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NURS 347 EXAM 6 > Headache > Flashcards

Headache Flashcards

1
Q

Headache pain can arise from both ?

A

Intracranial and extracranial sources

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2
Q

Notes
Pain sensitive structures include
Venous sinuses
Dura
Cranial blood vessels
Divisions of trigeminal nerve
Facial nerve
Glossipharybgeal nerve
Vagus nerve
Cervical nerves

A
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3
Q

Heads aches can be classified as what?

A

Primary vs secondary

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4
Q

What is primary headache?

A

Not caused by disease or another medical condition

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5
Q

What is secondary headaches?
Examples?

A

Caused by another condition or disorder

Sinus infection
Neck injury
Stroke

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6
Q

Primary classifications of headaches
There are 3 types what are they?

A

Tension type
Migraine
Cluster

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7
Q

Can patients have more than one type of headache?

A

Yes

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8
Q

Most frequent site of pain
Think of photo!
Tension type
Migraine
Cluster

A

All around, like a band
One side above the ear
On the eye

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9
Q

What is a tension type headache characterized by?
It’s normally what?

A

Bilateral location and pressing/tightening quality

Mild or moderate intensity

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10
Q

What is the most common type of headache?

A

Tension type

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11
Q

Tension type headache is also known as?

A

Stress headache

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12
Q

Tension type headache can last from
___ to ___
And it’s often subcaterogorizes into (2)

A

Minutes to day
Episodic & chronic

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13
Q

Tension type headache
Etiology and pathophysiology (2)
It’s an increase of what?
And has similar mechanism to what?

A

It’s increased tension in muscles of face, neck and scalp

Mechanism in all patients with tension type headaches has neurovascular factors similar to those involved in migraine headaches

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14
Q

What is the clinical manifestations of tension type headache?
Associated with what?

It may involve?
May occur?

A

Bilateral frontal-occipital discomfort or band like pain

Neck pain

Sensitive to light and sound but no nausea or vomiting

Intermittently for weeks months or years

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15
Q

What is the diagnostic study for tension type headache? (2)
It may reveal what?
It also may not show what during the headache?

A

Careful history taking

EMG may be performed
- reveal sustained contraction of neck, scalp, facial muscles
- may not show increased tension even when test is done during headache

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16
Q

A migraine is a recurring headache that is characterized by? (3)

A

Unilateral or bilateral throbbing pain

A triggering even or factor

Manifestations associated with neurologic and autonomic nervous system dysfunction

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17
Q

Migraine are more common in who?
Men or women?
Prevalence js highest in those of?
__% have a family member with migraine

The most common age is for?

A

Females
Lower socioeconomic status
70%
20-30

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18
Q

Migraine headache
Etiology and pathophysiology
What is cause?
What is involved?
Associated with?

A

It’s unknown for exact cause

Vascular, muscular and biochemical factors are involved

Associated with seizures disorder, ischemic stroke, asthma, depression, MI, anxiety, raynuads, IBS

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19
Q

Migraine headache may be precipitated or triggered by? (3)

A

Menstraution
Head trauma
Physical exertion
Fatigue
Stress
Missed meals
Weather
Drugs
Foods

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20
Q

What types of foods can trigger a migraine?

A

Chocolate
Cheese
Oranges
Tomatoes
Onions
Mono sodium glutamate
Aspartame
Alcohol ( red wine )

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21
Q

Migraine headaches can be preceded by what? (2)

A

Aura and prodrome

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22
Q

Migraine without aura is ?
Migraine with aura Is?

A

Most common type of migraine
10% of migraine episodes

23
Q

Migraine headache
Clinical manifestations
Prodrome can occur days before gm headache
What are the 3 symptoms ?

A

Photophobia
Irritability
Food cravings

24
Q

Migraine aura occurs immediately before a migraine which are? (6)

A

Bright lights
Patchy blindness
Zigzag lines
Sounds
Smells that don’t exist
Motor function symptoms

25
Q

Migraine headaches may last up to how many hours?
It’s classified as what?
It’s usually a what type of headache?
However can switch to the opposite side of the head In what?

A

4-72hours
Steady, throbbing pain that is synchronous with the pulse

Unilateral
Another episode

26
Q

During a migraine many patients tend to ___
And seek ?

A

Hibernate

Seek shelter from noise, light, odors, people and problems

27
Q

Migraines vary in severity
Such as
Not all migraines are ___
And some may become progressively ?

A

Disabling

Worse

28
Q

Migraine diagnostic studies ? (4)
Test typically are __
No need for specific ___

A

Patients history

Neurologic and diagnostic examinations are normal

No specific lab,radiology test

Neuro imaging techniques are not recommended unless abnormal findings are found on examination

29
Q

What is a cluster headache?

Can occur repeatedly for ?

A

Most severe and rare form of headache with a sharp stabbing pain

Weeks to months at a time followed by period of remission

30
Q

Cluster headache is classified as?

