The patient looks straight ahead while you wiggle your fingers, moving them from the outside edge of the six cardinal visual fields to the center. Face the patient and ask them to cover one eye while you cover your eye on the same side. Visual fields are evaluated with confrontation testing. Impairment can be related to non-neurologic causes (smoking, nasal congestion, aging) or neurologic causes (trauma, Alzheimer’s disease, or Parkinson’s disease).Ĭare implications: Testing of this cranial nerve frequently is deferred in the acute settings.ĭescription: This sensory nerve involves vision.Īssessment and findings: Testing is done with a Snellen chart or by having the patient read printed material or count fingers. ( See Cranial nerve overview.)ĭescription: This sensory nerve detects odor and transmits smell.Īssessment and findings: Ask the patient to close their eyes and identify nontoxic smells under each nare. For example, CN VII affects taste and the corneal response as well as upper and lower facial movement. Some cranial nerves have both sensory and motor function (B). Cranial nerves also can be remembered based on their function: sensory (S), such as smell (CN I) or vision (CN II), and motor (M), such as moving the eyes laterally toward the ear (CN VI) or sticking out the tongue (CN XII). For example, “On” is the first word in the mnemonic and CN I is olfactory. To connect the cranial nerve numbers with their names, use the saying “On old Olympus’s towering top a Finn and German viewed some hops.” The first letter of each word represents a cranial nerve beginning with the same letter. Remembering all 12 cranial nerve types and their functions can be overwhelming, so we recommend connecting each cranial nerve with a basic function. Other creative tools for aiding cranial nerve recall include a University of Texas Southwestern Neurology YouTube video and a visual developed by Bolek. However, the most important component of a cranial nerve assessment is knowing normal vs. Several mnemonics have been created to help nurses remember the name and function of the 12 cranial nerves. They reflect a possible neurologic emergency that requires immediate intervention. In unconscious patients, pupillary light reflex response is the most sensitive indicator unless the patient had previous eye surgery or has pre-existing eye trauma. In conscious patients, LOC changes provide the earliest indicator of neurologic compromise. Regardless of LOC and cognition, the following cranial nerves usually can be assessed: A patient with a decreased LOC will have limited participation in a full assessment. A fully awake and aware patient can follow commands that permit bilateral assessment of all 12 cranial nerves. Each cranial nerve has either a sensory, motor, or a combined function.Ĭranial nerve assessments help you determine cerebral cortex and brainstem function depending on the patient’s level of consciousness (LOC). The cranial nerves control most of the sensory and motor function in the head and neck in addition to peripheral nerves that exit from the midbrain or the brainstem. The 12 pairs of cranial nerves are referred to by Roman numerals (CN I through XII) or by name. Mnemonics can aid assessment recollection and recognition of abnormal findings. However, many nurses may find cranial nerve assessment challenging if they don’t perform it routinely. Abnormal findings-subtle or gross-reflect sensory, motor, and reflexive function and have significant implications for nursing care. Understanding normal and abnormal cranial nerve assessments can aid early diagnosis and treatment.Īcute and chronic neurologic presentations exist in all healthcare settings.Neurologic assessments occur in all healthcare settings.Many nurses find remembering the cranial nerves and their functions to be challenging.Use mnemonics to aid remembering and identifying abnormal findings. Author Guidelines and Manuscript Submission.
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