Tension and Cluster Headaches

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Pain Management (Cheatsheet)
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Outline

Overview

  1. Tension Headaches
    1. Caused by stress or contracted muscles
    2. Tight pain in the head
    3. Are episodic or chronic
  2. Cluster Headaches
    1. Unknown exact cause -> thought to be histamine release and/or vasoconstriction and sudden vasodilation
    2. Sharp pain in the head
    3. Are episodic or chronic

Nursing Points

General

  1. Tension Headaches
    1. Episodic
      1. Caused by stress
      2. Moderate
    2. Chronic
      1. Caused by contracted muscles of neck and scalp
      2. Occur daily
    3. Risk factors
      1. Stress
      2. Poor posture
      3. Anxiety and/or depression
  2. Cluster Headaches
    1. Associated with histamine release and/or vasodilation of vessels
    2. Episodic
      1. 2 phases that last 7 days to 1 year
      2. Remission 1 month or longer
    3. Chronic
      1. Occur more than once a year
      2. Remission less than 1 month
    4. Risk factors
      1. Males
      2. Smoking
      3. Alcohol consumption

Assessment

  1. Presentation
    1. Tension
      1. Frontal-occipital tightening pain
      2. Sensitivity to light
      3. Sensitivity to sound
    2. Cluster
      1. Stabbing pain in temporal or periorbital regions
      2. Agitation and restlessness
      3. Accompanied by allergy symptoms
        1. Nasal stuffiness
        2. Eyelid swelling

Therapeutic Management

  1. Tension Headaches
    1. Medications for pain
      1. Analgesics
      2. NSAIDs
    2. Lifestyle changes
      1. Improve posture
      2. Exercise and stretching
      3. Adjust sleep schedule
      4. Manage stress
  2. Cluster Headaches
    1. Medications
      1. Prevention
        1. Antihistamines
        2. Calcium channel blockers -> less calcium = relaxed smooth muscles = dilated arteries
      2. Treatment
        1. Ergotamine drugs -> stimulate serotonin, norepinephrine, and dopamine receptors causing constriction
        2. Anesthetics
        3. SSRIs -> stimulate serotonin receptors causing constriction
    2. Lifestyle changes
      1. Stop drinking
      2. Stop smoking
      3. Manage stress

Nursing Concepts

  1. Intracranial Regulation -> chemicals causing dilation and inflammation
  2. Pharmacology -> medications to treat/prevent
  3. Patient Education -> lifestyle changes to prevent headaches an avoid triggers

Patient Education

  1. Manage stress
  2. Stop smoking
  3. Stop drinking alcohol
  4. Monitor triggers
  5. Exercise

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Transcript

Hey guys! In this lesson we will discuss tension and cluster headaches.

In this lesson on tension and cluster headaches, we will cover what they are, why they occur, and how they are treated. Let’s begin with tension headaches.

Tension headaches consist of tight pain in the head that is caused by stress or contracted muscles. They may be episodic which are caused by stress and there are periods of time in between headaches. They may also be chronic and occur daily, which are typically caused by contracted muscles of the neck and scalp. Risk factors for tension headaches include stress, poor posture, anxiety or depression. Next, let’s look at cluster headaches.

Cluster headaches consist of a sharp pain in the head. The exact cause is unknown, but they are thought to occur because of histamine release and/or constriction with sudden vasodilation. Cluster headaches are either episodic or chronic. Episodic cluster headaches occur in two phases that last from seven days up to one year with a remission of at least one month between. Chronic cluster headaches occur more than once a year and the remission time in between episodes is less than one month long. Risks factors for these headaches include being male, smoking, and consuming alcohol. Next, let’s look at how these patients present during assessment.

A person with a tension headache experiences tightening pain in the frontal-occipital area. They typically are sensitive to light and sound, causing them to seek out dark, quiet rooms to rest.

A person with person with a tension headache experiences tightening pain in the frontal-occipital area. They typically are sensitive to light and sound, causing them to seek out dark, quiet rooms to rest.

 cluster headaches has stabbing pain in their temporal or periorbital regions. They typically appear agitated or restless, rather than resting in bed. They often have allergy symptoms such as nasal stuffiness or eyelid swelling because of the increased histamine. Now let’s move on to management of these headaches.

Tension headaches can be managed with medications for pain and lifestyle changes. Medication that may be used include analgesics or NSAIDs. Lifestyle changes include improving posture, exercising and stretching, adjusting sleep schedules, and managing stress. You know in nursing school you get headaches because you are leaning over the books studying and hunched over your computer. You probably aren’t getting enough exercise or sleep and are super stressed, so changing these lifestyle concerns can help fix that.

Cluster headaches are managed with medications to treat or prevent them and lifestyle changes. Lifestyle changes include avoiding drinking alcohol and smoking, and managing stress. Let’s discuss the different medications that the doctor may prescribe.

