The nurse is providing care to a patient with a migraine headache. What action should the nurse take?

A. A positive Romberg sign (difficulty maintaining balance with eyes closed) can indicate a neurological issue, but it is not directly associated with a migraine.

B. A subnormal temperature (low body temperature) is not typically associated with migraines and may indicate another issue, but it is not as concerning as other findings.

C. An ill college roommate might suggest a viral illness, but it is not a direct concern for the student’s migraine. Migraines are not contagious, and other signs of illness would be more concerning.

D. Positive Brudzinski sign, which involves involuntary flexion of the hips and knees when the neck is flexed, is indicative of meningeal irritation, a sign of meningitis. This is a medical emergency and much more concerning than the symptoms of a migraine. The student should be further assessed for signs of meningitis, which requires urgent treatment.

A. Isolation is not typically required for a patient receiving radiation unless there is a specific infection concern. Radiation does not require isolation.

B. While assessing pain is important, the priority at this point is to ensure that the patient understands the treatment process and what to expect, which can help reduce anxiety and improve cooperation during treatment.

C. Padding the bed rails is typically done for patients at risk of seizures or injury. While this might be relevant for some patients with brain tumors, the immediate priority is to educate the patient about the treatment.

D. Teaching the patient what to expect with radiation treatments is the priority. This helps reduce anxiety, ensures informed consent, and prepares the patient for the treatment process. Education about side effects, the procedure, and the expected outcomes is crucial for managing the patient’s experience.