Discussion 1
You are currently seeing a 60-year-old female with a past medical history of hypertension, mild obesity, and hypothyroidism. You have diagnosed her with chronic fatigue syndrome.
1. What further assessment would the nurse practitioner need?
2. What are the immunologic or rheumatologic diagnosis?
3. What are some differential diagnoses to consider?
4. What imaging and labs are indicated to confirm your diagnosis?
5. What are the non-pharmacological and pharmacological treatment plans?
6. What education and risk information will be beneficial for the patient?
7. What will be the follow up and possible referral options?
Discussion 2
A 37-year-old female has been seen for chronic pain management. Since a motor vehicle accident 2 years ago, the pain was limited to her neck and upper back, but it has gradually spread and now she reports diffuse pain that is unrelenting. The pain is interrupting her sleep, and when she awakes, she does not feel rested. “I am exhausted all of the time,” she states. This condition is now having an adverse effect on her work and family life. She has used up all of her allowable time off from work and is concerned that she will lose her job. A physical exam reveals an otherwise healthy-appearing female, and a musculoskeletal exam is positive for tender points at the posterior cervical spine, bilateral shoulders, bilateral elbows, and hips.
1. What further assessment would the nurse practitioner need?
2. What are the immunologic or rheumatologic diagnosis?
3. What are some differential diagnoses to consider?
4. What imaging and labs are indicated to confirm your diagnosis?
5. What are the non-pharmacological and pharmacological treatment plans?
6. What education and risk information will be beneficial for the patient?
7. What will be the follow up and possible referral options?
