Ear Anatomy, Otitis Media, Otitis Externa, Barotrauma
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| Which cranial nerve receptors are contained in the ear | 8th – Acoustic
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| What does the ear function to perform | Hearing and Balance
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| What are the divisions of the ear | External, Middle, Inner
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| How is the tympanic membrane of a newborn positioned | Horizontal
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| What is the appearance of the tympanic membrane of a newborn | Dull, Opaque, Inconsistent light reflex
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| What are the characteristics of the newborn Eustachian tube | Short, Wide, Straight
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| What are the Eustachian tube’s functions | Ventilation of the middle ear, Protection from nasopharyngeal secretions and sound pressure, Drainage
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| What is a nurse looking for when examining the ear | Alignment, Cleanliness, Drainage
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| What can low set ears indicate | Kidney disorders, Mental retardation
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| How should the ears be aligned | Should cross an imaginary line from the inner canthus to the lower occiput
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| What is used to examine the inner ear | Otoscope
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| What positions are used to examine the ears | Laying with arms held above the turned head, In the lap of an adult with head pressed to adult’s chest
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| How are ears positioned for drops to be instilled | Infant’s pinna is pulled down and back, Children’s pinna is pulled up and back
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| What is an acute external ear infection called | Otitis externa AKA Swimmer’s ear
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| What are signs of an otitis externa infection | Pain and tenderness on manipulating the pinna or tragus
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| Why are the ear canals of newborns pliable | Underdeveloped cartilage and bony structure
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| Define erythematous | With otitis externa, the ear canal may be erythematous, but the tympanic membrane is ___
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| What should be ruled out before diagnosing otitis externa | Foreign body, Cellulitus, Diabetes Mellitus, Herpes Zoster
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| What are the treatments for otitis externa | Irrigation, Topical antibiotics, Antivirals
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| What is otitis media | Inflammation of the middle ear
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| Where is the middle ear located | Tiny cavity in temporal bone
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| What guards the middle ear | Tympanic membrane
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| Which part of the ear contains the organs of hearing and balance | Inner
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| What does sound pass through from the tympanic membrane to get to the inner ear | Oval window
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| What is the middle ear connected to | Mastoid sinuses, Throat
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| What part of the ear opens into the throat | Eustachian tube in the middle ear
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| What allows infection to easily spread to the middle ear and mastoid | Mucous membrane lining
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| Where do middle ear secretions drain to | Nasopharynx through the eustachian tube
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| Where is air pressure between the middle ear and outside air equalized | Eustachian tubes
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| What happens if there is unequalized pressure in the ear | Negative pressure allows organisms to be swept into the eustachian tubes
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| What usually occurs after an upper respiratory infection | Otitis media
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| What age group is typically affected by otitis media | 6 – 24 month, Early childhood
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| What are the most common causes of otitis media | Streptococcus pneumonia, Haemophilus influenza
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| What has reduced the incidence of pneumococcal otitis media | Polyvalent pneumococcal polysaccharide vaccine
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| Why are polyvalent pneumococcal polysaccharide vaccines ineffective in children under 2 | They are unable to produce antibodies
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| Why are infants more probe to middle ear infections | Short, Wide, Straight eustachian tubes
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| What are the signs and symptoms of an ear infection | Articulation problems, Diarrhea, Fever, Headache, Hearing loss, Inattentive behavior, Irritability, Loud speech, Pain in the ear, Rubbing or pulling the ear, Rolling the head, Speech development problems, Vomiting
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| What does the tympanic membrane of a patient with otitis media look like | Red and Bulging
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| What may happen if an abscess forms in the ear | It may rupture the eardrum, drain, and relieve pressure
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| What can result from eardrum rupture | Hearing loss
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| When is otitis media considered a chronic condition | Lasts longer than 3 months
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| What can chronic otitis media lead to | Cholesteatoma
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| What is cholesteatoma | A cystlike sac filled with keratin debris
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| What kind of physician should treat cholesteatoma | Otolaryngologist
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| What are the complications of repeated acute attack of otitis media | Development of chronic otitis media with effusion
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| What is effusion | Fluid accumulation
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| How is an ear infection treated | Causative organism found, Relieve symptoms, Throat culture, Broad spectrum antibiotics, Analgesics
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| What are broad spectrum antibiotics | Those that cover gram positive and gram negative bacteria
