Fibromyalgia.
Assessment Findings of fibromyalgia
Less stringent guidelines may be used for diagnosis, which include widespread pain lasting at least 3 months and no evidence of other underlying conditions as a cause of the pain.
nursing management for fibromyalgia
A support group may prove helpful, so clients can share their experiences. It is important to refer clients to reliable sources for fibromyalgia, such as the National Fibromyalgia Association, and to remind them not to engage in treatments that have not been verified.
Medical management analgesics
Acetaminophen (Tylenol). NSAIDS Tramadol (ultram). Muscle relaxants Cyclobenzaprine (Flexeril. Antidepressants Duloxetime (Cymbalta) Venlafaxine (Effexor xr) Anti-seizure/convulsants Gabapentin (Neurontin) Pregabalin (Lyrica).
Physical exam & Health History.
Diagnosis is often difficult and involves ruling out other diseases and conditions. The presence of widespread and chronic pain in all four quadrants of the body, but most especially the axial chest, neck, and back, is particularly a hallmark for diagnosing fibromyalgia.
Nursing Management for fibromyalgia
Encouraging clients to live a healthy lifestyle is important. This includes a healthy diet, avoidance of caffeine and alcohol, regular exercise, decreased stress, and adequate sleep.
TENDERNESS.
Even a small amount of pressure can cause a lot of pain.
Other factors that could cause fibromyalgia
FAMILY HISTORY. The genes you inherit from your parents may increase the likelihood of developing fibromyalgia. TRAUMA. Physical and emotional trauma have been linked to fibromyalgia.
Tender Points assessment.
Identifying 11 of the 18 tender points identified by the American College of Rheumatology is useful but is not considered definitive by many physicians. Generally, clients are diagnosed based on all of their symptoms and not so much through specific tests.
Labs
Initial tests are done for blood counts, chemistry profile, thyroid levels, Lyme disease titer, and CRP, mostly to rule out other conditions.
medical management surgical
Invasive/noninvasive therapies: Acupuncture treatment. Massage therapies. CBT. Aquatherapy. Hyponotherapy. Vns.
Pathophysiology and Etiology
It is believed that repeated nerve stimulation results in abnormal levels of neurotransmitters that signal pain. The pain receptors in the brain develop a memory of the pain and are more sensitive to the signals.
Nursing Management for fibromyalgia
Nursing care focuses on providing support to clients. Often, clients have endured disturbing symptoms for a long period of time and feel that they were not believed.
antiepileptics and corticosteroids
Other medications are prescribed for treatment of specific symptoms a client may experience with fibromyalgia, such as for burning pain and as anti-inflammatory agents.
diagnostics for fibromyalgia
Physical exam & Health History. Labs. Tender Points assessment.
Associated risk factors
Sex. Family HX. Rheumatic disease.
noninvasive therapies.
Some clients benefit from acupuncture treatments, massage therapy, cognitive behavior therapy, biofeedback, aquatherapy, and hypnotherapy. states that clinical trials for vagus nerve stimulation are being conducted on clients with fibromyalgia. The vagus nerve is involved in central pain processing.
Other factors that could cause fibromyalgia
UTOIMMUNE DISEASES. People with disorders such as rheumatoid arthritis are more likely to develop fibromyalgia. INFECTIONS. There is some evidence to suggest that certain illnesses can act as a trigger.
WIDESPREAD fibromyalgia
The pain is felt all over, in both the upper and lower parts of the body. However, many people with fibromyalgia feel their pain in specific areas of their body, such as in their shoulder or neck.
CHRONIC fibromyalgia
The pain lasts a long time—at least 3 months or longer. Many people experience fibromyalgia pain for years before being diagnosed.
tender points
There are areas of pain on touch that can be identified on people with fibromyalgia that other people without this condition do not have. There is currently no explanation as to why this occurs.
Pathophysiology and Etiology
There is not any definitive identified with fibromyalgia. One theory of central pain syndromes states that the central nervous system becomes sensitized to a stimulus, increasing the client's sensitivity to pain signals
Possible causes of fibromyalgia
While the exact cause of fibromyalgia is unknown, recent studies suggest that changes in the central nervous system—the brain, spinal cord, and nerves—may be responsible for fibromyalgia pain.
Assessment findings/Signs & Symptoms
Widespread and chronic pain -most common).Others: Fatigue and sleep disturbances. Irritable bowel syndrome. Chronic headaches and tmj dysfunction. Heightened sensitivity to light, noise, touch. Depression &/or anxiety. Cognitive/memory impairment -"Fibro-fog").
FIBROMYALGIA- path/ etiology
Women, particularly middle-aged women, are most vulnerable to fibromyalgia, but the syndrome does affect men and children as well. Although it seems more prevalent and common today, fibromyalgia has been in existence for hundreds of years but was never accurately diagnosed.
Tramadol (Ultram),
a prescription pain reliever, may be taken with or without acetaminophen.
Dual serotonin-norepinephrine reuptake inhibitors, such as venlafaxine (Effexor XR) and duloxetine (Cymbalta),
are ordered to treat pain, sleep disorders, cognitive impairment, and mood changes.
Analgesics, including acetaminophen and NSAIDs,
are prescribed to alleviate some of the painful symptoms of fibromyalgia.
Tricyclic antidepressants (TCAs), especially amitriptyline,
are used with some success for chronic pain.
Assessment Findings of fibromyalgia
if a client has 11 out of 18 tender points, that is considered diagnostic for fibromyalgia.However, many clients with fibromyalgia have lower pain thresholds everywhere, not just at the identified tender points.
FIBROMYALGIA
is a chronic syndrome of musculoskeletal pain, fatigue, mood disorders, and sleep disturbances. middle age women most common.The pain is widespread, affecting muscles, ligaments, and tendons.
Fibromyalgia
is thought to be the result of overactive nerves. These nerves may be responsible for the chronic widespread pain and tenderness many people feel.
Muscle relaxants such as cyclobenzaprine (Flexeril)
may be prescribed short-term at bedtime to help with muscle aches.
Pathophysiology and Etiology
this process of central nervous system sensitization theoretically lowers a client's pain threshold.
Pregabalin (Lyrica), an antiseizure medication
used to treat some types of pain, is the first drug approved by the U.S. Food and Drug Administration to treat fibromyalgia. It is used to reduce pain and fatigue and improve sleep quality for people with fibromyalgia.