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CE Connection

Chronic fatigue syndrome

Nursing Management (Springhouse): October 2020 - Volume 51 - Issue 10 - p 1
doi: 10.1097/01.NUMA.0000719220.85627.ef
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GENERAL PURPOSE: To gain knowledge about CFS, including the pathophysiology, clinical manifestations, diagnostic criteria, and management strategies. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Summarize the epidemiology, pathophysiology, and clinical manifestations of CFS. 2. Identify the appropriate diagnostic and treatment approaches for patients with CFS.

  1. CFS is also referred to as
    1. fibromyalgia.
    2. Epstein-Barr viral infection.
    3. systemic exertion intolerance disease.
  2. CFS is more likely to be diagnosed in patients who are
    1. male.
    2. middle age.
    3. adolescent.
  3. Immune system changes that occur with CFS involve
    1. a reduced number of cytokines.
    2. abnormal functioning of white blood cells.
    3. an increased ability to use energy on the cellular level.
  4. The pathophysiology of CFS includes a dysregulation of several limbic-hypothalamic-pituitary-adrenal axes that affect levels of certain hormones such as
    1. cortisol.
    2. glucagon.
    3. thyroid-stimulating hormone.
  5. Another factor that may contribute to the pathophysiology of CFS is
    1. neuroinflammation.
    2. decreased lactate levels.
    3. spots in the brain's gray matter.
  6. While assessing the patient's medical history, he reveals experiencing fatigue that doesn't improve with rest and can't be explained by an underlying medical disorder. This description is
    1. the hallmark of CFS.
    2. a rare symptom of CFS.
    3. not associated with CFS.
  7. The newly diagnosed patient with CFS asks about long-term disabilities. The patient is advised that about half of individuals affected by CFS
    1. experience “crash” reactions daily.
    2. are able to return to work, either full or part time.
    3. are house- or bedbound at some point during their illness.
  8. The patient calls the healthcare provider's office and states that she's currently experiencing a “crash,” which is also identified as a phenomenon called
    1. Sjögren syndrome.
    2. daytime hypersomnia.
    3. PEM.
  9. The newly diagnosed patient asks about common manifestations of CFS. It's explained that many individuals with CFS experience
    1. nighttime insomnia.
    2. normal rhythm and quantity of sleep.
    3. an increase in BP upon standing.
  10. When assessing a patient for CFS, it's helpful to ask about common comorbidities that are present with this disorder, such as
    1. asthma.
    2. psoriatic arthritis.
    3. postural tachycardia syndrome.
  11. The National Academy of Medicine proposed which of the following as a diagnostic criterion for CFS when accompanied by cognitive impairment and/or orthostatic intolerance?
    1. a substantial reduction in activity that lasts for at least 3 months
    2. persistent headaches that occur at the onset of PEM
    3. profound, new-onset fatigue unrelated to exertion and not relieved with rest
  12. A nanoelectronic assay test is
    1. an accepted biomarker test used to diagnose CFS.
    2. an investigational blood test with 100% accuracy in one study.
    3. a test to identify a specific antigen that causes CFS.
  13. Some studies have shown positive short-term results for patients treated with
    1. modafinil.
    2. hydrocortisone.
    3. methylphenidate.
  14. Which drug resulted in some improvement for patients with CFS but without enough epidemiologic significance to become the gold standard of treatment?
    1. selegiline
    2. donepezil
    3. nefazodone
  15. The primary goal of CFS treatment is helping patients improve their quality of life through
    1. symptom relief.
    2. GET.
    3. CBT.
  16. Nonpharmacologic therapies that may be recommended for patients with CFS include
    1. aromatherapy.
    2. phototherapy.
    3. acupuncture.
  17. It's important for healthcare providers to encourage patients with CFS to
    1. be as active as their energy allows.
    2. limit activity to the barest minimum.
    3. avoid taking a rest after a period of activity.
  18. When caring for patients with CFS, interventions to consider include
    1. encouraging ambulation without standby assist for patients with orthostatic intolerance.
    2. providing supplements as desired even if there's a known interaction with the treatment regimen.
    3. inquiring about vitamins to avoid interactions with prescribed medications.
  19. It's important to note that many patients with CFS
    1. have elevated BP.
    2. have no functional impairment.
    3. show no outward signs of illness.
  20. According to Dr. Unger, the predominant concern of patients with CFS and their families is
    1. accepting that there may never be any improvement in symptoms.
    2. the challenges of leading a productive life with CFS symptoms.
    3. the difficulty of finding informed and compassionate healthcare providers.
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