Medical Surgical Parkinson’s Disease PD #4

Question

A client with trigeminal neuralgia returns to the clinic for follow-up. Which assessment is most important for the nurse to perform for the client with trigeminal neuralgia?

Answers

  1. Skin temperature
    • Rationale:

      This answer is not correct because skin temperature is not useful. Skin temperature does not affect trigeminal neuralgia one way or the other.

  2. Determining areas of pain through palpation
    • Rationale:

      This answer is not correct because palpation for pain may trigger more intense pain and should be avoided. Areas of pain will be in the face, since the trigeminal nerve is the nerve responsible.

  3. Examination of dentition
    • Rationale:

      This answer is correct because assessment of teeth and gums are important because dental care is often not performed for fear of pain associated with the oral care. Most pain is experienced in the upper or lower jaw and runs in cycles. Examination of dentition is important because dental hygiene is very important to one’s health.

  4. Perform cranial nerve IX and X assessment
    • Rationale:

      This answer is not correct because cranial nerve IX and X are not affected by trigeminal neuralgia. Trigeminal nerves control sensations in the face, (trigeminal nerve is V).

Overview

Trigeminal neuralgia is pain caused by the trigeminal nerve, which is a cranial nerve. Even gentle touch to the face can cause extreme pain in trigeminal neuralgia, thus making some clients avoid dental care.

Explanation

Learning Outcomes

The trigeminal nerve is the 5th cranial nerve and is responsible for sensations in your lower jaw, gums, teeth and sometimes around the nose and eyes. Due to the excruciating pain associated with trigeminal neuralgia, many clients with this condition avoid going to the dentist. They may also neglect brushing their teeth. This results in suboptimal dental hygiene. Poor oral health can cause brain or heart infections, cancer and diabetes. Trigeminal neuralgia is caused by a blood vessel putting pressure on the trigeminal nerve. Other causes include multiple sclerosis, facial injury, brain tumor, or stroke.

Test Taking Tip

A way to remember the trigeminal nerve is to think about “tri makes you cry” and the tears start at the eye and go down your face to your jaw. Then think, “oh my” and if the person places their hands on their face (like the Home Alone boy), then that is all 5 fingers or the CN5.

Video Rationale