but the majority of patient's have experienced a viral upper respiratory infection 1 to 3
weeks prior to the onset of symptoms. Complications associated with Bell's palsy
include facial weakness, facial spasm with contracture, corneal ulceration, and
blindness.
b. Signs and Symptoms.
(1)
Distortion of face.
(2)
Numbness of face and tongue.
(3) Overflow of tears down the cheek from keratitis caused by drying of
cornea and lack of blink reflex.
(4)
Decreased tear production that may predispose to infection.
(5)
Speech difficulty secondary to facial paralysis.
c. Nursing Care Considerations.
(1)
Objectives of care:
(a)
Maintain muscle tone of the face.
(b) Prevent or minimize denervation.
(2)
Protect the involved eye.
(a) If blink reflex is absent, eye is vulnerable to dust and foreign
particles.
(b) Instill artificial tears (methylcellulose) to protect the cornea.
(c)
Increase environmental humidity.
(d) Instruct patient to close affected eye frequently using accessory
facial muscles.
(e) Instruct patient to wear a protective patch at night. (Keep in mind
that patch may eventually abrade cornea as paralyzed eyelids are difficult to keep
closed.)
(f) Instruct patient to wear protective glasses to further protect eye and
MD0919
2-50