Fibromyalgia Flashcards
How is fibromyalgia described?
-Widespread musculoskeletal pain, stiffness, fatigue, sleep disturbances and difficulty concentrating
How many American’s does fibromyalgia affect?
10 million
What percentage of those affected by fibromyalgia are women?
75-90%
When does the diagnosis of fibromyalgia typically occur?
ages 20-50
What are the things that may trigger fibromyalgia?
- Infection
- Trauma
- Stressors
Where is the pain typically in a patient with fibromyalgia?
- Neck
- Spine
- Shoulders
- Hips
- Elbows
- Knees
What are the risk factors for fibromyalgia ?
- Female, ages 20-50
- Family history
- Psychiatric disorder (ADHD or depression)
- Medical disorder (Irritable bowel syndrome, rheumatoid arthritis)
- Genetics
How can you prevent fibromyalgia?
- Maintain a healthy lifestyle
- Prompt diagnosis and treatment of symptoms can reduce flare ups and manage pain and fatigue
What are the clinical manifestations of fibromyalgia?
- Widespread pain
- Fatigue, other sleep disturbances
- Enhanced sensitivity to heat or cold
- Mood disorders
- Cognitive dysfunction
Whom is fibromyalgia most common in?
Middle aged women
In terms of fibromyalgia- what may children and adolescents develop?
-Juvenile primary fibromyalgia syndrome (JPES)
Where is a patient with fibromyalgia often referred to?
A rheumatologist
If a patient has fibromyalgia a what types of collaboration are used to treat them?
- Treatment of their underlying illnesses (depression, cognitive impairments, irritable bowel syndrome)
- encourage different therapies
Because there are no diagnostic tests for fibromyalgia what other types of tools can they use to diagnose fibromyalgia?
- Pain scale: extent and duration
- Pain in four quadrants of body
- Painful response on 11 of 18 tender points
What are the types of pharmacologic therapy for fibromyalgia?
- Duloxetine, Milancipran -SSNRIs
- Pregabalin: GABA analog
- Acetaminophen (NSAIDs)
- Tricyclic antidepressants
What is the method of action for pregabalin?
- GABA analog
- Increases neuronal GABA levels
What are the contraindications/cautions for pregabalin?
- Suicidal ideation
- Depression
- Renal impairment
- History of drug or ETOH abuse
- CHF
What are the adverse effects for pregabalin?
- Ataxia
- Amnesia
- Dizziness
- Neuropathy
- Abnormal thinking
- Vertigo
- Chest pain
- Diplopia
- Edema
- Weight gain
What should a patient avoid taking and doing on pregabalin?
- Avoid ETOH
- Avoid stopping abruptly
What are the nonpharmacologic therapies for fibromyalgia?
- Aerobic exercise
- Strength training
- Cognitive-behavioral therapy
- Relaxation therapy
What are the nursing goals for a patient with fibromyalgia?
- Reduce pain
- Increase restorative sleep
- Improve physical function
When is fibromyalgia often diagnosed?
When other diagnoses are ruled out
What are your focused assessments for a patient with fibromyalgia?
- Widespread pain for at least 3 months
- Pain at 11 of 18 tender points
- Absence of disorder that would explain pain
When using FIBROMYALGIA as a mnemonic what does the F stand for?
Fatigue
When using FIBROMYALGIA as a mnemonic what does the first I stand for?
Irritability
When using FIBROMYALGIA as a mnemonic what does the B stand for?
Brain fog
When using FIBROMYALGIA as a mnemonic what does the R stand for?
Restless Legs
When using FIBROMYALGIA as a mnemonic what does the O stand for?
Overlapping Syndromes
When using FIBROMYALGIA as a mnemonic what does the M stand for?
Muscle and Joint pain
When using FIBROMYALGIA as a mnemonic what does the Y stand for?
You never feel good
When using FIBROMYALGIA as a mnemonic what does the first A stand for?
Anxiety and depression
When using FIBROMYALGIA as a mnemonic what does the L stand for?
Loss of control
When using FIBROMYALGIA as a mnemonic what does the G stand for?
Grief and Worry
When using FIBROMYALGIA as a mnemonic what does the second I stand for?
Immune Dysfunction
When using FIBROMYALGIA as a mnemonic what does the second A stand for?
A lifetime fight
What will the nurse plan for in a patient with fibromyalgia?
- Client will report decreased pain
- Client will report fewer sleep disturbances
- Client will improve activity tolerance
- Client’s score on a symptom severity scale will be less than 5
What will the nurse implement for a patient with fibromyalgia ?
- Pain management
- Fatigue reduction
- Increased activity tolerance
- Education about the proper use of medication and nonpharmacologic methods to reduce pain
- Teach clients good sleep hygiene
- Encourage mild exercises
- Information about coping mechanisms
What evaluations would you expect from a nurse of a fibromyalgia patient?
- Client is able to reduce pain sufficiently to allow periods of activity and sleep.
- Client voices feelings related to chronic condition
- Client obtains adequate follow-up
- Client avoids use of narcotics, addictive substances
The nurse is assessing a client who has come to the clinic with complaints of not feeling well. The nurse suspects fibromyalgia when the client reports which of the following?
- Musculoskeletal pain, stiffness, and tenderness
- Abdominal pain
- Constipation or diarrhea
- Headache
- musculoskeletal pain, stiffness, and tenderness
The nurse is planning care for a client with fibromyalgia based on which of the following nursing diagnoses?
- Bowel Incontinence
- Ineffective Activity Planning
- Disturbed Body Image
- Activity Intolerance
- Activity intolerance
A client who is being evaluated for a diagnosis of fibromyalgia asks the nurse what kind of diagnostic tests will be ordered. The nurse responds with which of the following?
- An electrolyte panel
- A pain assessment
- A CT scan
- There are no specific tests for fibromyalgia
- A pain assessment
