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REPLY TO THIS DISCUSSION (3) RESOURCES NEEDED:What additional questions would you ask to learn more about her headaches? Additional questions to ask the patient are (Dunphy, Winland-Brown, Porter, & Thomas, 2015):Onset, location, character, numbness How many headaches does she have in a week or month?Does she experience an aura before the onset of pain?Is there a family history of headaches?Do you experience changes in vision?Is there a history of trauma to the head? Have you noticed a relationship between the headaches and menstrual cycle? How do you classify headaches? According to the International Classification of Headache Disorders (2019), headaches are classified into two categories: Primary and Secondary. Primary headaches includes migraines, tension-type headaches, and trigeminal autonomic cephalalgias. Secondary headaches are those that are attributed to trauma, substance withdrawal, hormones, or infection. How can you determine if this is an old headache or a new headache/s? Is this a chronic or episodic condition? Establishing the onset of symptoms will provide insights as to whether or not this is a new headache or an old one. Chronic migraines are classified as headaches 15 or more days/month on at least 8 days/month for more than 3 months (ICHD-3, 2019). It is nearly impossible to distinguish individual headaches for those experiencing episodic migraines due to the frequency. Can you make a definite diagnosis through an open-ended history followed by focused questions? The use of open-ended questions will contribute to the differential diagnosis and differentiate between a primary or secondary headache and to rule out other diagnosis. The location and characteristics of the pain along with associated symptoms are important in diagnosing the type of headache. The type of headache will then direct the physical assessment and tests to be ordered. The physical exam should focus on the neurological system. How can you use the patient history to distinguish between benign headaches and serious ones that require urgent attention? The patient history will provide insights as to any trauma to the head as well as red flag symptoms such as sudden onset of severe pain, vomiting, and descriptors such as “worse headache ever” (Dunphy et al., 2015). What diagnostic tests do you want to include to help with your diagnosis?CBC and CMP Urinalysis Thyroid-TSH and T4Estradiol and Progesterone levels CT MRI if indicated based on CT results and symptom presentation Create a differential diagnosis flow sheet for this patient and include the diagnostics related to the differentials.Primary Headache – Migraine Blood tests, CT, MRI based on CT findingsSecondary Headache – Menstrual Migraine Blood tests, CTPrimary Headache – Tension Blood test, CT References Dunphy, L., Winland-Brown, J., Porter, B., & Thomas, D. (2015). Primary Care: The art and science of advance practice nursing, (4th Ed.). Philadelphia, PA: F.A. Davis CompanyInternational Classification of Headache Disorders. (2019). HIS Classification ICHD-3. Retrieved from ichd-3.org.
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Discussion Board (DB) Participation Rubric
Discussion boards (DBs) are what make an online course a course and not an independent study.
DBs are vital to demonstrating that the learner has met the expected course level outcomes.
Collaboration between peers and your instructor in the DB is an important aspect of the online learning experience and is expected in the course.
Any exceptions to the following DB rubric will be at the instructor’s discretion.
The purpose of a DB is to stimulate critical thinking in a scholarly manner.
Critical thinking consists of synthesis, creating solutions, application to real world situations, and testing, debating, and defending evidence-based solutions.
Critical thinking is not repetition of assigned reading material. Outside research of the literature is a vital part of the DB.
Posts need to be substantive. This means that responses such as “I agree” or “great post” do not meet grading rubric requirements.
Initial posts for each discussion question (DQ) is due no later than Saturday of the unit week.
The initial post must be an answer to the DQ topic, not a comment on other posts. Initial posts for each DB must also include a minimum of three peer-reviewed citations.
Citations must include outside sources and no more than one citation from assigned course readings may be used each week.
While the discussion board tool limits the ability to use APA formatting (e.g., hanging indents), posts must include the required elements of an APA in-text citation and list of references.
Initial post
timeliness
Inappropriate
Below Average
Average
Above Average
1
2
3
4
Provides an
initial post on or
after Sunday.
Score
Weight
Final
Score
N/A
N/A
Provides an initial post by
Saturday.
15%
0.00
Posts 2 comments per
Discussion topic on separate
days (resulting in total
participation on three
different days throughout the
discussion). At least two
comments include a citation.
10%
0.00
5%
0.00
Additional
comment
requirement
Does not post
responses to
others.
Posts one comment
per Discussion topic.
Posts 2 comments per
Discussion topic on
separate days. At least
one comment includes
a citation.
Engagement
N/A
Participates, but
does not post
anything that
encourages others to
respond to the
posting.
Attempts to motivate
the group discussion.
Frequently attempts to
motivate the group
discussion.
Submission does
not relate to the
topic.
Answers some
question/topics with
some clearly stated
opinions. Supports
post using text only.
Answers all questions
with opinions and ideas
that are stated clearly.
Supports post using
text and at least two
peer-reviewed sources.
Answers all questions with
opinions/ideas creatively and
clearly. Supports post using
several outside, peerreviewed sources.
35%
0.00
APA Format
Major errors or
no APA format
used.
Minor errors with
APA format.
Rare errors with APA
format.
No errors with APA format.
10%
0.00
Spelling/
Grammar/
Formatting/
Mechanics
Significant
errors in spelling
and/or
grammar. Major
flaws in writing
mechanics and
formatting.
Poor spelling and
grammar are
apparent.
Uses Standard
American English with
rare errors and
misspellings.
Consistently uses Standard
American English with no
misspellings. Appropriate
mechanics and formatting.
10%
0.00
Length
Submission does
not meet length
requirements.
N/A
N/A
The initial post is at least 200
words. This does not include
repeating the DB question or
the citations and references.
15%
0.00
100%
0.00
0
#####
Content Quality
Initial Response
Final Score
Percentage
Total available points =
4
Instructions: First enter total points
possible in cell C15, under the rubric. Next
enter scores (between 0 and 4) into yellow
cells only in column F.
Low
Rubric Score
High
3.5
4.0
2.5
3.49
1.7
2.49
0.0
1.00
Grade points
Low
0
0
0
0
Percentage
High
0
0
0
0
Low
90%
80%
70%
0
High
100%
89.99%
79.99%
69.99%

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