Kategorier: Alla - stress - assessment - pain - contrast

av kellyanne fontaine för 10 årar sedan

2194

headache Concept map

When assessing and managing migraines, healthcare providers employ a multifaceted approach. Diagnostic imaging, like CT scans, may be utilized, sometimes enhanced by an iodine-based contrast medium to better visualize the head'

headache Concept map

Scans using a series of xrays of the head from different directions,Contrast medium, an iodine-based dye that is injected into the bloodstream to enhance CT images, may be used in a scan

headache Concept map

Headaches are a symptom not a disease -could be neurological , stress related , vasodilated ,skeletal muscle tension

neurological reasons for a headache
symptoms of neurological migraine

Subtopic

1.pain on one side or both sides of face and head, consistent rhythmic throbbing ,difficulty thinking concentrating ,disrupted motor coordination,

2 categories of headaches

secondary - underlying cause -stroke hemmorhage , infection siutitis .
SSNOOPS systemic symptoms fever wt loss , Secondary risk factor HIV cancer, Neurological symptoms confusion impaired alertness ,Onset sudden abrupt split second , Older -new onset progressive headache over 50 , Previous headache history pattern changes
Primary
Overactive paind senstive areas in the structures of the brain . No underlying cause like secondary. Could be a genen that is carried forward

Diagnostic test s for migraines

testing for blood vessels problems , infection of brain or spinal cord, checking for toxins
Esr erythrocyte Sedimentation rate, C reative Protein
Reason for tests- Dr is unable to be diagnos based on symptoms and neuro exam .Thuderclap , Different from other headaches you have had , over 50, gets worse with exercise , comes with fever ,seizure , vomiting, change of vision or speech
Medical imaging
Ct cross sections images used to diagnose tumor or infection or brain damage or bleeding

MRI - magnetic field and radio waves produce images of the blood vessels

Lumbar puncture -checking for infection or bleed , needle into the spine aspirating cerebralspinal fluid for analysis . beware that the side effects can be a very extreme headache

reasons for getting a LP1st or steady worsenting , Severe rapid onset progressively getting worse

Nursing interventions for migranes

Assessment questions?
3 main questions to ask to determine if it qualifies as a migraine

if you answer yes to altelast 2 you have a form of miograne headache

has this headache been limiting your activities for the last 3 months or longer

do you feel nausea or stomach when you have a headache

do you find that the light bothers you ?

How long has this been going on ? Have your been journallling what is happening?

pain level -1-10

describe the pain ? heavy throbbing stabbing constant location things that make it worse or better

observe for nonnverbal cles of pain -posture restlessness / grimacing crying diaphresis (sweating ) HR increase breathing rapid

lifestyle
discuss what they think the factors are that can be modified or eliminated

Join a gym, seting a walk plan , meditaite, joing a group

stress

money ? is this an issues ? Is there a way that a budget could be made to stream line and to purchase a healthier diet pand

what is causing the stress ? can it be eliminated or modified. COuld councleling work to empower them to remove the stress

food/diet/hydration/meds/vitamins /suppletments

growing a garden , or joining a foodshare group, or community garden . Sharing meal preperations with freinds doing potlucks .

discuss food portions and the types of processed diet taht they eat ? how much water do they get? Maybe a med review could be in order if they are oon some kind of hormone therapy? what vitamins could they take , or supplemetns .

alternative choices

ride your bike to work once a week instead of the care or take the bus .

Make sure that you ask the patient how long this has been going onDo they have a regular Dr. tx , what meds tx"s therapies are they taking now . how are they physically manifesting ,what is the pain scale they are at , Asess the level of pain and or discomfort and how it affects their day life , suggest rest in quiet room, discuss triggers , food meds stress ,compress on forehead, encourage alternative therapies if interested , discuss stress relief , change of lifestyle

treatments for migraines

treatment goals
decrease migraine frequency intensity,decrease pain , increase relief stop symptom,improve quality of life ,educate patient on medications and treatments so that they can be the most effective for them ,
basic 5 steps of tx of a migraine - diagnosis , assess the level of disability Physical,mental, psychological , patient ability to be educated and what they already know , there own individual management system , layering of treatments
Medications
alternative medications/ treatments/ vitamins/tea

teas-

green tea , oolong tea chamomile - careful if pregnant can cause miscarriages, low birht wts, decrease in growth to fetus , can make astha attack worse

Accupunture - the insertion of thin needles into energy median on the basis that the tract are blocked

massage therapy

Is considered a proactive and active treatment. It enhances optimum levels of relaxation= realxe muscles/spasms and pressure point triggers , lowers the chances of a stress induced migrane

Cognitive behavioural therapy

this is a transportable treatment that can be done by the patient anywhere. No side effects . Keepin in mind the gate theory . Negative thoughts and emotions =gate open =increase in pain . Possitive thought s and emotions = closed gate=decrease in pain .Our pain is influeneced by our emotions and actions and thoguths. No side effects

Vitamin B-2

Riboflavin , enhances a component substance ta the body need to create energy production. help in the growth and developmetn of red blood cells

Co enzyme 10

helps with cell function, repairs damaged cells , helps to create energy

Magnesium suppletment s

helps relax the muscles

bio feed back _ technique to learn how to control your own body functions based on info from electrodes and how it is interpreted ..It helps narrow specific situations behaviors or thoguhts and allow the patients to recognize thougths and behaviours and how it influences their body symptoms. Therefore a form of mind over matter

thermal biofeedback- measures skin temp

electromyography - measures muscle tension

neurofeedback - measures brainwave activity

abortive medications

most effective 15 minutes after first symptom

abortive medications are specifically for compete and effective migraine treatment. They can be sued to prevetn the attack or stop the attack during the prodromal stage .