Antihistamines may be given to prevent the release of histamine in the body that is thought to cause cluster headaches. Calcium channel blockers prevent calcium from contracting smooth muscles which results in dilated arteries to prevent the initial constriction. Ergotamine drugs stimulate serotonin, norepinephrine, and dopamine receptors causing vasoconstriction to prevent the sudden vasodilation. Anesthetics are sometimes given to control the pain. SSRIs stimulate serotonin receptors causing constriction.

It’s important to educate your patients with headaches on different things they can do to prevent them. They should work on managing their stress, stop smoking, stop drinking alcohol, and exercise. They can monitor for triggers that set off their headaches so that they may be avoided in the future.

The priority nursing concepts for the patient with tension and cluster headaches include intracranial regulation, pharmacology, and patient education.

Alright, now let’s review the key points. Tension headaches consist of tight pain in the head that is caused by stress or contracted muscles in the head and neck. Cluster headaches consist of sharp pain in the head that is thought to be caused by histamine release and/or constriction of the vessels in the brain with sudden dilation after. Treatment for both types of headaches include lifestyle changes such as managing stress and avoiding alcohol and smoking. Medications for tension headaches target pain, whereas medications for cluster headaches target the histamine release, vasoconstriction, or vasodilation to prevent or treat the headache. Our patients should be educated to work on stress management, stop smoking and drinking, monitor triggers, and exercise.

 

We love you guys! Go out and be your best self today! And as always, Happy Nursing!
 

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Concepts Covered:

  • Cardiac Disorders
  • Musculoskeletal Trauma
  • Integumentary Disorders
  • Neurologic and Cognitive Disorders
  • Oncology Disorders
  • EENT Disorders
  • Respiratory Disorders
  • Gastrointestinal Disorders
  • Hematologic Disorders
  • Communication
  • Test Taking Strategies
  • Pregnancy Risks
  • Fundamentals of Emergency Nursing
  • Concepts of Mental Health
  • Basics of NCLEX
  • Prioritization
  • Emotions and Motivation
  • Tissues and Glands
  • Skeletal System
  • Muscular System
  • Nervous System
  • Sensory System
  • Circulatory System
  • Hematologic System
  • Respiratory System
  • Digestive System
  • Urinary System
  • Endocrine System
  • Reproductive System
  • Labor Complications
  • Disorders of Pancreas
  • Eating Disorders
  • Neurological Emergencies
  • Noninfectious Respiratory Disorder
  • Vascular Disorders
  • Upper GI Disorders
  • Lower GI Disorders
  • Liver & Gallbladder Disorders
  • Urinary Disorders
  • Sexually Transmitted Infections
  • Female Reproductive Disorders
  • Renal Disorders
  • Integumentary Disorders
  • Integumentary Important Points
  • Immunological Disorders
  • Shock
  • Endocrine and Metabolic Disorders
  • Musculoskeletal Disorders
  • Musculoskeletal Disorders
  • Neurological Trauma
  • Central Nervous System Disorders – Brain
  • Central Nervous System Disorders – Spinal Cord
  • Peripheral Nervous System Disorders
  • Emergency Care of the Neurological Patient
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Oncologic Disorders
  • Studying
  • Cardiovascular Disorders
  • Basic
  • Adult
  • Pediatric
  • Neonatal
  • Emergency Care of the Trauma Patient
  • Emergency Care of the Cardiac Patient
  • Emergency Care of the Respiratory Patient

