Bell’s palsy nursing care? Yep, you are reading right article about it. If you are a nurse, then you should know how to plan a right bell’s palsy nursing care. Bell’s palsy is a neurology disturbance in facial nerve.
What is Bell’s Palsy Definition?
Bell’s palsy is neurology disturbance that attacks 7th cranical nerve (facial nerve), it makes unilateral facial weakness and paralysis. This disease attack is fast. It can attack all ages, but the most often age is about 20-60 years old. 80-90% of this disease can recover spontaneously in 1-8 weeks. But, adults lately become 100 % recover. If the recovery is partial, contracture can occur in paralyzed face. Bell’s palsy can be recurrent in same face side or opposite face side.
- Ischemia, tumor, meningitis, or local trauma
- Inflammatory reflex in 7th cranial nerve
- Virus disease (the most common virus are herpes simplex or herpes zoster).
Sign and symptoms
- Bell’s phenomenon: partial eyelid close in paralyzed face with excessive tears
- Sound hypersensitive
- Unilateral facial weakness, sometime involve pain in jaw corner or behind ear
- Mouth or lip weakness with hyper saliva, difficult to close eyelid, and taste sense disorder in anterior tongue.
After 10 days, electromyography help predict the recovery by comparing temporary conduction damage with nerves interruption pathology.
- Corticosteroid can decrease fatal nerve edema and increase nerve conduction and blood flow
- After day 14 of corticosteroid therapy, electrotherapy can prevent facial muscle atrophy
Complete treatment for Bell’s Palsy, read here (Treatment of Bells Palsy, Choose The Right One!)
Bell’s Palsy Nursing care
- If patient has corticosteroid therapy, aware of side effect like gastrointestinal distress and fluid retention. If patient has diabetes condition, corticosteroid must be use carefully and monitor blood glucose
- To reduce the pain, compress with warm compress on paralyzed face, but it should not burn the skin. If patient is prescribed an analgesic, monitor the therapeutic effects from medicine.
- To maintain the muscle tonus, massage patient’s face with upward direction for 5-10 minutes, ask the patient to massage his face by his/her self. If he/she is ready to do active exercise, ask the patient to smile in front of mirror.
- Suggest the patient to close his/her eye with eye protector, especially if the patient go out. Ask patient to stay in warm circumstance, avoid dust and wind, and close the eye with dangerous exposure
- To avoid complication in swallowing like aspiration and body weight decrease, ask patient to upright sit while he/she eat, chewing in non-paralyzed face side, chewing with small portion, consume balance nutrition foods, and avoid solid foods
- Give patient privacy while patient has meal time, so the patient will not feel embarrass
- Use face strap to symmetrize the lip
- Perform mouth care and be careful with foods remain between lip and gingiva
- Give psychological support. Ensure the patient that the recovery needs 1-8 weeks.