A client with a new diagnosis of trigeminal neuralgia is receiving education to prevent triggering an acute onset. Which of the following will the nurse include in teaching?
Massage the affected side multiple times a day.
Apply ice directly to the skin.
Provide pureed consistency foods.
Consider alternative therapies such as yoga, biofeedback, or meditation.
The Correct Answer is D
Choice A reason: This is incorrect because the nurse should not include this in teaching. Massaging the affected side multiple times a day can trigger an acute onset of trigeminal neuralgia. Trigeminal neuralgia is a condition that causes severe pain in one or more branches of the trigeminal nerve (cranial nerve V), which innervates the face. The pain can be triggered by touch, pressure, or movement of the face. The nurse should advise the client to avoid touching or stimulating the affected side.
Choice B reason: This is incorrect because the nurse should not include this in teaching. Applying ice directly to
the skin can trigger an acute onset of trigeminal neuralgia. Trigeminal neuralgia can be triggered by temperature changes or cold stimuli on the face. The nurse should advise the client to avoid exposure to cold air or wind and to protect their face with a scarf or mask.
Choice C reason: This is incorrect because the nurse should not include this in teaching. Providing pureed consistency foods can trigger an acute onset of trigeminal neuralgia. Trigeminal neuralgia can be triggered by chewing, swallowing, or talking. The nurse should advise the client to eat soft foods that do not require much chewing and to avoid hot or spicy foods that can irritate the mouth.
Choice D reason: This is correct because the nurse should include this in teaching. Considering alternative therapies such as yoga, biofeedback or meditation can help prevent triggering an acute onset of trigeminal neural
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Correct Answer is C
Explanation
Choice A reason: This is incorrect because using sign language when communicating with the client is not an appropriate action for the nurse to take. Sign language is a form of communication that uses hand gestures, facial expressions, and body movements. It is not a universal language and requires training and practice. The nurse should not assume that the client knows or prefers sign language unless they have indicated so.
Choice B reason: This is incorrect because speaking loudly and into the client's good ear is not an appropriate action for the nurse to take. Speaking loudly can distort the sound quality and cause discomfort or irritation to the client. Speaking into the client's good ear can also create a sense of imbalance and isolation. The nurse should speak at a normal volume and tone, and face the client directly.
Choice C reason: This is the correct answer because speaking directly to the client in a normal, clear voice is an appropriate action for the nurse to take. Speaking directly to the client can help them see the nurse's mouth movements and facial expressions, which can enhance understanding and communication. Speaking in a normal, clear voice can help convey the message clearly and respectfully.
Choice D reason: This is incorrect because sitting by the client's side and speaking very slowly is not an appropriate action for the nurse to take. Sitting by the client's side can make it difficult for them to see the nurse's face and hear their voice. Speaking very slowly can also make the message unclear and patronizing. The nurse should sit in front of the client and speak at a normal pace.
Correct Answer is B
Explanation
Choice A reason: This is incorrect because a drop in heart rate from 74 to 68/min is not a manifestation that requires immediate reporting to the provider. A mild decrease in heart rate can be normal or due to other factors such as medication, sleep, or relaxation. It does not indicate a worsening of brain injury or increased intracranial pressure.
Choice B reason: This is the correct answer because a change in the Glasgow Coma Scale score from 14 to 10 is a manifestation that requires immediate reporting to the provider. The Glasgow Coma Scale is a tool that measures the level of consciousness based on eye-opening, verbal response, and motor responses. A score of 14 indicates mild impairment, while a score of 10 indicates moderate impairment. A decrease in score can indicate deterioration of neurological status and increased intracranial pressure, which can be life-threatening.
Choice C reason: This is incorrect because the headache is not a manifestation that requires immediate reporting to
the provider. Headache is a common symptom of mild TBI and can be managed with analgesics, rest, and hydration. It does not indicate a worsening of brain injury or increased intracranial pressure unless it is severe, persistent, or accompanied by other signs such as vomiting, confusion, or seizures.
Choice D reason: This is incorrect because diplopia is not a manifestation that requires immediate reporting to
the provider. Diplopia means double vision and can be caused by damage to cranial nerves or eye muscles due to TBI. It can be treated with eye patches, glasses, or surgery. It does not indicate a worsening of brain injury or increased intracranial pressure unless it is associated with other symptoms such as blurred vision, loss of vision, or eye pain.
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