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NU 340 > Ch. 40 > Flashcards

Ch. 40 Flashcards

1
Q

function of ear

A
  • promote auditory sensory perception which occurs when sound is delivered through air to external canal
  • sound waves strike eardrum
  • receptors at cochlea change vibrations into action and are conducted to brain as nerve impulses
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2
Q

how often should older adults be screened for hearing acuity?

A

on a regular basis

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3
Q

age-related changes in the ear

A
  • drier, impacted cerumen
  • loss of tympanic membrane elasticity
  • degenerative changes of pinna and cochlea
  • diminished hearing acuity
  • disturbed vestibular function
  • decreased ability to hear high-frequency sounds
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4
Q

conductive hearing loss: causes

A
  • cerumen
  • foreign body
  • edema
  • infection
  • tumor
  • perf tympanic membrane
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5
Q

conductive hearing loss: assessment findings

A
  • evidence of obstruction with otoscope
  • abnormal tymp membrane
  • speaking softly
  • hearing better in noisy places

*No permanent damage/hear loss

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6
Q

sensorineural hearing loss: causes

A
  • prolonged exposure to noise
  • presbycusis
  • ototoxic drugs
  • Menieres disease
  • Acoustic neuroma
  • DM
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7
Q

sensorineural hearing loss: assessment findings

A
  • normal appearance of external canal and tymp membrane
  • occasional dizziness
  • speaking loudly
  • hearing poorly in loud places

*Hearing loss often permanent

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8
Q

which type of hearing loss is often permanent?

A

sensorineural

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9
Q

assessment clues of hearing loss

A
  • during interview, face patient and assess their posture and responses: tilting head to one side or leaning forward
  • ask questions about any history of hearing issues, exposure to loud noise
  • ask questions about meds- anything ototoxic like NSAIDS, diuretics, or certain antibiotics
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10
Q

tests to assess hearing

A
  • voice test
  • watch test
  • tuning fork tests: weber, rinne
  • audiometry
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11
Q

weber test

A
  • tuning fork hearing test used to screen for conductive or sensorineural hearing loss
  • heard midline
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12
Q

rinne test

A
  • tuning fork hearing test used to screen for conductive or sensorineural hearing loss
  • positive in healthy individuals: indicates air conduction is more beneficial than bone conduction
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13
Q

gross hearing acuity tests

A
  • assess clients response to normal voice tones
  • watch tick test
  • tuning fork tests: weber’s test, Rinne test
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14
Q

non-surgical/medical interventions for hearing loss

A
  • early detection
  • safety measures (d/t hearing loss)
  • medications
  • assistive devices: hearing aids
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15
Q

surgical interventions for hearing loss

A
  • tympanoplasty
  • implants (ie cochlear devices)
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16
Q

tympanoplasty

A

microsurgery ― surgery using a microscope or endoscope― to fix holes in the eardrum that do not heal on their own

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17
Q

cochlear implant

A

A cochlear implant is an implanted electronic hearing device, designed to produce useful hearing sensations to a person with severe to profound nerve deafness by electrically stimulating nerves inside the inner ear

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18
Q

interventions for hearing loss

A
  • surgical
  • nonsurgical
  • maximize communication
  • community resources (support groups)
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19
Q

how can you maximize communication in a patient with hearing loss?

A
  • lip-reading
  • sign language
  • collaborate with speech therapist/audiologist
  • manage anxiety
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20
Q

3 types of otitis media

A
  • acute
  • chronic
  • serous
21
Q

acute otitis media

A
  • sudden onset of ear pain
  • lasts a few days - few weeks (depending on if receive treatment)
  • treatment: oral antibiotics (amoxicillin)
22
Q

chronic otitis media

A
  • continually getting acute otitis media several times a year
  • treatment: tubes put into ears
23
Q

serous otitis media

A
  • typical inflammation of otitis media but with fluid build up in middle ear
24
Q

otitis media: assessment

A
  • ear pain: most common sx
  • patient may report tinnitus, HA, malaise, fever, N/V, dizziness
  • otoscopic findings will vary depending on the condition’s stage
  • eardrum may be spontaneously perforated
25
Q

otitis media: nonsurgical management

A
  • quiet environment
  • bedrest with limited head movement
  • heat and cold applications
  • systemic and topical antibiotic therapy
  • analgesics
  • antihistamines
  • decongestants
26
Q

earwick

A

If the ear canal is very swollen, it can make using ear drops difficult. Your doctor may insert a tiny sponge called an ear wick into the canal to help carry the medicine into the ear.

