The nurse has given the male client with Bell’s palsy instructions on preserving muscle tone in the face and preventing denervation. The nurse determines that the client needs additional information if the client states that he or she will:
A. Wrinkle the forehead, blow out the cheeks, and whistle.
B. Massage the face with a gentle upward motion.
C. Perform facial exercises.
D. Exposure to cold and drafts.
Correct Answer: D. Exposure to cold and drafts.
Exposure to cold or drafts is avoided. Local application of heat to the face may improve blood flow and provide comfort. Facial pain is controlled with analgesic agents or heat applied to the involved side of the face.
Option A: The neurology nurse must educate the patient on facial exercises that can help improve muscle strength and facial coordination. These exercises can reduce poor aesthetics and improve the functionality of the facial muscles.
Option B: Show the patient how to perform facial massage with gentle upward motion several times daily when the patient can tolerate the massage. Massage and mild electrical stimulation of the paralyzed muscles can help maintain facial muscle tone and prevent the loss of muscle function.
Option C: Prevention of muscle atrophy with Bell’s palsy is accomplished with facial massage, facial exercises, and electrical stimulation of the nerves. Demonstrate facial exercises, such as wrinkling the forehead, blowing out the cheeks, and whistling, in an effort to prevent muscle atrophy.
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