STUDY - Technical - New Dacian's Medicine
Fatigue
(Classical / Allopathic Medicine)
Fatigue is a
feeling of excessive tiredness, lack of energy, or exhaustion
accompanied by a strong desire to rest or sleep. This common
symptom is distinct from weakness, which involves the muscles,
but may occur with it.
Fatigue is a
normal and important response to physical overexertion,
prolonged emotional stress, and sleep deprivation. However, it
can also be a nonspecific symptom of a psychological or
physiologic disorder - especially viral infection and
endocrine, cardiovascular, or neurologic disease.
Fatigue reflects
hypermetabolic and hypometabolic states in which nutrients
needed for cellular energy and growth are lacking because of
overly rapid depletion, impaired replacement mechanisms,
insufficient hormone production, or inadequate nutrient intake
or metabolism.
HISTORY:
Ask the patient about related symptoms and recent viral illness or stressful changes in his lifestyle.
Ask the patient about his nutritional habits and appetite or weight changes.
Review the patient's medical and psychiatric history for chronic disorders that commonly produce fatigue. Ask the patient if there's a family history of such disorders.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Ask the patient about related symptoms and recent viral illness or stressful changes in his lifestyle.
Ask the patient about his nutritional habits and appetite or weight changes.
Review the patient's medical and psychiatric history for chronic disorders that commonly produce fatigue. Ask the patient if there's a family history of such disorders.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
PHYSICAL
ASSESSMENT:
Observe the patient's general appearance for overt signs of depression or organic illness.
Evaluate the patient's mental status, noting especially mental clouding, attention deficits, agitation, psychomotor retardation, or depression.
Conduct a full physical assessment to identify causation.
Observe the patient's general appearance for overt signs of depression or organic illness.
Evaluate the patient's mental status, noting especially mental clouding, attention deficits, agitation, psychomotor retardation, or depression.
Conduct a full physical assessment to identify causation.
SPECIAL
CONSIDERATIONS:
Fatigue may result from various drugs, such as antihypertensives and sedatives. In cardiac glycoside therapy, fatigue may indicate toxicity.
Fatigue may result from various drugs, such as antihypertensives and sedatives. In cardiac glycoside therapy, fatigue may indicate toxicity.
PEDIATRIC
POINTERS:
When evaluating a child for fatigue, ask his parents if they've noticed any change in his activity level.
Fatigue without an organic cause occurs normally during accelerated growth phases in preschool-age and prepubescent children.
Psychological causes of fatigue must be considered - for example, a depressed child may try to escape problems at home or school by taking refuge in sleep.
In the pubescent child, consider the possibility of drug abuse, particularly of hypnotics and tranquilizers.
When evaluating a child for fatigue, ask his parents if they've noticed any change in his activity level.
Fatigue without an organic cause occurs normally during accelerated growth phases in preschool-age and prepubescent children.
Psychological causes of fatigue must be considered - for example, a depressed child may try to escape problems at home or school by taking refuge in sleep.
In the pubescent child, consider the possibility of drug abuse, particularly of hypnotics and tranquilizers.
AGING ISSUES:
Always ask older patients about fatigue because this symptom may be insidious and mask more serious underlying conditions in patients of this age-group.
Temporal arteritis, which is more common in people older than age 60, usually presents as fatigue, weight loss, jaw claudication, proximal muscle weakness, headache, vision disturbances, and associated anemia.
Always ask older patients about fatigue because this symptom may be insidious and mask more serious underlying conditions in patients of this age-group.
Temporal arteritis, which is more common in people older than age 60, usually presents as fatigue, weight loss, jaw claudication, proximal muscle weakness, headache, vision disturbances, and associated anemia.
PATIENT
COUNSELING:
Regardless of the cause of fatigue, help the patient alter his lifestyle to achieve a balanced diet, a program of regular exercise, and adequate rest. Teach stress-management techniques, as appropriate. Refer the patient to a community health nurse, housekeeping service, or psychological counseling, as necessary. If fatigue results from organic illness, help the patient determine which of his daily activities he may need help with and how to pace himself to ensure sufficient rest.
Regardless of the cause of fatigue, help the patient alter his lifestyle to achieve a balanced diet, a program of regular exercise, and adequate rest. Teach stress-management techniques, as appropriate. Refer the patient to a community health nurse, housekeeping service, or psychological counseling, as necessary. If fatigue results from organic illness, help the patient determine which of his daily activities he may need help with and how to pace himself to ensure sufficient rest.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)