ear changes
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| ear changes in the elderly | Drier impacted cerumen
Loss of tympanic membrane elasticity
Dec body ossicle movement
Degenerative changes of cochlea
Disturbed vestibular function
Diminished hearing acuity
Dec ability to hear high-frequency sounds
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| otoscope | the nurse holds the otoscope upside down, like a large pen. Normal tympanic membrane looks like mobile pars tensa, opaque to pearly gray, always intact
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| Audiometry | frequency is the highest or lowest of tones. Intensity is expressed in decibels. Threshold is the lowest level of intensity at which pure tones and speech are heard. Pure tones are generated by an audiometer to determine hearing acuity
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| ototoxic | From ibuprofen, furosemide (Lasix), asprin, gentamicin (garamycin)
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| Conductive hearing loss | physical obstruction. Pain, fever, HA, altered growth, personality change. Comp: meningitis from infection. Impl: heat, antibiotics, hearing aid, ear irrigation. have pt lie on affected to facilitate drainage. Post-op: on unaffected side to dec swelling.
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| Sensorineural hearing loss | resulting from a defect in the cochlea. The VIII cranial nerve or brain. Pain, fever. HA, discharge, altered growth & development, personality changes. Comp: vertigo, tinnitus, vomiting. plan: enhange communication
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| how to enhance communication | Position self directly I front of client. Well-lit, quiet room. Get clients attention, move close to better ear if appropriate
Speak clearly and slowly, do not shout. Keep hands and other objects away from mouth. Use appropriate hand motions
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| Otitis media | HA, tinnitus, pain, bulging tympanic membrane. Apply heat, oral analgesics, topical antibiotics, bedrest. Causes: infection of middle ear. Necrotizing or malignant is the most virulent form of external otitis.
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| Meniere’s syndrome | Dilation of the labyrinth. vertigo with sensorineural hearing loss. Comp: N&V, vertigo, tinnitus, fullness. hearing loss on involved side. Plan: benedryl, Compazine, valium Diuretics. Bedrest. Low sodium diet, no caffeine. Decompr of endolumphatic sac.
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| furuncle | Localized external otitis caused by bacterial infection of a hair follicle. Hearing impaired if the lesions block the canal, cerumen (wax). Treat with local & systemic antibiotics, heat app, ear with 1 ½ strength burow’s solution to relieve pain
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| Perichondritis | Infection of the perichondrium, a tough, fibrous tissue layer that surrounds the cartilage and gives shape to the pinna. Ex: recent ear piercing
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| Cerumen | Wax, most common cause of an impacted canal. Irrigate canal with mix of water and hydrogen peroxide at body text (98) for impacted cerumen. Cerumenex softens wax
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| mastoiditis | Infec of the mastoid by untreated or inadequately treated otitis media. Antibiotics, simple radical mastoidectomy with tympanoplasty. Comp: damage to cranial nerves, vertigo, meningitis, brain abscess, chronic purulent otitis media, wound infection.
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| Tinnitus | Ringing in the air. Caused by otosclerosis, continuous exposure to loud noise, medications, Meniere’s disease. Encourage music or white noise during sleep. Diagnostic tests cannot confirm, no observable characteristics,can lead to emotional consequences.
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| important ear | 70% of DS have hearing loss as adults. Most imp part of hearing is understanding speech. Pt on Lasix can be ototoxic. Check renal problems if pt has ext ear defor. drops: place in warm water, tilt pt head in oppo direction,pack opening of ear with cotton
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