What is Bells Palsy and what should be done first?
unilateral facial paralysis, stroke should be ruled out
(thought to be a reactivation of a dormant herpes simplex virus)
Common s/s of Bell's Palsy
cannot wrinkle forehead/pucker lips, close eye, smile on affected side, excessive tearing and
drooling on affected side
What medications are used to treat Bells palsy? patient teaching
corticosteroids to suppress inflammation around nerves, antivirals, artificial tears
-tape eye close/ wear protective eye patch QHS, high calorie snacks/soft diet
What is myasthenia gravis?
progressive-acquired autoimmune disease characterized by proximal and distal muscle
weakens, ptosis ( upper eyelid droops over the eye), diplopia (double vision)
Resp. compromise (highest risk is aspiration)
What is nurses role during pre-operative period?
Educator, advocate, promoter of health and safety
Our function is to act as an educator. MD describes the procedure, then RN has to go back and
make sure pt understands. Advocate.
Whos responsibility is it to obtain informed consent?
the providers NEVER the nurses
-nurse may clarify questions but never provide new or additional information and confirm
consent was signed
What happens if medication has been administered and consent is needed?
, consent can not be signed if medications have been administered
What is IGG used for when a patient has Myasthenia Gravis?
to decreased the production of acetylcholine
Cholinesterase Inhibitor Drugs= 1st option
Pyridostigmine (Mestinon, Regonolo)
-doses can vary day by day and should be taken with food to avoid GI side effects
What are nursing roles for a patient who has Myasthenia Gravis?
Gas exchange- chest physiotherapy
Promote mobility- schedule test/activity early allow for rest periods
Avoid sedatives, magnesium- can cause resp./cardiac depression and increase muscle
weakness
What is myasthenic crisis?
Complication from myasthenia gravis causing rapid onset of dysphagia, resp. distress- priority is
to maintain airway and hold cholinesterase inhibiting drugs
What is a TIA?
brief interruption in cerebral blood flow (mini stroke)- can indicate a major stroke is coming/high
risk of more
Treatment options for TIA?
-traditional/minimally invasive surgery to remove atherosclerotic plaque buildup
-Carotid angioplasty with stenting
-Antiplatelet drugs
-reducing high blood pressure
-life style changes
What is a stroke?
brain attack-interruption of perfusion to any part of the brain that results in infraction (cell death)
Hemorrhagic stroke cause by?
Aneurysm, HTN or Arteriovenous malformation
-vessel integrity is interrupted and bleeding occurs- Treatment= Vit K, fresh frozen
plasma/surgery