Bell’s palsy is a key medical-surgical topic from the nervous system section that you’ll need to know, especially if you want to pass the NCLEX with flying colors.
This is why today I’ll be sharing with you everything –and I really mean everything– you need to know about Bell’s palsy, from what causes it to what symptoms to look out for to how to treat it and everything in between.
And as always, we’ll also be answering a few practice questions together to make sure you lock all that information in!
Are you ready for this?
Let’s dive in!
Everything You Need to Know About Bell’s Palsy
Bell’s palsy occurs when the facial nerve VII is inflamed, which usually happens as a result of a viral infection. Other causes can be a tumor, an injury, or meningitis. However, an exact cause may not always be found.
Due to the inflammation of facial nerve VII, sudden, unilateral facial weakness or facial paralysis occurs. Bell’s palsy can affect any age group.
The Signs and Symptoms of Bell’s Palsy
The signs of Bell’s palsy are:
- Sudden, unilateral facial weakness or facial paralysis
- Jaw pain
- Drooping mouth
- Drooling on the affected side
- Difficulty keeping the eyelid closed on the affected side
- Difficulty raising the eyebrow or making facial expressions
How to Diagnose Bell’s Palsy
We base the diagnosis of Bell’s palsy on clinical findings and symptoms. MRI and CT scans may be done to rule out strokes or tumors that can cause facial paralysis.
Potential Complications
Teach the patient to report for any abnormal findings, such as vision changes or severe changes. When this happens, you must notify the healthcare provider as soon as possible.
How to Treat Bell’s Palsy
Prednisone is an oral corticosteroid that we prescribe to reduce the swelling of the facial nerve. We also prescribe eye drops to keep the eye on the affected side moist since the eyelid cannot completely shut or stay shut.
Pain medications, such as Ibuprofen, can be administered for pain relief. Physical therapy is recommended for facial exercises.
Note that recovery can occur spontaneously without treatment. Because the symptoms of Bell’s palsy mimics serious conditions, such as stroke, a healthcare provider still should be notified immediately.
Nursing Management
When it comes to Bell’s palsy, you should:
- Educate the patient and caregivers on the condition, treatment, and management.
- Provide emotional support. Keep in mind that Bell’s palsy affects the patient’s physical looks, so self-esteem and mental health may be affected as well, even if it is a temporary situation.
- Encourage facial exercises as directed, which may include grimacing in the mirror.
- Keep the affected eye protected with an eye patch, especially when outdoors.
- Tape the eyelid at night time to keep it shut since it cannot stay shut on its own.
- Educate to avoid wind and dust exposure.
- Apply moist heat on the affected side of the face to reduce pain.
- Massage the face as directed.
- To prevent a nutrition deficit, encourage eating and drinking on the unaffected side.
Bell’s Palsy Questions and Answers
Question #1: The nurse is providing care for a patient diagnosed with Bell’s palsy. Which of the following interventions is appropriate?
- Wear an eye patch on the affected eye
- Place eye drops as directed
- Wear an eye patch on the unaffected eye
- Both 1 and 2
Answer: Both 1 and 2.
Rationale: The affected eye should be protected since the eyelid cannot fully close. Eye drops are prescribed and should be administered to keep the affected eye moist.
Question #2: The nursing student is studying Bell’s palsy, which is one of the nervous system disorders. Which of the following is a potential cause of Bell’s palsy? Select all that applies:
- Injury
- Meningitis
- Tumor
- Viral infection
Answer: 1, 2, 3, and 4.
Rationale: Injury, meningitis, tumor, and viral infection are all potential causes of Bell’s palsy.
Question #3. The nurse is providing care for a patient diagnosed with Bell’s palsy. Which of the following statements requires further evaluation?
- “I should avoid wind exposure.”
- “I should keep the affected eye covered.”
- “Bell’s palsy can go away on its own.”
- “I understand that Bell’s palsy is a permanent condition and will not go away.”
Answer: “I understand that Bell’s palsy is a permanent condition and will not go away.”
Rationale: Wind exposure should be avoided. The affected eye should be covered since the eyelid cannot close all the way on its own. Bell’s palsy can subside on its own over time.
Question #4: The nurse is about to administer medication for a patient diagnosed with Bell’s palsy. Which of the following medications is given to reduce facial nerve edema?
- Tylenol
- Metoprolol
- Prednisone
- Ibuprofen
Answer: Prednisone.
Rationale: We give prednisone to reduce the facial nerve swelling. Metoprolol is given to alleviate hypertension, which is not necessary for Bell’s palsy. Ibuprofen and Tylenol are not given to reduce facial nerve edema, but to provide pain relief.
Question #5: Nursing student Ana is providing care for a patient with Bell’s palsy and is learning more about the nervous system disorder. Which of the following cranial nerves are affected by Bell’s palsy?
- Cranial nerve V
- Cranial nerve VI
- Cranial nerve VII
- Cranial nerve X
Answer: Cranial nerve VII.
Rationale: Bell’s palsy is a result of an inflammation affecting the Cranial Nerve VII, which is the facial nerve. The brain is connected to the muscles that control facial expressions and movements.
Cranial nerve V, the trigeminal nerve, is responsible for sensory information from the face to the brain.
Cranial nerve VI, abducens nerve, is responsible for the extraocular motor functions of the eye.
Cranial nerve X, the vagus nerve, is responsible for the involuntary body functions, such as digestion and heart rate.
Bell’s Palsy True or False Statements
Statement #1: To prevent a nutrition deficit, encourage eating and drinking on the unaffected side.
This statement is true.
Statement #2: Bell’s palsy is a permanent condition with no known cure.
This statement is false. Those with Bell’s palsy can recover. However, there is no known cure.
Statement #3: Unilateral facial weakness is one of the symptoms of Bell’s palsy.
This statement is true.
Statement #4: Facial muscle exercises, such as grimacing, should be encouraged.
This statement is true.
Statement #5: A patient with Bell’s palsy should be advised to protect the eye on the unaffected side.
This statement is false. A patient with Bell’s palsy should be advised to protect the eye on the affected side.
