I need assistance to answer the questions associated with this case scenario please

I need assistance to answer the questions associated with this case scenario please

Opening Scenario
Wendy Raymond is a 38-year-old woman who is new to this practice. Her primary complaint today is her problems with migraine headaches.

History of Present Illness
“I have had migraines for about 10 years. I have about four to five per month, and they are very severe. I have nausea and occasional vomiting. I have the sensation of flashing lights in my eyes before I get the headache. The headaches are more often on the right than left. They seem to come most frequently on weekends. They last about 6 to 8 hours, are improved by going into a dark room and lying down with a cool cloth on my forehead. I haven’t sought treatment before because I hate coming into an office and I’ve just been too busy. I finally decided that I needed to do something now because I’ve been missing family events and the headaches seem to be getting more frequent. I have tried acetaminophen 1000 mg every 4 hours when I get a headache, but it has minimal effect. I have not noticed particular foods or activities that cause my headaches. I have no history of head trauma.”
Medical History
Tonsillectomy and adenoidectomy as a child and endometriosis diagnosed at age 19. No other hospitalizations or injuries.
Family Medical History
MGM: 82 years old (mild arthritis)
MGF: Deceased at age 71 (heart attack)
PGM: Deceased at age 64 (Alzheimer’s disease)
PGF: Deceased at age 79 (stroke)
Mother: 63 years old (mild HTN)
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Father: 65 years old (chronic obstructive pulmonary disease; occasionally has problems with his eyes “going out of focus”)
Siblings: Two sisters 35 and 41 years old (A&W)
Social History
Married for 17 years. Two children, 8 and 10 years old. Works as a fourth-grade teacher. Never smoked. Alcohol very rarely (only for a toast at a wedding). Has one cup of regular coffee each morning. Denies other caffeine intake.
Medications
Acetaminophen: 1000 mg every 4 hours (when she gets a headache) for three to four doses
Allergies
NKDA

Review of Systems
General: Overall health good
Integumentary: No itching or rashes or lesions
HEENT: No history of head injury; no corrective lenses; denies eye pain, excessive tearing, blurring, or change in vision; no tinnitus or vertigo; denies frequent colds, hay fever, or sinus problems; headaches as noted under History of Present Illness
Neck: No lumps, goiters, or pain
Thorax: Denies shortness of breath, paroxysmal nocturnal dyspnea
Cardiovascular: No chest pain, no shortness of breath with normal activity, no palpitations. No excessive bruising; no history of transfusions
Hematological: No excessive bruising; no history of transfusions
Gastrointestinal: No nausea, vomiting, constipation, or diarrhea; denies belching, bloating, reflux, and black or clay-colored stools
Genitourinary: No dysuria; frequency; hormonal IUD × 3 years; history of endometriosis followed by her gynecologist, but she does not currently perceive it to be a problem because she started the hormonal IUD and has no menses; G2P2
Musculoskeletal: No joint pains or swelling
Neurological: No seizures, no numbness or tingling, no falls or dizziness
Endocrine: No polyuria, polyphagia, polydipsia; temperature tolerances good, no unexplained weight gain or loss

Physical Examination
Vital signs: Temperature 98.0° F; pulse 76 bpm; respirations 18/min, BP 120/74 mm Hg
Height: 5 ft 6 in; weight: 127 lb
General: Well nourished, well developed; in no acute distress; appears stated age
HEENT: Normocephalic without masses or lesions; pupils equal, round, and reactive to light; extraocular movements intact; fundi no AV narrowing or nicking, no papilledema, nares patent and mucosa noninjected; throat without erythema or lesions; no tenderness on temporal palpation or on sinus percussion/palpation; no deviation or clicks on mandibular opening; teeth in good repair
Neck: Supple without thyromegaly or adenopathy
Heart: Regular rate and rhythm; no murmurs, rubs, or gallops
Lungs: Clear to auscultation and percussion
Abdomen: No hepatosplenomegaly; abdomen soft, nontender, no masses
Extremities: Range of motion functionally intact; no cyanosis, clubbing, or edema
Neurological: Reflexes 2+ at Achilles, patellar, biceps, triceps, and brachioradialis; negative Babinski; cranial nerves 2 to 12 intact; negative Romberg; point-to-point movements intact; motor and sensory findings normal and symmetrical

QUESTIONS:

1. Learning

Before identifying your recommended Assessment and Plan, identify any learning issues that you believe are important for you to explore about this case:

2. Assessment
Please indicate the problems or issues you have identified that will guide your care (preferably in list form):
3. Plan
Please list your plans for addressing each of the problems or issues in your assessment:

especially why would cranial nerve 1 be affected- from hormonal iud?

references:

Cappiello, J., Eaton, J.; & Harkless, G. (2017). Case studies in primary

Thank you