Nursing care plan for Headache, its Diagnosis and Interventions

A frequent issue, headaches are characterized by discomfort in the head or face. This feeling may be mild, harsh, throbbing, or constant.

Headaches can be treated with medication, relaxation techniques, and biofeedback, among other things.

Types of Headache

Depending on the location, severity, frequency, and underlying reason, there are more than 150 different types of headaches. Primary headaches and secondary headaches are the two basic kinds of headaches.

Primary Headaches

Primary headaches have no secondary causes or connections to any underlying illnesses. It is not thought to be a sign of a pre-existing illness.

Although primary headaches might incapacitate a person, they are not life-threatening. These headaches are caused by inflammation in painfully sensitive bodily regions, often the head and neck.

The nerves, blood vessels, and muscles are some of these regions. This category includes the following forms of headaches:

• Tension Headache: The most frequent form of headache in both adults and teens is a tension headache. Mild to severe discomfort that is often persistent but not pulsing. Bilateral headache pain is felt on both sides of the head and feels better after using an over-the-counter pain medication. Getting worse when performing everyday tasks like bending over and going upstairs. The most typical signs of tension headache are throbbing, pounding pain that can linger for four to 72 hours. It frequently coexists with other symptoms including lack of appetite, stomach or abdominal discomfort, nausea, vomiting, sensitivity to light, sound, or scent. The following symptoms of a migraine in children are typically present: lightheadedness, blurred vision, pallor, fever, and stomach ache.
• Cluster Headache: This is the most severe kind of primary headache, and it typically occurs in a cluster or group, generally in the spring or fall. During a cluster phase, the pain may occur one to three times each day and persist for up to three hours. Typically, the cluster phase lasts between two and three months. There is a scorching or piercing feeling behind or around one eye, and the pain is severe, pulsating, and constant. teary eyes, drooping eyelids, red eyes, and constricted pupils can all be found at the area of discomfort.
• New Daily Persistent Headache: In this kind of headache, the pain begins suddenly, doesn’t go away in a day, and returns nearly every day. This kind of headache is less frequent than others. However, it has an impact on daily tasks and routines. People without a history of headaches are more likely to acquire headaches.
• Sinus Headache: This is a side effect of a sinus infection that is connected to nasal congestion and sinus inflammation. A quick head movement or when straining make headaches worse. Also experiencing severe discomfort are cheekbone and forehead areas. Face edoema, mucous discharge, fever, facial puffiness, and poor taste are other symptoms.
• Medication Overuse Headache: This form of headache is brought on by often using painkillers for headaches. Overmedication can make headaches more common, and the patient can spend more days in pain than not. The discomfort typically grows greater in the morning.

Secondary Headaches

Headaches that are secondary to other medical issues. They set off pain-sensitive regions in the head and neck. There is no difference in the prevalence of primary and secondary headaches. The fact that they may be a symptom of an underlying ailment, such as one of the following, makes them potentially more severe:

• brain tumors
• head injury
• high blood pressure
• aneurysm
• infection
• medication overdose
• nasal congestion
• trauma
• injury to the neck or brain
• tumor

Risk Factors of Headache

A risk factor is something that makes being sick more likely. Depending on the patient’s kind of headache, a number of causes can cause headaches.

1. Tension Headache

   •  Lifestyle – more stress, exhaustion, rage, and sleep deprivation
   •  Pre-existing medical issues – tension headaches have been linked to despair and anxiety.

1. Migraines

   • Lifestyle – The most prevalent lifestyle variables include skipping meals, fasting, consuming certain foods and beverages, having difficulties falling asleep, being under stress, and consuming alcohol.
   • Present health issues
   • Other circumstances, such as menstruation cycle, weather or altitude changes, harsh lighting, loud music, ambient noise, and strong odours like perfume.
   • Medications, such as hormone replacement treatment and hormonal contraceptives, pain medications that are taken regularly or almost daily.

2. Cluster headache

   • Lifestyle-cluster headaches are more frequent in smokers.
   • Health issues – Depression and anxiety are related to cluster headaches, just like they are to other forms of headaches.

3. Sinus Headache

• • Medical conditions that cause pressure, discomfort, and the production of mucus in the tissue lining of the nose. These factors raise the likelihood of these issues:
  •  Allergies – These comprise pollen, pollution, and seasonal allergies.
  • Sinus surgery history
  • Low immune system
  • Nasal congestion
  • common colds
  • upper respiratory infections
  • nasal polyps
  • deviated septum
  • cystic fibrosis
  • nasal polyps.
  • Trauma or injuries that influence and restrict sinus passages.

