Page 2031 - Saunders Comprehensive Review For NCLEX-RN

4. Glycerol injection: Destroys the myelinated fibers of
the trigeminal nerve (may take up to 3 weeks for pain
relief to occur)
XV. Bell’s Palsy (Facial Paralysis)
A. Description
1. Caused by a lower motor neuron lesion of cranial
nerve VII that may result from infection, trauma,
hemorrhage, meningitis, or tumor.
2. It results in paralysis of 1 side of the face.
3. Recovery usually occurs in a few weeks, without
residual effects.

B. Assessment

1. Flaccid facial muscles
2. Inability to raise the eyebrows, frown, smile, close the
eyelids, or puff out the cheeks
3. Upward movement of the eye when attempting to
close the eyelid
4. Loss of taste

C. Interventions

1. Encourage facial exercises to prevent the loss of
muscle tone (a face sling may be prescribed to prevent
stretching of weak muscles).
2. Protect the eyes from dryness and prevent injury.
3. Promote frequent oral care.
4. Instruct the client to chew on the unaffected side.
XVI. Guillain-Barré Syndrome
A. Description
1. An acute infectious neuronitis of the cranial and
peripheral nerves.
2. The immune system overreacts to the infection and
destroys the myelin sheath.
3. The syndrome usually is preceded by a mild upper
respiratory infection or gastroenteritis.
4. The recovery is a slow process and can take years.

The major concern in Guillain-Barré syndrome is difficulty

breathing; monitor respiratory status closely.
B. Assessment
1. Paresthesias
2. Pain and/or hypersensitivity such as with the weight
of bed sheets or other items touching the body
3. Weakness of lower extremities
4. Gradual progressive weakness of the upper
extremities and facial muscles

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