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Nursing 3 Test 3
Disorder of the Ear
| Question | Answer |
|---|---|
| Structures of the Ear | External, Middle and Inner |
| Middle ear is made up of... | typanum, ossicles(malleus, incus and stapes), and eustachian tube |
| Inner Ear is made up of... | semicircular canals, cranial nerve #8, and cochlea |
| types of hearing loss | conductive, sensorineural and mixed |
| conductive hearing loss | (outer, middle and typanic) impaired transmission of sound |
| sensorineural hearing loss | (inner ear, cochlea nerve) prebycusis, drug damage to nerve(ototoxic) |
| prebycusis | slow loss of hearing that people get as they get older |
| mixed hearing loss | mixture of conductive and senorineural hearing loss |
| drugs that are ototoxic | asa, chemo agents, and antibiotics |
| nursing assessment for hearing impairment | adult and aged-family hx, present hx, ototoxic drugs, age related changes, occupational hx, communication |
| nursing assessment for hearing impairment:infant | family hx, prenatal, immunization, hearing, speech development |
| hearing impairment of infant | lack of startle reflex, not awakened by environmental noise, unable to localize source of sound(6mo), absence of babble/voice inflection(7mo), failure to respond to spoken word, failure to respond to verbal direction |
| hearing impairment of child | use of gestrures,not verbalization(15mo), unable to develop intelligible speech(24mo), monotone,less laughter,plays alone, stubborn,confused facial expression,yelling to express annoyance,tantrums,asking to repeat,incorrect resp,head banging,foot stamping |
| Diagnostic Data analysis | rhinne test, weber, otoscopic, audiometry, CBC, electronystagmograph, ct scans, x-rays |
| rhinne test | It compares perception of sounds transmitted by air conduction to those transmitted by bone conduction through the mastoid |
| weber test | Distinguishes between conductive and sensorineural hearing.2) Strike a tuning fork softly3) Place the vibrating fork on the middle of the client's head 4) Ask client if the sound is heard better in one ear or the same in both ears |
| meniere's disease(endolyphatic hydrops) | triad of symptoms:tinnitus, unilateral hearing loss, vertigo |
| attacks of meniere's dx | self limiting and can last for minutes or hours, GI-n/v, vertigo described as spinning, whirling w/staggering gait |
| vertigo | sense of motion when there is none |
| syncope | lack of CO(O2 to the brain) more likely to faint |
| causation of meniere's dx | idiopathic(don't know why) |
| diagnosis of meniere's dx | electronystag, CT, glycerol |
| glycerol | agent that pulls fluid from inner ear |
| medication tx's for meniere's dx | diuretic, antiemetic, antihistamines, anticholinergics |
| diet for meniere's dx | low sodium |
| surgical intervention for meniere's dx | endolyphatic decompression, vestiblular neurectomy, labyrinthectomy |
| antivert | given to keep from being dizzy |
| electronystagmograph | measures symptom known as nystagmus |
| nystagmus | bouncing back of eyeball when inner ear (vestibular) is stimulated |
| cochlear | hearing |
| vestibular | balance |
| meniere's dx | too much endolymph, it also increases pressure on cochlear hair cells |
| endolymph | fluid contained in the membranous labyrinth of the inner ear. It is also called Scarpa's fluid |
| Nursing concerns for Meniere's dx | altered perception, safety, sleep pattern disturbance, health promotion, home care |
| otitis media | infection and/or inflammation of middle ear |
| otitis media is common in... | infants and young children due to shorter and straighter eustachian tubes |
| aerotits | form of otitis media |
| assessment with pt with otitis media | reveals: pain,bulging,red eardrum,absent light reflex,decrease ear landmarks,fever,fussiness,past URI,decreased appetitie,purulent ear drainage,tugging at ear |
| diagnose otitis media with | otoscopy and audiometry |
| complications of otitis media | hearing loss,speech delay etc |
| treatments for otitis media | tympanostomy tube(myringotomy),amoxicillin(choice drug or bactrim), |
| chronic otitis media can affect... | ossicles, eustachian tube and mastoid bone(behind ear) |
| complications of chronic otitis media | cholesteatoma(collection of scar tissue) |
| bacterias that cause otitis media | pseudomonas, staphylcoccus, clepsiella |
| otosclerosis | abnormal collection of tissue that fixates the stapes-results in conductive loss |
| manifestations of otosclerosis | hereditary, seen in caucasion females, can see in pregnancy |
| care of pt with otosclerosis | possible drug therapy of sodium fluidie,vit d and calcium carbonate |
| perioperative care including... | blowing nose properly, avoidance of hair wash, cotton ball with vaseline in ear for 6 wks, avoid rapid head movements and bending |
| surgical tx of otosclerosis | stapedectomy/otomy |
| tympanoplasty | reconstruction of ear drum |
| amplification aids and cochlear implant | devices to improve hearing |
| devices to improve hearing include: | hearing aids,lip-reading,sign language,closed captioning tv |
| asistive devices for ADL's.. | teletypewriters,trained hearing aid dogs,flashing lights on door or phone,vibrating alarm clock under pillow |
| cochlear implants are used to... | assist lost neural function and are either implanted in the cochlea or in the brainstem |
| Nurses role in promotion of ear health | wear ear protection,do not use Qtips, sneeze-open mouthed,avoid risky activities,watch exposure to excessive noise,avoid ototoxic drugs, early tx of URI's |
| Disorder characterized by a triad of symptoms affecting the endolypmh | meniere's dx |
| this disorders has a growth of tissue in the middle ear | otosclerosis |
| the eardrum is visualized as red and bulging | otitis media |
| treatment can include antihistamines | meniere's dx |
| stapedectomy would be a tx for this disorder | otosclerosis |
| a complication of this disorder is cholesteatoma | otitis media |
| the client is complaining of ringing in the ears. Which of th follwing data should the nurse document? | Tinnitus |
| otorrhea | any discharge from the ear |
| which ototoxic medication should the nurse administer cautiously? | an intravenous aminoglycoside antibiotic |
Created by:
jbittner
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