One of the commonly evaluated symptoms by neurologists and clinicians is cephalalgia [headaches] (Bernstein, Fox, Martin, & Lockey, 2013). The woman experiencing the recurrent headaches that mostly cause pain on the left side of the head requires a diagnosis to alleviate the condition. In this case, differential diagnosis is essential to ensure that the right treatment is administered to improve the patient’s health status. The associated disorders for the headache symptoms that include photophobia and phonophobia necessitate differential diagnosis to identify the correct treatment since there are over 300 different headache etiologies and types.
The intolerance to light and loud sounds, which underscore photophobia and phonophobia, require particular differential diagnosis strategies for headache disorders. Thus, tension-type headache (TTH), cluster headaches, and migraines are the common conditions associated with the symptoms observed. This aspect implies that a differential diagnosis of the three conditions would be relevant (Bernstein et al., 2013)
Since the headaches have recurred since her teenage years, chronic characteristics of TTH, cluster headaches, and migraine would be considered. In chronic TTH, mild nausea, phonophobia, or photophobia occurs. Pericranial tenderness may also develop depicting the presence of TTH. Forehead pains that are usually near the eye characterize chronic cluster headaches and movement does not intensify the condition. Besides, rhinorrhea, red eye, and face tearing are attributes of the disorder. Migraine symptoms include pounding or severe pain that affects one part of the head, nausea, or vomiting, eye pain, photophobia, and phonophobia (Bernstein et al., 2013).
Additionally, asking several questions to enhance the diagnosis is essential, and it should include the following. How frequent and how long do the headaches take? What parts of the head experience the pain? Does light or sound intensity trigger the headaches?
The behavior portrayed by Miranda is not normal, and thus it requires timely medical intervention to ensure the improvement of her health status and academic performance. Carrying out a differential diagnosis based on the provided clinical and behavioral manifestations is vital for the administration of the right treatment. Considering ADHD for diagnosis is strategic since the manifestations portray impulsivity, hyperactivity, and inattention. Besides, the situation affects Miranda’s academic, cognitive, emotional, behavioral, and social functioning. However, identifying the comorbid disorders that are associated with ADHD like anxiety, oppositional defiant disorder, and learning disabilities is crucial for a strategic diagnosis approach (Grauvogel‐MacAleese & Wallace, 2010).
Disorders associated with developmental variations, neurological conditions, emotional and behavioral conditions and psychosocial and environmental factors would thus be considered in the differential diagnosis (Grauvogel‐MacAleese & Wallace, 2010). Therefore, considering the intellectual disability, anxiety, and substance abuse, the differential diagnosis is appropriate for Miranda’ case.
The Intellectual disability aspect would encompass the school motor activity, reduced attention, and poor academic performance as the key symptoms. The anxiety disorder depicts signs like impaired school performance, poor social relationships, and naughty behavior. Thus, the signs are associated with childhood dementia manifested through the anxiety disorder. The substance abuse aspect of the differential diagnosis would focus on signs like diminished interest in schoolwork, depression, complaints from teachers, hyperactivity, inattention, and hostility. The signs could have been induced by a stressful home setting. However, the effects do not manifest both at school and at home (Grauvogel‐MacAleese & Wallace, 2010).
Therefore, settling at ADHD as the condition for treatment should ensure that the impulsivity, inattention, and hyperactivity persists for more than six months, occurs before the age of 12 years in various environments, and impairs the academic and social functioning of the child.
The developmental and behavioral assessment tools that include checklists and rating scales, as the ADHD-specific scales, are essential are useful for the diagnosis the evaluation of Miranda’s condition. Additionally, the Conners’ rating scales, Vanderbilt ADHD Parent Rating Scale, and Vanderbilt ADHD Teacher Rating Scale (VADTRS) could be applied (Grauvogel‐MacAleese & Wallace, 2010).
The expected course outcomes have facilitated the realization of MSN program outcome #3 as the integration of advanced communication systems has revealed its importance in the nursing practice. Advanced communication modalities are essential for streamlined communication within the nursing practice environment as interoperability, and the efficiency of patient service are achieved. Besides, the integration of ICT has enabled the development of support programs for patients with long-term conditions. Decision-making has also been fostered using support systems, thus promoting efficiency in service delivery (While & Dewsbury, 2011).
Since the MSN Essential IX specifications require a professional approach to nursing practice to enhance the attainment of improved patients’ health status, the course underscores the relevance of the aspect. Additionally, advocacy for better health standards of the population is inculcated amongst the nursing practitioners at the master’s level to facilitate policy formulation and implementation. Furthermore, the integration of knowledge derived from other sciences has been achieved. Therefore, it fosters the knowledge base for effective nursing practice (Edmunds & Mayhew, 2013).
The development of core competencies for desirable nursing practice has also been in line with the course’s anticipated outcomes. The integration of knowledge management tools, translation of health information, and patient education and coaching have been inculcated successfully throughout the course. Moreover, core competencies in information literacy skills, designing of clinical information systems, and the integration of technology systems for nursing practice evaluation have been imparted as essential for quality nursing practice. Thus, expectations of high-quality patient-oriented services would be achieved as part of the course outcomes (Edmunds & Mayhew, 2013).
References
Bernstein, A., Fox, W., Martin, T., & Lockey, F. (2013). Headache and Facial Pain: Differential Diagnosis and Treatment. The Journal of Allergy and Clinical Immunology, 1(3), 242-51.
Edmunds, W., & Mayhew, S. (2013). Pharmacology for the primary care provider. St. Louis, MO: Elsevier Health Sciences.
Grauvogel‐MacAleese, N., & Wallace, M. (2010). Use of Peer‐Mediated Intervention in Children with attention Deficit Hyperactivity Disorder. Journal of Applied Behavior Analysis, 43(3), 547-551.
While, A., & Dewsbury, G. (2011). Nursing and information and communication technology (ICT): A discussion of trends and future directions. International Journal of Nursing Studies, 48(10), 1302-10.