What is Fibromyalgia : NursingCrib.com Updates
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| What is Fibromyalgia Posted: 25 Jan 2010 05:16 PM PST 
 Is a syndrome characterized by fatigue, diffuse muscle pain and stiffness, sleep disturbance, and the presence of tender points on physical examination. - There is no unknown etiology, but theories have suggested a variety of possible pathophysiologic mechanisms, such as neural-hormonal disturbance, antecedent physical trauma, viral infection, immune dysregulation, psychiatric disturbances, and heightened sensitivity to pain.
- Complications include disability and inability to maintain functional roles.
Assessment - Fatigue, poor or nonrestorative sleep.
- Generalized muscle aches and stiffness
- Irritable bowel syndrome
- Tension headaches
- Paresthesias, sensation of swollen hands
- Presence of pain in 11 of 18 defined tender point sites
- Anterior: low cervical, second rib, lateral epicondyle, knee.
- Posterior: occiput, trapezius, supraspinatus, gluteal, greater trochanter.
- Complete history and physical examination to rule out other disorders.
Diagnostic Evaluation - Complete blood count, blood chemistries, erythrocyte sedimentation rate, thyroid-stimulating hormone, and arthritis panel rule out other disorders.
- X-rays and imaging studies are all normal.
Therapeutic Interventions - Cardiovascular fitness training
- Electromyogram biofeedback
- Cognitive behavioral therapy
- Hypnotherapy
- Electrical stimulation or acupuncture.
Pharmacologic Interventions - Nonsteroidal anti-inflammatory drugs, acetaminophen or tramadol to relieve pain.
- Antidepressants to help control chronic pain and depression.
- Muscle relaxants, such as cyclobenzaprine, to relieve muscle tension and spasm.
- Sleep agents and antianxiety agents may be considered.
Nursing Interventions - Monitor pain level and effectiveness of treatment plan.
- Assess functional ability.
- Encourage regular use of analgesics and antidepressants as directed.
- Encourage regular exercise routine, including stretching, aerobic activity, and muscle-strengthening exercises.
- Suggest referrals to physical therapist or pain specialists for additional pain control modalities as needed.
- Suggest regular night time ritual to promote sleep.
- Discourage staying up late and erratic sleep habits.
- Encourage relaxation periods or short nap during day as needed for fatigue.
- Advise limiting caffeine intake during day and especially after 4 p.m.
- Encourage patient to look at fibromyalgia as a chronic condition that can be controlled.
- Help patient plan schedule and pace activities to accomplish routine activities.
Nursing Care Plan – Fibromyalgia Related posts: - Online Nursing Care Plan – Fibromyalgia
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