Question

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? b. On what areas should the nurse concentrate when assessing the patient? c.What diagnostic test are used with fibromyalgia syndrome?

Answer 1

a. Fibromyalgia syndrome is a chronic disorder which is characterized by musculoskeletal pain and fatigue with multiple tender points. Patients suffering from fibromyalgia syndrome may experience sleep which is often restorative in nature, morning stiffness, irritable bowel syndrome and anxiety. It often happens that some of the clinicsl manifestations overlap with those of CFS. Patients with FMS complains of a widespread burning pain that worsens and improves through the course of a day. Women with FMS may experience more difficult menstruation, with a worsening of disease symptoms during this time. Patients often experience pain in 11 of the 18 tender points on palpation and a history of widespread pain is noted for atleast 3 months.

b.Pain and the related symptoms of FMS can cause significant stress and also there is some indication that patients simply do not process stress well. Patients with FMS need support from the nurse and other members of health care team. FMS patients may also experience difficulty swallowing, because of abnormalities in esophageal smooth muscle function. Increased frequency of urination and urinary urgency, in the absence of a bladder function are to be assessed.

C.it is difficult to establish a definitive diagnosis. ANA titre is done to rule out FMS but it is not diagnostic. Muscle biopsy reveal a nonspecific moth- eaten appearance or fiber atrophy.