Nursing Diagnosis for Trigeminal Neuralgia

Trigeminal neuralgia is a medical diagnosis that refers to a disorder of the fifth cranial nerve (known as the trigeminal nerve). The term "nursing diagnosis," on the other hand, refers to a taxonomy of standardized nursing language developed by NANDA to allow nurses to identify patient issues in a way that can be consistently communicated across clinical settings. RNs cannot make medical diagnoses, but they do make nursing diagnoses.

Symptoms

• Trigeminal neuralgia, also known as tic douloureux, causes unexpected spasms of moderate to severe pain along one or more branches of the trigeminal nerve alternating with pain-free periods. Branches of the nerve supply specific parts of the face, so the location of the pain reflects the parts of the nerve involved.

Chronic Pain

• The premiere nursing diagnosis associated with trigeminal neuralgia is chronic pain. Most people are affected on only one side of the face, and the pain is provoked when one of the trigger points (the terminals of the involved branches) are stimulated by pressure or other sensations. Nursing interventions are aimed at avoiding trigger points and administering prescribed medications.

Anxiety

• When a patient has suffered innumerable paroxysms of facial pain, it's not unusual for him to develop anxiety about future episodes. He may also be anxious because he's not sure how long the pain will last and whether it will continue to get worse.

Self-Care Deficits

• A nurse may identify nursing diagnoses around self-care deficits when she asks the patient what triggers his pain. A man with trigeminal neuralgia may experience a paroxysm of pain when shaving his face, or a woman may have stabbing pain when using facial cleansers or applying make-up. In those situations, the appropriate nursing diagnosis is self-care deficit: bathing/hygiene.

Imbalanced Nutrition

• Because chewing food or enjoying a cold beverage can also trigger trigeminal pain, some patients may think twice about eating or drinking. If the problem persists, the nurse may diagnose "nutrition, imbalanced: less than body requirements or fluid volume, deficient, risk for."

Sleep Deprivation

• A nurse may select the nursing diagnosis of sleep deprivation if the patient's pain interferes significantly with normal sleep patterns. If pain or fear of potential pain continues, the patient may develop insomnia, another nursing diagnosis.

Surgery

• When pain persists over time and doesn't respond to prescribed medications, the patient may undergo a surgical procedure to sever affected portions of the trigeminal nerve. A nurse caring for the patient in the post-operative period may use a number of nursing diagnoses such as acute pain; aspiration, risk for; infection, risk for; perioperative positioning injury, risk for; and mobility: bed, impaired.