Reference no: EM133468975

A 21-year-old female college student is studying with her friends when she notices that she is having difficulty controlling the right side of her mouth as she attempts to eat a snack. Because of this, her speech is a bit garbled. She mentions her concern to her friends. As they look at her, they notice that she has facial droop on her right side. One of her friends drives her to the nearest emergency department to help determine what is wrong.

After arriving at the emergency department, a nurse begins to assess the client. The client's speech is still slightly garbled. The assessment also reveals the client is alert and oriented, interacting appropriately, and providing proper answers to questions. The client's vital signs are temperature 36.1 degrees Celsius, pulse 106 beats per minute, respirations 18 per minute, blood pressure 124/78 mm of Hg, and SpO2 is 97% on Room Air. Blood glucose is 98 mg/dl. Her pupils are equally round and reactive to light and accommodation. There are no bumps or bruises on her head. She is not able to completely close her right eye or raise her eyebrow on the right side of her face. Drooling is noted from the right side of the mouth at times, and when the nurse asks the client to smile, the right side of the client's mouth does not respond well. She is unable to curl her tongue normally and is now complaining of pain in her right ear. There is no arm drift upon examination.

As the nurse obtains a client history, she notes that the client has not had any previous neurological concerns. The client has not recently consumed alcohol or other recreational drugs. The client does not report any trauma or unusual events prior to the onset of symptoms. The client does take levothyroxine for her hypothyroidism but does not take any other routine medications.