Fibromyalgia

After a lesson on fibromyalgia, a nursing student is summarizing fibromyalgia pain. The instructor knows the student needs clarification when the student states: a) "Fibromyalgia pain is widespread and may be described as burning, tender, or stiff." b) "Pain from fibromyalgia is chronic and may lead to decreased quality sleep and activity intolerance." c) "Patients with Fibromyalgia may feel most stiff in the mornings and often experience less pain as the day progresses." d) "Like other chronic pain syndromes, patients with Fibromyalgia may report cognitive dysfunction like memory lapses or mood disorders such as anxiety and depression."

"c) "Patients with Fibromyalgia may feel most stiff in the mornings and often experience less pain as the day progresses." This statement is incorrect, indicating that the student would benefit from clarification. While stiffness may peak in the morning, particularly after nonrestorative sleep, pain may worsen or improve through the course of a day (Chapter 64, p. 1547).

What is Fibromyalgia

Fibromyalgia is a chronic pain syndrome that involves stiffness, sleep disturbance, generalized muscle weakness and chronic fatigue. It is estimated that 25% to 65% of people who have fibromyalgia have another form of a rheumatologic disorder, such as RA or SLE. Occurrence of autoimmune disorders increases with age.

One of the most common distinctions of pain is whether it is acute or chronic. Which examples describe chronic pain? Select all that apply. a) A patient is receiving chemotherapy for bladder cancer. b) An adolescent is admitted to the hospital for an appendectomy. c) A patient is experiencing a ruptured aneurysm. d) A patient who has fibromyalgia requests pain medication. e) A patient has back pain related to an accident that occurred last year. f) A patient is experiencing pain from second-degree burns.

a) A patient is receiving chemotherapy for bladder cancer. d) A patient who has fibromyalgia requests pain medication. e) A patient has back pain related to an accident that occurred last year. Chronic pain is pain that may be limited, intermittent, or persistent but that lasts beyond the normal healing period. Examples are cancer pain, fibromyalgia pain, and back pain. Acute pain is generally rapid in onset and varies in intensity from mild to severe, as occurs with an emergency appendectomy, a ruptured aneurysm, and pain from burns.

A patient with fibromyalgia could benefit from nursing management that includes education or resources about (select all that apply) a) Stress management techniques b) Behavioral cognitive therapy and support groups c) Alternating cardiovascular exercise with weight or resistance training d) Appropriate sleep hygiene e) Long-acting opioids with prophylactic bowel care

a) Stress management techniques b) Behavioral cognitive therapy and support groups d) Appropriate sleep hygiene c incorrect. Patients with fibromyalgia may

Jennifer Carson is a 35-year-old woman who presents at the healthcare provider's office. She states that she has "been more tired than usual" for the past few months and that she has "a general achiness, especially in my back and hips." The healthcare provider is questioning a diagnosis of fibromyalgia and has ordered blood to be drawn for thyroid hormone levels. While preparing to perform the blood draw, Ms. Carson says, "If there are no tests to determine the diagnosis of fibromyalgia, why are they testing my thyroid?" What is your most informative response? a. "Sometimes the symptoms of fibromyalgia present similar to the symptoms of hypothyroidism. Knowing how your thyroid is functioning will allow for an accurate diagnosis." b. "Thyroid problems may precede the onset of fibromyalgia. If your thyroid is not functioning properly, it will be important to treat both conditions." c. "Checking thyroid function is the first endocrine gland to assess because fibromyalgia often presents with endocrine imbalances." d. "If your thyroid is not functioning properly, correcting thyroid hormone levels may prevent fibromyalgia from developing."

a. "Sometimes the symptoms of fibromyalgia present similar to the symptoms of hypothyroidism. Knowing how your thyroid is functioning will allow for an accurate diagnosis."

A patient is waiting for the results of genetic testing that was done to help identify health problems.Which pain disorder should the nurse recall that has been associated with a mutation of the SCN9A gene? a. Fibromyalgia b. Neuropathic pain c. Psychogenic pain disorder d. Sympathetically mediated pain

a. Fibromyalgia

During assessment of the patient with fibromyalgia syndrome (FMS), the nurse would expect the patient to report (Select all that apply.) a. sleep disturbances. b. multiple tender points. c. urinary frequency and urgency. d. cardiac palpitations and dizziness. e. multijoint pain with inflammation and swelling. f. widespread bilateral, burning musculoskeletal pain.

a. sleep disturbances. b. multiple tender points. c. urinary frequency and urgency. f. widespread bilateral, burning musculoskeletal pain.

When taking a health history, which statement from the client would support a diagnosis of fibromyalgia? a. "I have experienced persistent pain in my knees, ankles, and feet." b. "I have had generalized pain throughout my body for at least 3 to 4 months." c. "My joints are stiff when I get up in the mornings." d. "I have experienced heart palpitations and a fluttering sensation for the past few weeks."

b. "I have had generalized pain throughout my body for at least 3 to 4 months."

A healthcare provider prescribes duloxetine(Cymbalta) for a client diagnosed with fibromyalgia. The client asks the nurse why this medication is being prescribed. The nurse will base the response on which rationale: a. To reduce neuropathic pain b. To increase levels of dopamine and serotonin c. To decrease joint pain and swelling d. To relax the client and promote sleep

b. To increase levels of dopamine and serotonin

The nurse is planning care for a client with fibromyalgia. Which potential problems are priorities for the nurse to address?(Select all that apply.) a. Risk for injury b. Decreased cardiac output c. Activity intolerance d. Fatigue e. Pain

c. Activity intolerance d. Fatigue e. Pain

The nurse is caring for several patients who have the diagnosis Comfort, Impaired.Which patient statement should the nurse identify as describing discomfort related to fibromyalgia? a. "It seems like any activity increases my heart rate." b. "I have suffered a progressive loss of muscle tone." c. "I feel like I am having more difficulty breathing." d. "I have continual tenderness in my neck, spine, shoulders, and hips."

d. "I have continual tenderness in my neck, spine, shoulders, and hips."

Diagnosis of SEID include all of the following EXCEPT a) Profound fatigue lasting at least 6 months b) Unrefreshing sleep c) Postexertional malaise: total exhaustion after even minor physical or mental exertion d) Previous diagnosis of fibromyalgia

d) Previous diagnosis of fibromyalgia This is false because although fibromyalgia and SEID share common characteristics, no diagnosis of fibromyalgia is needed to be diagnosed with SEID

The nurse is educating a client newly diagnosed with fibromyalgia about prescribed medications. Which medication will the nurse include in the teaching session that will assist in treating neuropathic pain and may reduce pain associated with fibromyalgia? a. Fluoxetine b. Tramadol c. Milnacipran d. Pregabalin

d. Pregabalin