👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: migraine · vascular headache · sick headache
💡
Use this quick-reference guide to spot, treat, and prevent Migraine Headache on the NCLEX. Keep it handy during review and on exam day!
🩺
📒 The 1-minute cheat sheet
🩺 Signs
Unilateral throbbing/pulsating pain
Aura: flashing lights, zigzags
Photophobia + phonophobia + N/V
📌 Triggers
Stress, hormones, missed meals
Tyramine: aged cheese, wine, MSG
🧪 Meds
Abortive: triptans (sumatriptan)
Prophylaxis: beta-blockers, topiramate
Triptans: hold if CAD/uncontrolled HTN
✅ Do
Quiet, dark room, rest
Treat early → at aura onset
Cool cloth to forehead
📚 Migraine Headache — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
A migraine is a recurrent, throbbing, often unilateral headache caused by neurovascular changes, frequently accompanied by nausea, vomiting, and sensitivity to light (photophobia) and sound (phonophobia). Some patients experience an aura (visual or sensory warning) before the headache begins. Attacks last 4 to 72 hours and are commonly triggered by stress, certain foods, hormonal changes, lack of sleep, and bright lights. Management focuses on aborting acute attacks and preventing recurrence.
🔑
Key points
Understand these first
Pain is typically unilateral, pulsating/throbbing, and worsened by physical activity, lasting 4 to 72 hours.
Associated symptoms include nausea, vomiting, photophobia, and phonophobia; some patients have a preceding aura such as flashing lights or zigzag lines.
Abortive (acute) treatment: triptans (sumatriptan) and ergotamines cause vasoconstriction and are taken at onset; NSAIDs and antiemetics are adjuncts.
Triptans and ergotamines are contraindicated in coronary artery disease, uncontrolled hypertension, and pregnancy because of their vasoconstrictive effect.
Preventive drugs (beta-blockers like propranolol, topiramate, amitriptyline, CGRP antagonists) are used when attacks are frequent.
✅
Nursing priorities
What to do, in order
Provide a dark, quiet, cool environment and minimize light, noise, and movement during an attack.
Administer abortive medication early at the first sign of a migraine for best effect.
Apply cool cloth to the forehead and encourage rest in a comfortable position.
Assess pain characteristics, triggers, and response to treatment, and help the patient keep a headache diary.
Administer antiemetics as needed and monitor hydration if vomiting occurs.
🚩
Red flags — report now
Escalate immediately
A sudden 'worst headache of my life,' headache with fever and stiff neck, or new focal deficits — these suggest hemorrhage, meningitis, or stroke, not a typical migraine.
Chest pain, tightness, or signs of coronary ischemia after taking a triptan or ergotamine — hold the drug and notify the provider.
🗣️
Patient teaching
What patients must know
Identify and avoid personal triggers such as aged cheese, red wine, caffeine, MSG, stress, and skipped meals using a headache diary.
Take abortive medication at the very first sign of a migraine rather than waiting.
Rest in a dark, quiet room during attacks and maintain regular sleep, meals, and hydration.
Do not exceed prescribed triptan/ergotamine dosing to avoid medication-overuse (rebound) headaches.
Report headaches that change in pattern, become more severe, or are accompanied by new neurologic symptoms.
❓ Migraine Headache: NCLEX FAQs
What are the priority nursing interventions for Migraine Headache?
Provide a dark, quiet, cool environment and minimize light, noise, and movement during an attack. Administer abortive medication early at the first sign of a migraine for best effect. Apply cool cloth to the forehead and encourage rest in a comfortable position. Assess pain characteristics, triggers, and response to treatment, and help the patient keep a headache diary.
What are the warning signs of Migraine Headache a nurse must report?
A sudden 'worst headache of my life,' headache with fever and stiff neck, or new focal deficits — these suggest hemorrhage, meningitis, or stroke, not a typical migraine. Chest pain, tightness, or signs of coronary ischemia after taking a triptan or ergotamine — hold the drug and notify the provider.
What do I need to know about Migraine Headache for the NCLEX?
Pain is typically unilateral, pulsating/throbbing, and worsened by physical activity, lasting 4 to 72 hours. Associated symptoms include nausea, vomiting, photophobia, and phonophobia; some patients have a preceding aura such as flashing lights or zigzag lines. Abortive (acute) treatment: triptans (sumatriptan) and ergotamines cause vasoconstriction and are taken at onset; NSAIDs and antiemetics are adjuncts. Triptans and ergotamines are contraindicated in coronary artery disease, uncontrolled hypertension, and pregnancy because of their vasoconstrictive effect.
What patient teaching is important for Migraine Headache?
Identify and avoid personal triggers such as aged cheese, red wine, caffeine, MSG, stress, and skipped meals using a headache diary. Take abortive medication at the very first sign of a migraine rather than waiting. Rest in a dark, quiet room during attacks and maintain regular sleep, meals, and hydration. Do not exceed prescribed triptan/ergotamine dosing to avoid medication-overuse (rebound) headaches.
✨
Quick Tip
Pain is typically unilateral, pulsating/throbbing, and worsened by physical activity, lasting 4 to 72 hours.