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FIBROMYALGIA SYNDROMEKey signs and symptoms Diffuse, dull, aching pain across the neck, shoulders, lowerback, and proximal limbs Fatigue Sleep disturbancesKey test results The diagnosis is made mostly based on subjective informationfrom the client.

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Antibiotic therapy: broad-spectrum untilthe causative organism is identified and thena specific antibioticINTERVENTIONS AND RATIONALES Assess cardiovascular and respiratorystatus for complications.

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Assessmentfindings include: acrocyanosis (cyanosis of the hands andfeet), which results from high levels of hemoglobin and vasomotor instability during thefirst week of life milia (clogged sebaceous glands) on thenose or chin lanugo (fine, downy hair) appearing after20 weeks of gestation on the entire bodyexcept the palms and soles vernix caseosa (a white, cheesy protectivecoating composed of desquamated epithelialcells and sebum) erythema toxicum neonatorum(a transient, maculopapular rash) telangiectasia (flat, reddened vascularareas) appearing on the neck, upper eyelid, orupper lip port-wine stain (nevus flammeus), a capillary angioma located below the dermis andcommonly found on the face strawberry hemangioma (nevus vasculosus), a capillary angioma located in the dermaland subdermal skin layers indicated by arough, raised, sharply demarcated birthmark Mongolian spot, an area of bluish skin discoloration sometimes found in Blacks, NativeAmericans, and neonates of Mediterraneandescent.

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CONTRIBUTING FACTORS Traumatic, stressful, or humiliating experienceASSESSMENT FINDINGSNursing carein pain disordermay focus onpain managementtechniques, suchas relaxation andmeditation.

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Insights from this collaboration can be found in our first full article from the PV State of Mind program, an ongoing series that discusses the relevant topics in PV today.

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HypertensionIntense thirstOliguriaPitting edemaPulmonary edemaRough, dry tongueSeizuresTachycardia Note conditions that may cause excessivesodium lossdiaphoresis, prolonged diarrheaor vomiting, or severe burnsto preventhyponatremia.

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NURSING DIAGNOSES Activity intolerance Decreased cardiac output Risk for injuryTREATMENT Bed rest Maintaining sufficient fluid intake Surgery (in cases of severe valvulardamage) to replace defective valveDrug therapy Antibiotics: based on infective organism AspirinINTERVENTIONS AND RATIONALES Before giving antibiotics, obtain a clienthistory of allergies to prevent anaphylaxis.

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