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Homework answers / question archive / NU 621 Unit 6 Discussion - Neurologic Disorders Read the following case study and answer the posed questions Case #1: For over 15 years, James, aged 64, has had severe, intermittent headaches
Read the following case study and answer the posed questions
Case #1: For over 15 years, James, aged 64, has had severe, intermittent headaches. These headaches are characterized by an intense burning pain on one side of his head, accompanied by tearing in his eye and a runny nose. When they strike, the attacks typically occur several times a day and usually last about an hour. James can be headache free for months at a time, but the attacks always return.
Case #2: Mr. Smith is a new patient with a history of recent stroke approximately 3 months ago. He was hospitalized in another state, but you don't have his records now. The patient's wife is extremely anxious and worried about him because he hasn’t been “acting right”. She wants him checked out. She does not think he had hypertension but adds "he does not like to go to doctors."
Cite current research findings, national guidelines, and expert opinions and controversies found in the medical and nursing literature to support your position.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Please review the rubric to ensure that your response meets the criteria.
NU 621 Unit 6 Discussion – Neurologic Disorders
Case #1
Pathology of headache.
Cephalalgia, another name for headache, is a frequent condition that makes it difficult to go about your everyday routine. Despite the fact that most headaches are harmless and innocuous, they may be a warning of more severe and potentially life-threatening illnesses like a brain tumor or intracranial hemorrhage. The pathophysiology of a sequel headache is Direct mechanical, pharmacological, or inflammatory activation of pain-generating tissues to less well-characterized processes as evidenced in primary headache disorders (Cutrer and O'Donnell, 2019) . While the underlying mechanism of a primary headache is not well known. When there is "depolarization to the nociceptive neurons within the cranial or spinal nerves (trigeminal or vagus or glossopharyngeal cranial nerves) or within the upper cervical roots, as well as when there is direct electrical or mechanical activation of areas involved in pain processing with the brain, as suggested by the information from procedures involving intracrural stimulation, a condition known as 'cephalalgia' has been described." In addition, "any nociceptor activation inside surrounding tissues, such as blood vessels, meninges, muscle fibers, facial structures, might result in the experience of headache," according to this study (Baranessand Baker,2021).
Based on the different etiologies for headaches, which fit this patient's situation?
Primary headaches, including tension, migraine, and cluster headaches, do not have an identified underlying cause. Still, secondary headaches, which include traumatic brain injury and vascular diseases, are caused by an underlying pathological condition. Suppose you look at how cluster headaches are defined. In that case, they are "severe, intense, unilateral, preorbital pain spreading to the face and jaw and neck, with a characteristic of tearing of the eyes and rhinorrhea as described by James," which is exactly what he's experiencing (American Migraine Foundation, 2019). It is also frequent in men between the ages of 20 and 50, making cluster headache the most plausible diagnosis for James, a 64-year-old man who has suffered from headaches since he was 49. " (McCance & Huether, 2015.)
Additional aspects of the history and physical examination provide relevant information to help diagnose.
It is possible to rule out or exclude major secondary headache causes using CT, MRI, and EEG even though "normal laboratory testing and imaging may not truly aid in detecting main headaches." [page needed] (McCance & Huether, 2015.). James' main headaches may be diagnosed by a thorough history and physical examination, as seen in this case. If you have a past headache condition or have had a prior history of headaches, be sure to mention any family history, triggering events, and any accompanying or preceding symptoms, such as nausea, vomiting, or hypersensitivity. The responses to these "particular inquiries" about secondary headaches, together with any physical results, "will lead to further testing or emergency treatment," according to a statement from the American Academy of Neurology (Baraness and Baker,2021).
The diagnosis of migraine without aura is well-supported by the available data.
An attack of migraine headaches, which are incapacitating and frequently unpredictable, may strike at any time and without prior notice. While migraine with aura happens with a pre-existing warning indication, migraine without aura occurs when there are no warning indicators. It is the most frequent kind of migraine. It is triggered by "hereditary factor, specific meals, medicines, hormonal changes, extreme hunger, mental stress etc. There is evidence to support the diagnosis of a migraine without an aura when a patient has "severe one-sided throbbing pain, typically with nausea, vomiting, cold hands and sensitivity to light and sound" (Baraness and Baker,2021).
Case#2
The Plan for care
There will be a detailed history and physical examination to determine the patient's condition based on this information. Suppose the patient's wife has seen any episodes of disorientation, headaches, slurred speech, or problems seeing or walking. In that case, the history should include questions regarding when she last witnessed her husband acting correctly, and events that occurred before the patient's vital signs and a thorough examination of the whole system should be conducted to establish a baseline and begin therapy if necessary (giving antihypertensives, statins, antiplatelets etc.). In addition to stroke prevention and medication adherence, patients will learn about better diet and lifestyle choices to help them maintain their current state of health. The patient will also participate in physical and occupational therapy to help restore their bodily capabilities once the procedure has been completed.
Goals to ensure prevention of a repeat brain ischemic event in patients.
Treatment of hypertension, weight reduction, good diet, decreasing LDL, and increasing physical activity are the key objectives in preventing a repeat brain ischemia accident (Cutrer & O'Donnell, 2019). Patients with a history of ischemic stroke should have their blood pressure and lipid biomarkers like LDL under control with antihypertensives and cholesterol-lowering medications, respectively. Along with this, patients should be educated on how to improve their cardiovascular fitness following a stroke by changing their daily activities to include things like quitting smoking, eating healthier, getting their sleep apnea checked out, and engaging in regular aerobic and strength training exercises (Cutrer & O'Donnell, 2019). In order to prevent a recurrence of a stroke, one must focus on losing weight since obesity raises the risk. Obesity and hypertension work together to increase the risk of a recurrent stroke.
References
American Migraine Foundation. (2019). Understanding cluster headache. https://americanmigrainefoundation.org/resource-library/cluster-headache-2/
Baraness, L. and Baker, A. M. (2021). Acute Headache. https://www.ncbi.nlm.nih.gov/books/NBK554510/
Cutrer, M.F. and O'Donnell, A. (2019). Pathophysiology of headaches. https://accessanesthesiology.mhmedical.com/content.aspx? bookid=411§ionid=40429803
McCance, K. L., & Huether, S. E. (2015). Pathophysiology: the biologic basis for disease in adults and children. St. Louis: Mosby.
