A&E II final exam NYU nursing QUESTIONS WITH COMPLETE SOLUTIONS

Bell's Palsy correct answer: Peripheral Facial Nerve Paralysis (CNVII) -Benign, unilateral -cause unknown -Flaccidity of affected side of face w/dropping of mouth -recovery within a few weeks or months. Small number have long term facial paralysis Bell's palsy Clinical manifestations correct answer: -increased pain -inability to close eys -tearing -flattening of naso-labial fold -loss of taste -dropping of mouth -fever -tinnitus -pain behind the ear on affected side Bell's Palsy Diagnosis correct answer: -by elimination -electromyography Bell's palsy meds correct answer: -prednison -zovirax Bell's Palsy Nursing Interventions: correct answer: -pain meds (acetaminophen) -moist heat -protect face -nutrition (chew on unaffected side, oral hygiene) -dark glasses -eye patch -artificial tears Trigeminal neuralgia correct answer: Compression of the Trigeminal nerve (CNV) -involving maxillary and mandibular brances (ophthalmic usually spared) -chronic pain syndrome -unknown etiology --nerve compression, herpes simplex, jaw and teeth infection Trigeminal neuralgia Clinical manifestations correct answer: -abrupt onset of excruciating facial pain -burning, knife-like, electric shock-like --effected areas: lips, gums, cheeks, forehead, or side of nose -intense twitching, grimacing, blinking, eye tearing -attacks are brief, 2-3 seconds, unilaterally -course is unpredictable and cyclical -precipitating stimuli: chewing, brushing teeth, hot or cold air, touch or tickle -poor nutrition and hygiene, withdrawal, excessive sleep Trigeminal neuraligia Dx and MEdication correct answer: -hx of pain -MRI, CT scan, Lumbar puncture to rule out other problems -complete neurological assessment -anti seizure meds: phenytoin, carbamazepine (stabilize the neuronal membrane) Trigeminal neuralgia interventions correct answer: -surgical: to relieve pain-injection of glycerol into trigeminal nerve roots -environmental management: room temperature, draft free -pt's perform own facial care, hygiene, oral care -limit talking during acute periods -assess nutritional status gullian-barre syndrome etiology and pathop