Peripheral nerve And Spinal Cord Problems Flashcards
What are clinical manifestations of Trigeminal neuralgia?
Very painful, sharp electric-like spasms that last for a fee seconds of minutes.
Usually only on one side of the face, often around the eye, cheek, and lower part of the face
Pain may be triggered by touch or sounds
What Cranial Nerve does Trigeminal Neuralgia effect?
5th CN (sensory & motor)
When can pain triggers occur in Trigeminal Neuralgia?
Brushing teeth Chewing Drinking Eating Shaving
What are some treatments for Trigeminal Neuralgia?
Relieve pressure on cranial nerve 5
Temporarily or permanently interrupt CN5
Use a nerve block
This is temporary
What are the goals of a patient with Trigeminal Neuralgia
Will be pain free
Will maintain adequate nutrition and oral hygiene
Will have minimal to no anxiety
Will return to normal of previous socialization and occupational activities
What is the nursing care for a patient with Trigeminal Neuralgia?
Assess I&O's Assess hygiene Assist patient to manage triggers If nerve function interrupted: Have patient chew on good side Monitor food temps (burns) Manual removal of pouched foods
How do you diagnose Trigeminal neuralgia?
History and Physical examination
CT scan
To rule out other problems
MRI
What is the collaborative therapy of Trigeminal Neuralgia?
Drug therapy Tegretol is the first choice Local nerve blocking Biofeedback Surgical intervention
What is Bell’s Palsy
Acute disruption of cranial nerve 7 (facial nerve)
Inability to move one side of face
Inability to move one eye, blink
Eye becomes dry, painful with excessive tearing
Requires patch for protection
What are symptoms of Bell’s Palsy?
Forehead not wrinkled Eyeball rolls up Eyelid does not close Flat nasolabial fold Paralysis of lower face
make sure to give them privacy
What is the etiology of Bell’s Palsy?
Possible reactivation of herpes vesicles in and around the earl will proceed facial paralysis
What is the treatment for Bell’s Palsy?
Corticosteroids
Antivirals
Time-85% Full recovery in 6 months
Moist heat
Gentle massage
Protect eye
Pain relief and social support
How do you diagnose Bell’s Palsy?
Blood tests for sarcoidosis or Lyme Disease
MRI - not in all patients
Electromyography (EMG)-confirms the presence of nerve damage
Nerve conduction test
What are the patient’s goals with Bell’s Palsy?
Will be pain free
Will not experience any complications
Will maintain optimal intake
Will have minimal side effects from corticosteroids
Will return to previous perception.of body image
What are the clinical manifestations of Gullain-Barre’ Syndrome?
Muscle weakness or the loss of muscle function and it effects both sides of the body
Tingling foot or hand pain, clumsiness, increased drooling
Typical symptoms include: loss of reflexes in the arms and legs and muscle weakness or loss of muscle function
May get worse over 24-72 hours
May occur in the nerves of the head only
May start in arms and legs; will move up or down
May have respiratory distress and may need to be an advance airway
What is the nursing management for Guillain-Barre’ Syndrome?
Assess- reflexes, respiratory status, watch their gait, push/pull and grips, for skin breakdown turn every 2 hours
Nursing Diagnosis-skin breakdown, risk for aspiration, ineffective breathing, fear
Watch for signs of infection because of foley
How do you diagnose Guillain-Barre’ Syndrome?
A loss of reflexes
Look at titers
How do you treat Guillain-Barre’ Syndrome?
High doses of sanuloglobbulin will help reduce the length and the extent of the symptoms
How do you classify a spinal cord injury?
Mechanisms of injury: hyperextension, flexion, etc.
Level of injury-
Skeletal: vertebral level most damage
Neurologic: lowest level: cervical, thoracic and lumbar
Degree of injury: complete or incomplete
What do the cervical spinal nerves control?
Diaphragm
Chest wall muscles
Arms
Shoulders