Assessment and Management of Patients With Rheumatic Disorders (Case Study)
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)
On what areas should the nurse concentrate when interviewing the patient during the history
On what areas should the nurse concentrate when assessing the patient?
What diagnostic tests are used with fibromyalgia syndrome?
2. Julie Walker, a 22-year-old patient, is newly diagnosed with systemic lupus erythematosus
(SLE). She presented with extreme fatigue; muscle and joint aching and swelling; a butterflyshaped, flat, red rash across the bridge of the nose; patchy alopecia; a low-grade fever; and loss
of appetite. Further workup revealed a positive antinuclear antibodies (ANA) titer, anemia,
leucopenia, and mild thrombocytopenia. She has an abnormal lipid profile, proteinuria, and
hypertension. The liver and renal profiles are within normal range. The physician ordered overthe-counter ibuprofen as needed for joint discomfort, but not to exceed 1,200 mg/day;
hydroxychloroquine sulfate (Plaquenil) before meals at the same time each day; and prednisone
in tapering doses over the next month. The physician also started the patient on lisinopril, an
ACE inhibitor for the hypertension and a statin for the elevated lipids. The clinic nurse is asked
by the physician to provide patient and family education. (Learning Objective 5)
What teaching-plan topics should the nurse provide for the patient?