NURSING > STUDY GUIDE > Walden University - NURS 6560 week11 ihuman_100% Correct. (All)

Walden University - NURS 6560 week11 ihuman_100% Correct.

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week11 ihuman Primary Diagnosis: Migraine Headache Status/Condition: Stable Code Status: Full Allergies: NKDA Admit to Unit: Outpatient Activity Level: As tolerated. Diet: Encourage PO intake. No caffeine. IVF: N/A Critical Drips: N/A Respiratory: N/A Medications: Continue home medications Sumatriptan 6 mg SC as a single dose; May repeat in 1 hr. Maximum 12 mg/day migraine Naproxen 500 mg PO now, then Naproxen 500 mg PO BID PRN maximum 1250 mg/day migraine. Metoclopramide 20mg IM now, then 10 mg PO Q8H PRN for nausea. Maximum dose 45mg/day Will consider Propranolol hydrochloride ER 80 mg PO QD for migraine prophylaxis and stress. Nursing Orders: Vital signs in office. Monitor BP upon discharge Follow Up Lab tests: Urine pregnancy test, VDRL, ESR, TSH/T4, urine and blood toxicology screen (Tylenol Q4H); CBC, CMP, ECG, LFTs in 4 weeks Diagnostic testing: CT of head without contrast- r/o SAH and/or stroke Consults: Neurology-new onset migraines; psychiatrist and counselor – increased stressed levels and coping mechanisms Patient Education and Health Promotion: • Teach the patient about the importance of compliance to the treatment regimen • Take all medications as prescribed. • Medication side effects and adverse effects • Maintain headache diary in order to identify and avoid triggers • Get adequate sleep, at least 8 hours per night, no naps • Maintain food diary in regards to headache symptoms • Eat regularly, not skipping meals, and staying hydrated • Monitor BP especially with sumatriptan and propranolol • Avoid alcohol, excessive caffeine • Avoid artificial sweeteners- aspartame; monosodium glutamate-chinese food; nitrates in cured meat, chocolate, tyramine in aged cheese and wine • Discharge planning and required follow-up care: • Discharge patient home with medications and treatment plan • F/U appointment with PCP in 1 week • Set up appointment with neurologist and psychiatrist and counselor is patient is willing • Notify PCP if headache persists with treatment • Go to the ER for worsening or unrelieved symptoms References Bajwa, Z., & Smith, J. (2018). Acute treatment of migraine in adults. Retrieved from UpToDate: https://www.uptodate.com/contents/acute-treatment-of-migraine-in-adults?search=migraine%20treatment&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1. Bajwa, Z., & Smith, J. (2018). Preventive treatment of migraine in adults. Retrieved from UpToDate: https://www.uptodate.com/contents/preventive-treatment-of-migraine-in-adults?search=migraine%20treatment%20beta%20blocker&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1. Chawla, J. (2018). Migraine headache treatment & management. Retrieved from Medscape: https://emedicine.medscape.com/article/1142556-treatment?pa=Yrdgwov%2B%2FX4p1f%2FjIXql3FeWv36YgG9Zsx7OCzCtahKx2EVaW8Y6r2LU9UcSPCTMLCEJNCrbkqLWYvqLrhntWA%3D%3D#d11. Collins, T. (2018). Migraine headaches in adults. Retrieved from Epocrates: https://online.epocrates.com/diseases/10/Migraine-headache-in-adults.

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