Study Plan Lessons

The 5-Minute Assessment (Physical assessment)
General Assessment (Physical assessment)
Integumentary (Skin) Assessment
Neuro Assessment
Head/Neck Assessment
EENT Assessment
Heart (Cardiac) and Great Vessels Assessment
Thorax and Lungs Assessment
Abdomen (Abdominal) Assessment
Lymphatic Assessment
Peripheral Vascular Assessment
Musculoskeletal Assessment
Genitourinary (GU) Assessment
Communicating with Patients
SATA
Absolute Words
Nursing Process
What do you want me to know?
Duplicate Facts
Repeating Words
Denying Feelings
NCLEX® Question Traps
Opposites
Same
Priority
Acute vs Chronic
Hierarchy of O2 Delivery
Nutrition Assessments
Abuse
Therapeutic Communication
Nurse-Patient Relationship
Thinking Like a Nurse
Critical Thinking
Prioritization
Triage
Maslow’s Hierarchy of Needs in Nursing
Overview of the Nursing Process
Skin Structure & Function
Skeletal Anatomy
Bone Structure
Development of Bones
Joints
Muscle Anatomy (anatomy and physiology)
Muscle Cytology
Skeletal Muscle
Muscle Contraction
Muscle Physiology
Nervous System Anatomy
Membrane Potentials
Nerve Transmission
Autonomic Nervous System (ANS)
Spinal Cord
Cranial Nerves
Sensory Basics
Intro to Circulatory System
The Heart
Cardiac Cycle
Electrical Activity in the Heart
Cardiac (Heart) Physiology
Blood Vessels
Blood Pressure (BP) Control
Blood Plasma
Blood Grouping
Vessels & Fluid
Respiratory Structure & Function
Breathing Movements
Breathing Control
Respiratory Functions of Blood
Digestive System Anatomy
Mouth & Oropharynx
Esophagus
Stomach Video
Small Intestine
Large Intestine
Liver & Gallbladder
Urinary System Anatomy (Anatomy and Physiology)
Renal (Kidney) Structure & Function
Renin Angiotensin Aldosterone System (RAAS)
Formation & Excretion of Urine
Renal (Kidney) Fluid & Electrolyte Balance
Renal (Kidney) Acid-Base Balance
Pituitary Gland
Thyroid Gland
Adrenal Gland
Pancreas
Male Reproductive Anatomy (Anatomy and Physiology)
Female Reproductive Anatomy (Anatomy and Physiology)
Epithelial (Skin) Tissues
Types of Epithelial (Skin) Tissue
Glands
Connective Tissues
Membranes
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Phosphorus-Phos
Heart (Cardiac) Sound Locations and Auscultation
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Aortic Aneurysm
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
GERD (Gastroesophageal Reflux Disease)
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
Nursing Care and Pathophysiology for Hemorrhoids
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology for Herpes Simplex (HSV, STI)
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology of Glomerulonephritis
Pressure Ulcers/Pressure injuries (Braden scale)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Skin Cancer
Integumentary (Skin) Important Points
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Breast Cancer
Diabetes Management
Nursing Care and Pathophysiology for Sepsis
Fluid Volume Deficit
Fluid Volume Overload
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Compartment Syndrome
Fractures
Casting & Splinting
Impulse Transmission
Cerebral Metabolism
Blood Brain Barrier (BBB)
Levels of Consciousness (LOC)
Routine Neuro Assessments
Adjunct Neuro Assessments
Brain Death v. Comatose
Intracranial Pressure ICP
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Parkinsons
Miscellaneous Nerve Disorders
Tension and Cluster Headaches
Migraines
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Stroke Assessment (CVA)
Stroke Therapeutic Management (CVA)
Stroke Nursing Care (CVA)
Seizure Causes (Epilepsy, Generalized)
Seizure Assessment
Seizure Therapeutic Management
Nursing Care and Pathophysiology for Seizure
Neurological Fractures
Spinal Cord Injury
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology of Pneumonia
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Coronavirus (COVID-19) Nursing Care and General Information
Artificial Airways
Airway Suctioning
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Pulmonary Embolism
Lung Sounds
Alveoli & Atelectasis
Gas Exchange
Wound Care – Assessment
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
Aortic Aneurysm – Thoracic signs Nursing Mnemonic (PEE BADS)
Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)
Coronary Arteries – Location Nursing Mnemonic (I have a RIGHT to CAMP if you LEFT off the AC)
Cor Pulmonale – Signs & Symptoms Nursing Mnemonic (Please Read His Text)
CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Cyanotic Defects Nursing Mnemonic (The 4 T’s)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Increase MAP Nursing Mnemonic (VAK)
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Vascular Disease – Deep Vein Thrombosis Nursing Mnemonic (HIS Leg Might Fall off)
Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)
Digestion & Absorption
Nutrition-related Diseases
CPR-BLS (Basic Life Support)
Advanced Cardiovascular Life Support (ACLS)
Pediatric Advanced Life Support (PALS)
Neonatal Resuscitation Program (NRP)
Prioritizing Assessments
Triage in the ER
Critical Incident Management
Aggressive & Violent Patients
Legal & Ethical Issues in ER
EMTALA & Transfers
Trauma Survey
Blunt Thoracic Trauma
Penetrating Thoracic Trauma
Blunt Abdominal Trauma
Penetrating Abdominal Trauma
Crush Injuries
Head Trauma & Traumatic Brain Injury
Massive Transfusion Protocol
Acute Coronary Syndrome (ACS)
Aneurysm & Dissection
Cardiopulmonary Arrest
Dysrhythmia Emergencies
Heart (Heart) Failure Exacerbation
Hypertensive Emergency
Arterial Pressure Monitoring
Rapid Sequence Intubation
Pulmonary Embolism
Acute Respiratory Distress
Ventilator Settings
Acute Confusion
Intracranial Hemorrhage
Increased Intracranial Pressure
Stroke (CVA) Management in the ER
Seizure Management in the ER
Sodium and Potassium Imbalance for Certified Emergency Nursing (CEN)