iHuman Case Study Report – Week 6: Emily
Green (Migraine Headache) – NR 509 –
Chamberlain University (2025/2026)
Abstract
This iHuman Case Study Report details the assessment, diagnosis, and management of Emily
Green, a 32-year-old female presenting with recurrent headaches suggestive of migraines. The
report employs a systematic approach to advanced health assessment, integrating evidence-based
practice, clinical reasoning, and patient-centered care. Sections include patient demographics,
history, physical findings, differential diagnoses, final diagnosis of migraine without aura, and a
comprehensive plan of care. The report includes pathophysiology, cultural considerations, and
extensive patient education to support holistic management, aligning with NR 509 course
objectives to enhance advanced assessment skills for nurse practitioners.
Introduction
Migraine headaches are a prevalent neurological condition affecting approximately 12% of the
U.S. population, with a higher incidence in women aged 20–40 years. They significantly impact
quality of life, causing disability and lost productivity. Nurse practitioners (NPs) play a critical
role in diagnosing and managing migraines in primary care, using advanced assessment skills to
differentiate migraines from other headache disorders. This case study of Emily Green illustrates
the application of systematic history-taking, physical examination, and evidence-based decision-
making to diagnose and manage migraines, incorporating patient-centered care and cultural
considerations (Burch et al., 2021; Dodick, 2020).
Patient Introduction & Demographics
Name: Emily Green
Age: 32 years
Gender: Female
Occupation: Marketing manager
Relevant Background: Ms. Green is a Caucasian female with no significant past medical
history. She works in a high-stress marketing role, requiring 10–12 hours daily at a computer,
contributing to sleep deprivation and stress. She is married, lives with her spouse in an urban
apartment, and has no children. She denies smoking or recreational drug use but consumes 1–2
cups of coffee daily and 1–2 glasses of wine weekly. Family history includes migraines (mother,
onset age 30) and hypertension (father, onset age 50). She maintains a balanced diet but relies on
takeout due to work demands. Exercise is sporadic (yoga 1–2 times/week), and she sleeps 5–6
hours/night. No known allergies. No current medications.
, Chief Complaint (CC)
“I’ve been having really bad headaches for the past month, and they’re getting worse.”
History of Present Illness (HPI)
Ms. Emily Green, a 32-year-old female, presents with a 1-month history of recurrent headaches,
occurring 2–3 times per week. Using the OLDCARTS framework:
Onset: Headaches began 1 month ago, with no clear precipitating event, though stress
and sleep deprivation are noted.
Location: Unilateral, left-sided, frontotemporal region.
Duration: Each episode lasts 6–12 hours if untreated.
Characteristics: Pulsating, throbbing pain, rated 7–8/10 in severity, accompanied by
nausea, photophobia, and phonophobia.
Aggravating Factors: Stress, bright lights, loud noises, and lack of sleep worsen
symptoms.
Relieving Factors: Rest in a dark, quiet room and ibuprofen (400 mg) reduce pain to
4/10.
Timing: Episodes occur randomly, often in the evening after work.
Severity: Pain disrupts work and daily activities, requiring her to lie down.
She denies vomiting, visual disturbances (e.g., aura), numbness, weakness, or fever.
Triggers include work stress, caffeine, and irregular sleep. She reports similar headaches
in her 20s, managed with ibuprofen, but recent episodes are more frequent and severe. No
recent trauma, medication changes, or infections.
Past Medical History (PMH), Family History (FH), and
Social History (SH)
PMH: No chronic illnesses, hospitalizations, or surgeries. History of occasional tension
headaches in her 20s, resolved with ibuprofen. No history of head trauma, seizures,
stroke, or neurological disorders. No recent infections or vaccinations.
FH: Mother with migraines (onset age 30, managed with triptans); father with
hypertension (onset age 50). No family history of stroke, brain tumors, seizures, or other
neurological conditions.
SH: Marketing manager with a high-stress job, working 10–12 hours/day, often under
tight deadlines. Lives with spouse, no children. Denies smoking or illicit drug use;
consumes 1–2 cups of coffee daily and 1–2 glasses of wine weekly. Diet includes
balanced meals (e.g., vegetables, lean proteins) but frequent takeout due to time
constraints. Exercises sporadically (yoga 1–2 times/week, 30-minute sessions). Sleeps 5–
6 hours/night due to work demands, reporting difficulty falling asleep. No significant
financial or access-to-care barriers.
