Headaches are a common complaint in patients and can be symptomatic of a larger problem or occur seemingly at random. The first stage of treating a patient with complaint of a headache is to conduct an assessment to understand the type of headache and possible underlying causes (Gordon, 2014). There is no laboratory test used for the diagnosis of headaches. The first stage is to take a patient history to gain insight into the headache: why is the patient consulting now and how recently did the headache start? It is also important to note whether this is part of a pattern of headaches, and how frequent they are: episodic, daily, or unremitting (Gordon, 2014). Another assessment is to understand the type and intensity of pain, where it is located and whether it has spread (Lewis et al., 2015). It can also be useful to note whether there are any other symptoms associated with the headache. Visual disturbances and nausea, for example, are common in migraines (Lewis et al., 2015). The main types of headache are migraine, tension, cluster, and medication-related.
Physical assessments are also useful. Optic fundi and blood pressure should be assessed (Lewis et al., 2015). Jaw and bite are also common assessment tools. Head and neck muscle tenderness, stiffness, and crepitation are common in tension headaches and can also be used to rule out anything more serious, such as meningitis (Lewis et al., 2015).
There are several treatment options for headaches. Migraines are the most complex, and treatment usually involves triptans, over-the-counter pain relief, and treatment of the symptoms, including anti-nausea medications (Tonelli & Wachholtz, 2014). Cluster and tension headaches are usually treated with over-the-counter pain medications such as aspirin or ibuprofen (Tonelli & Wachholtz, 2014). If there is an underlying cause, this should be treated on a case-by-case basis and is dependent on the need of the individual patient.
- Gordon, M. (2014). Manual of nursing diagnosis. Jones & Bartlett Publishers. Retrieved from https://books.google.ca/books?hl=en&lr=&id=t3W-BQAAQBAJ&oi=fnd&pg=PR3&dq=headache+nursing+diagnosis&ots=TrXYSaxbDV&sig=hrExcOKb8Bzeuv_4zt2pQzX3IwU
- Lewis, S. L., Maltas, J., Dirksen, S. R., & Bucher, L. (2015). Study guide for medical-surgical nursing: Assessment and management of clinical problems. Elsevier Health Sciences. Retrieved from https://books.google.ca/books?hl=en&lr=&id=gfkkCwAAQBAJ&oi=fnd&pg=PP1&dq=headache+nursing+diagnosis&ots=u-nqfEbpiu&sig=lCUEe10trvsCPmVPa0YNbaxkog8
- Tonelli, M. E., & Wachholtz, A. B. (2014). Meditation-based treatment yielding immediate relief for meditation-naïve migraineurs. Pain Management Nursing, 15(1), 36–40.