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Jasmin sakay case study

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Jasmin Sakay Case Study Presentation
NRP/507 Version 3
1
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Jasmin Sakay Case Study Presentation
HPI: Jasmin Sakay is a 46-year-old Filipino woman with several complaints. She has migraine headaches
(HA) every month before her menstrual period for the last several months. She rates the unilateral
temporal pain as 8 out of 10, and this is associated with nausea and occasional vomiting. She prefers to
be in a dark, quiet room when the pain starts. Sometimes she cannot take migraine medication, as she
awakens with a migraine and is already nauseated. She denies aura, paresthesias, visual changes, sinus
symptoms, or dizziness
She tells you that her right hip is bothering her. She was hit by a car in her teens and has arthritis in that
hip. She rates the pain as 7 out of 10 prior to taking ibuprofen and 5 out of 10 an hour after taking it.
Partial pain relief lasts only about 2 hours. She denies other joint pain, morning stiffness, and fever.
She notices that her hip feels stiff after sitting for a while, but it loosens up after taking a few steps.
She reports burning in her stomach that seems to be worse after she takes Excedrin
®
or ibuprofen, which
is somewhat relieved by food and worsened by caffeine. The stomach pain occasionally awakens her at
night. She denies dark stools, alcohol intake, and nausea and vomiting not associated with HA.
Her final complaint is that her menstrual periods have become heavy and somewhat irregular the past 6
months. She bleeds for 10 days with clotting the first day. Tampons last 1 to 2 hours on the first day. Her
cycles range from 25 to 40 days. She denies dysmenorrhea, abdominal pain, orthostasis, vasomotor
symptoms, or a new sexual partner.
Medical history: Infrequent migraine headaches since her 30s.
Family history: Her parents and siblings are in the Philippines. She explains that she has no way of
supporting herself since her divorce.
Medications: OTC Excedrin
®
Migraine without relief.
Ibuprofen 200 mg, 3 to 4 tablets tid for the hip pain.
Allergies: None reported.
Social history: Recently divorced with two grown children; has no close relatives in the United States.
Physical examination:
This is a w/d, w/n female, who is 5 ft tall and weighs 130 lb.
BP 110/70 sitting & 106/72 standing, P96, BMI 25
Neurological exam was unremarkable; chest cta, cardiac nsr, abd soft and nontender.
Labs:
Her stool is guaiac-negative.
CBC
Hemoglobin: 10 (12.115.1)
Hematocrit: 30 (3644)
RBC: 3.0 (4.05.0)
RBC indices
MCV: 72 (80100)
MCH: 23 (2731)
MCHC: 30 (3236)
RDW: 17% (11.514.5%)

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Jasmin Sakay Case Study Presentation NRP/507 Version 3 University of Phoenix Material Jasmin Sakay Case Study Presentation HPI: Jasmin Sakay is a 46-year-old Filipino woman with several complaints. She has migraine headaches (HA) every month before her menstrual period for the last several months. She rates the unilateral temporal pain as 8 out of 10, and this is associated with nausea and occasional vomiting. She prefers to be in a dark, quiet room when the pain starts. Sometimes she cannot take migraine medication, as she awakens with a migraine and is already nauseated. She denies aura, pa ...
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