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ADULT Health > Ear Content > Flashcards

Ear Content Flashcards

1
Q
  1. What is included as part of the Outer (External) ear??
    Middle and Inner ear???
A
  1. Outer:Outer ear/ external canal up to the tympanic membrane!!
  2. Middle: From the tympanic membrane (ear drum) and the little bones!
  3. Inner: Vestibular system, Cochlea, and 8th cranial nerve!! (8th cranial nerve sends sounds signals back to the temporal lobe of the brain)
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2
Q

What is Conductive Hearing Loss?

A

A PROBLEM CONDUCTING SOUND WAVES from the environment & in thru the EXTERNAL ears & thru the structures of the MIDDLE ear!
(so problem with the external & middle ear!!!!).

So, If there’s problem in the external ear like a big ball of wax, OR a problem in the middle ear like Otitis media, tumor, or the little bones becoming stiff and doesn’t vibrate, then these will become conductive hearing problems!!!!

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3
Q

What type of hearing loss is a sound wave conduction problem??????

A

CONDUCTIVE hearing loss!!!

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4
Q

What is Sensorineural hearing loss??

A

Problem with the Inner ear and 8th Cranial Nerve!!! (or even w/ the temporal lobe of the brain).

  1. Sensory loss sometimes REVERSIBLE
  2. Neural loss is PERMANENT, may be related to a tumor
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5
Q

What contributes to Conductive hearing loss???

A
  1. Obstruction (foreign body, cerumen/ear wax, external otitis)
  2. Otitis Media
  3. Ear trauma
  4. Tumors
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6
Q

What contributes to Sensorineural hearing loss???

A
  1. Genetic disorder
  2. LOUD Noise exposure (like working in constructions)
  3. Presbycucis
  4. Tumor of the cerebellopontine angle
  5. Demyelinating disease (like multiple sclerosis)
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7
Q

What are risk factors for hearing loss?

A
  1. Aging
  2. Repeated infections of the ear
  3. Meds with ototoxic side effects
  4. Ear trauma
  5. Occupations that place the patient in the presence of loud noises
  6. Tumor of the ear
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8
Q

What is mixed loss???

A

Combination of conductive and sensorineural hearing loss!

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9
Q

What are the 7 signs of hearing loss???

A
  1. Turning up the volume
  2. Frequent requests to repeat
  3. Withdrawal from conversations
  4. Social avoidance
  5. Altered speech quality
  6. Fighting over hearing-related issues
  7. Delayed speech or academic difficulty in children
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10
Q

What is Presbycusis???

A
  1. Is a gradual Sensorineural LOSS that occurs with Aging!!!!
  2. Hearing loss is not expected in younger patients and is an indication of PATHOLOGY!!!
  3. High frequency is lost first!!! SOO, Speaking with lower tone is helpful!!
  4. Expect some auditory reaction or responding time bc they hear but take lil time to process!!!
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11
Q

Under sensorineural, would sensory loss and neural loss reversible or permanent??

A
  1. Sensory loss sometimes REVERSIBLE
  2. Neural loss is PERMANENT, may be related to a tumor
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12
Q

What are the 3 ways to evaluate hearing (the tests for hearing)??

A
  1. AUDIOSCOPY: Provides impulses sounds @ various frequencies and pt will be able to indicate if they hear the sound or not!!!
  2. WATCH TEST:
    HCP will hold up a ticking watch to the pt’s ear & asks if they hear it!
  3. VOICE TEST:
    Stand where the pt can’t see ur face and patient’s one ear will be covered. One ear at a time is evaluated with a soft speech (whisper)!!!
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13
Q

What are the implications of Ototoxic medications??
What are the examples of ototoxic meds??***

A
  1. Ringing in the ears (TINNITUS!!!), Sensorineural hearing loss!!!!!
  2. Examples:
    1) Furosemide (Lasix)
    2) NSAIDs
    3) Chemotherapy drugs
    4) Some abx like VANCOMYCIN and Other “mycin” antibiotics!!!! CHECK TROUGH LEVELS!!!!!!
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14
Q

Which kind of hearing loss CAN ototoxic medications cause??

A

Sensorineural loss!!!!

