Bell’s Palsy – Pathophysiology, Nursing Care Plan & Podcast

Bell's Palsy

Bell’s Palsy

Bells’ Palsy is described as a sudden weakness in the patients facial muscles. The patient will usually exhibit a unilateral facial droop. The cranial nerve that is usually affected is cranial nerve 7.

The exact cause of Bell’s Palsy is unknown, but it can occur at any age. Inflammation and swelling of nerves that control muscles on the patients face are thought to a possible cause. Viral infections may also be a cause of this condition.

While Bell’s Palsy is usually self limiting and temporary, some patients may continue to show signs and symptoms for the rest of their life. Usually signs and symptoms resolve in a few weeks, and will rarely recur. It is possible for Bell’s Palsy to affect both sides of face, although this is a very rare occurrence.

 Signs and Symptoms

Bell’s Palsy may occur quickly. Some signs will include:

  • Drooling
  • Headache
  • Decreased taste sensation
  • Altered tears and saliva production
  • Mild facial weakness or total paralysis to one side of face.
  • Facial droop
  • Difficulty smiling or closing eyes
  • Pain behind ear or jaw on the affected side

Complications

Bell’s Palsy usually resolves within a few weeks. However, the following complications may occur:

  • Permanent damage to the facial nerve
  • Possible blindness resulting from scratching and drying of the cornea.
  • Permanent contractures of certain facial muscles

Diagnosis

Diagnosis is usually made by patient presentation. In the majority of cases, weakness is limited to just one side of the face. The healthcare provider will also need to rule out other possible causes of facial paralysis, such as stroke, tumors, infections, or lyme disease.

  • Electromyography (EMG): may confirm the nerve damage and severity of the damage.
  • CT or MRI: can eliminate other possible causes of nerve damage.

 Treatments

Most patients with Bell’s Palsy make a complete recovery. However, the healthcare provider may prescribe the following to assist with the recovery of the patient:

  • Antiviral medications: may be of some use shortening the duration of the disease.
  • Corticosteroids: Used for their anti-inflammatory properties to reduce the inflammation of the facial nerve.
  • Pain medication
  • Eye care: keep eye moist and protect from harmful agents.
  • Physical therapy: to help prevent facial contractures.
  • Surgery: to decompress and relieve the pressure on the facial nerve.

Nursing Care Plan

Nursing Diagnosis

1. Body image disturbance related to alteration in structure and function for vision secondary to Bell’s Palsy.

Desired Outcomes:

Within 1 hour of nursing interventions, the patient will be able to demonstrate increased self esteem and body image by the ability to acknowledge, touch, and look at altered body part.

InterventionsRationals
InterventionsRationals
Assess patients knowledge of change in structure or function of the body part.The level of response is related to the perceived value or importance that the patient places on the affected body part.
Assist patient to identify actual changesPatients may perceive changes that are not actually present.
Encourage verbalization about concerns of the disease process and future expectations.This provides an opportunity to identify fears/misconceptions and deal with them directly.

 

2. Disturbed sensory perception: Visual

Desired Outcomes:

Within 1 hour of nursing interventions, patient will remain free from harm resulting from visual disturbances.

InterventionsRationals
InterventionsRationals
Assess patients knowledge of change in structure or function of the body part.The level of response is related to the perceived value or importance that the patient places on the affected body part.
Assist patient to identify actual changesPatients may perceive changes that are not actually present.
Encourage verbalization about concerns of the disease process and future expectations.This provides an opportunity to identify fears/misconceptions and deal with them directly.

Here is our podcast on Bell’s Palsy


 

 

Disclaimer:

Please follow your facilities guidelines and policies and procedures. The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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Anna C. RN-BC, BSN, PHN, CMSRN Anna began writing extra materials to help her BSN and LVN students with their studies. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process. She is a clinical instructor for LVN and BSN students along with a critical care transport nurse.

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