NR603week1.docx - PBL Case Discussion Neurologic Disorders Part One NR603 Week 1 PART 1 What further questions do you have for Christopher at this visit

NR603week1.docx - PBL Case Discussion Neurologic Disorders...

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PBL Case Discussion: Neurologic DisordersPart One NR603 Week 1PART 1What further questions do you have for Christopher at this visit?O-When do the headaches occur? (Morning, evening, night, prior or during a period, ect.) Whileor after reading? (Migraine, eyestrain, tension headache)L- Where exactly do your headaches hurt? On one side of the head or both sides? (Migraine, tension headache, eyestrain)D- How long to your headaches last? Do you wake up with them? Gradual or sudden onset? (Migraine, tension headache)C- What do they feel like? (throbbing, dull, sharp, like a band is around your head, ect) (Migraine, tension headache, eyestrain)A- What are you doing when your headaches start? (Migraine) Are they provoked by stress or anxiety? (Tension headache) Do you get them after or during reading on the computer? (eye strain)R- What do you do to relieve the pain? (Sleep, dark room) (Migraine, tension headache)T- Do you take OTC medications for your headache? If so do they help? (Migraine, tension headache, eyestrain)S- How would you rate the pain of your headaches 0-10? (Migraine, tension headache, eyestrain)I would like discuss Christopher’s headache history without the mother present:Any family history of migraines? (Migraine)Any sensitivity to light or sound when you are having a headache? (Migraine)Do you see any flashes of light, or visual changed prior to your headache? (Migraine)Any blurred vision or vision changes? (Eyestrain)How many headaches do you get a day? How many a week? Month? (Migraine, tension headache, eyestrain)Do you feel depressed, anxiety, stressed? (Tension headache)How often are you on the computer, cellphone, or reading? (Eyestrain)
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What is your differential diagnosis list for this visit thus far with rationale?Tension headache (G44.209)- this is a common headache disorder common in children and adolescents. Childhood consists of rapid growth, emotional maturation, physiological perturbations, and hormonal changes which influence headache disorders. These headaches last from 30 minutes to 7 days, bilateral pressure, tightening or nonpulsating headache of mild to moderate intensity. These occur without nausea or vomiting but may have photophobia or phonophobia. This is brought on by stress, anxiety and depression (Buttaro, Trybulski, Bailey, Sandberg-Cook, 2013).Rational-Christopher is only 15; his headaches may be due to stress of school work, hormonal changes, anxiety or depression, more information is needed.Migraine (G43.909)-is a neurobiological disorder with attacks being based on external triggers. Prevalence of migraine increases with age, with puberty there is a higher prevalence for migrainein girls than boys. Migraines can be caused by sleeplessness, sunlight, hunger, exercise and watching TV (Buttaro, Trybulski, Bailey, Sandberg-Cook, 2013). Rational-Migraines are more prevalent in females, he only gets 5-6 hours of sleep a night, and he is on the computer a lot according to mom.
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