A

Trigeminal autonomic cephalgia

31
Q

Notes!!
Also involves dysfunction of intracranial blood vessels
Sympathic nervous system
Pain modulation system

A
32
Q

Cluster headaches clinical manifestation?

Where is pain usually located?

A

Sharp stabbing intense pain typically lasting from a few minutes to 3 hours

Around the eye, radiating to the temple, forehead, check, nose, gums

33
Q

Other clinical manifestations of cluster headaches include? (5)

A

Swelling around the eye
Lacrimation (crying) on affected side
Facial flushing /pale
Rhinitis
Construction of pupils

34
Q

During a cluster headache
The patient is often agitated and restless; why?

How often does it occur?
Same time of day as well^?

Typically last daily for how many weeks to months

Then into remission for ?

A

Regular
Yes

2weeks to 3 months

Months or years

35
Q

Cluster headache
Diagnosis is based primarily on history
But what systems can you do?

What is helpful for patients to have too?

A

CT,MRI,MRA
To rule out aneurysm, tumor or infection

Headache diary

36
Q

Notes
Headaches
Other types can be symptoms of serious illness like

A

Subarachnoid hemorrhage
Brain tumors
Other intracranial masses
Vascular abnormalities
Trigeminal neuralgia
Disease of eyes, nose, teeth and systemic illness

37
Q

Overall headache symptoms can vary greatly; so it’s important for a nurse to have a thorough clinical evaluation of a persons? (5)

A

Personality
Life adjustment
Environment
Family situation
Neurology / physical status

38
Q

If no systemic underlying disease is the cause, the type of headache guides what??

A

The therapy

39
Q

What two therapies are used ?
Examples?

A

Symptomatic and prophylactic ?

Drugs, medications, yoga, biofeedback, cognitive-behavioral therapy, relaxation training

40
Q

Drug therapy
Tension type headache
Symptomatic (3) with (2)

Prophylactic (4)

A

Aspirin, acetaminophen, NSAID
and sedative muscle relaxant / transquilizer

Tricyclic antidepressants
Topiramate, divalproex, mirtazapine

41
Q

Drug therapy
Migraine
Symptomatic
This is when it’s mild form !! (3)

A

NSAID, aspirin, caffeine analgesics

42
Q

Drug therapy for migraine
When it becomes moderate or severe
What is the first line of therapy?

It’s most effect at ___
Affect selected ____ receptors
Reduce ____
Produce ___
( we want to avoid giving this to people who have CAD why? )

A

Triptans

Onset of headache

Serotonin

Neurogenic inflammation of cerebral blood vessels

Vasoconstriction

Increases blood clot & because of the plaque

43
Q

Migraine drug therapy
Prophylactic (3)

This is based on frequent, severity, disability for each individual

A

Anti seizure drugs
Botox
Antidepressants

44
Q

Drug therapy
Cluster headache
Symptomatic
Drug therapy isn’t as good, so we do instead?(2)

A

Inhalation of 100% oxygen at 6-8L/Min for 10/20 minutes

Sumatriptan also effective for acute cluster headache

45
Q

NOTES!!
Drug therapy
Cluster headache
Prophylactic

A

Verapamil
Lithium
Ergotamine
Divalproex
Melatonin
Anti seizure medication

Invasive nerve blockers and ablative neurosurgical procedures have been used for refractory cluster headaches

46
Q

We also want to be very mindful of other type of headaches which can be caused by the potential overuse of analgesics ; like ? (4)

A

MOH ( medication overuse headache )

ASPIRN, NSAID, Sumatriptain, opioids

47
Q

What is the nursing assessment or a headache? (4)

A

Asking about health history
( seizures, stroke, cancer ? )
Medications
Surgery
Treatments

48
Q

You also wanna make sure to ask for the specific location of headache like?
L
T
o
f
d
R

A

Location
Type of pain
Onset
Frequent
Duration
Relation to outside events

49
Q

What objective data will you collect from a headache?

A

Anxiety of apprehension
Diaphoressis
Pallor
Unilateral flushing with cheek edema, conjunctivitis

50
Q

What’s the planning of headache in the nursing management? (4)

A

Have no pain
Demonstrate understanding of trigger events
Use positive coping strats

Experience increased quality of life

51
Q

Should daily exercise, relaxation periods, socializing help reduce recurrence ?

A

YES!!!

52
Q

Should you suggest alternative pain management such as relaxation, medication, yoga, and self hyponosis?

A

YES!!

53
Q

Notes
You want to teach the patient to avoid foods triggers, smoking and environmental triggers

Encourage dim quiet environment

Massage and heat packs
Written notes of medications to prevent overdose

A
54
Q

What is the last goal of evaluation of headaches?

A

No pain!!!

Uses of drugs and non drug measure appropriate to mangane pain

NURS 347 EXAM 6 (17 decks)

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