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SARCOIDOSIS

SARCOIDOSIS. Definition Cause / Etiology Clinical Manifestations Pathophysiology Diagnostic Tests Medical Management Nursing Management. Definition. Sarcoidosis is an inflammatory condition that affects many body systems.

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SARCOIDOSIS

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  1. SARCOIDOSIS Definition Cause / Etiology Clinical Manifestations Pathophysiology Diagnostic Tests Medical Management Nursing Management

  2. Definition • Sarcoidosis is an inflammatory condition that affects many body systems. • Its onset typically occurs between 20 & 40 years of age, it can be present in children and older adults. • It is characterized by the formation of wide spread granulomatos lesions. In addition to lung involvement which occurs in more than 90% of cases, clients may present with clinical manifestations involving the peripheral lymphatic system, eyes, skin, liver, spleen, bones, salivary glands, joints, nervous system, and heart.

  3. Causes / Etiology • The causes of sarcoidosis remains unknown. • It is suggested that a triggering agent (which may be genetic, infections, immunologic, or toxic) stimulates enhanced cell-mediated immune process at the site involvement.

  4. Clinical Manifestations • There maybe no symptoms. When symptoms occur, they can involve any body part or organ systems in the body. • Almost all patients have lung and chest symptoms: • Chest pain (most often behind your breastbone) • Dry cough • Shortness of breath

  5. Hemoptysis • Pneumothorax • Symptoms of general discomfort or uneasiness often occur: • Fatigue • Fever • Arthralgia • Overall feeling of discomfort, illness, or lack of well-being • Weightloss

  6. Skin symptoms: • Hair loss • Erythemanodosum • Rash • Scars that become raised or inflamed • Nervous System symptoms: • Headache • Seizures • Weakness on one side of the face

  7. Eye symptoms: • Burning sensation • Discharge from the eye • Dry eyes • Ithching • Pain • Vision loss • Other symptoms include: • Dry mouth • Nosebleed

  8. Hemoptysis • Pneumothorax

  9. Pathophysioloy

  10. LEGEND: Intervention

  11. Diagnostic Tests • Physical Examination result: • Abnormal breath sounds • Enlarged liver • Enlarged lymph glands • Enlarged spleen • Rash

  12. Different imaging test: • Chest x-ray • CT scan of the chest • Lung gallium scan • Bronchoscopy • Bronchoalveolarlavage • Mediastinoscopy • Open-lung biopsy • For definitive diagnosis tissue biopsy is performed.

  13. This disease may affect the laboratory result of the following: • Calcium levels • Complete Blood Count • Immunoelectrophoresis-serum • Liver Function Test • Quantitative immunoglobulin • Serum phosphorus

  14. Medical Management • Medical management is primarily determined by the extent to which the client’s life is disturbed by the manifestations experienced. • If the client with sarcoidosis is asymptomatic, management involves ongoing assessment for further disease progression, such as obtaining a chest radiograph every 6 months. • When manifestations are present, medical treatment usually consist of systemic corticosteroids to suppress the immune process and often leads to improvement.

  15. Nursing Management • Nursing intervention in clients with sarcoidosis is the same as that in clients with other restrictive lung diseases and hypoxemia. • Access for drug side effects, especially adverse responses to corticosteroids (such as weight gain, change in mood, and development of diabetes mellitus).

  16. Also assess for manifestations of improvement, such as increased exercise tolerance, disappearance of initial assessment findings, improvement of pulmonary function studies, and better oxygenation. • If assessment findings worsen, document them and notify the physician.

  17. References: • Drake W, Newman LS. Sarcoidosis. In: Mason RJ, Broaddus VC, Martin Tr, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 59. • Iannuzzi MC, RybickiBa, Teirstein AS. Sarcoidosis. N Engl J Med. 2007;357:2153-2165. • Weinberger SE. Sarcoidosis. Goldman L, Ausiello D. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa:Saunders Elsevier; 2007:chap 95. • Sharon L. Lewis, et al., Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 7th ed. Mosby Inc., p. 597

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