NURSING 2NN3 Lecture Notes - Lecture 11: Chronic Pain, Rheumatoid Arthritis, Fibromyalgia
2 Sep 2018
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How is fibromyalgia diagnosed: diffuse body pain with associations of fatigue, sleep disturbance, cognitive changes, mood disturbances, and other somatic symptoms, clinical evaluation, attention to past health status and physical examination. Clinical presentation of fibromyalgia: prevalent in females, occurs in persons of all ages (occurs mostly in 5th decade). Tender point examination: 11/18 tender points in different soft tissue sites, manual palpation. What investigations should be done: no laboratory investigation confirms clinical diagnosis of fm, establish a diagnosis of fibromyalgia as early as possible. What conditions can present similarly to fm: rheumatoid arthritis, spondylarthritis, systemic lupus. Recommendations: considerable healthcare/personal costs, utilize multidisciplinary team or team member to provide support and reassurance, should ensure empathetic, open, honesty, and should not demonstrate negative attitudes, shared decision-making. What causes fibromyalgia: neurophysiologic abnormalities have been identified in patients with fibromyalgia, abnormalities of peripheral, central, and sympathetic nervous systems, and hpa axis, psychosocial distress.
