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Scleroderma Patients: What Nurses Need to Know


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As a nurse, you’ll care for patients from all walks of life. You’ll also encounter a wide range of disorders and diseases. To provide the best care possible, it’s necessary to learn what you can about treating a diverse range of patients as well as a wide variety of different medical conditions. Today, we’re going to cover one of the rarer diseases you may not have encountered yet in your nursing career: scleroderma.

Scleroderma affects fewer than 500,000 Americans, which is one reason why many nurses don’t know much about the disease. Compared to other diseases, in fact, scleroderma is something of an enigma in medicine. We don’t know what causes scleroderma, and we don’t know why it affects some people differently than it affects others. Fortunately, we do know how to treat many of its symptoms effectively. Here are some of the things you should know about treating scleroderma in order to improve your patients’ outcomes:

Scleroderma is an autoimmune disease

Like Graves’ disease and systemic lupus, scleroderma is an autoimmune disease. So, unlike a normal person’s immune system that solely fights off foreign invaders like bacteria and viruses, a patient with scleroderma has an immune system that actively attacks their own tissues as well.

Scleroderma affects connective tissues

Scleroderma is a disease that affects patients’ connective tissues. While the most visible sign of scleroderma is hardened skin due to its effects on collagen, connective tissues throughout the body are impacted, causing a wide range of issues. Many of these issues can be quite serious; some are even life threatening.

Scleroderma can be deadly

For some patients, scleroderma is more of an annoyance than anything else. For others, however, scleroderma causes serious damage to vital organs. Sometimes this damage is serious enough to threaten patients’ lives. Pulmonary fibrosis, for instance, is one potential scleroderma complication, and it has become one of the leading causes of death in scleroderma patients.

Scleroderma can cause systemic discomfort

Comfort should be a consideration for all patients, but scleroderma patients require some extra consideration. As with other rheumatic diseases, scleroderma often causes musculoskeletal pain. It can also cause dry eyes, dry mouth, and more, so be sure to assess your scleroderma patients’ comfort in a comprehensive manner.

Skin assessments are critical

When assessing a patient with scleroderma, it’s very important to perform a thorough skin assessment. This means checking all over the patient’s body and carefully noting scleroderma-related abnormalities. Doing this helps give medical providers a clearer picture of the patient’s general condition, how active the disease is, and whether or not it may be affecting their internal organs.

Vital signs must be monitored carefully

It’s easy to forget that scleroderma often affects more than just a patient’s skin. While the effects of scleroderma on the skin are the most readily apparent signs of the disease, it’s important to assess for effects on other organ systems. One of the best ways to do this is to obtain your patient’s vital signs regularly, especially their blood pressure. Scleroderma patients with hypertension are at an increased risk for kidney damage, and renal function should always be tested in these cases.

Listening to lung sounds is important

As mentioned earlier in the article, lung-related complications are currently the leading cause of death in patients with scleroderma. While doctors often order a variety of lung-function tests for their scleroderma patients, listening to lung sounds can also provide indications of potential lung-related issues. For instance, crackling sounds in the bases of a scleroderma patient’s lungs might indicate interstitial lung disease, a potentially deadly complication.

Mood disorders are common comorbidities

In many cases, scleroderma is disfiguring. It often affects skin on the hands and the face, two of the most visible areas on the human body. For this reason, scleroderma patients often have poor self-image, and they may shy away from social situations as a result. Be sure to assess your scleroderma patients for self-image issues and potential mood disorders, and be ready to encourage therapy if you feel they would benefit from it.

When working with scleroderma patients, providing thorough, sensitive care is incredibly important. By learning more about scleroderma and some of the effects it has on patients, both physical and mental, you’ll be in a better position to help them manage the disease.

Have you treated patients with scleroderma in the past? If so, what did you do to keep them comfortable and to promote their overall health? Share your experiences with us and our readers by posting a comment in the section below!

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