Respond to two of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.
Shawn Billings, a 28-year-old African American patient comes into the clinic today. He has been deemed a “frequent flyer” by the staff at the clinic and was at the clinic last week and 4 days ago with a migraine, given a shot of Toradol and Ativan and sent home. He is here today again for an extreme headache. He is very agitated today. He is here with his father and is worried that he will not get any medication.
Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned.
From a medical perspective, those who attend the emergency room (ED) more than ten times a year are considered frequent flyers. Their complex medical and social conditions, which include greater rates of disability, mental illness, substance misuse, and homelessness, are more likely to affect men, and they are more likely to be homeless. They are less likely to need hospital admission, making the cost to the health care system lower (EMRA, 2019).
An incident of moderate to severe throbbing and pulsating pain on one side of the head occurs repeatedly with migraine headaches. Attacks go untreated for four to 72 hours. The pain from ordinary physical activity, movement, or even coughing or sneezing can exacerbate other typical symptoms such as heightened sensitivity to light, noise, and scents, nausea, and vomiting. Mornings are when migraines most usually strike, especially right after awakening. Other people experience migraines at regular intervals, such as the day before their period or the weekend after a challenging work week. Although many people experience weakness or exhaustion after a migraine, they are typically symptom-free in between attacks (NIH, 2023).
Treatment for migraines aims to reduce symptoms and stop further attacks. A cool cloth or an ice pack can be applied to the forehead to relieve symptoms. Other quick remedies include napping or resting with the eyes closed in a quiet, darkened area (NIH, 2023).
There are two types of drug therapy for migraines: acute and preventative. To treat pain and regain function, acute or “abortive” drugs are used as soon as symptoms appear. The goal of preventive treatment is to lessen the severity of upcoming attacks or prevent them from occurring altogether (NIH, 2023).
Any of the following medicines may be used as acute migraine treatment: Serotonin levels in the brain are raised by triptan medications. Blood vessels tighten as a result of serotonin, which also lowers the pain threshold. The preferred migraine medication, triptans, reduces moderate to severe migraine discomfort. Drugs made from ergot bind to serotonin receptors on nerve cells to lessen the flow of pain signals along nerve fibers. They work best when migraines are still in the early stages. Less severe migraine headaches can be treated with over-the-counter or non-prescription analgesics such as acetaminophen, aspirin, or ibuprofen. Combination analgesics combine medications, such as caffeine and acetaminophen, to treat migraines that may be resistant to simple analgesics. NSAIDs, which are non-steroidal anti-inflammatory medicines, can alleviate pain. Prescription nausea medications can reduce nausea brought on by different forms of headache. Narcotics are momentarily prescribed to treat pain. Chronic headaches shouldn’t be treated with these medications (NIH, 2023).
Acetaminophen and nonsteroidal anti-inflammatory drugs are first-line treatments for mild to moderate migraines, whereas triptans are first-line treatments for moderate to severe migraines. Toradol is a medication approved by FDA (Food and Drug Administration) to treat short-term, moderately severe pain. It is a member of the class of pharmaceuticals known as nonsteroidal anti-inflammatory drugs (NSAIDs). Additionally, it is also utilized off-label to relieve migraine pain (AAFP, 2018).