Review of Systems (ROS)
Green (Migraine Headache) – NR 509 –
Chamberlain University (2025/2026)
Abstract
This iHuman Case Study Report details the assessment, diagnosis, and management of Emily
Green, a 32-year-old female presenting with recurrent headaches suggestive of migraines. The
report employs a systematic approach to advanced health assessment, integrating evidence-based
practice, clinical reasoning, and patient-centered care. Sections include patient demographics,
history, physical findings, differential diagnoses, final diagnosis of migraine without aura, and a
comprehensive plan of care. The report includes pathophysiology, cultural considerations, and
extensive patient education to support holistic management, aligning with NR 509 course
objectives to enhance advanced assessment skills for nurse practitioners.
Introduction
Migraine headaches are a prevalent neurological condition affecting approximately 12% of the
U.S. population, with a higher incidence in women aged 20–40 years. They significantly impact
quality of life, causing disability and lost productivity. Nurse practitioners (NPs) play a critical
role in diagnosing and managing migraines in primary care, using advanced assessment skills to
differentiate migraines from other headache disorders. This case study of Emily Green illustrates
the application of systematic history-taking, physical examination, and evidence-based decision-
making to diagnose and manage migraines, incorporating patient-centered care and cultural
considerations (Burch et al., 2021; Dodick, 2020).
Patient Introduction & Demographics
Name: Emily Green
Age: 32 years
Gender: Female
Occupation: Marketing manager
Relevant Background: Ms. Green is a Caucasian female with no significant past medical
history. She works in a high-stress marketing role, requiring 10–12 hours daily at a computer,
contributing to sleep deprivation and stress. She is married, lives with her spouse in an urban
apartment, and has no children. She denies smoking or recreational drug use but consumes 1–2
cups of coffee daily and 1–2 glasses of wine weekly. Family history includes migraines (mother,
onset age 30) and hypertension (father, onset age 50). She maintains a balanced diet but relies on
takeout due to work demands. Exercise is sporadic (yoga 1–2 times/week), and she sleeps 5–6
hours/night. No known allergies. No current medications.
, Chief Complaint (CC)
“I’ve been having really bad headaches for the past month, and they’re getting worse.”
History of Present Illness (HPI)
Ms. Emily Green, a 32-year-old female, presents with a 1-month history of recurrent headaches,
occurring 2–3 times per week. Using the OLDCARTS framework:
Onset: Headaches began 1 month ago, with no clear precipitating event, though stress
and sleep deprivation are noted.
Location: Unilateral, left-sided, frontotemporal region.
Duration: Each episode lasts 6–12 hours if untreated.
Characteristics: Pulsating, throbbing pain, rated 7–8/10 in severity, accompanied by
nausea, photophobia, and phonophobia.
Aggravating Factors: Stress, bright lights, loud noises, and lack of sleep worsen
symptoms.
Relieving Factors: Rest in a dark, quiet room and ibuprofen (400 mg) reduce pain to
4/10.
Timing: Episodes occur randomly, often in the evening after work.
Severity: Pain disrupts work and daily activities, requiring her to lie down.
She denies vomiting, visual disturbances (e.g., aura), numbness, weakness, or fever.
Triggers include work stress, caffeine, and irregular sleep. She reports similar headaches
in her 20s, managed with ibuprofen, but recent episodes are more frequent and severe. No
recent trauma, medication changes, or infections.
Past Medical History (PMH), Family History (FH), and
Social History (SH)
PMH: No chronic illnesses, hospitalizations, or surgeries. History of occasional tension
headaches in her 20s, resolved with ibuprofen. No history of head trauma, seizures,
stroke, or neurological disorders. No recent infections or vaccinations.
FH: Mother with migraines (onset age 30, managed with triptans); father with
hypertension (onset age 50). No family history of stroke, brain tumors, seizures, or other
neurological conditions.
SH: Marketing manager with a high-stress job, working 10–12 hours/day, often under
tight deadlines. Lives with spouse, no children. Denies smoking or illicit drug use;
consumes 1–2 cups of coffee daily and 1–2 glasses of wine weekly. Diet includes
balanced meals (e.g., vegetables, lean proteins) but frequent takeout due to time
constraints. Exercises sporadically (yoga 1–2 times/week, 30-minute sessions). Sleeps 5–
6 hours/night due to work demands, reporting difficulty falling asleep. No significant
financial or access-to-care barriers.
Review of Systems (ROS)
