Patient Background
The patient is Ronda Pakerson, a 41-year-old woman who lives alone in Los Angeles. She received a high level of education in journalism but has never worked in this field. Instead, she spent many years as a houseworker while her late husband had a business. Notably, her husband, Jim Pakerson, died three years ago due to a heart stroke. Since then, the patient has experienced constant waves of headaches and panic attacks.
Consequently, the above-mentioned symptoms allow one to determine migraines as the primary diagnosis for Ronda. As a nurse professional, one should collaborate closely with the patient to identify potential migraine triggers. For example, if it is concluded that her overthinking and soreness cause the patient’s constant headaches and stress, it will be useful to implement specific lifestyle changes.
Pathophysiology
First, it is essential to define migraine and explain how it is identified from a scientific perspective. Notably, this illness is a neurological condition that is accompanied by various symptoms and can have many adverse effects without proper treatment. According to Eigenbrodt et al. (2021), the scientific determination of this illness is that “Migraine manifests clinically as recurrent attacks of headache with a range of accompanying symptoms” (p. 501). In addition, one should note that this disease is widespread, affecting over 1 billion people worldwide (Ashina, Katsarava et al., 2021). Therefore, when designing the treatment, it is important to consider the current practices and techniques already in place.
Second, migraines have specific symptoms that can be identified through direct communication with the patient and through particular tests. Remarkably, as one of the primary Migraine symptoms, it is essential to name headaches (Ashina, Buse et al., 2021). The patient with this illness experiences constant headaches that can have various side effects.
Among them are vomiting and nausea, which can be significant in terms of worsening the patient’s health state (Ashina, Buse et al., 2021). Many scientists name genetic and environmental factors as the primary causes of migraines. Consequently, it is vital to address as many factors related to the client’s life as possible to be able to assess the potential triggers of migraine.
History
The patient’s health state has two primary diagnoses based on her condition. First, in addition to the headaches, cases of vomiting were mentioned. Second, other illnesses are associated with panic attacks that were identified as a starting point of anxiety disorders. Therefore, there are two diagnoses that Ronda has: Migraine and anxiety disorder. As for previous treatments that the patient obtained, it is vital to mention surgery on her knee that was due to the trauma from a fall from a bike. The operation was conducted with the use of anesthesia, to which Ronda did not have an allergy.
Nursing Physical Assessment
The patient’s overall health state is normal. The patient’s blood pressure is 124/73 mmHg. Heart rate of 80 beats per minute. Respiratory rate of 15 breaths per minute. Temperature of 97.1°F. Her bowel sounds are normative in all quadrants. The patient reports no difficulty with ambulation. Her oxygen saturation on room air is 95%. The patient’s skin shows no defects or redness and is not dry.
Related Treatments
The patient receives ongoing support from healthcare professionals to maintain a healthy lifestyle. In particular, nurses support various activities to reduce overthinking and stressors. It assumes that the patient should be directed to search for her life purpose and the particular activities that will bring her happiness. Moreover, this approach is important for reducing panic attacks in society.
Nursing Diagnosis & Patient Goal
The main problem for the patient is external factors, which can be assessed as environmental issues. Particularly, due to the loss of her husband and further loneliness, Ronda experiences a high level of anxiety and stress. These factors caused headaches in cases of vomiting. Consequently, the diagnosis of Migraine was established by the healthcare professionals. It is important to address the patient’s social life improvements and make her routine more exciting. As a goal for helping the patient, one should mention her reunification with society, reduced overthinking, and a sense of life.
Nursing Interventions
The nursing goals will be accomplished through therapies aimed at changing the patient’s lifestyle and habits. For example, according to Ashina, Buse et al. (2021), among possible approaches that can change a person’s lifestyle are “non-pharmacological therapies, such as neuromodulation and biobehavioural approaches, can be used for a multidisciplinary approach to clinical management” (p. 1505). Therefore, these therapies will be important for the patient’s well-being.
Evaluation
Even though at the beginning of the treatment, the patient not only refused to receive help but also became even more stressed, the procedures produced important effects. In particular, the patient improved in her communication skills. Social anxiety decreased, and headaches were much less frequent. As a result of the procedures, Ronda became more positive about her future. In addition, she should find hobbies that allow her to reduce stress.
Recommendation
In the future, Ronda needs to engage in various social events and activities to help prevent overthinking and panic attacks. Through communication with others, her loneliness will be reduced. In addition, it will be vital to implement specific therapeutic practices to maintain Ronda’s mental health. For example, the nurse can use Telehealth techniques to communicate with the patient and provide sufficient support.
References
Ashina, M., Buse, D., Ashina, H., Pozo-Rosich, P., Peres, M., & Lee, J. (2021). Migraine: Integrated approaches to clinical management and emerging treatments. The Lancet, 397(10283), 1505-1518.
Ashina, M., Katsarava, Z., Do, P., Buse, D., Pozo-Rosich, P., & Ozge, A. (2021). Migraine: Epidemiology and systems of care. The Lancet, 397(10283), 1485-1495.
Eigenbrodt, A., Ashina, H., Khan, S. et al. (2021). Diagnosis and management of migraine in ten steps. Nat Rev Neurol, 17, 501–514.