is an example of what’s needed to be done to create a scenario on a disease process . The disease should be Hypertension and medication has to be Carvedilol ( Coreg).

Disease- Headache- Migraine 2. Definition of Disease- Primary Headache- A recurring type of headache. May cause moderate to severe pain that is throbbing or pulsing. The pain is often on one side of the head. Other symptoms, such as nausea and weakness may occur, with a sensitivity to light and sound. 3. Epidemiology- 90%-95% of individuals in the US have headaches annually. According to the World Health Organization, Migraines rank among the world’s most disabling illnesses. Prevalence is 18% for females and 6 % for males. 4. Patient Presentation- 24-year-old female presents with a severe headache localized to the right forehead area. Pain is pulsing and throbbing. Symptoms began last night with 10/10 pain level. Patient C/O nausea and states that the frequency of headaches has increased over the past year. The patient took one Tylenol this morning at 6 am with no relief. 5. Past medical history- No significant medical history or surgeries. Smokes one pack of cigarettes a day for 8 years. 6. Physical examination- Alert and oriented x 4, no recent head trauma, stated has not taken any illicit drugs or alcohol taken. Lungs clear, no murmurs or gallops noted, abdomen without tenderness or masses, extremities- good pulses, cranial nerves- intact 7. Vital Signs- T- 98.5, Pulse- 101, BP- 132/78, Res.- 20, O2 – 98 % on room air 8. THREE Medications to prescribe-Trade and Brand name- Ketorolac (Toradol) – 9. Mechanism of Action- This medication (Links to an external site.) is a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body’s production of certain natural substances that cause inflammation (Links to an external site.). This effect helps to decrease swelling, pain, or fever. 10. Use-For the short-term treatment of moderate to severe pain in adults. 11. Side Effects- Upset stomach (Links to an external site.), nausea (Links to an external site.), vomiting, constipation, diarrhea (Links to an external site.), gas, dizziness, or drowsiness may occur. 12. Contraindications- High blood pressure- this medication may raise blood pressure. 13. Interactions with other medications- Some medications that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as losartan, valsartan), lithium, methotrexate, probenecid, corticosteroids (such as prednisone), other medications that may affect the kidneys (including cidofovir, “water pills”/diuretics such as furosemide). They may decrease the effect of Toradol and the ability of kidneys to function properly. Toradol may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, “blood thinners” such as dabigatran/enoxaparin/warfarin, among others. 14. Laboratory and/or medical tests for patients on this medication- Blood pressure, kidney function tests 15. The antidote for an overdose of the drug (if there is one)- IV Fluids and emergency department (no specific Antidote for Toradol) 16. Nursing considerations- Check a patients blood before administering. Comfort measures- Keep the hospital room dark and noise to a minimum. Ask the doctor for nicotine patch for the patient since they smoke 1 pack a day and will not be able to smoke. She may experience withdrawals which include headaches. 17. Other pertinent information- Referral to a neuro doctor for may be needed. The patient has been experiencing migraines for over 10 years with no relief. A referral to her PCP for hormone testing and to try other medications since her current medication regimen is becoming less effective over time. 18. Critical Thinking Component- When the patient first presented to the physician’s office, the nurse practitioner ordered a CT scan to rule out a bleed or a clot in the brain.


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