Case Study #3
S. T., a 24-year-old graduate student, visits the clinic to report “bad headaches.” She says
that her headaches occur two to three times a month and last at least an entire day. The
headache centers above and behind her eyes, throbs, and is not relieved by any over-the-
counter medications. She says that they get worse when exams are near and she spends
time in the library to study. She is worried that the headaches will cause her to fail
- What subjective questions would you ask?
- What are the types of headaches described in the text?
- Discuss any additional information that might be needed before a judgment or diagnosis
can be made,
- Identify at least one relevant nursing diagnosis for any actual or potential problem
Some of the subjective questions that I am likely to ask the patient include the following;
- Apart from when the exams are nearing, are there other times when you experience the
- Do you take alcohol? If so, does the headache occur after an episode?
- Do you smoke?
- Do you normally exercise in hot weather? If so, does the headache occur afterwards?
- Are you taking any medications?
- Is the headache more common in spring and autumn?
The text describes cluster headaches that are excruciating pain attacks on one head side.
Often, there is severe pain behind the eye. There are sometimes referred to as ‘suicidal
headaches’ since they are very severe. The headaches begin suddenly and they are much more
painful compared to migraines and other headache types (TouchNEUROLOGY.com, 2014).
The term cluster headaches originated from the fact that sufferers experience 1-3 attacks daily,
for some months or weeks, before they go away. This is followed by a pain-free period that may
last for years or months, before the attacks begin again. The pain is usually so intense that some
people rock or bang the head against a wall or pace a room as a result of despair, frustration, and
restlessness (TouchNEUROLOGY.com, 2014). Cluster headaches may be episodic where
clusters are separated by a month or months of headache-free periods or chronic where clusters
are separated by a less than a month headache-free period or there is no separation.
Approximately 10% of the headaches are chronic. These headaches when the hypothalamus is
extremely busy where blood vessels widen and more blood moves to the brain. The headaches
cannot be treated using over-the-counter drugs (TouchNEUROLOGY.com, 2014).
Before making a diagnosis, there is a need to find out whether the patient has a watery
red eye when experiencing the headache, which is accompanied by nasal congestion on the
suffering side (TouchNEUROLOGY.com, 2014). In addition, does the patient have a swollen or
drooping eyelid, flushing, or sweating? A proper nursing diagnosis is an in-depth headache