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34 Cards in this Set
- Front
- Back
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Fibromyalgia is a ________ disorder that is _________, _________ ______________ pain.
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-CHRONIC
- widespread - non-articular - musculoskeletal |
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True or false
Fibromyalgia is a major cause of disability. |
True
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Who does Fibromyalgia mainly affect?
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Women 20-55 yrs
But can occur at any age and any ethnic group |
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Fibromyalgia S/S?
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- widespread burning pain
- head or facial pain - TMJ - Fatigue - 11 or more tender points - migraine headaches - depression, anxiety - paresthesia - restless leg syndrome - IBS |
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How are diagnostics used in dx Fibromyalgia?
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- Lab results rule out other disorders
- Muscle biopsy may show abnormalities |
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What are the 2 criteria for a Fibromyalgia dx?
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- Pain in 11 of 18 tender points upon palpation
- Widespread pain noted for 3 months |
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What is the treatment for Fibromyalgia?
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- Treatment is symptomatic
- Rest - Analgestics (non- opiate) - Antidepressants - Muscle relaxants - Anti-anxiety meds - Supportive therapy - Exercise - Nutrional support |
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Lyrica is? what does it do? side effects?
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- The first drug approved by the FDA to treat Fibromyalgia.
- Helps reduce pain and improve function. - Dizziness, sleepiness, blurred vision, swelling of hands and/or feet, dry mouth |
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Gout is?
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A systemic disease caused by an increase in uric acid production, an underexcretion of uric acid by the kidney, or an increase intake of foods containing purines.
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Purine metabolism results in what?
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uric acid
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State and explain the 2 types of gout
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Primary: hereditary disorder of purine metabolism which leads to the overproduction or retention of uric acid
Secondary: excessive uric acid in the blood caused by another disorder or drug |
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What are some examples of causes of secondary gout?
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- Renal problems
- Chemo drugs - thyazide diuretics |
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What are the 4 phases of gout?
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- Asymptomatic
- Acute - Intermittent - Chronic |
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Define the acute gout phase
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Rapid onset, inflammation of one or more joints, especially the great toe
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Define the intermittent gout phase
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Asymptomatic period between acute attacks
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Define the chronic gout phase
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Repeated episodes of acute gout caused by deposits of urate crystals (tophi) under the skin and within the major organs, especially the renal system
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Define tophi
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- Urate crystals formed from uric acid
- Yellow, gritty substance that can leak out of skin - Eats away at cartilage and joints - Can also form in organs |
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Gout S/S?
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- Excruciating pain in involved joints
- Swelling of the joints - Tophi present - Low grade fever - Malaise and headache - Pruritis - Renal stones |
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What lab findings would you assoicate with gout?
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- Elevated serum uric acid levels (>6 mg/dl)
- Elevated erythrocyte sedimentaton rate (40-70 moderate inflammation, 70-105 severe inflammation) - Elevated uric acid in urine for 24 hrs |
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What procedure makes a dx of gout?
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Presence of sodium urate crystals in aspirated joint fluid
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What is considered a high serum uric acid level?
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> 6 mg/dl
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An elevated ESR of 40-70 means?
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Moderate inflammation
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An elevated ESR of 70-105 means?
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Severe inflammation
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A patient with gout should avoid what in their diet?
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- Organ/ red meats
- Wines/ beer - Aged cheese - Shellfish - Anchovies - Shellfish - Mussels - Venison - Lentils - Herring - Asparagus - Spinach |
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Why should patients with gout increase their fluid intake? to how much?
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- To prevent stone formation
- 2500- 3000 ml/ day |
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What would the nursing care/ home care be with an acute attack of gout?
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- Bed rest with joint immoblilized
- Monitor joint ROM- protect from excessive movement - Elevate affected extremity - Admin meds as prescribed - Skin care |
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What are the 3 main meds for gout?
(A,B, C's) |
- Allopurinol (Zyloprim)
- (Benemid) Probenecid - Colchicine |
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Which gout med is for prevention and blocks the production of uric acid?
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Allopurinol (Zyloprim)
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Which gout med is a uricosuric drug and gets rid of the uric acid?
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(Benemid) Probenecid
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Which gout med is an anti- inflammatory that usually provides dramatic relief in 24-48 hrs?
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Colchicine
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Which gout med is usually used with chronic patients?
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Colchicine
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What is Benemid inactivated by? and is ineffective with what body issue?
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- Aspirin
- Renal issues |
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What other meds can be given for gout besides the "A, B, C's"?
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- NSAIDs
- Intraarticular injections of corticosteroids - Systemic corticosteroids if routine treatment is contraindicated or ineffective |
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Chronic inflammation from gout may result in?
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Joint destruction and eventually lead to osteoarthritis
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