see below

MM  week 7 

S: a 46-year-old Caucasian man presents with a three year history of migraine headaches for
management evaluation. He has additional medical history of hypertension and a myocardial
infarction at age 39. His medications include Losartan 50mg daily, Verapamil SR 100mg at
night, Carvedilol 25mg daily, Lipitor 40mg daily and Topamax 50mg daily. He has had three
half week to week admissions in the past six months for migraines and received IV Dilaudid,
corticosteroids and magnesium sulfate as treatment.
O: VS: BP 132/84, P 82, R 15; Skin is warm, dry, pink in color. Neuro, pt is A&O with cranial
nerves II-XII intact; Pulses +2, HR regular
A: Migraines
P: Therapeutic: Per Arcangelo et al. (2017), the goal in treating this patient’s
migraines is to prevent and relieve his attacks with minimal side effects. In the acute time frame,
treatment goals include reducing the migraine severity, amount of migraine days and nausea. In
addition to the short term goals, long term goals also include decreasing disability, increasing
quality of life, avoiding increases in medication(s), providing education and empowering the
patient to manage his migraine disorder. During assessment, a detailed account of the patient’s
headaches should be retrieved including what period of the day his migraines usually occur, how
long the last, how often they occur, presence of an aura, identified factors that may cause or
relieve it, the quality, location and severity of his migraine pain, if he experiences any otherThis study source was downloaded by 100000760925736 from CourseHero.com on 04-12-2024 13:13:57 GMT -05:00
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