Prevvent attack can be given during th prodroal stage to stop proceeding .

Means of taking - can be given via inject to thigh , wafer melt on tongue,nasal spray, As of 2013 Sumatiptan is now available as a patch

Ergot Alkaloids - acts a s a vasoconstrictor of the carotid arteries. These types of meds have a sertonegic effect , which means that it stimulates the serotonin levels in the brain. Sufferer tend to have lower levels of serotonin

means of taking - injection , sublingual , or rectally

Black box warning - do not mix ergotamine and CYP3A4 inhibitors = cerebral ischemia . Could cause a thombus teratogentic warning - could cause premature contractions=miscarriage , fetal distress,

triptans are a type of medications that are targeted to affect the chemial seratonin which is usually low in migrane sufferse. It narrows the blood vessels reieving the swelling

means of taking triptans -tablets, injectables,nasal spray

Sumatriptan (Imitrex) Sumatriptan/Naproxen (Treximet) Zolmitriptan (Zomig) Eletriptan (Relpax) Naratriptan (Amerge) Rizatriptan (Maxalt) Frovatriptan (Frova) Almotriptan (Axert)

do not use more than 2x daily, and do not use more than 3 x in a week

prophalactic medications- givens as a preventative , deceresase the frequentcy and severity , make the acute attacks more receptive and respond better to abort therapy

Types of meds that are prophalactic( preventaive types)Beta-blockers propanalol,Toprol ,metoprolol, which relax blood vessels Calcium channel blockers- Cardizem (dilatizem) and verapamil, which reduce the amount of narrowing of the blood vessels Antidepressants- amitriptyline and nortriptyline ,tricyclic antidepressants Anticonvulsants -Depakote ,valproic acid,Topamax Botox (botulinum toxin), which can be injected in small quantities around the face and scap

means of taking prophalactic- most of them are oral

There are over 150 diagnosed headache classifications . I plan on discussing 5. I will be discussing migrane in detail in this concept map

tension
tension headache is the most common . affects your visionan and can cause nausea. Feel like a band is stretched over yoru forehead tightly
cluster

Cluster headaches are rare , they are severely painful , the come in cylces of clusters, last weeks to months that are followed by periods of remission.

mixed

Mixed headaches are a combination of tension headaches and migraines. it is believed that the migraine starts first causing the tension in the muscles causing the tension headache as well. This class has symptoms of both can last up to 72 hours from dull to throb and mild to severe pain. Activity tends to make it worse. It used to be called mixed headache syndrome

sinus

Sinus headache is cause by usually an inflammation in the sinus cavities in the brain. It is a buildup of fluid that causes te pressure on the membranes that causes the pain .

Migraine Is a recurrent throbbing that is severe affecting one side of the head usually followed with nausea , disturbed vision usually preceded by sensory warnings

4 phases of a migraine

postdromal phase after the storm . Not feel well up to a day after .tires quicly and sluggish , lethargic and confused

s/s fatigue. lowered intellect levels. lowered mood levels, especially depression, or feelings of well-being and euphoria. poor concentration and comprehension.

attack phase - migraine actually begins. Can last for hours or days. Pain above the eyes . Throughout the head, intense throb increase pain with exercise or exertion, very sensitive to light

s/sThrobbing pain Pain behind one of your eyes. Moderate to very bad pain. Pain so intense you can't do your normal things Pain that gets worse with routine physical activity. Nausea, vomiting, or both. Pain that gets worse when you e experience noise and smells

If you have some of these symptoms check with yoru dr. you might be having tia

dr 911Problems speaking. Tingling in your face, arms, and shoulders. Short-term weakness on one side of your body.

Aura Phase- no real migrane yet, Strange sensations , vision changes , flickering lights, imagine past, hallucinations, skin sensations like pins and needles , diffulty with communication

aura usully starts 30 minutes before migraine starts . Visions ; spots, wavy lines, or flashing lights .

Prodromal phase - Early warning signs ,prior to migrane unusual sensations , crave certain foods certain triggers .

s/s you experience being Depressed or cranky. Very happy, very awake, or full of energy. Restless or nervous. Very sleepy. Thirsty or hungry,Or you may not feel like eating.

migraine

migrane risk factors

Increased levels of C-reactive protein( blood marker for information if there is an inflammation in the blood in the arteries marker for upcoming heart issues ) Increased levels of interleukins( auto immunie and inflammation Increased levels of TNF-alph (tumor necrosis factor is a marker that the acute phase of the inflammation process has started ) Oxidative stress and thrombosis Increased body weight High blood pressure Hypercholesterolemia Impaired insulin sensitivity High homocysteine levels Stroke Coronary heart disease

oxiative stress = imbalance of freee radicals( are oxygen molecules that have more than one electron=very reative to other molecules . So if they react with DNAor lipids or proteins molecules =unstable = major free radicals .

Antioxideants - they can give up a molecule to the radical and still be stable and have no damage doen to the cell

homocysteine level -

Poor diet, lifestyle, social standing