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15
Q

How do you determine if it’s a Conductive Loss?? (History and Assessments)

A

History: Obstruction (external structures), Otitis Media, Tumors & Ear trauma!

Assessment:
1) Signs of hearing loss
2) Audiometry
3) Weber Test (tuning fork): sound localizes to the affected ear
4) Rhine Test: Bone conduction is > Air conduction (an abnormal test is termed “negative”)

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16
Q

How do you determine if it’s a Sensorineural Loss?? (History and Assessments)

A

History: Genetic disorders, noise exposure, presbycusis (aging), Ototoxic meds, Tumor, Demyelinating disease (multiple sclerosis)

Assessment:
1) Signs of hearing loss & Audiometry
2) Normal external structures & tympanic membrane
3) Tinnitus & dizziness/Vertigo
4) Weber
5) Rhine

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17
Q

What kind of hearing loss are Hearing aid and Cochlear Implant???

A
  1. Hearing aid: Conductive, mixed, or mild/moderate sensorineural loss
  2. Cochlear implant: Bilateral severe sensorineural loss
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18
Q

What care should you give to someone with hearing aid and cochlear implant??

A
  1. BOTH shouldn’t be put in water!
  2. Both shouldn’t be moist!
  3. BOTH require battery changes
  4. Hearing aid should be kept CLEAN!
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19
Q

What are the care of the patient with Cerumen (ear wax) problems??

A
  1. DO NOT USE COTTON SWABS
  2. Ear Irrigation:
    1) CERUMINOLYTICS help soften cerumen (ex: mineral oil, 1/2 strength hydrogen peroxide, Cerumenex)
    2) Method for irrigation:
    1. Syringe, basin
    2. Body temp saline (cool temp can cause VERTIGO, NYSTAGMUS, & N/V)
    3) Precautions:
    1. Don’t irrigate when ear drum is inflamed or perforated - LOOK FIRST!!!!!!!!!!
    2. Don’t aim directly at Cerumen (can worsen impaction)
    3. STOP for pain, N/V, or dizziness/Vertigo
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20
Q

How would you alter care for a patient with hearing impairment?

A
  1. Face the pt directly when speaking
  2. Speak slowly & be attentive to enunciation
  3. Lower the pitch of voice!!!
  4. DON’T shout!
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21
Q

In the elderly adults, what safety alert would you want to be aware of about the Cerumen problems?? (What causes dryness of the cerumen for them?)

A

ATROPHY of the apocrine glands that produce cerumen can cause DRYNESS of the cerumen!! Therefore increasing risk of impaction.

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22
Q

What is External otitis also called? What is it?
What are the risk factors for it???

A

Swimmer’s ear!!! It is the inflammation WITH OR WITHOUT infection!
- Infection (90% of cases are cause by bacterial infection) or Allergic response in the external ear.

Risk factors:
1. Trauma
2. Warm temp climates (water sports season is usually longer, increasing frequency)
3. High humid climates
4. Recent hx of swimming
5. Hearing aid use!

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23
Q

How do you assess someone with external otitis “swimmer’s ear”?

A
  1. PAIN w/ movement or pressure to the outer auricle
  2. Reduced hearing, feeling like the ear is “plugged”
  3. Erthyema and/or edema in the ear canal
  4. Scant, clear drainage - can be purulent
  5. Itching, node swelling, AND facial pain
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24
Q

What patient care/teaching would you give to someone with external otitis “swimmer’s ear”?

A
  1. Pain relief (meds, comfort measures like heating pad, positioning/ pt would be more comfortable in an upright position to reduce pressure in the ear)
  2. Medications: Acetic or Boric Acid, Antibiotic and steroid drops (with ear wick if necessary)
  3. Good hand hygiene, keep ear dry
  4. AFTER INFLAMMATION HEAS DECREASED, can use dilute alcohol drops to prevent recurrence
25
Q

What meds do you give for someone with External otitis???

A

1) Acetic or Boric acid
2) Antibiotic and Steroid drops!
3) Ear wick if necessary

25
Q

What can happen if you put a cold saline (and not body temperature) to do ear irrigation????

A

Too cool can cause Vertigo, Nystagmus, and N/V!!!

