Assess for the presence of depression,anxiety, and other stressors.
Conduct assessment to determine patient’s daily activities that contribute to fatigue.
Help patient to develop an energy-conserving plan for completing daily and other activities and work.
Suggest planning for rest periods as needed throughout the day to conserve energy.
Encourage patient to get 8-10 hours of sleepat night.
Encourage exercise as tolerated.
ssess patient’s prescription and non-prescription drug regimen and dosages.
Assess the patient’s usual daily dietary intake by asking her or him to keep a food diary.
Develop a dietary plan with the patient that encourages healthful eating. If the patient has nutrition-related lupus complications, refer her or him to a registered dietitian for specialized counseling.
Encourage exercise as tolerated.
Record patient’s weight at each visit.
Instruct patient to weigh herself or himself at home once a week and record it.
Monitor patient’s WBC count.
Teach patient to monitor temperature during a lupus flare.
Teach patient to look for signs and symptoms of infection, particularly urinary and respiratory infections. (Note: The cardinal signs of infection may be masked because of corticosteroids and antipyretic medications.)
Instruct patient to call physician if signs and symptoms of an infection appear or if a fever is elevated above normal baseline.
Explore possible ways of concealing skin lesions and hair loss.
Allow patient to express feelings and needs.
Assess patient’s usual coping mechanisms.
Acknowledge that feelings of denial and anger are normal.