Diagnosis of Headache

1. Physical Assessment: To make the proper diagnosis and create an accurate treatment plan, an accurate evaluation is required. The patient will be questioned on their symptoms, the frequency, intensity, and location of their headaches, as well as what makes them feel better. The patient’s complete medical history, including current medical conditions, past illnesses, allergies, prescription medications, and other information, will also be obtained by the doctor. After that, a physical examination will be performed.
   Finding the appropriate category is crucial in the diagnosis of a headache. These actions may be conducted for a correct diagnosis depending on whether the headache is primary or secondary.
2. Headache Diary: This tool keeps track of crucial information concerning the headache. The frequency, length, and intensity of headaches throughout time will be precisely noted in this journal. It also includes details on the pattern, potential triggers, medications taken, and reactions to it. It aids the doctor in developing a precise diagnosis and a successful treatment strategy.
3. Headache trigger tracker: This instrument helps in figuring out what triggers and aggravates headaches. Food, beverages, activities, and other things can be included. With the use of this tracker, both the patient and the doctor may better treat the headache by being aware of each other’s triggers.
4. Neurological Exam: In addition, the doctor will examine the patient’s reflexes, sensibility, mental state, and cranial nerve function.
5. Lumbar puncture: A lumbar puncture or spinal tap is advised to determine whether bleeding or a bacterial or fungal infection is present.
6. Nasal endoscopy: The nose and sinus canals are being examined. This is done to look for nasal tumour development as well as any inflammation in that location.
7. Imaging: It is possible to determine if a headache is caused by a problem with the central nervous system by performing imaging diagnostic techniques of the head, such as CT scans and MRI. Images of the brain’s cross-section obtained from these procedures can be used to evaluate any abnormalities or issues.

Complications of Headache

In most cases, main headache problems result from overusing a therapy rather than the headache itself. Non-steroidal anti-inflammatory medication (NSAID) abuse, which can cause stomach discomfort and gastrointestinal bleeding, is one well-known example.

Overmedication headaches, also known as rebound headaches, are frequent side effects of primary headaches. When opioids are used excessively, this occurs. The medication must be stopped as a therapy. However, withdrawal effects from some headache medications are possible. Consequently, a medical practitioner must be in charge of the therapy.

Other headache side effects include:

• Status migrainosus: This is a migraine episode, but the agony is severe and lasts for almost three days. It could make you feel exhausted or perhaps handicapped. Dehydration is more likely to occur when a patient is in this sort of discomfort because they are unable to obtain adequate rest or control their nausea. The patient may need to be sent to the hospital and given intravenous medicine.
• Migrainous infarction: This includes the brain’s blood arteries constricting, which lowers the amount of oxygen delivered to the brain. The typical occurrence is abrupt, accompanied by an aura and a variety of odd sensations, such as a decrease in light flashes, blind areas, and tingling in the hands or face.
• Persistent aura without infarction: There are migraines that occasionally have an aura that lasts for longer than a week. There is no real brain bleeding, yet the symptoms resemble those of a stroke.
• Seizures: During or after a migraine with aura, a seizure caused by the migraine might happen.

Treatment of Headache

Before recommending any medicine, the doctor will first rule out any potential underlying causes of the headache. For pain relief and headache therapy, there are several products on the market.

• Acute Treatment: These drugs are used to treat headaches and related symptoms once they have begun. To lessen pain and inflammation, they include nonsteroidal anti-inflammatory medications (NSAIDs). For sinusitis, the common cold, and nasal congestion, nasal spray is frequently utilised.
• Preventive Measures: These are consistently consumed to stop headache bouts and symptom aggravation. Antihypertensive, antidepressant, seizure, and antipsychotic treatments may be among them.

Prevention of Headache

The following actions might stop headache signs:

•  Recognize your triggers and try to stay away from them. Keep a headache journal to note and track attacks.
• Acquire skills in stress reduction such as yoga, meditation, and deep breathing.
•  Follow a consistent eating routine.
• Get adequate sleep.
• Regular exercise.
• Drink more fluids orally.

Nursing Diagnosis for Headache

Nursing care plan for Headache First

Acute Pain

Nursing Diagnosis: Acute headache pain from alcohol withdrawal that is accompanied by trembling, anxiety, stomach discomfort, restlessness, and an accelerated heart rate.

Desired Results:

• The patient will express vocal pain relief with satisfactory pain management at a score of 4 out of 10.
• The patient’s blood pressure, breathing, and heart rate will all improve and fall within the normal range.
• The patient will demonstrate the advantages of adopting appropriate relaxation techniques and diversionary activities.

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Nursing care plan for Headache Second

Activity Intolerance

Nursing Diagnosis: Activity intolerance associated with headache owing to hypertension as seen by exhaustion, increased blood pressure in response to exercise, and breathing problems.

Desired Results:

• The patient will engage in regular activities with a decreased frequency of headaches, respiratory problems, chest discomfort, excessive perspiration, and dizziness.
• The patient’s blood pressure will rise to a normal level.
• The patient will voice a considerable improvement in activity tolerance and employ identifiable tactics to increase activity tolerance.
• The patient’s physiological symptoms of intolerance will reduce.

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Nursing Care Plan for Headache Third

 Impaired Comfort

Impaired As shown by discomfort, lack of sleep, quick and shallow breathing, and anxiety, comfort associated to headache subsequent to nerve problem.

Desired Results:

• The patient will verbally report better pain, with a pain scale score of less than 3 out of 10.
• The patient will demonstrate how to use a coping technique in a healthy way when under stress.
• The patient will acknowledge feeling more at ease.

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Nursing Care Plan for Headache Fourth

Disturbed sleep pattern

The symptoms of a disturbed sleep pattern brought on by a migraine headache include difficulty falling asleep, exhaustion, restlessness, waking up in the middle of the night, and a morning headache.

Desired Results:

• The patient’s sleeping habits will be better.
• The patient will express having slept better and more soundly.

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Nursing Care Plan for Headache Fifth

Nausea

Nursing Diagnosis: Consisting of choking, a foul taste in the mouth, stomach discomfort, and increased swallowing, chronic migraine headache-related nausea.

Desired Results:

• The patient will say that their nausea is gone.
• The patient will learn useful techniques for avoiding sickness.

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