On a history and physical examination of a 34-year-old patient, during the review of systems, he reports occasional episodes of headache. He describes the headache pain as a "band is around his head" and tightness in the neck and shoulders
The clinician should recognize these symptoms as:
A. Tension headache
B. Cluster headache
C. Sinusitis
D. Migraine headache
ANS: A
Typical symptoms of tension headache include mild to moderate nonthrobbing pressure, or squeezing pain, that can occur anywhere in the head or neck. The pain often starts slowly as a dull and aching discomfort that progresses to holocranial pain and pressure. The pain can recur intermittently, lasting from minutes to hours, usually remitting with rest or removal of the stressful trigger. There is usually no associated nausea and vomiting. Although patients may report photophobia and phonophobia, it is less severe than those associated with migraines. Tension headaches are not aggravated by movement or activity. The neck muscles are often tight to palpation.
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The patient with fecal incontinence should be taught the importance of maintaining good skin integrity. The nurse's teaching should focus on teaching the patient to:
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