A client with chronic tension-type headaches asks about non-pharmacological treatment options. Which of the following therapies would a nurse recommend? Select all that apply
Acupuncture
Relaxation training
Biofeedback
Feverfew supplements
Botox injections
Correct Answer : A,B,C
Chronic tension-type headaches are often associated with muscle tension, stress, and poor posture. Non-pharmacological interventions aim to reduce muscle tightness and stress, and improve coping strategies. Evidence-based approaches such as acupuncture, relaxation training, and biofeedback have been shown to help reduce headache frequency and severity.
Rationale for correct answers:
- Acupuncture: Stimulates specific points in the body to help reduce headache frequency and intensity; may benefit some clients with tension-type headaches.
- Relaxation training: Techniques like progressive muscle relaxation and deep breathing reduce stress and muscle tension, helping prevent headache onset.
- Biofeedback: Teaches clients to monitor and control muscle tension and other physiological processes to reduce headache occurrence.
Rationale for incorrect answers:
4. Feverfew supplements: Primarily used for migraine prevention; limited evidence supports its use for tension-type headaches.
5. Botox injections: Approved for chronic migraine prevention, not indicated for tension-type headaches.
Take home points
- Stress management strategies are a cornerstone of tension-type headache treatment.
- Acupuncture, relaxation training, and biofeedback are safe and effective non-drug interventions.
- Supplements and Botox are better suited for other headache types, particularly migraines.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
Preventive therapy for frequent migraines focuses on medications that reduce the frequency, severity, and duration of attacks. Common classes include beta-adrenergic blockers (e.g., propranolol), certain antidepressants (e.g., amitriptyline), and calcium channel blockers (e.g., verapamil). These work through mechanisms such as stabilizing vascular tone, modulating neurotransmitter levels, and reducing cortical excitability.
Rationale for correct answers:
1. Beta-adrenergic blockers: Effective in migraine prophylaxis by reducing vascular reactivity and stabilizing sympathetic tone.
2. Antidepressants: Tricyclic antidepressants like amitriptyline can reduce migraine frequency, especially when tension-type headaches or depression coexist.
4. Calcium channel blockers: Reduce migraine frequency by preventing abnormal vascular constriction and stabilizing neuronal excitability.
Rationale for incorrect answers:
3. NSAIDs: Primarily used for acute migraine relief, not long-term prevention.
5. Triptans: Designed for acute migraine attacks; not used for daily prophylaxis due to cardiovascular risks.
6. Opioids: Not recommended for migraines due to dependency risks and lack of preventive efficacy.
Take home points
- Migraine prevention commonly involves beta-blockers, certain antidepressants, and calcium channel blockers.
- Acute treatments (e.g., NSAIDs, triptans, opioids) are not used for long-term prophylaxis.
- Preventive therapy is considered for clients with frequent or severe migraine attacks affecting quality of life.
Correct Answer is C
Explanation
High-flow oxygen therapy via a non-rebreather mask at 12–15 L/min is the first-line treatment for acute cluster headaches. The client should sit upright during administration, and therapy typically continues for about 10–20 minutes or until symptoms resolve.
Rationale for correct answer:
3. "You should use a non-rebreather mask and sit upright during a headache attack.": This ensures high oxygen concentration delivery and optimal breathing mechanics to relieve pain quickly.
Rationale for incorrect answers:
1. "The oxygen should be delivered at a low flow rate of 2 L/min.": This is insufficient for cluster headache relief; high flow is required.
2. "You should use a nasal cannula for delivery of the oxygen.": A nasal cannula cannot deliver the necessary high concentration of oxygen.
4. "Treatment should continue for at least 60 minutes, even if symptoms subside.": Extended therapy is unnecessary and may cause oxygen toxicity; therapy usually lasts 10–20 minutes.
Take home points
- Use 12–15 L/min oxygen via a non-rebreather mask for acute cluster headaches.
- Sit upright during treatment for optimal relief.
- Therapy generally lasts 10–20 minutes, stopping once symptoms resolve.
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