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Nursing Skills 2 > Ear Exam > Flashcards

Ear Exam Flashcards

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1
Q

The ear exam can be focused on problems related to

A

Ear
Head
Hearing
Vestibular problems

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2
Q

What is the role of the RVT in an ear exam

A

Assist with history
Predict tests and procedures
Assist sample collection and tests
Perform/teach cleaning and medicating to the client

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3
Q

What are the non emergent complaint related to the ear

A

Scratching at ears
Wounds/redness/discharge/smell
Masses/growths

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4
Q

What are the emergent complaints related to the ear

A 
Swollen ear
Head shaking
Head tilt
Loss of balance
Horner’s syndrome
Loss of hearing
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5
Q

How many cones do you need to perform an ear test with an otoscope

A

2 -one per ear

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6
Q

What is Horner’s syndrome

A

Droopy ear and eyelid
Raised 3rd eyelid
Miosis

A collection of changes caused by damage to the sympathetic nerve feeding the ear, eye and face

Many causes including lesions in the middle ear, middle ear infections, reactions to topical medications

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7
Q

Who is most sensitive to ear medications

A

Cats

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8
Q

True or false

A hematoma requires a same day emergency/surgery

A

True

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9
Q

How do you visualize the tympanic membrane

A

With an otoscope (direct down the cheek)

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10
Q

True or false

You can put a medication in the ear without seeing the tympanic membrane

A

FALSE
never put a medication into the ear without confirming the TM is intact. If you have to then it must be one that is made to be safe if there is a damaged TM

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11
Q

What is AS, AD and AU

A

AS: left ear
AD: right ear
AU: both ears

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12
Q

What is stenosis of the ear

A

Construction of the ear

Swollen, excess tissue

Canal may be closed off

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13
Q

Define pruritic

A

Itchy

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14
Q

What are the different discharges/exudate descriptions used

A

Slight/moderate/copious

Back/brown, cream coloured, yellow, frank blood

Wet/dry/glandular

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15
Q

What are the rules during an ear exam of the tympanic membrane

A

The animal cannot move (major)

Do not occlude the canal by putting pressure on the neck while restraining

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16
Q

What does pulling on the pinna do for an ear exam

A

Elongates the canal to make it easier to find the tympanic membrane

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17
Q

What shape does the vertical and horizontal canals of the ear make

A

An L

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18
Q

Which way should you direct the otoscope in the ear

A

Towards the check

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19
Q

What is a cotton tipped applicator used for in an ear swab

A

Clean but not sterile, used for swabs for cytology and cleaning around the pinna

20
Q

What is a sterile culturette used for in ear swabs

A

Culture and sensitivity tests

Stores in transport media or tube

21
Q

If the ear is dry, for an ear swab what can you do

A

Moisten swab with saline

22
Q

What is cytology tests used for

A

Testing for presence of:

Epithelials, bacteria, yeast and WBCs

23
Q

What is the hint for waxy ears and diff quick stains

A

Leave longer in #3 (1min)

24
Q

If rods and recurrent otitis is present what should you test for before cleaning the ear

A

Sterile swab to test for culture and sensitivity

25
Q

Who are ear mites more common in

A

Cats

26
Q

Otodectes cyanotic mites may be seen in the ear in ____

What does this mean?

A

Various life stages

Means it needs a longer treatment to treat all life stages

27
Q

True or false

With ear mites you don’t need to check other pets in the hose because they are easily spreadable

A

False

There are very contagious. Always ask if there are other pets in the household

28
Q

What are the reasons for cleaning the ear

A 
Otitis externa 
Discharge
Facilitating examination of the ear
Removes microbes/foreign bodies
Exposes lining to topical meds 
Prevents inactivation if topical meds
29
Q

What is the normal a mount of discharge from the ear

A

NONE

30
Q

What are the rules for ear cleaning and medications

A

Do all tests and examination before
Must confirm TM
Never use alcohols or antiseptics
Purulent discharge can inactivate meds (must clean before meds)
Medications must reach sites of infection
Very painful/stenotic ear may need systemic treatment first

31
Q

When giving medications, where should you rub to increase tolerance

A

Rub the cheek and back of skull below the ear (over the horizontal canal)

32
Q

True or false

Fill ear to the “brim” with cleaners

A

True

33
Q

Why do you not want to release pressure on dispenser while in the ear

A

Noise/wind stresses dogs out

34
Q

Why is massaging for 30-60 seconds recommended after putting in medications and cleaners

A

Agitates cleaner and breaks up discharge

Increases tolerance

35
Q

True or false

Never let the patient shaken it’s head after giving cleaner solutions in the ear

A

False

Always let them shake to bring up discharge

36
Q

How long should you wait after cleaning the ears before giving medications

A

15 minutes

37
Q

Why should you not use Q tips in the ears

A

Packs debris into the canal

Risk of perforating the TM

38
Q

What are the different types of ear cleaners

A

Surfactant/foaming: mild detergent

Cerumenolytic: softens/breaks down ear wax

Drying solutions: removes excess moisture (swimming dogs)

EDTA: good for purulent discharge, sensitive ears, base for topical meds, and ruptured tympanic membranes

Sterile saline

39
Q

True or false

You can never over clean the ear

A

FALSE

40
Q

What is the exception to cleaning the ear everyday besides for bacteria

A

Regular swimmers

41
Q

How often do you clean the ear for treating otitis externa

A

2-3x a week

42
Q

How often do you clean the ear for maintenance

A

Once a week

43
Q

Describe an ear flush

A

Ears are cleaned with a solution under mild pressure using a catheter placed into the canal

Only performed under anesthesia (needs an inflated cuff when intubated to prevent contamination of the respiratory tract if there is a rupture tympanic membrane)

Indicated when the patients ears are too painful or swollen or obstructed with debris

44
Q

Most topical ear medications consist of

A

Anti inflammatories

Antibiotics

Antifungals

45
Q

How to increase effectiveness and reduce drug resistance with ear medications

A

Only use medications when it is necessary and use proper medications for bacteria/viruses/fungus

Use as prescribed for prescribed duration and frequency

Only use drugs if the infection has be confirmed

46
Q

What are some adverse reactions from ear medications

A

Pain
Head tilt
Loss of hearing

47
Q

Revisits to assess infections and treatment are done in

A

10-14 days

Nursing Skills 2 (5 decks)

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