Ramsay-Hunt syndrome results from reactivation of varicella zoster virus (VZV) dormant in the geniculate ganglion of cranial nerve VII (facial nerve). When the virus reactivates — triggered by immunosuppression, stress, or aging — it causes viral neuritis with inflammation, edema, and ischemia of the facial nerve within the bony fallopian canal. This produces the clinical triad of peripheral facial nerve palsy, otalgia, and vesicular eruption in the ear canal or auricle. Because the geniculate ganglion is adjacent to the vestibulocochlear nerve (CN VIII), patients frequently develop hearing loss, vertigo, and tinnitus. The nurse monitors facial nerve function, assists with eye protection, administers prescribed antivirals and corticosteroids, and reports any changes in symptoms.