Assignment: NURS 6501 Advanced Pathophysiology
Assignment: NURS 6501 Advanced Pathophysiology
The case concerns a 24-year-old female who comes to the ED complaining of an acute right-sided headache. This is the sixth time she has had a headache in the last two months. The headaches last 2-3 days and affect her concentration at work. She also reports having nausea and vomiting three times within three hours and photophobia. She rates the headache at 10/10. The purpose of this assignment is to explore the pathophysiological processes accounting for the symptoms and racial/ethnic variables affecting physiological functioning.
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Neurological and Musculoskeletal Pathophysiologic Processes
The patient has migraine headaches attributed to neurological and musculoskeletal pathophysiology. The neurological processes that cause migraine headaches involve impaired central neuronal processing, characterized by activation of brain stem nuclei, cortical hyperexcitability, and diffusing cortical depression. The trigeminovascular system’s involvement triggers neuropeptide release, which results in painful inflammation in cranial vessels and the dura mater (Gupta & Gaurkar, 2022). This explains the patient’s severe headaches. Migraines can be accompanied by aura, caused by temporary neurologic disturbances that affect sensation, balance, speech, muscle coordination, and vision and causes occasional nausea and vomiting. The patient has migraine with an aura which explains the photophobia, concentration difficulties, nausea, and vomiting.
[elementor-template id="165244"]Musculoskeletal pathophysiology related to migraine involves increased trigger points, decreased mobility of the upper cervical spine, and heightened pain sensitivity when the upper cervical spinal joints are palpated (Luedtke et al., 2018). Thus, the patient is at risk of reduced mobility during combined flexion and rotation and impaired thoracic spine mobility.
Racial/Ethnic Variables That May Impact Physiological Functioning
Studies show that American Indians/Alaska Natives have the highest prevalence of migraines in the US, with a rate of 17.7%. Whites have the second highest prevalence at 15.5%, followed by Hispanics at 14.5 and Blacks at 14.45% (Amiri et al., 2022). Asians have the least prevalence of migraines at 9.2%. Thus American Indians/Alaska Natives are at a higher risk of having migraines which may impact their daily functioning.
How These Processes Interact To Affect the Patient
The neurological and musculoskeletal processes collectively cause concentration difficulties during migraine attacks. Besides, routine physical activity usually exacerbates migraine headaches. Neurological processes have affected the patient by causing aura, as evidenced by the patient being sensitive to light photophobia that may force the patient to stay in a quiet, dark room, impairing social interactions (Gupta & Gaurkar, 2022). The severe migraine attacks can incapacitate this client and may further disrupt her work and family life.
Conclusion
The client has migraine with an aura which can be attributed to impaired central neuronal processing. The release of neuropeptides results in painful inflammation in cranial vessels and the dura mater, leading to frequent severe headaches. Native Americans have the highest risk of migraines that may impact their physiological functioning. The aura has affected the patient by causing photophobia, concentration difficulties, nausea, and vomiting.
References
Amiri, P., Kazeminasab, S., Nejadghaderi, S. A., Mohammadinasab, R., Pourfathi, H., Araj-Khodaei, M., Sullman, M., Kolahi, A. A., & Safiri, S. (2022). Migraine: A Review on Its History, Global Epidemiology, Risk Factors, and Comorbidities. Frontiers in Neurology, 12, 800605. https://doi.org/10.3389/fneur.2021.800605
Gupta, J., & Gaurkar, S. S. (2022). Migraine: An Underestimated Neurological Condition Affecting Billions. Cureus, 14(8), e28347. https://doi.org/10.7759/cureus.28347
Luedtke, K., Starke, W., & May, A. (2018). Musculoskeletal dysfunction in migraine patients. Cephalalgia, 38(5), 865-875.
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