Which finding would the nurse expect when assessing a patient with a tension type headache (TTH)?
A) A throbbing unilateral headache
B) A constant, bilateral, dull bandlike pain around the head with vomiting
C) A sudden onset of severe unilateral piercing or burning pain, located behind or around the eye
D) Premonitory or prodromic symptoms
B) A constant, bilateral, dull bandlike pain around the head with vomiting
Explanation: A) Patients with a migraine headache may present with a throbbing or pulsatile unilateral headache (frontal or ocular) that lasts anywhere from 4 to 72 hours, nausea and vomiting, and sensitivity to light (photophobia) and sound (phonophobia).
B) Tension type headaches are characterized by a constant, bilateral, dull, nonthrobbing bandlike pain around the head, especially at the temples or the back of the head and neck.
C) Symptoms of cluster headache include a sudden onset of a severe unilateral pain that is piercing or burning in nature and located behind or around the eye. The pain is strongest in the first 10-15 minutes and spreads to the forehead, jaw, upper teeth, temples, nostrils, shoulder, or neck.
D) In many patients, migraine headache is preceded by premonitory or prodromic symptoms that last less than 24 hours. These include fatigue, excessive yawning, fluid retention, sensory hypersensitivity, mood changes, and increased appetite and thirst. Over 30% of migraines are accompanied by an aura, a reversible focal neurologic symptom that generally precedes the headache.
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