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Self Care > Headache, Fever, And Musculoskeletal Injuries > Flashcards

Headache, Fever, And Musculoskeletal Injuries Flashcards

1
Q

What are the 3 types of headaches?

A

Tension, sinus, migraine

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2
Q

Frequency: Tension Headache

A

Episodic or chronic

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3
Q

Frequency: Sinus Headache

A

Acute or chronic sinusitis

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4
Q

Frequency: Migraine

A

Patient specific triggers

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5
Q

Location: Tension Headache

A

Bilateral, over the top of the head, extending to the base of the skull

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6
Q

Location: Sinus Headache

A

Face, forehead, or periorbital area

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7
Q

Location: Migraine

A

Usually unilateral

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8
Q

Characteristics: Tension Headache

A

Diffuse aching, tight, pressing, constriction pain

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9
Q

Characteristics: Sinus Headache

A

Pressure behind the eyes or face, dull, bilateral pain, worse in the morning

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10
Q

Characteristics: Migraine

A

Throbbing, may be preceded by aura

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11
Q

Onset: Tension Headache

A

Gradual

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12
Q

Onset: Sinus Headache

A

Associated with sinus symptoms

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13
Q

Onset: Migraine

A

Sudden

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14
Q

Duration: Tension Headache

A

Minutes to days

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15
Q

Duration: Sinus Headache

A

Resolves with sinus symptoms

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16
Q

Duration: Migraine

A

Hours to 2 days

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17
Q

What other symptom(s) may someone experience with a tension headache?

A

Scalp tenderness

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18
Q

What other symptom(s) may someone experience with a sinus headache?

A

Nasal congestion

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19
Q

What other symptom(s) may someone experience with a migraine?

A

Photophobia, incapacity, nausea (PIN)

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20
Q

Risk factors: Tension Headache

A

Stress

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21
Q

Risk factors: Sinus Headache

A

Viral infection

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22
Q

Risk factors: Migraine

A

Tiggers, female gender, family history

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23
Q

What are possible migraine triggers?

A

Stress, fatigue, oversleeping, fasting/skipping meals, medications, caffeine, alcohol, changes in altitude/pressure, menstrual period

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24
Q

Describe: Cluster Headache

A

Relatively uncommon (effects primarily men), severe, unilateral, and pulsating, typically lasts 30-180 minutes, “attacks”= once’s every other day + 8x/day with headache free periods for days-months. Autonomic symptoms on the same side of headache

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25
Q

What medications can cause headache?

A

Overuse (more than 2/weekly for 3 months+) of acetaminophen, aspirin, caffeine, triptans, opioids, butalbital, ergotamine. Can occur within hours of stopping agents so they should be tapered and eliminated

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26
Q

What are the exclusions for self-care for headache?

A

-severe pain (pain score >6)
-persistent headache > 10 days
-last trimester of pregnancy
-<8 years old
-high fever or signs of serious infection
-history of liver disease or consumption >2 drinks per day
-secondary headache, due to underlying disease
-migraine, but no formal migraine diagnosis

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27
Q

What are the treatment goals for self-care of headache?

A

-alleviate acute pain
-restore normal functioning
-prevent relapse
-minimize side effects
-reduce frequency

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28
Q

Non-pharmacological treatment: Tension Headaches

A

relaxation exercise, physical therapy

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29
Q

Non-pharmacological treatment: Migraines

A

maintain regular sleep/eat schedule, practice methods for stress relief, dietary restrictions, cold packs, avoid light

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30
Q

MOA: Acetaminophen (APAP)

A

produces analgesia through a central inhibition of prostaglandin synthesis

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31
Q

Indication: Acetaminophen (APAP)

A

relief of mild-moderate pain and fever

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32
Q

Pharmacokinetics/pharmacodynamics: Acetaminophen

A

-rapidly absorbed from the GI tract
-extensively metabolized in the liver
-onset of analgesic activity in 30 minutes
-duration of action= 4 hours

