The nurse is planning education for a patient diagnosed with fibromyalgia. Which risk factors should the nurse include in the teaching plan? (Select all that apply)

Choice A rationale:
Pitting edema of the hands and fingers is not a typical finding in SLE. It can occur in some cases, but it is more commonly associated with other conditions such as kidney disease or heart failure.

Choice B rationale:
Grey colored, non-purpuric papular rash is not a characteristic of SLE. This type of rash is more commonly seen in conditions such as lichen planus or sarcoidosis.

Choice C rationale:
A dry, red rash across the bridge of the nose and on the cheeks, also known as a malar rash, is a classic sign of SLE. It is often described as a "butterfly rash" because of its shape. The rash is caused by inflammation of the small blood vessels in the skin. It is typically worsened by sun exposure.

Choice D rationale:
Subcutaneous nodules on the ulnar side of the arm are a characteristic finding in rheumatoid arthritis, not SLE.

Choice A rationale:
History of rheumatologic conditions: Research has demonstrated a link between fibromyalgia and other rheumatologic conditions, such as rheumatoid arthritis, lupus, and osteoarthritis. Individuals with these conditions may have a predisposition to developing fibromyalgia due to shared genetic factors, immune system dysregulation, and chronic inflammation.
Choice B rationale:
Nutritional deficiency: While nutritional deficiencies, particularly in vitamin D, magnesium, and iron, have been associated with fibromyalgia symptoms, there's not enough evidence to establish them as direct risk factors for its development.
Nutritional deficiencies can worsen pain and fatigue, but they aren't considered primary causes of fibromyalgia.
Choice C rationale:

Previous injury to the bone: Past bone injuries typically aren't considered a risk factor for fibromyalgia. Fibromyalgia is a chronic pain syndrome that affects muscles and soft tissues, not bones themselves. While pain from an injury might trigger fibromyalgia symptoms, it's not a direct cause.
Choice D rationale:
Deep sleep deprivation: Sleep disturbances, especially disruptions in deep sleep (also known as slow-wave sleep), are strongly linked to fibromyalgia. Deep sleep is crucial for restorative processes in the body, including pain regulation. Insufficient deep sleep can lead to heightened pain sensitivity and contribute to the development of fibromyalgia.
Choice E rationale:
Physical and emotional trauma: Physical and emotional trauma, such as experiencing accidents, abuse, or significant psychological stress, can significantly increase the risk of developing fibromyalgia. Trauma can trigger changes in the brain's pain processing pathways and stress hormone regulation, contributing to chronic pain and other fibromyalgia symptoms.