In a systematic review, aerobic exercise, such as walking and bicycling, was associated with reduced fatigue in adults with chronic autoimmune conditions such as Systemic Lupus Erythematosus. (Neill, Belan, & Ried, 2006.)

Although fluid drainage though a chest tube is the most efficient way to treat a pleural effusion, percussion and vibration of the entire left lung can aid in fluid drainage. Depending on the severity of the pleural effusion, the reverse Trendelenburg may be contraindicated, so percussion/vibration techniques would be done in right sidelying.

Patients diagnosed with pleural effusion demonstrate improved lung function and decreased hospital stay if deep breathing exercises are implemented along with typical medical treatment. (Valenza-Demet et al., 2014)

Patients with pericarditis often experience intensified chest pain when coughing, so teaching the patient how to perform an assisted cough may decrease the patients discomfort.

In a study on patients with pleural effusion, the practice of Pranayama yoga aided in faster lung re-expansion in comparison to those in routine Physical Therapy treatment. (Prakasamma & Bhaduri, 1984.)

Expect absent breath sounds in the area of pleural effusion in the left lung.

Important to know both the patients' pain level and pain tolerance throughout treatment. Additionally, may want patient to take pain medication prior to treatment.

It is important that we understand how all aspects of this autoimmune disease affect the patients life and their rehabilitation potential.

Patients with Systemic Lupus Erythematosus experience severe fatigue and pain, so it is important to educate the patient on ways to conserve energy throughout her day.

Patients with pleural effusion demonstrate decreased lung function, specifically their vital capacity and forced expiratory volume, as shown with incentive spirometry. (Gilmartin, Wright, & Gibson, 1985)

Important to know baseline. Expect to see normal or low blood pressure due to the pericarditis.

Due to the acute pericarditis, we would want to keep the patient in the mod range for cardiovascular training.

Yoga is also a safe and energy efficient form of exercise that can be more easily tolerated for patients experiencing severe fatigue.

Due to her recent weight loss, I would like her to seek advice from a dietitian to ensure she is eating right.