A 20-year old female presents with chief complaint of fatigue, anxiety, and heart palpitations. She has recently given birth to her second child, a daughter. Initial recommendation from her follow up appointment is to rest. The patient’s symptoms worsen and then gradually resolve. Over the next year she has increased fatigue and headaches. She also starts to complain of joint pain in her ankles, knees, elbows, wrists, and fingers. Rest and over-the-counter pain medication relieve her symptoms, but it is difficult for her to find time for much rest due to the responsibilities of caring for a family and working full-time. The winter brings a new intolerance to low temperatures. She states her hands and feet becoming painful and discolored when she is exposed to cold. Her extremities became painful, stiff, and altered in color when exposed to cold temperatures. She also develops a butterfly rash.

DX: systemic lupus erythematosus.

Rx: prednisone and hydroxychloroquine

You are providing the patient with education on her new diagnosis. Create a patient teaching plan that covers the following questions.

1. What is lupus?

2. What key lifestyle changes will the patient need to address to manage her condition?

3. What are the important teaching points for her medications?

4. What are the recommendations to manage her symptoms, to avoid flare-ups, and to monitor her condition?

5. What symptoms, if they occur, should she report immediately to her provider and why?

Journal writing provides a nonthreatening way to explore different thoughts, ideas, and topics without being concerned about audience presentation. The process of writing can facilitate reflection and allow you to express your feelings regarding your educational experiences as well as clarify your thinking.

Dementia impacts a person’s capacity to make informed decisions. When we consider a person with dementia with regard to engaging in sexual or intimate situations, the person must be able to have the capacity to make informed decisions. Imagine you are the director of a skilled nursing facility and you have two patients who are married. One resident is cognitively impaired, and the other is not and chooses to engage in sexual and intimate acts with their spouse as they have always done. How do you respond? What is your role in protecting the person with cognitive impairment? Does it matter that they are married and have engaged in these sexual and intimate acts all of their life? What ethical factors related to decision-making and engaging in sexual relationships should be considered? 

Your journal entry should be 250 to 400 words long. No outside research is expected and, therefore, no references are needed.