Case study:  Moira Moira is a 54-year-old female with a two-…

Questions

Cаse study:  Mоirа Mоirа is a 54-year-оld female with a two-day history of a pulsating/throbbing headache which is worse with movement and physical activity.  She describes photophobia and phonophobia.  She is nauseated but has not vomited.  Moira describes the pain as 6-7/10, with 10 being the worst pain imaginable.  The pain began while at work 2 days ago.  It started with her seeing what she describes as halos around lights.  Moira has a history of migraine headaches.  She has been given naproxen sodium 500 mg. tablet, to take at onset of headache and then every 12 hours as needed for pain.  She has taken it as prescribed, but the headache has not resolved.  Moira is very frustrated.  She has these types of headaches approximately 5 days out of the month and often misses 1-2 days of work each month due to these migraines.  Moira reports no change in the frequency or intensity of these headaches, but no longer feels the current treatment plan is effective.  She has not been to work since this headache began 2 days ago.  Based on what you know, what is your diagnosis? Are there any diagnostic tests you would order? What is your treatment plan for Moira going forward?  Include any changes you would make to the current treatment plan. Please include patient teaching.

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