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Chapter 60: Spinal Cord and Peripheral Nerve Problems Lewis: Medical-Surgical Nursing, 10th Edition

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Chapter 60: Spinal Cord and Peripheral Nerve Problems Lewis: Medical-Surgical Nursing, 10th Edition The nurse assessing a patient with newly diagnosed trigeminal neuralgia will ask the patient about a. visual problems caused by ptosis. b. triggers leading to facial discomfort. c. poor appetite caused by loss of taste. d. weakness on the affected side of the face. - ANS ANS: B The major clinical manifestation of trigeminal neuralgia is severe facial pain triggered by cutaneous stimulation of the nerve. Ptosis, loss of taste, and facial weakness are not characteristics of trigeminal neuralgia. DIF: Cognitive Level: Apply (application) Which patient assessment will help the nurse identify potential complications of trigeminal neuralgia? a. Have the patient clench the jaws. b. Inspect the oral mucosa and teeth. c. Palpate the face to compare skin temperature bilaterally. d. Identify trigger zones by lightly touching the affected side. - ANS ANS: B Oral hygiene is frequently neglected because of fear of triggering facial pain and may lead to gum disease, dental caries, or an abscess. Having the patient clench the facial muscles will not be useful because the sensory branches (rather than motor branches) of the nerve are affected by trigeminal neuralgia. Light touch and palpation may be triggers for pain and should be avoided. DIF: Cognitive Level: Apply (application) When evaluating outcomes of a glycerol rhizotomy for a patient with trigeminal neuralgia, the nurse will a. assess if the patient is doing daily facial exercises. b. question if the patient is using an eye shield at night.

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