The Nurse Is Assessing a Client Who Had a Dissection

question 16

Multiple Choice

The nurse is assessing a client who had a dissection of all branches of the right trigeminal nerve.When asked to wrinkle his forehead,the client wrinkles only the left side.Which is the nurse's best action?

• A) Place the client in high Fowler's position.
• B) Document the finding.
• C) Assess the corneal reflex.
• D) Notify the health care provider.

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Definitions:

Spinal Cord

The central nerve bundle running down the spine that transmits messages between the brain and the body.

Sympathetic Nervous

Part of the autonomic nervous system responsible for the 'fight or flight' response, preparing the body for action.

Autonomic Nervous

Part of the nervous system that controls involuntary bodily functions such as heart rate, digestion, and respiratory rate.

Parasympathetic Nervous

Part of the autonomic nervous system responsible for relaxation and conservation of energy by slowing the heart rate and increasing intestinal and gland activity.