Case Study, Chapter 39, Assessment and Management of Patients With Rheumatic

Case Study, Chapter 39, Assessment and Management of Patients With Rheumatic Disorders 1. Ellie Long, a 55-year-old patient, presents to the pain clinic with the diagnosis of fibromyalgia syndrome. The nurse at the clinic obtains a history and physical assessment of the patient. (Learning Objective 2) a. On what areas should the nurse concentrate when interviewing the patient during the history process?

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When interviewing a pt during the history process the nurse should concentrate on:  Including pertinent data r/t the pt’s functional abilities; ADLs, IADLs, and ability for the pt to perform different activities, the nurse should not any problems r/t mobility.  Health history should be include family history, general health maintenance, nutrition, occupation, leaning needs, socioeconomic factors, and medications (including OTC)  Assessment of pain, tenderness, and altered sensations.  Check for paresthesia (numbness, burning, and tingling)  Physical assessment of posture, gait, bone integrity (amputations, shortened extremities, symmetry, alignment, deformities), joint function (ROM passive and active), muscle size and strength, neurovascular status, and ability to change positions. b. On what areas should the nurse concentrate when assessing the patient? 

The nurse should concentrate on the description of pain, fatigue, what areas of body are affected, the physical assessment (posture, gait, joint function, muscle strength and size). This will help the nurse come up with the individualized treatment plan for pt.

c. What diagnostic tests are used with fibromyalgia syndrome?

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There is no lab test to confirm a diagnosis of fibromyalgia. Your PCP may order blood tests to R/O other conditions that may show similar symptoms: Complete blood count Erythrocyte sedimentation rate Cyclic citrullinated peptide test Rheumatoid factor Thyroid function tests

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