Medical Surgical Bell’s Palsy and Trigeminal Neuralgia #3

Question

Which nursing diagnosis is priority with a client who has been diagnosed with trigeminal neuralgia?

Answers

  1. Altered Nutrition
    • Rationale:

      This answer is not correct because although altered nutrition is a nursing diagnosis for trigeminal neuralgia, it is not the most important. Addressing the pain will help the altered nutrition since chewing can cause pain to the client.

  2. Fear and Anxiety
    • Rationale:

      This answer is not correct because although fear and anxiety is a nursing diagnosis for trigeminal neuralgia, it is not the priority. With trigeminal neuralgia, the nursing diagnosis of fear and anxiety is related to the client’s fear of an impending attack of debilitating pain. Therefore, addressing the client’s pain is priority.

  3. Deficient Knowledge
    • Rationale:

      This answer is not correct since deficient knowledge is not a priority with a client who is suffering from trigeminal neuralgia pain. Deficient knowledge in the disease process of neuropathic pain is common for clients with trigeminal neuralgia. Education about the condition should be given after pain is addressed.

  4. Acute Pain
    • Rationale:

      This answer is correct because pain is the fifth vital sign and must always be addressed since it is a requirement of proper client care. Trigeminal neuralgia has been characterized as one of the most painful disorders in medicine. First intervention should be providing pain relief for the client with trigeminal neuralgia.

Overview

The trigeminal nerve (cranial nerve V) is responsible for facial sensation. Trigeminal neuralgia is irritation to the trigeminal nerve and causes excruciating pain.

Explanation

Learning Outcomes

Trigeminal neuralgia is a severely painful neuropathic disorder of cranial nerve V which is responsible for facial sensation. The priority nursing diagnosis of this client will be consideration of debilitating pain associated with this condition, therefore pain control will be the priority intervention. Instructing the client to avoid potential triggers such as eating foods that are too cold or too hot, chewing foods on the unaffected side, and using cotton pads to gently wash the face are just a few interventions for acute pain. Placing the client on a mechanical soft diet will help with altered nutrition. Fear and anxiety of pain can actually make pain worse, so addressing fear and anxiety is also an important nursing diagnosis. Obtaining an order for an antidepressant or anti-anxiety medication will aid in the client’s fear and anxiety of impending pain. Providing the client with information about trigeminal neuralgia and the condition and need for medication and staying ahead of the pain is the appropriate intervention for deficient knowledge of this disease process.

Test Taking Tip

Understanding how painful trigeminal neuralgia is and how the experience of pain is a trickle-down effect to a client’s nutrition and emotional status will help the student realize that addressing the pain first may help resolve these other issues (nursing diagnoses).

Video Rationale