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This Concept Map, created with IHMC CmapTools, has information related to: Complex cases - group A case 4, Referals inc aquatic therapy, Ankylosing Spondylitis TX posture edu, strengthen back ext, stretch flexors,, orthopedist ???? xrays/MRI of neck or knee, Psychosocial self efficacy pt has neg affect if they have pain or think they can't do it, Meds in case Lunesta sleep aid side effects - pain, drowsiness, HA, Tx warm up arm bike, recumbent bike, treadmill, heat, 5 min massage, RA meds celebrex, cortico streroid, anti-malaryial meds, Fibromyalgia sx's soft tissue pain, reduced exercise tolerance, fatigue, depression, HA sleeping problems, 11/18 trigger points( neck, sternum, shoulders, low back), SLE causes genetics, drug induced, sun exposure, estrogen *NO KNOWN CAUSE, GERD casue stress, anxiety, aquatic therapy ???? decrease WB on joints, Systems Review Integumentary - rashes, circumferential, temp, color, infection, GERD inc stomach contents lead back into esphagus, RA inc autoimmune inflammatory disorder, presentation should be symmetrical, Diagnosis is Primary -> Lupus 7/11, Fibromyalgia -ɮ/11, Depression/Anxiety -> 2/11 Secondary -> opposite of above, SLE TX cortocisteroids, antiinflam meds, steroids monthly infusions (cyto),, SLE dx - rule out (no true lab value) - ANA lab value, - WBC 43-10,000 - urinalysis ( protein in urine) CXR (pericarditis/pleuritis - can alter results ESR F-ɭ-20 mm/hr M -ɭ-13 (+) indicative inflam - low platelet count 150-300,00 (avoid resistive therex), Ankylosing Spondylitis sx's bilateral butt pain, disapperance of lumbar lordosis, dull & diffused pain, progressive spinal pain & ROM, loss of appetite early -> mild fever, loss of apetite, general discomfot, later -> one side or alt, becomes chronic and bilateral over time, stiffness/pain speads up sine into neck, inc fatigue/anemia, advanced -> kyphpotic posture, lack spinal mobility, general stiffness/pain, Referals inc massage therapy, Fibromyalgia Dx pain for 3 months