Chap 61- Nerve and Spinal Cord Study Set Questions With Solved Solutions.
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Course
Spinal disorders
Institution
Spinal Disorders
The nurse assessing a 54-year-old female 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. - Answer ...
Chap 61- Nerve and Spinal Cord Study
Set Questions With Solved Solutions.
The nurse assessing a 54-year-old female 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. - Answer triggers leading to facial discomfort.
The major clinical manifestation of trigeminal neuralgia is severe facial pain that is triggered by
cutaneous stimulation of the nerve. Ptosis, loss of taste, and facial weakness are not characteristics of
trigeminal neuralgia.
Which action should the nurse take when assessing a patient with 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. - Answer Inspect the oral mucosa and
teeth.
Oral hygiene is frequently neglected because of fear of triggering facial pain. Having the patient clench
the facial muscles will not be useful because the sensory branches of the nerve are affected by
trigeminal neuralgia. Light touch and palpation may be triggers for pain and should be avoided.
When evaluating outcomes of a glycerol rhizotomy for a patient with trigeminal neuralgia, the nurse will
a. assess whether the patient is doing daily facial exercises.
b. question whether the patient is using an eye shield at night.
c. ask the patient about social activities with family and friends.
d. remind the patient to chew on the unaffected side of the mouth. - Answer ask the patient about
social activities with family and friends.
, Because withdrawal from social activities is a common manifestation of trigeminal neuralgia, asking
about social activities will help in evaluating whether the patient's symptoms have improved. Glycerol
rhizotomy does not damage the corneal reflex or motor functions of the trigeminal nerve, so there is no
need to use an eye shield, do facial exercises, or take precautions with chewing.
Which action will the nurse include in the plan of care for a 62-year-old patient who is experiencing pain
from trigeminal neuralgia?
a. Assess fluid and dietary intake.
b. Apply ice packs for 20 minutes.
c. Teach facial relaxation techniques.
d. Spend time talking with the patient. - Answer Assess fluid and dietary intake.
The patient with an acute episode of trigeminal neuralgia may be unwilling to eat or drink, so
assessment of nutritional and hydration status is important. Because stimulation by touch is the
precipitating factor for pain, relaxation of the facial muscles will not improve symptoms. Application of
ice is likely to precipitate pain. The patient will not want to engage in conversation, which may
precipitate attacks.
The nurse identifies a patient with type 1 diabetes and a history of herpes simplex infection as being at
risk for Bell's palsy. Which information should the nurse include in teaching the patient?
a. "You may be able to prevent Bell's palsy by doing facial exercises regularly."
b. "Prophylactic treatment of herpes with antiviral agents prevents Bell's palsy."
c. "Medications to treat Bell's palsy work only if started before paralysis onset."
d. "Call the doctor if you experience pain or develop herpes lesions near the ear." - Answer "Call the
doctor if you experience pain or develop herpes lesions near the ear."
Pain or herpes lesions near the ear may indicate the onset of Bell's palsy and rapid corticosteroid
treatment may reduce the duration of Bell's palsy symptoms. Antiviral therapy for herpes simplex does
not reduce the risk for Bell's palsy. Corticosteroid therapy will be most effective in reducing symptoms if
started before paralysis is complete but will still be somewhat effective when started later. Facial
exercises do not prevent Bell's palsy.
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