26
Q

In someone with external otitis, what would you do after inflammation has decreased???

A

Use dilute alcohol drops to Prevent recurrence

26
Q

What are the PRECAUTIONS for giving ear irrigation for someone with cerumen problems????

A
  1. Don’t irrigate when the tympanic membrane/ear drum is still INFLAMMED or PERFORATED – LOOK FIRST!!!!!
  2. Don’t aim directly at the cerumen (can cause impaction)
  3. STOP FOR PAIN, N/V, AND VERTIGO
27
Q

Acute and Chronic Otitis Media are considered to be which type of hearing loss?

A

Conductive hearing loss!!! (remember? since risks of conductive hearing loss include otitis media!)

27
Q

What should you look first before giving ear irrigation??

A

If the tympanic membrane is Inflamed or Perforated!!!!! LOOK FIRSTTTT

28
Q

For chronic otitis media, what kind of meds are given to help?????**

A
  1. Antibiotics
  2. NSAIDS
  3. Decongestants
28
Q

What patient findings would you find that make you stop giving ear irrigation to the pt???!!!

A

if the patient is in PAIN, has N/V, and feels VERTIGO!!!!

29
Q

What are types of the ceruminolytics (for cerumen problems)?

A

Mineral oil,
1/2 strength hydrogen peroxide,
Cerumex

29
Q

What medications would you give to someone with External otitis?

A

Meds: Acetic or Boric acid,
Antibiotics and Steroid drops,
Ear wick possibly

30
Q

What can you give to someone with External otitis after inflammation has decreased?????*** WHY?

A

When inflammation has decreased, use dilute alcohol to prevent recurrence!!!!!

31
Q

Keeping hand hygiene AND dry ears are part of patient care for which “disease”?????***

A

External Otitis!!

32
Q

What is Acute Otitis Media??

A

Inflammation of the middle ear, mostly caused by bacteria. The Inflammation leads to accumulation of fluids behind the tympanic membrane which causes bacterial growth and infection. THIS IS COMMON IN CHILDREN BECAUSE OF THEIR ATONOMICAL FEATURES!

33
Q

Who is commonly seen with Acute otitis media?????? WHY?

A

CHILDREN!! Because of their ATANOMICAL FEATURES (Their estuchian tube is flat and tht can lead to infection)

34
Q

What are the risk factors for Actute otitis media????

A
  1. Anatomical features (kids have flat estuchian tube which can lead to infection)
  2. Presence of URI/ Upper respiratory infection (bc the estuchian tube connected to the middle ear goes to the throat. So whatever infection you have in ur Upper respiratory, it can lead to infection in the middle ear too)
  3. *Seasonal allergies
    • Craniofacial abnormailities
  5. *Genetic predisposition
  6. ** Smoking in the Household!
35
Q

Smoking in the household is a risk factor for which disease????

A

Acute otitis media!!!

36
Q

Which disease’s risk factors can be because of presence of URI? WHY?

A

Acute otitis Media!!
bc the estuchian tube connected to the middle ear goes to the throat. So whatever infection you have in ur Upper respiratory, it can lead to infection in the middle ear too

37
Q

What are the Assessment for Acute Otitis Media in the adults?????!!!

A
  1. PAIN whether with or without movement
  2. Difficulty laying down/sleeping
  3. Bloody purulent exudates
  4. **Fever & N/V
  5. **Headaches
  6. **Tympanic membrane PERFORATED!!
38
Q

What are the assessment for acute otitis media IN THE CHILDREN???

A
  1. Children may tug/pull their ears
  2. Babies refuse to suck (bc sucking hurts ears)
  3. HIGHHH FEVER in children!!!!
39
Q

What are the patient care for Acute otitis media???

A
  1. Comfort measures: Heating pads/ water bottle, UPRIGHT or semi upright position
  2. Medications:
    1) Analgesics (pain) AND Antipyretics (fever)
    2) SYSTEMATIC ANTIBIOTICS!!!
    3) Decongestants and Antihistamines!!!!
  3. AVOID GETTING EAR IN THE WATER!!!
40
Q

Fever is usually part of what “disease”?

A

Acute Otitis media

41
Q

Face pain is in what type of disease’s assessment/findings??

