Definition:

Connective tissue disease

Collagen Diseases

Are a chronic inflammatory, autoimmune disorder characterized by a wide array of clinical manifestations in vascular and connective tissue.

A wide variety of disorders are referred to as "Collagen Diseases:

Some examples include:

Systemic Lupus Erythematous

Schleroderma (Systemic Sclerosis )

Previously called "Hard Skin"

Rheumatoid Arthritis

Poly Arteritis Nodosa

Dermatomyositis

Collagen Diseases:

Produce widespread changes in collagenous connective tissue.

Cause problems involving almost every organ

May be autoimmune in nature

Are difficult to diagnose

Have no cure

Cannot be prevented

Systemic "Lupus" Erythematosis (SLE)

Definition: Serious inflammatory disease of unknown etiology occurring mainly in young women.

Diffusely involves the vascular and connective tissues of many organs producing inflammation and biochemical and structural changes.

Lupus-Factors that appear to contribute to the development:

Exposure to sunlight

UV light

Sunlamps

Tanning beds

Fluorescent lights

Certain drugs

Viral infections

Hormonal influences

Environmental factors associated with acute exacerbations are:

Physical stresses of infections

Surgery

Pregnancy

Emotional tension

UV light

Fluorescent lights

Sun lamps

Tanning beds

Lupus (SLE) S&S

Fever

Malase

Delirium

Convulsions

Coma

Musculoskeletal aches and pains

Butterfly rash, on the face

Pleural effusion

Lupus (SLE) S&S

Basilar pneumonia

Generalized lymphadenopathy

Pericarditis

Tachycardia

Hepatosplenomegaly

Kidney disease (50% of the cases)

Manifested by hematuria, proteinuria and tubular acidosis

Lupus (SLE) S&S

Fever

Malaise

Wt. Loss

Arthritis

Low grade temp and chills

Hair loss (alopecia)

Photosensitivity

More on the overhead

Diagnosis of SLE (Lupus)

ANA (Antinuclear Antibodies) most sensitive.

CBC: shows mild to moderate normocromic/normocytic anemia, mild leukopenia and mild thrombocytopenia

Sedimentation Rate: elevated when diseases is active.

Treatment of LUPUS (SLE)

ASA

Steroids

Chemotherapy drugs

Diet high in calories and high in vits.

Physical therapy

Nursing care for pt. With lupus.(SLE)

Teaching about disease process

Protect from infections

Safety

Progressive systemic sclerosis
Scleroderma
Hard skin

Definition: A progressive systemic connective tissue disease

Scleroderma

Edema and inflammation of the involved tissue lead to ischemia, fibrosis, and excessive collagen depositing.

The tissues lose their elasticity and become smooth, thick, tight, and shiny.

The skin is frequently involved, but other tissues including blood vessels, lungs, esophagus, GI tract, heart, and kidneys can be affected also.

Clinical Manifestations of Scleroderma

Hard skin initial skin involvement

Fingers are often first affected.

Progression occurs as the arms, face and chest become involved.

Facial skin becomes tight and masklike without expression.

Mouth becomes rigid with restricted movement of lips.

Swallowing can be difficult

Respiration may be impaired as the chest skin firms and limits chest expansion.

Clinical Manifestations of Scleroderma

Pain/stiffness of fingers and extremities often render them immobile and useless.

Tissues of other organs are affected as the disease progresses.

Proteinuria, hematuria, and hypertension accompany renal involvement.

Clinical Manifestations of Scleroderma

RAYNAUD’S PHENOMENON

Brought on by cold and emotions (stress)

Effects hands, sometimes feet, ears or nose, pallor in color, painful, relieved by heat.

Diagnosis of Scleroderma

Skin biopsy are the most specific diagnostic info.

Increased ESR (maybe)

Increased RA factor (maybe)

Positive ANA (maybe)

Treatment of Scleroderma

There is no therapy available to retard the progression.

Treatment is essentially symptomatic and is directed at the organ (s) involved.

Nursing care of Scleroderma

Comparable to that of Lupus

2 additional problems with scleroderma

Pressure sores secondary to immobility due to vascular changes

Dysphagia secondary to oroesophageal involvement

Others you need to look up.

Rheumatoid Arthritis

Polyarteritis Nodosa

Dermatomyositis/Polymyositis

Burgers Disease

ONLY ONE MORE SET OF SLIDES

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