27
Q

irrigation of the external ear

A

a procedure in which nurses flush their patient’s ear canal with sterile water or saline solution

28
Q

surgical management of otitis media

A

myringotomy
- surgical opening of the pars tensa of the eardrum
- operative procedure includes grommet (polyethylene tube) placed through the tympanic membrane to drain fluid from ears

29
Q

post-operative care (post-myringotomy)

A
  • keep external ear and canal free of other substances while the incision is healing
  • keep head dry for several days
  • no showering!
30
Q

mastoiditis

A

infection of mastoid air cells caused by progressive otitis media

31
Q

clinical manifestations of mastoiditis

A
  • swelling behind ear
  • pain when moving ear or head
  • red, dull, thick, immobile eardrum
32
Q

treatment of mastoiditis

A
  • antibiotics
  • surgical removal of infected tissue if no response to antibiotics
33
Q

tinnitius

A

continuous ringing or noise perception
- cannot be observed or confirmed with dx tests
- one of the most common problems with ear or hearing disorders

34
Q

one of the most common problems with ear or hearing disorders

A

tinnitus

35
Q

diagnostic tests for tinnitus

A

there are none
- cannot be observed or confirmed with dx tests

*continuous ringing is the typical dx sx

36
Q

if no cause of tinnitus is found, therapy focuses on ___

A
  • masking the tinnitus with background sound, noisemakers, and music during sleeping hours
37
Q

common manifestations of many ear disorders

A
  • vertigo
  • dizziness
38
Q

if a patient feels vertigo or dizziness, advise them to

A
  • restrict (fast) head motions and move more slowly
  • maintain adequate hydration
  • take anti-vertiginous drugs (on an as needed basis)
  • prevent loss-of-balance accidents
39
Q

Ménière’s Disease

A

condition with classic trio of symptoms:
1. tinnitus
2. one-sided sensorineural hearing loss
3. vertigo

  • occur in attacks that can last for several days
  • common in adults 20-40 years old
40
Q

Ménière’s Disease: nonsurgical management

A
  • slow head movements
  • diet (low sodium/salt) and lifestyle changes
  • smoking cessation
41
Q

Ménière’s Disease: drug therapy

A
  • *diuretics (Furosemide)
  • nicotinic acid
  • antihistamines (Meclizine)
  • *antiemetics (Meclizine, Promethazine, Ondansetron)
  • intratympanic therapy with gentamycin and steroids.

*most common

42
Q

Ménière’s Disease: surgical management

A
  • labyrinthectomy
  • last resort because hearing in the affected ear is often lost from the procedure
43
Q

Ménière’s Disease: Meniett device

A

The Meniett device is a minimally invasive, nondestructive treatment that may be used to provide longer-term reduction of vestibular symptoms in patients with Ménière’s disease

44
Q

most common cause of impacted ear canal

A

cerumen

45
Q

symptoms of impacted ear canal

A
  • fullness of ear with or without hearing loss
  • may have pain
  • itching
  • dizziness
  • bleeding from the ear
46
Q

management of impacted ear

A
  • referral to ENT
  • liquid agents that can dissolve the wax in the ear: cerumenolytic agent
  • watchful waiting
  • manual removal
47
Q

if mastoiditis is not treated, complications:

A
  • brain abscess
48
Q

causes of tinnitus

A
  • age
  • ototoxic drugs: NSAIDS (ASA, Ibup), diuretics (lasix), certain antibiotics (ie. genomyacin)
  • loud noise
49
Q

common in adults 20-40 years old

A

Ménière’s Disease

NU 340 (26 decks)

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