.

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 patient's diet.

Objective: Educate patient about healthful eating to prevent alteration in nutritional status.

1. Encourage the patient to maintain a healthful diet, and discuss nutritional claims of "curing lupus", which are often misleading.

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 are depleted.

4. Suggest vitamin and mineral supplementation, if necessary.

5. Refer the patient to dietitian for assistance in dietary planning for serious conditions associated with SLE.

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