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Med Surg 2 > Ch 43 > Flashcards

Ch 43 Flashcards

1
Q

Hearing acuity: normal

A

0-25

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2
Q

Impacted cerumen is accumulated earwax that obstructs the __

A

External acoustic Meatus

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3
Q

Trapped cerumen interferes with the transmission of ___

A

Sounds carried on airways

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4
Q

Assessment findings of impacted cerumen

A

Sense of fullness or pain (otalgia) in the ears

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5
Q

Tests that reveal conductive hearing loss

A

Audiometric
Rinne
Weber

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6
Q

Medical management for impacted cerumen

A

Soften with carbamide peroxide (Debrox)
Mechanically removed with irrigation if the tympanic membrane is intact (50-70mL)
Using a cerumen spoon or curette

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7
Q

Never irrigate ear if ___

A

Tympanic membrane is not intact

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8
Q

How many mL to irrigate the ear

A

50-70 mL

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9
Q

Assessment findings of a foreign object in the ear

A

Discomfort, diminished hearing, feeling movement, hearing buzzing sound
Inspection: evidence of abrasion from trauma or an object is seen

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10
Q

Med management for foreign object

A

Mineral oil to smother insect
Solid object removed with small forceps

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11
Q

Inflammation of the tissue in the external auditory canal

A

Otitis Externa

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12
Q

Pathogen that causes otitis externa

A

Staph aureus

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13
Q

Assessment findings of otitis externa
(SATA)

A

Tissue in external ear looks red
Tympanic membrane may be hard to see due to swelling
Discomfort that increases with manipulation during exam
Hearing reduced bc of swelling
Severe infection: fever, enlarged lymphoid behind ear
Otoscopic exam reveals diffuse or confined inflammation, swelling & pus (C&S purulent drainage for cause microorganisms)

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14
Q

Medical management for otitis externa

A

Warm soaks

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15
Q

An acute inflammation or infection in the middle ear

A

Otitis media

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16
Q

Pathogens that cause otitis media

A

Strep pneumoniae
Harmophilus influenzae

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17
Q

A collection of pathogen free fluid behind the tympanic membrane, results from irritation associated with respiratory allergies and enlarged adenoids

A

Serous otitis media

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18
Q

A collection of pathogen free fluid behind the tympanic membrane, results from irritation associated with respiratory allergies and enlarged adenoids

A

Serous otitis media

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19
Q

Results from the spread of microorganisms from the Eustachian tube to the middle ear during upper respiratory infections

A

Purulent otitis media

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20
Q

Clients with ___ are prone to repeated infections

A

Perforated tympanic membranes

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21
Q

In otitis media, infection may also extend to the ___, causing ___, or ___ may result from its extension to the brain.
If __ occurs, the infection can spread to the __ at the base of the brain & cause ___

A

Meninges
Meningitis
Brain abscess
Septicemia
Large veins
Lateral sinus thrombosis

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22
Q

Assessment findings of otitis media
(SATA)

A

Recent URI or seasonal allergies
S&S of the inflammation: fever, severe earache, diminished hearing

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23
Q

In otitis media, tenderness behind the ear indicates __. The tympanic membrane looks __ & ___. Pressure in the middle ear or dysfunction if the inner ear structures can cause ___, ___, & ___.
If the tympanic membrane perforates, fluid drains into the ___ & ___ is relieved

A

Mastoiditis
Red & bulging
Nausea, vomiting & dizziness
External acoustic canal
Pain

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24
Q

Med/surg management of otitis media & description

A

Myringotomy or tympanotomy
Incision opening of tympanic membrane. Facilitates drainage of purulent material, eases pressure, relieves throbbing pain.
Incision heals readily, with little scaring

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25
Q

The result of a bony overgrowth of the stapes and a common cause of hearing impairment among adults.
Fixation of stapes occurs gradually over many years

A

Otosclerosis

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26
Q

More common in women that men.
Usually becomes apparent in the second & third decades of life.
Accelerated during pregnancy

A

Otosclerosis

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27
Q

Assessment findings for otosclerosis
(SATA)

A

Progressive BL loss of hearing most characteristic symptom
Notices hearing loss when it begins to interfere with ability to follow conversation
Particular difficulty hearing others when speaking in soft, low tones but adequate hearing when sound loud enough
Tinnitus appears of hearing loss progresses, especially noticeable at night when quiet, can be very distressing to pt
*perform rinne & weber test

28
Q

In otosclerosis, after surgery position pt on ___ side. Take care to prevent dislodgment of prostheses as a result of __, __, or ___.
Assess ___ function by checking symmetry when the pt __ or __.

