Please Following Case Explained for Students (Easy Guide)
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What This Question Is About
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Key Explanation
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Original Question
Please use the following case as a guide to answer the questions below and respond to one of your peers. You will also want to read through chapter 25 and the article on pediatric headache management in the Module Overview to help guide your answers. Please also find at least one other article to support your rationales for the answers. Patient: J. H. Sex: Female BP: 115/75 P:72 R: 16 DOB: 8-24-10 Allergies: PCN LMP: 3-15-22 J.H. a 12-year-old female presents to the clinic today with her mother for recurrent moderately severe headaches. She has been previously seen several months ago at the clinic for headaches and has been using OTC Ibuprofen (400 mg every 4 hours during a headache) to treat her headaches which are seeming to become more frequent in the past three months. Her mother has a history of migraine headaches and at her past appointment the provider did not identify any red flags requiring imaging. Her review of systems and physical exam today also did not identify any red flags or a need for urgent intervention. Her main complaint is that she is having up to four headaches a week that last from 2-8 hours in length and she becomes sensitive to light and loud noises and feels nauseated with these headaches. She states she needs to get in a dark room and lay down when she has a headache. Mom is concerned because she is missing at least two days of school a week recently with these frequent headaches. J.H. describes the headaches as throbbing and pounding that is mainly on the left side of her head. She states she can tell when she is getting ready to have a headache because she starts to feel “kind of tingly” and her vision gets “different”. She denies diplopia or loss of vision but says her vision gets “kind of wavy”. She started menstruating two months before she turned 12, but her cycles have been irregular over the past 6 months (which can be normal at this age). The Nurse Practitioner has diagnosed the patient with having “migraines with aura”. INITIAL POST: Please answer the all of the following questions regarding this patient. Also, please try to make your initial post by Thursday so that others can reply by Sunday. You are the Nurse Practitioner treating this pre-adolescent patient. How would you approach the treatment plan for her migraine headaches? Is there any further history or clinical information you would like to know prior to starting any different pharmacological treatments? Be specific about what pharmacological treatments your plan would entail and include a rationale for each of your choice(s). Would you consider an abortive and a preventive medication for her headaches at this time? Why or why not? Please include a strong rationale and use references to support your answer. What teaching would you give to this patient and her family regarding her headaches, any possible nonpharmacologic interventions, and medications?
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