Week 9: Case Study, Chapter 69
1. Joan Centers, a 42-year-old patient, presents to the clinic with drooping of
the right side of the face with paralysis of the right eyelid resulting in
decreased blinking and inability to close the eye. The patient has increased
lacrimation of the right eye. The patient complains that the right side of her
face feels like pins and needles pricking it, and the pain includes her right
eye and behind her right ear. The patient’s speech is slurred and the patient
has no control of facial muscles on the right side when swallowing. (Learning
Objective 4)
a. How should the nurse describe the diagnosis of Bell palsy to the
patient?
A sudden onset of unilateral paralysis of the facial muscle, including the
forehead and lower face.
b. What medical treatments does the nurse anticipate will be ordered for
the patient, and what rationale justifies the treatments?
Corticosteroids therapy to reduce inflammation and edema, analgesic or
heat pad for the pain.
c. What nursing care should be provided for the patient?
Educate patient about eye care cover awith a shield use eye drops at day and
ointment at night; close eyelid manually before going to sleep wear
sunglasses/goggles to decrease evaporation from the eye. Facial massage
with a gentle upward motion, facial exercises wrinkling the forehead, blowing
out the cheeks and whistling. They want to avoid exposing the face to cold
and drafts