Initial Discussion Question/Prompt Due Wednesday by 11:59 pm
Discussion post for this week, please take the following descriptive information and place it with the appropriate categories listed. Based on the descriptive information would this be a focused or comprehensive assessment and if focused what system or systems would you want to assess and why?
Descriptions
Presents with c/o headache
Pain is a ‘4’ on a scale of 1-10
Scoliosis corrected with Charleston brace, broken toe
No cold/sinus symptoms
Eye exam 2 years ago
No medications, NKDA
No hospitalizations
No tobacco use, wine once monthly, no recreational drug use
Single, lives alone
Traveled to UK, Caribbean in past 3 months
Throbbing for past 2 hours, can feel pulse in temple
Sports-induced asthma
No fever, no changes in vision
Categories
Chief Complaint
History of Present Illness
Past Medical History
Personal and Social History
Review of Symptoms
Discussion Peer/Participation Prompt Due Sunday by 11:59 pm
Instructions:
Please respond to at least 2 of your peer’s posts. To ensure that your responses are substantive, use at least two of these prompts:
Do you agree with your peers’ assessment?
Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
Share your thoughts on how you support their opinion and explain why.
Present new references that support your opinions.
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 in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.please any to peer 1 and 2 use different updated references:
Alexandra Dzikowski
MondayMay 31 at 5:49pm
NU610 Week 4 discussion post
According to Bickley and Szilagyi (2012), focused patient assessments are appropriate for established patients, addresses focused concerns or symptoms, and methods of examination are applied to the areas relevant to the concern or problem the patient presented with. In the case of this discussion post, I believe that this assessment is a focused assessment based on the complaint of headache and the details presented. The systems I would want to assess for a focused exam include Head, Eyes, Ears, Nose, and Throat (HEENT), Neurologic, Musculoskeletal, Psychiatric, and Gastrointestinal (GI). Depending on my findings and the patients history, I may want to expand to include other systems to make sure I have sufficient information to proceed with diagnostics if needed, diagnosis, a treatment plan.
Chief Complaint
Presents with c/o headache
History of Present Illness
Pain is a ‘4’ on a scale of 1-10
Throbbing for past 2 hours, can feel pulse in temple
Past Medical History
Scoliosis corrected with Charleston brace, broken toe
No hospitalizations
Sports-induced asthma
Under medications: No medications, Under allergies: NKDA
Under Health Maintenance – Eye exam 2 years ago
Personal and Social History
No tobacco use, wine once monthly, no recreational drug use
Single, lives alone
Traveled to UK, Caribbean in past 3 months
Review of Symptoms
No cold/sinus symptoms
No fever, no changes in vision
Reference:
Bickley, L., & Szilagyi, P. G. (2012). Bates’ guide to physical examination and history-taking. Lippincott Williams & Wilkins.
ReplyReply to Comment
Collapse SubdiscussionKayla McClaren
Kayla McClaren
ThursdayJun 3 at 11:19am
Alexandra,
Great post! When I initially reading your discussion response, I was curious at to why you would include a psychiatric assessment on this patient with the complaint of a headache. However, while doing some research, I found out that headaches significantly interferes with the daily functioning of affected patients, and according to the World Health Organization (WHO), migraine is the top leading cause of global burden of diseases in adults aged 15–49 years (Lee et al., 2019). Pharmacological approaches for the prophylaxis of headache disorder have been studied, and a wide range of medications are currently being used. Cardiovascular, antidepressant and anticonvulsant medications, such as propranolol, tricyclic antidepressants, and topiramate have demonstrated efficacy for migraine prophylaxis and are frequently used. However, the efficacy has not been entirely sufficient, and generally, no single drug has appeared to reduce headache frequency by much more than 50% in approximately half of patients (Lee et al., 2019).
Psychological treatment can be appropriate for headache disorder. As headache disorder often become chronic and distressful, psychological factors such as stress, specific personality traits or temperament and psychiatric disorders have been reported to be frequent in headache patients. High perceived disability in patient with migraine was reported to be associated with depression and symptoms of stagnation (Lee et al., 2019). Now that I have researched some myself, I agree that a psychiatric evaluation should be completed if the patient suffers from chronic headaches, especially those that affect activities of daily life.
References:
Lee, H. J., Lee, J. H., Cho, E. Y., Kim, S. M., & Yoon, S. (2019). Efficacy of psychological treatment for headache disorder: a systematic review and meta-analysis. The Journal of Headache and Pain, 20(1). https://doi.org/10.1186/s10194-019-0965-4
Edited by Kayla McClaren on Jun 3 at 11:21am
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