A

Non operative side
Coughing, sneezing, vomiting.
Facial nerve function
Smiles or frowns

29
Q

Common problems after surgery for otosclerosis

A

Nausea and dizziness

30
Q

Surgery performed for otosclerosis

A

Stapedectomy- all or part of stapes removed, prosthesis inserted that vibrates oval window

31
Q

Sensation of movement when there is none, or a sense of exaggerated motion when moving

A

Vertigo

32
Q

A person is stationary and the environment is moving (a sensation of things moving around oneself)

A

Objective vertigo

33
Q

When a person feels motion but the surrounding environment is stationary (a spinning sensation)

A

Subjective vertigo

34
Q

When a person feels motion but the surrounding environment is stationary (a spinning sensation)

A

Subjective vertigo

35
Q

Vertigo is not a __ but a __ of a disease

A

Disease
Symptom

36
Q

A form of physiologic vertigo. Repeated and constant motion causes this disturbance

A

Motion sickness

37
Q

Symptoms of motion sickness

A

N/V, preceded by pallor and diaphoresis

38
Q

Treatment for motion sickness

A

OTC antihistamines such as dimenhydrinate (Dramamine)
meclizine hydrochloride (Antivert)
to prevent N/V

39
Q

A disorder characterized by fluctuations in the fluid volume and pressure in the endolymphatic sac of the inner ear

A

Meniere disease (endolymphatic hydrops)

40
Q

This disorder causes distention of the endolymphatic compartment

A

Meniere disease (endolymphatic hydrops)

41
Q

Characteristic triad of Meniere (endolymohatic hydrops)

A

Hearing loss
Vertigo
Tinnitus

42
Q

Generally, Meniere affects ___, but can affect __

A

Only one ear
Both

43
Q

Clients with Meniere experience

A

Fluctuating periods of tinnitus
Sensation if ear fullness
Severe vertigo

44
Q

With Meniere, when a person moves their head, the endolymph also moves. Nerve receptors within the ___ send signals to the brain about the movement

A

Membranous labyrinth

45
Q

In Meniere, an increase in the __ causes the membranous labyrinth to __ like a __ referred to as __

A

Endolymph
Dilate
Balloon
Endolymphatic hydrops

46
Q

Meniere is typically __, appears during __, and occurs with __ in men and women

A

Unilateral
Middle age
Equal frequency

47
Q

In meniere, at times the pt is symptom free except for __ as the number of attack increases

A

Permanent residual hearing loss

48
Q

Causes of meniere

A

Viral infections of the inner ear
Head injury
Hereditary factors
Allergic reactions

49
Q

The onset of meniere

A

Sudden & symptoms may occur daily or infrequently

50
Q

Most incapacitating symptom of meniere

A

Vertigo
Pt reports whirling dizziness and the need to lie down

51
Q

In meneire, severe vertigo causes ___. Typically, also experience __ and _ that lasts for several hours as well as __ and ___

A

N/V
Tinnitus
Hearing loss
Headaches
Abdominal discomfort

52
Q

In meniere, __ of the eyes may result from ___ of eyemovement

A

Nystagmus
An imbalance in vestibular control

53
Q

In meniere, generally __ returns between attacks but ___ becomes __\ with ___

A

Hearing
Gradually
Worse
Repeated attacks

54
Q

Treatment for meniere

A

Reduce fluid production in inner ear
Facilitating inner ear drainage
Treating symptoms that accompany attack
*low sodium diet

55
Q

An antihistamine often prescribed because it suppresses the vestibular system

A

Meclizine (Antivert)

56
Q

Or other tranqulizers, may be ordered for acute episodes to help control vertigo, used only for short term therapy because of the addictive potential

A

Diazepam (Valium)

57
Q

Or other antiemetics, ordered to help control NV, also had an antihistamine effect

A

Promethazine (Phenergan)

58
Q

Or other diuretics, may decrease the fluid in the endolymphatic system and relieve symptoms

A

Hydrochlorothiazide

59
Q

Avoid _ & _ products, which can increase tinnitus and vertigo

A

ASA
ASA products
Tinnitus one of first symptoms of ASA toxicity

60
Q

In meniere, nursing mang. Assess _\ & perform __ & __ test

A

Gross hearing
Rinne & Weber

61
Q

Ototo =

A

Vanco
Tobra

62
Q

During an attack in menieres the nurse administers prescribed drugs, __ and __

A

Limits movement
Promotes clients safety

63
Q

__ Describes the detrimental effect of certain medications on the _ or hearing structures

A

Ototoxicity
8th cranial nerve

64
Q

Drugs associated with ototoxicity include

A

Sylicylates, loop diuretics, quinidine, quinine & aminoglycosides (vanc, tobra, genta)

65
Q

Symptoms of ototoxicity

A

Tinnitus
Sensorineural hearing loss

66
Q

Vestibular toxicity S&S

A

Lightheadedness
Vertigo
N/V

67
Q

Also know was vestibular schwannoma, a benign Schwann cell tumor that progressively enlarges and adversely affects cranial nerve __ (which consists of the vestibular & cochlear nerves)

A

Acoustic neuroma
VIII

Med Surg 2 (8 decks)

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