Nursing Case Study

Migraine headache. She is seeing Dr. Somireddy. She is going to go ahead and continue her follow up with her as well and will continue with her current

A visit note from Dr. Carico, dated 04/25/2017, indicated that the claimant had scalp area pain, upper back pain, and spares the face. Objective findings showed a blood pressure of 136/84 with a BMI of 44.1. She was referred to neurology.

He tolerates his medications without any side effects. He is taking Norco for moderate to severe pain. With Norco, he is able to walk 60 minutes longer, sleep longer and be more active. He can help take care of his kids with the help of his medications and standing. The pain is better with medications. He rates his pain as 10/10 without pain medications and 7-8/10 with pain

Overall, Dr. Scharf’s report is quite concise. He documented the applicant’s current complaint as neck pain, radiating pain to both arms, and occasional headaches, as

Per the medical report dated 07/18/16, patient is being seen for her lower backache, rated 7/10 with medications and 10/10 without medications. Current medications include Ambien 10mg; Maxalt-MLT 10mg; Norco 10/325mg; Evzio 0.4mg; orphenadrine 100 mg and gabapentin 600 mg.

Pt is currently on citalopram 20 mg one-half tablet by mouth once daily. Citalopram is appropriate as first line therapy for treatment of major depression per APA Practice guidelines. Starting dose of citalopram is also appropriate as patient is elderly. Citalopram has no major drug interactions with pt’s current medications or current medical conditions. Pt reports tolerating it well and has been adherent to

Migraine headaches are the third most prevalent illness in the world, and ranked as the sixth most disabling illness. Statistics show that only about fifty percent of people who suffer from chronic headaches know that they’re suffering from a migraine. 76% of people who suffer from migraines worry that they will suffer for the rest of their lives, and 37% of sufferers worried about their migraines between attacks. Studies found that approximately 12% of Americans suffer from migraines, and 40% of Americans could benefit from preventative therapies. Even though studies show that at least 40% of sufferers could benefit from preventative therapies, only one in five sufferers are currently using preventative therapies. Studies also show that over 25% of people who suffer from migraine attacks miss at least one working day over the past three months, and nine out of ten sufferers say that they cannot “function normally” during those days. At least 98 percent of migraine attack sufferers take medications for temporary headache relief, whether it be over the counter or prescription. Only 12% of sufferers take preventative medications as opposed to the 98% of sufferers taking medications for relief. Severe migraines are ranked in the highest of seven disability classes, along with psychosis, dementia, and quadriplegia, published by the World Health Organization. People who participated in a survey who admitted to a

DOI: 7/2/2010. The patient is a 57-year old female claims examiner who sustained a work-related cumulative trauma injury to multiple body parts that include head/cervical spine, shoulders, arms knees, and left hip. As per progress report dated 7/11/16, the patient reports neck and low back pain. IT was noted that the pain is associated with left lower extremity numbness, tingling, and weakness. The patient has tried and failed multiple anti-inflammatories, which causes gastrointestinal upset, except for Celebrex. Her psychiatrist, Dr. Nehoryan has recommended her current regimen including Cymbalta and Restoril intermittently for sleep. It was mentioned that the patient had a fall in early 2/2016 due to left lower extremity numbness and is continuing

Discussing the nighttime routine, the patient states they go to sleep at 10 p.m. and does not use

Pain that is undertreated can limit her post-op mobility and ability to participate actively in rehabilitation program. Mrs. M had pain at a level 5-8 during the night which indicates a moderate to intense pain that apparently interferes her sleep and probably limits her ability to perform normal daily activities.

The medication that Mrs. A is on is Clozapine. The decision to use clozapine is not taken lightly because of the potentially life threatening side effect. An awareness of side effects is important to primary care practitioners because they have most contact with the patients.

To treat symptoms of insomnia or anxiety, she has had trials of lorazepam, clonazepam and temazepam, and in 2016, quetiapine in doses of 25-50mg per day was prescribed.

-Keppra XR 2000 mg once nightly P.O (there is room to further optimize her dose of Keppra in the future for breakthrough seizures)

Patient reports dizziness and light headedness for the past 2 weeks. Current medication: Wellbutrin 150 mg XL QD. Patiet states she is not taking her medication regular bases, especially for the past one week.

Although many studies suggest the similarity in the effectiveness of these agents, only Pregabalin and duloxetine have approved for the treatment of diabetic neuropathic pain by the U.S. Food and Drug Administration (FDA), Health Canada, and the European Medicines Agency. (Pop-Busui Rodica, et al 2017)