What are the three main types of headaches? - Migraine, Tension, Cluster
Steps to Pain Assessment
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Provoking
Quality
Radiation
Severity
Time
Provoking - has anything made it better or worse
Quality - Sharp, dull, achy, throbbing
Radiation - Does it radiate to another part of the body
Severity - Pain scale, 1-10 scale, intense pain, Other symptoms: N/V, photophobia
Time - how long has it been going on? how long does it usually last?
Tension Headache - Bandlike, tightness
Describe a Migraine - Unilateral, supra and retro orbital, pulsating or throbbing,
worse with movement, sensitivity with light and sounds
Cluster - Lancinationg or stabbing, 5-30 minutes. Extreme pain
Migraine Pathophysiology - Pathophysiology - Not entirely clear.; theories?
Prevalence: May be seen in children and adults; Among children more common in
boys; among adults more common in women.
History of patient with migraine: Otherwise healthy, usually female in 30's
Individualized triggers (stress, smells, foods, hormones, menses)
Tyramine rich foods- chocolate, cheeses, beer, wine, cigar, sweet and low.
Treatment for Migraine - Vasoconstriction works the best, irritation of the 5th
cranial nerve, Estrogen hormone can causes migraines.
Migraine Manifestations - Manifestations
Pain: Usually unilateral, supra/retro-orbital, pulsating. Worse with movement.Accompanied by non-h/a symptoms: N/V, photophobia, phonophobia,
Aura: (20% of cases):
Migraine Interventions - Pain management
Symptom management
Ex. Pitch black, turn off all the lights, N/V causes dehydration
Migraine Drug Therapy - APAP/Caffeine/ Butabital (Fioricet)
NSAIDS : Naprosyn
CCBs and Beta- Blockers (Preventative therapy) : Verapamil
Triptans and ergotamine's: Sumatriptan and Cafergot
Anticonvulsants (Preventative therapy): Topiramate
Botox Injections (monthly)
Magnesium
Migraine Complementary and alternative therapies - Acupuncture, Yoga, Stress
reduction activities, Supplemental mag, Distraction sometimes works.
Pound acronym - P:Pulsating
O:Duration
U: Unilateral location
N: N/V
D: Disabling
Epilepsy - Chronic disorder with two or more seizures experienced by the client.
Epilepsy Assessment - Inquire about the seizure activity, frequency, precipitating
factors, aura (pre-ictal phase).
Family history
Collateral medical conditions (hx stroke, HTN, TBI, drug/alcohol abuse)
Seizure risk factors - V: Vascular
I: Infection or Inherited conditions
T: Trauma
A: Alzheimers/Autoimmune
M: Metabolic derangements
I: Idiopathic
N: Neoplasm
S: pSychiatricEpilepsy Triggers - Sleep deprivation
Stress
Alcohol/ Alcohol Withdrawl
MSG
pg 878 Chart 42-9 [Show Less]