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| What is myringotomy | Incision in the tympanic membrane to relieve pressure and prevent tears by spontaneous rupture
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| What may be inserted in a myringotomy | Tympanic membrane (TM) button, Typanostomy ventilating tube (PE Pressure Equalizer)
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| How are TM buttons and PEs removed | Fall out spontaneously within 6 – 12 months
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| How is a child with a ruptured ear drum positioned | On the affected side
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| Hearing LossWhat can hearing loss affect | Speech, Language, Social and Emotional Development, Behavior, Academic achievement
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| When is the inner ear fully formed | During the first months of prenatal life
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| What can cause a hearing loss called congenital deafness | Mother with German measles or other viral infection during the first months of prenatal life
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| What can cause acquired deafness | Infectious diseases, Measles, Mumps, Chickenpox, Meningitis, Common cold, Some medications, Loud noises, Allergies, Ear infections
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| What can cause temporary deafness | Cerumen accumulation
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| At what decibel can some toys emit sound | 110
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| At what decibel can ear damage be caused | 80
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| What is a complete bilateral hearing loss | Loss in both ears
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| What problems cause hearing loss | Defects in sound transmission to the middle ear, Damage to the auditory nerve or ear structures, Mix of defects in nerve pathways and interference
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| How do children learn to talk | Imitating what they hear
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| What may be responsible for behavioral problems in school | Partial bilateral deafness
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| What most commonly causes partial bilateral deafness | Chronic ear infections, Blockage of eustachian tubes
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| How should a nurse communicate with a hearing impaired child | Eye level, Face to face, Eye contact, Short sentences, Avoid exaggeration of movement
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| What is the goal of the American Academy of Pediatrics regarding hearing loss | Detection of impairment by 3 months of age, Interventions started no later than 6 months of age
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| What is the preferred method for testing the hearing of a neonate | Evoked Otoacoustic Emissions test (OAE)
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| What test records brain wave responses generated by the auditory system | Brainstem Auditory Evoked Response (BAER)
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| What are the first signs that can alert a parent or nurse to hearing loss in an infant | lack of response to sounds or music or lack of startle response by 4 months
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| When is complete bilateral deafness usually discovered | During infancy
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| When is partial deafness usually discovered | When the child begins school
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| Who usually discovers hearing problems in children during school | School nurse
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| What is tympanometry | Ear pressure measuring
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| What is a Rinne test | Using a tuning fork to evaluate for air conduction
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| What is a Weber test | Using a tuning fork to evaluate for bone conduction
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| What confirms a diagnosis of hearing loss | Visual Reinforcement Audiometry (VRA)
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| What can be used in some children with hearing loss due to nerve damage | Cochlear implants
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| What does the Brazelton Neonatal Behavioral Assessment Scale evaluate regarding hearing | The infant’s orientation response to the sound of a voice
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| The Moro reflex beyond ___ months may indicate deafness | 4 months
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| If an infant makes no verbal attempts by ___ it should undergo a complete physical exam | 18 months
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| When a child with a hearing aid goes to surgery, what is done with the hearing aid | It is given to the parents or put in a safe place
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| What should the nurse check for with hearing aid fit | That there are no ear hairs caught on the end
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| What can ear hair caught on the end of a hearing aid cause | Fit problems, Noise, and Whistling
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| What should children do during decent of an airplane |
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| Yawn or Chew gum to promote swallowing |
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| What should infants be encouraged to do during airplane decent | The bottlefed juice or water to promote swallowing
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| What can be taken before air travel | Systemic decongestants timed so that their peak effectiveness occurs during airplane descent
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| What can cause barometric pressure changes to the ear in adolescents | Underwater diving
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| What can barometric pressure changes in the ear cause | Severe earaches and other serious problems
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| What phase of underwater diving should be slow to minimize negative pressure | Descent
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| Why should the decent phase of underwater diving be done slowly | To minimize negative pressure
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| What may occur during the ascent phase of underwater diving | Sensory hearing loss and vertigo with nausea and vomiting indicating early signs of decompression sickness
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| What are contraindications to diving | Upper respiratory infections or tympanic membrane perforation
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| Why are upper respiratory infection or tympanic membrane perforation contraindications to diving | Vertigo, Nausea, Vomitting, Disorientation can occur with dangerous results
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