33
Q

Dosing: Acetaminophen

A

-adults=
-> reg 325-650 mg q8h or 1000mh 3-4x/day
->ext 1300 q8h
MAX= 4000 mg/day or 2000mg/day in pt with liver disease
-pediatrics (<12 yo)
-> 10-15 mg/kg/dose every 4-6h
-> MAX= 5 doses in 24 hours

34
Q

Adverse Effects: Acetaminophen

A

-hepatoxicity
-nephropathy
-blood dyscrasias
-anemia

35
Q

Drug Interactions: Acetaminophen

A

-alcohol
-warfarin

36
Q

Patient Counseling Points: Acetaminophen

A

-avoid or limit alcohol use
-read package labeling
-know dosing limits
-avoid duplicating products that contain acetaminophen

37
Q

MOA: NSAIDS

A

relieve pain through peripheral inhibition of prostaglandin synthesis (analgesic, antipyretic, anti-inflammatory)

38
Q

Indications: NSAIDS

A

relief of minor pain associated with headache, common cold, toothache, muscle ache, backache, arthritis, menstrual cramps

39
Q

Adverse Effects: NSAIDS

A

-dyspepsia
-heartburn
-nausea
-anorexia
-epigastric pain
-fluid retention/edema

40
Q

Drug Interactions: NSAIDS

A

-aspirin
-ibuprofen
-digoxin
-anti-hypertensive agents
-anticoagulants
-alcohol
-methotrexate

41
Q

Patient Counseling: NSAIDS

A

-take with food, milk, or antacids
-avoid in patients at high risk for GI or cardiovascular risk
-naproxen not recommended in children <12

42
Q

MOA: Salicylates (aspirin)

A

inhibit prostaglandin synthesis from arachidonic acid by inhibiting both COX-1 and COX-2

43
Q

Pharmacodynamics/pharmacokinetics: Salicylates

A

-absorbed by passive diffusion in stomach and small intestines
-eliminated through the kidneys

44
Q

Indication: Salicylates

A

mild-moderate pain and fever

45
Q

Dosing: Salicylates

A

650-100 mg every 4-6h, MAX= 4000mg/day, not recommended for children < 16 yo due to risk of Reye’s Syndrome

46
Q

Define: Reye’s Syndrome

A
47
Q

Adverse Effects: Salicylates

A

-upper GI symptoms (dyspepsia, epigastric discomfort, N/V)
-gastritis, GI bleed, ulceration
-serious ASA intolerance

48
Q

Define: Salicylism

A

chronic toxic blood levels, multitude of symptoms, patients at high risk include: renal or hepatic impairment, metabolic disorders, unstable disease, status asthmaticus, multiple co-morbidities

49
Q

Drug Interactions: Salicylates

A

-NSAIDS/COX inhibitors
-anticoagulants
-alcohol
-methotrexate
-sulfonylureas

50
Q

Patient Factor Precautions: Salicylates

A

-hypoprothrombinemia
-vitamin K deficiency
-hemophilia
-H/O bleeding disorders
-H/O peptic ulcer disease
-H/O gout/hyperuricemia
-children/teenagers with viral illness

51
Q

Define: Fever

A

core body temp >100F, regulated rise in body temp maintained by the hypothalamus in response to a pyrogen

52
Q

Define: Hyperthermia

A

malfunctioning of the normal thermoregulatory process at the hypothalamic level

53
Q

Define: Hyperpyrexia

A

body temp >106F that typically results in mental and physical consequences , resulting from hyperthermia or fever

54
Q

Signs/Symptoms: Fever

A

-headache
-sweating
-malaise
-chills
-tachycardia
-arthralgia/myalgia
-irritability
-anorexia

55
Q

Describe: Digital Thermometers

A

-quickest, most accurate reading
-regulated by the FDA
-easy-to-read
-can be used at any age depending on route

56
Q

Describe: Electronic Ear Thermometers

A

-measures tympanic temp
-quick reading
-accurate when used correct
-not recommended <6 months

57
Q

Describe: Forehead Thermometers

A

-measures temporal artery temp
-non-invasive
-prone to error
-not recommended to make clinical decisions

58
Q

What complication can arise from having a fever?

