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Labs  Hbg 12-18  Hct 37-52%  WBC 5-10  RBC 4.2-6.1  PLT 150-400  PT 11-12.5 sec (1.5-2.5x normal on Coumadin = 16.5-31.25 sec)  INR 0.9-1.2 sec (Therapeutic level 2-3x normal = 1.8-3.6 sec)  PTT 60-70 sec ...

Labs  Hbg 12-18  Hct 37-52%  WBC 5-10  RBC 4.2-6.1  PLT 150-400  PT 11-12.5 sec (1.5-2.5x normal on Coumadin = 16.5-31.25 sec)  INR 0.9-1.2 sec (Therapeutic level 2-3x normal = 1.8-3.6 sec)  PTT 60-70 sec (1.5-2.5x normal on Heparin = 90-175)  Na 135-145  K+ 3.5-5  Creatinine 0.5-1.2  BUN 10-20  Albumin 3.5-5  Mg 1.5-2.5  Ca 9-10.5  Cl 98-106  Phosphorus 2-4.5  Specific Gravity 1.005-1.030 Discoid lupus  Affects only the skin and is not lethal - Caused by UV rays  Macular Rash & Discoid Rash  Skin biopsy to dx Systemic Lupus Erythematosus (313-317) ***TEMPERATURE***  Chronic, progressive, inflammatory connective tissue disorder that affects multiple body systems &organs o REMISSIONS/EXACCERBATIONS (can end up in the ICU) - Autoimmune o Attracted to KIDNEY’s—Lupus Nephritis is leading cause of death; this is direct damage to the kidneys  Poor survival associated with high creatinine, low hematocrit, proteinuria o Young Women of child bearing age 20-40 Y (primary AA women) o SLE & DLE both share a disfiguring and embarrassing rash!!  Clinical manifestations o Malar rash – red flat or raised rash over cheeks sparing nasolabial folds “butterfly rash” o Discoid rash – Red raised patches with scaling follicle plugging o Photosensitivity– discoid skin rash from sun exposure - pt should wear sunscreen or protective clothing o Oral ulcers–usually painless o Polyarthritis-multiple joints affected  Small joints and knees inflamed  Osteonecrosis from chronic steroid use (5y+) o Pleuritis with pleural effusion or pericarditis o Fever is the major sign of exacerbation o Generalized weakness, fatigue, anorexia, weight loss o Renal disorders–proteinuria, cellular casts o Neurologic disorders – seizures, psychosis and also peripheral neuropathies o Raynaud’s phenomena  Exposure to cold or extreme stress – red, white, blue & pain of digits o Alopecia or hair loss common

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