A patient has been diagnosed with Bell’s palsy. The nurse assesses the patient to determine if which signs/symptoms are present?

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  1. Eye paralysis and ptosis of to eyelids
  2. Chewing difficulties and one-sided facial droop
  3. Fixed pupil and an elevated eyelid on one side
  4. Twitching of one side of the face and ruddy cheeks

Answer (Detailed Solution Below)

Option 2 : Chewing difficulties and one-sided facial droop
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Correct Answer: Chewing difficulties and one-sided facial droop
Rationale:
  • Bell's palsy is a condition characterized by sudden weakness or paralysis of the muscles on one side of the face due to inflammation or compression of the facial nerve (cranial nerve VII). It is often temporary but can significantly impact a patient's ability to perform facial movements.
  • The hallmark signs of Bell's palsy include a one-sided facial droop and difficulties with chewing or other motor functions of the face. The facial nerve innervates the muscles responsible for facial expressions and some functions related to chewing and swallowing.
  • In addition to motor deficits, patients with Bell's palsy may experience the inability to close one eye, drooping of the mouth, and possible changes in taste sensation on the anterior two-thirds of the tongue, as the facial nerve also carries some sensory fibers.
  • The condition is usually diagnosed based on clinical presentation, and treatment may involve corticosteroids to reduce inflammation, physical therapy, or eye protection to prevent complications from incomplete eyelid closure.
Explanation of Other Options:
Eye paralysis and ptosis of the eyelids
  • Rationale: While Bell's palsy can cause difficulty in closing one eye due to weakness of the orbicularis oculi muscle, it does not typically result in true eye paralysis or ptosis (drooping) of the eyelid. Ptosis is more commonly associated with conditions like myasthenia gravis or Horner's syndrome.
Fixed pupil and an elevated eyelid on one side
  • Rationale: A fixed pupil and an elevated eyelid are not characteristics of Bell's palsy. These symptoms are more indicative of conditions like third cranial nerve (oculomotor nerve) palsy or other neurological issues involving the eyes.
Twitching of one side of the face and ruddy cheeks
  • Rationale: Twitching of the face and ruddy cheeks are not hallmark symptoms of Bell's palsy. Facial twitching could suggest other conditions, such as hemifacial spasm or tic disorders, while ruddy cheeks may be a sign of rosacea or other unrelated skin conditions.
Conclusion:
  • The correct diagnosis of Bell's palsy is based on the presence of one-sided facial droop and associated motor difficulties, such as chewing problems. These symptoms are caused by dysfunction of the facial nerve. Other options describe symptoms related to different neurological or medical conditions and do not match the clinical presentation of Bell's palsy.
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