A

-parental anxiety
-acute= seizures, dehydration, change in mental status
-febrile seizures
-fever management more difficult in patients with comorbid condition

59
Q

Non-pharmacological recommendations: Fever

A

-adequate fluid intake
-wear light clothing
-remove blankets
-maintain room temp at 68F

60
Q

Exclusions for Self-Care: Fever (children and adolescents)

A

infants <3 months= >100.4F and children >104F or temp of 100.4F with any of the following symptoms: inability to swallow, drooling excessively, difficulty breathing, refusing oral fluids, drowsy (difficult to wake), delirious, glassy-eyed, extremely cranky or irritable, vomiting/diarrhea

61
Q

Exclusions for self-care of fever at any age

A

-unexplained spots or rashes
-loss of appetite, low energy, or noticeably pale or flushed
-environmental exposure to high temperatures
-history of seizures or febrile seizures
-stiff neck, severe headache, severe ear pain, or sore throat
-taking steroids or immunocompromised

62
Q

Define: Myofascial Pain

A

pain originating in the fascia (connective tissue)

63
Q

Define: Musculoskeletal Pain

A

pain originating from muscle, ligaments, tendons, and/or bone

64
Q

Define: Myalgia

A

generalized muscle pain

65
Q

Define: Fibromyalgia

A

chronic pain syndrome characterized by diffuse muscle and joint pain, joint stiffness, fatigue, and sleep disturbances

66
Q

Define: Tendonitis

A

inflammation of a tendon resulting from acute injury or chronic overuse of body part

67
Q

Define: Bursitis

A

common cause of localized pain, tenderness, and swelling which is worsened by any movement of the structure to the bursa

68
Q

Define: Sprain

A

injury to a ligament caused by joint overextension

69
Q

Define: Strain

A

injury to muscle or tendon caused by overexertion

70
Q

Define: Muscle Spasm

A

involuntary contraction of muscle

71
Q

Define: Muscle Cramp

A

prolonged muscle spasm that produces painful sensation

72
Q

Exclusions for self-care of muscular skeletal injuries

A

-moderate to severe pain (pain score >6)
-pain lasting >10 days after oral analgesics
-pain lasting >7 days after topical analgesics
-increased intensity or character of the pain
-pelvic or abdominal pain
-nausea, vomiting, fever, and/or other signs of systemic infection/disorder
-visual deformity of a joint, abnormal movement, weakness in a limb, or suspected fracture
-third trimester of pregnancy

73
Q

Complications: Muscular Skeletal Injuries

A

-further tissue damage or bone/cartilage remodeling
-disability
-loss of function
-reduction in ADLs, loss of work time
-physical impairment

74
Q

Describe: RICE Therapy

A

nonpharmacological treatment option for muscular skeletal injuries to promote healing and help reduce swelling and inflammation
-R= REST the injured area using slings or splints if necessary
-I= ICE the area as soon as possible in 10-15 minute increments 3-4 times per day (do NOT apply ice directly to skin)
-C= COMPRESS the injured area with an elasticized bandage (not too tight)
-E= ELEVATE at or above heart level for 2-3 hours per day to decrease swelling and pain

75
Q

OTC Pharmacological options for muscular skeletal injuries

A

systemic analgesics are the go to such as acetaminophen, NSAIDS, salicylates (limited to 10 days)
topical analgesics: counterirritants/topical salicylates, capsaicin, lidocaine, topical NSAIDS

76
Q

Describe: Counterirritants

A

-indication: treatment of minor aches and pains of muscles/joints
-MOA: nerve stimulation vs depression, paradoxical pain relief by causing less severe pain to counter more severe pain
-adjunct therapy
-dosing: apply no more than 3-4 times a day for 7 days
-products: methyl salicylate, camphor, menthol

77
Q

Describe: Capsaicin

A

-indication: relieves pain(not inflammation) of rheumatoid arthritis and osteoarthritis and diabetic neuropathy
-MOA: thought to deplete substance P from sensory neurons, elicits a transient feeling of warmth
-takes 14 days to exert full clinical action, could take 4-6 weeks

78
Q

Describe: Lidocaine Patch

A

-ideal for localized peripheral neuropathic pain
-patch or spray

Self Care (23 decks)

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