Free «Case Study 1: Cutaneous Lupus Erythematosus» Essay Sample

Case History

Mary is a 35-year-old woman who has been affected by a disease that results to rashes on both of her cheeks. Currently, her occupation is mechanical engineering. She is not married but lives with her boyfriend and does not have children. As reported by her, she has been having the rashes for a week. The hives started on the cheeks. However, they immediately spread to the bridge of her nose. The first instance when she realized that the rashes infected her occurred while hiking at a camp. Further explanation by the patient reveals that they have not spread to other parts apart from the two. Moreover, this is a unique experience to the patient as she has never experienced such a case in the past. When asked if she has done something as a response to the rashes, she denied and reported that her skin situation worsened when she got exposed to sunlight. The patient denied the use of new foods, body oil, different environment exposure, and new drug prescriptions. Other signs and symptoms shown by the disease are an increased fatigue in the body and rise in fever. Also, she lost some weight. The woman denies having a headache, ear and throat pain, nose congestion, breathing challenges, abdominal aches, and, lastly, feeling painful when urinating. There is a lack of mouth problems, but a pain in the muscles is still present. The latter is extreme in areas around the hands and wrists. Finally, there is negative joint firmness and intricacy when the patient wakes up in the morning.

Family History

Her family history is of high importance as her mother has rheumatoid arthritis. However, her father has been healthy throughout his lifetime.

Social History

Currently, Mary lives with her boyfriend. She has been living with him for five years. Concerning her education, Mary has completed master’s degree in engineering and worked on specialty. Her social life shows no use of any drug such as cigarettes or alcoholic drinks apart from the glass of wine that she takes almost every night after she gets done with dinner.

Past Medical History

The patient had a history of tonsillectomy for chronic strep throat disease when she was nine years old. Moreover, she has never been hospitalized for any reason. In her adulthood, she has all through being healthy.

Physical Examination

General: she is still young and very active with no difficulty sitting at the exam table.

Significant signs: her blood pressure is 112/66, and HR 62 BPM, which is normal. Her respiration rate is breathing twelve times per minute, and the body temperature is 100.3°F.

HEENT: the patient does not have exudates; she has a traumatic, a white sclera, clear conjunctivae, normocephalic, pupils contract from four to two millimeters. The disease is very reactive to light and especially when it is adjusted, her oropharynx is clammy, and there is the presence of erythema in the following pharyngeal circumvent, and, lastly, has moderate ulcers found in the buccal mucosa bilaterally.

Neck: lithe is absent in the cervical lymphadenopathy.

Extremities: lacks cyanosis, clubbing, or edema.

Presumptive Nursing Diagnosis

The patient diagnosis is cutaneous lupus erythematosus (CLE). There are various indications of the disease in her body and behavior. In most cases, CLE affects face parts especially cheeks and nose bridge. The disease most often occurs in women in the age group of 20-50 years. Basing on these notions, it is possible to conclude that Mary suffers from cutaneous lupus erythematosus. The tests the patient is expected to undergo to ascertain the disease comprise of antiRo/La extractable nuclear antigens (ENA). The reason for this is that almost seventy percent of the patients, who have this particular disease, have ENA. The adversity of the illness might get an evaluation through looking at the ANA and ENA titer (Jolly, Kazmi, Mikolaitis, Sequieira, & Block, 2013).

Teaching and Nursing Care Plan

From the diagnosis, it is clear that Mary is a patient suffering from cutaneous lupus erythematosus. Regarding studies carried out by various scientists, the condition is an autoimmune disorder of the tissue. The latter has an impact on one body part. Under certain circumstances, the disease has been found to affect other areas of the body too. The autoimmune condition is usually brought about by the loss of healthy immune by the affected person, and for this instance it is Mary. She has also lost her immune tolerance making the disease pathogenic. Different characteristics characterize this illness. Nevertheless, its signs and symptoms depend on individuals. The disease mostly has some chronic and relapsing lupus erythematosus (LE) specific. Moreover, the infection can have LE-non-specific inflammatory conditions. The patient’s disease classification is under the lupus erythematosus to be specific. This division is the right characterization of the illness because the rashes exhibited on Mary’s face are usually brought about and worsened when the infected person stays in a place where there is sunlight penetration (Vasquez et al., 2013).

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The age brackets that are mostly affected by this particular disease are 20-50-year-old adults. Sometimes, this illness might affect people of other age categories such as the elderly and children. Men also can fall victim of this particular infection. Cutaneous lupus erythematosus is related to pathogenic antibodies. These kinds of antibodies affect the composition of the cell nuclei located in different tissues. Ultraviolet radiation has a very significant effect on this infection. The reason as to why ultraviolet emissions are very useful for this disease is because the UV rays create keratinocyte necrosis in the body. The same rays also have been known to affect the immune system of the infected person and activate the creation of antibodies (Okon & Werth, 2013).

Various conditions and exposures influence cutaneous lupus erythematosus. A person suffering from this disease might worsen the situation if he/she smokes a cigarette. Sunlight is another factor that is known to worsen the terms of the rashes on the infected person’s skin. The disease might also get acceleration from hormone changes, viral infection, and use of some prescribed medicines. To evade worsening the situation of this disease, Mary ought to make sure that she does not start smoking cigarettes. Moreover, she should make sure that she covers her body whenever she goes out to the sunlight. Nicotine and UV rays are very reactive to the disease, and they need avoidance at all costs. Therefore, to prevent sunlight penetration, the infected person should wear clothes that are thick enough to prevent any light penetrating to the skin. Sunlight protection is by wearing the sunshine spectrum with a density of about SPF50+ (Vasquez, 2013).

The disease treatment is to be done as soon as possible to prevent worsening of the infected skin part. The total aspect of providing medication for this condition is improving a person’s appearance. The nursing plan of care for Mary is administering her with antimalarials. Immune modulators can also get prescribed to the patient. If sunlight effects are very adverse, supplementation of vitamin D is necessary. All these treatments can be applied by a local health care specialist (Jolly et al., 2013).