Medical-surgical Nursing Demystified

(^218) Medical-Surgical Nursing Demystified

• Assess gag reflex—as muscular changes occur, normal protective gag reflex
  will diminish.


• Explain to the patient:
  
  
  • How to suction oral pharynx to remove secretions or food particles. As mus-
    cle function decreases, the cough reflex will not be sufficient to remove these.
  
  
  • How to tuck chin while drinking and eating to decrease chance of
    aspiration.
  
  
  
  

Bell’s Palsy

WHAT WENT WRONG?

This is an acute idiopathic facial paralysis of the seventh cranial nerve that affects

one side of the face. Often due to inflammation, the disorder is more common in

diabetic patients. One side of the face is paralyzed, making the patient unable to

close the eyelid, raise the eyebrow, or smile on the affected side of the face. Some

patients will experience pain around the ear on the affected side. The patient may

have an associated change in taste.

PROGNOSIS

The more severe the symptoms at the time of presentation, the poorer the progno-

sis. Some patients will have long-term persistence of symptoms, like facial disfig-

urement. The majority of patients will have complete resolution of symptoms.

HALLMARK SIGNS AND SYMPTOMS

• Unilateral facial paralysis—inability to close eye, wrinkle forehead, puff out
  cheeks, or smile


• Pain near the ear and jaw


• Altered taste

INTERPRETING TEST RESULTS

• Electromyogram (EMG) used to indicate recovery time; can determine
  prognosis.

3