A

External otitis or “Swimmer’s ear”!!

42
Q

If you see a child pulling and tugging their ears, what kind of condition would this tell you they might have?

A

Acute otitis media!!!

43
Q

What are the 2 complications for Acute otitis media???

A
  1. Chronic otitis media
  2. Mastoiditis
44
Q

What is Chronic otitis media?
What are the assessments and interventions?

A

Because of repeated infections of acute otitis media! This is going to be longer, and more damage.

  • Assessments: Hearing loss and PAIN (NOT AS painful as acute otitis media)
  • Interventions: Tube insertion AND meds: “AND”, Antibiotics, NSAIDS, Decongestants
45
Q

What meds do you give to someone with Chronic otitis media???

A

“AND”
Antibiotics
NSAIDS
Decongestants!

46
Q

What is Mastoiditis? WHAT CAN THIS LEAD TO???
What are the assessments, interventions AND Symptoms?

A

Untreated middle ear infection can lead to infection in the mastoid process.
- Can lead to: CRANIAL nerve damage, MENINGITIS, Brain abscess, and vertigo,

  • Assessment: Pain, swelling behind the ear, Node Lymp Swelling, CELLULITIS and FEVER!!!
  • Interventions: IV Antibiotics and Surgical intervention
  • Symptoms: Fever, Neck stiff, Rash, Decreased LOC, Sleepiness & lethargy, HEADACHE AND SEIZURES AND LIGHT SENSITIVITY!!!!
47
Q

What is vertigo???? Related issue with what? What is safety issue related to it???

A

When things are spinning around you. Related to issue with the middle ear (the vestibules).
- Can cause N/V and PROBLEM AMBULATING!!!!!!!!!!!

48
Q

What kind of conditions is it where the assessments include CELLULITIS AND FEVER???

A

Mastoiditis!!

49
Q

What are the 8 steps/methods and patient teaching for EAR DROP administration??????

A
  1. Wash hands and verify meds ordered (DONNING gloves after washing is preferred for the person giving meds if they are available)
  2. Place bottle in WARM bowl of water 3-5 minutes!
  3. Tilt the patient’s head in the opposite direction of the ear that drops are to be given in
  4. **Pull the pinna UP AND BACK
  5. Put the correct number of ordered drops DOWN THE SIDE OF THE EAR CANAL
  6. *GENTLY move head back and forth 2 or 3 times
  7. *INSERT a cotton ball into the ear canal
  8. Wash hands !!!
50
Q

What are the 6 Patient care/Teaching FOLLOWING EAR SURGERY????

A
  1. Avoid activities which increase pressure in the ear (air travel/flying, straining, straw drinking!!)**
  2. Blow nose gently, one nostril at a time, with mouth OPEN!
  3. Keep ears dry, avoid getting HEAD WET for A WEEK!
  4. Avoid people with upper respiratory infections
  5. Report signs of infections: excess drainage and Fever
  6. Change dressing as instructed per MD
51
Q

What are the assessments for sensorineural hearing loss?

A
  1. Signs of hearing loss & audiometry
  2. NORMAL EXTERNAL EAR & TYMPANIC MEMBRANE***
  3. TINNITUS AND VERTIGO***
  4. Weber - Localized in the better ear
  5. Rhine - Air>bone but not twice as long!!
52
Q

In which type of hearing loss would you expect the patient to have tinnitus and Vertigo????!!!!!

A

Sensorineural hearing loss!!!!!!

53
Q

A patient recently treated for cerumen impaction and otitis media comes to the clinic and requests assistance with ear irrigation. After obtaining an order, what is the most essential action of the nurse prior to starting the procedure?
Question 16 Select one:

a.
Warming the irrigating solution.

b.
Performing an otoscopic examination.

c.
Obtaining a basin to collect the irrigant and dislodged cerumen.

d.
Informing the patient to report pain or nausea during the procedure.

A

B) Because remember that For ear irrigation, DON’T DO IT IF THE TYMPANIC MEMBRANE IS INFLAMMED or PERFORATED!!! So, an otoscopic examination is needed to see if our tympanic membrane is not inflamed and perforated before starting it!!

ADULT Health (24 decks)

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