The Fatigue Quiz- An Introduction To The Symptom Guide

1. It is important to assess treatable contributing factors such as anemia, weight changes, electrolyte imbalances and medications for fatigue.

True

False

Assessment of treatable contributing factors for fatigue should include:
1) Treatment complications (anemia, infection, fever)
2) Weight/caloric intake changes (how much weight loss)
3) Fluid and electrolyte imbalances (sodium, calcium, potassium, magnesium)
4) Medications (opioids, antihistamines, antidepressants, alcohol/recreational drug use)
5) Other symptoms/side effects (ESAS greater than or equal to 4 for pain, depression, anxiety, and sleep disturbances)
6) Activity level changes (decreased activity, decreased exercise patterns)
7) Co-morbid conditions contributing to fatigue
(Fatigue Symptom Management Algorithm, 2012)

Explanation

Assessment of treatable contributing factors for fatigue should include:
1) Treatment complications (anemia, infection, fever)
2) Weight/caloric intake changes (how much weight loss)
3) Fluid and electrolyte imbalances (sodium, calcium, potassium, magnesium)
4) Medications (opioids, antihistamines, antidepressants, alcohol/recreational drug use)
5) Other symptoms/side effects (ESAS greater than or equal to 4 for pain, depression, anxiety, and sleep disturbances)
6) Activity level changes (decreased activity, decreased exercise patterns)
7) Co-morbid conditions contributing to fatigue
(Fatigue Symptom Management Algorithm, 2012)

2. Fatigue is the most common & distressing symptom experienced during treatment.

True

False

70-100% of cancer patients are fatigued.
Fatigue is the most common & distressing symptom experienced during treatment
30 to 75% of cancer survivors continue to report fatigue symptoms months to years after treatment ends

Explanation

70-100% of cancer patients are fatigued.
Fatigue is the most common & distressing symptom experienced during treatment
30 to 75% of cancer survivors continue to report fatigue symptoms months to years after treatment ends

3. There are several prevention and supportive care interventions on fatigue for all patients and caregivers. Match the missing words to learn more about these strategies.

It is important to _______ the patients and caregivers about the difference between normal and cancer-related fatigue.

Counsel patients about ______________ techniques. Help them prioritize and pace activities and delegate less essential activities.

Encourage patients to use a ____________ so that they can monitor their levels and patterns of fatigue.

Prevention and Supportive Care Interventions for all Patients and Caregivers as appropriate include:

1) Educate
- The difference between normal and cancer-related fatigue
- Treatment related fatigue patterns/fluctuations
- Persistence of fatigue post treatment
- Causes (contributing factors of fatigue)
- Consequences of fatigue
- Need to keep physically active during and post treatment
- Signs and symptoms of worsening fatigue to report to health care professionals

2) Counsel
- Energy conservation
- Help patients prioritize and pace activities and delegate less essential activities.
- Balance rest and activities so that prioritized activities are achieved
- Use of distraction such as games, music, reading, socializing

3) Encourage patients to use a treatment log or diary
- To monitor levels and patterns of fatigue
- To help ascertain peak energy periods
- To help with planning activities
(Fatigue Symptom Management Algorithm, 2012)

Explanation

Prevention and Supportive Care Interventions for all Patients and Caregivers as appropriate include:

1) Educate
- The difference between normal and cancer-related fatigue
- Treatment related fatigue patterns/fluctuations
- Persistence of fatigue post treatment
- Causes (contributing factors of fatigue)
- Consequences of fatigue
- Need to keep physically active during and post treatment
- Signs and symptoms of worsening fatigue to report to health care professionals

2) Counsel
- Energy conservation
- Help patients prioritize and pace activities and delegate less essential activities.
- Balance rest and activities so that prioritized activities are achieved
- Use of distraction such as games, music, reading, socializing

3) Encourage patients to use a treatment log or diary
- To monitor levels and patterns of fatigue
- To help ascertain peak energy periods
- To help with planning activities
(Fatigue Symptom Management Algorithm, 2012)

Submit

4. What questions would you ask a patient when conducting a focused fatigue assessment? (Check all the apply).

When did the fatigue begin?

What helps to relieve your fatigue?

How is fatigue affecting your activities of daily living?

What other symptoms are you experiencing with your fatigue?

How would you like us to help you in managing this symptom?

When conducting a focused assessment on fatigue, it is important to include the following questions:
O- Onset--Fatigue onset (When did fatigue begin?)
P- Palliating--What do you do to relieve your fatigue?
Q- Quality-- Ask patient for the description of fatigue in own words
R-- Region/Radiating- Other symptoms of fatigue?
S-- Severity and duration- Fatigue duration: Constant or Change over time
T-- Treatment- Has there been a change in the medications you are taking, including over the counter medications?
U-- Understanding- What do you believe is causing your fatigue? How is fatigue affecting your activities of daily living and lifestyle? How distressing/bothersome is fatigue?
V--Values- What is your goal for this symptom?
(Fatigue Symptom Management Algorithm, 2012)

Explanation

When conducting a focused assessment on fatigue, it is important to include the following questions:
O- Onset--Fatigue onset (When did fatigue begin?)
P- Palliating--What do you do to relieve your fatigue?
Q- Quality-- Ask patient for the description of fatigue in own words
R-- Region/Radiating- Other symptoms of fatigue?
S-- Severity and duration- Fatigue duration: Constant or Change over time
T-- Treatment- Has there been a change in the medications you are taking, including over the counter medications?
U-- Understanding- What do you believe is causing your fatigue? How is fatigue affecting your activities of daily living and lifestyle? How distressing/bothersome is fatigue?
V--Values- What is your goal for this symptom?
(Fatigue Symptom Management Algorithm, 2012)

Submit

5. To manage moderate and severe fatigue, patients are advised to engage in moderate levels of physical activity. What activities would you suggest to your patient? (Check all that apply)

Fast walking

Cycling

Swimming

Resistive/resistance exercise

Marathon running

Advise patients to engage in moderate level of physical activity (e.g. fast walking, cycling, swimming, resistive/resistance exercise) during and after cancer treatment unless contraindicated for 30 minutes per day, 5 days per week as tolerated.

Explanation

Advise patients to engage in moderate level of physical activity (e.g. fast walking, cycling, swimming, resistive/resistance exercise) during and after cancer treatment unless contraindicated for 30 minutes per day, 5 days per week as tolerated.

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