ears Flashcards
removing cerumen steps
- fill w warm water and aim toward roof of canal
- hold head at 20 degree angle and use gentle even pressure
- if painful, decrease pressure or stop
voice test
block 1 ear, stand 2 ft away and whisper
conductive loss
obstruction of sound wave transmission
sensorineural loss
defect in the cochlea, 8 cranial nerve, or brain-
weber test
place fork in middle of head and indicate wh ear sound is louder
Rinne test
compares hearing between air and bone conduction
-place fork on mastoid process and ask when no longer heard then quickly move fork to front of pinna until no longer heard
hyperacusis
the intolerance for sound levels that don’t bother other people
risk factors for hearing loss
air travel, swimming, vitilligo, smoking, B12/folate def, hypothyroidism, atherosclerosis, ototoxic drugs
ototoxic drugs
“mycin” antibiotics, lasix, NSAIDS, chemo, aspirin (especially w poor kidney function)
test prep
no food several hours before, no caffiene 24-48 hrs before, carefully introduce liquids after
external otitis
swimmers ear, comfort measures-apply heat x3/day, minimal head movement, after inflammation solution w 50% rubbing alcohol 25% white vinegar and 25% distilled water
common ototoxic sign
tinnitis
otitus media
don’t wash hair or shower for several days, keep clean and dry
otitis media clinical implications
inflammation of mucosa, pain, conductive hearing loss, distorted/dizzy/tinnitis, systemic manifestations
recovery from ear surgery
- avoid: straining, straws, air travel, resp infection, showers, rapidly moving head
- when blowing nose-gentle, don’t block nostril, mouth open
- keep ear dry w cottonball w vasoline-change daily
- report excessive drainage to HCP
dizziness
disturbed sense of a person’s relationship to space
vertigo
a sense of whirling or turning in space
rn teach when dizzy
restrict head motion, move slow, take meds to decrease effects
meniere’s disease
move head slow, no smoke, hydrops diet, pressure pulse therapy, drugs (mild diuretics, nicotine acid, antihistamines)
conducive hearing loss causes
- foreign body, perferated tympanic mem, edema, cerumen, infection of middle/external ear, tumor, otosclerosis
sensorineural hearing loss causes
loud noise, presbycusis, ototoxic substance, menieres disease, acoustic neuroma, DM, labrynthitis, infection, myxdema
conducive hearing loss assessment findings
evidence of obstruction, abnormal tympanic membrane, speaking softly, hears best in noisy environment, rinne test (air better than bone), weber test (lateralization to affected ear)
sensorineural hearing loss assessment findings
normal external canal/membrane, tinnitis common, occasional dizziness, speak loudly, hear poor in loud environment, rinne test (air less than bone), weber test (lateralization to unaffected ear)
tympanoplasty rn care
keep pt flat w head turned operative side up for 12 hrs post surgery
stapedectomy rn care
hearing improvement may not occur for 6 wks, assess for facial nerve damage or muscle weak, asymmetric/drooping features, ask about changes in facial perception of touch and taste, assist w ambulaion, move head slow
communication w hearing impaired
stand directly in front of pt, well lit quiet room, have pt attention, direct speech to better ear, don’t shout, have pt repeat statements
adaptations for age-related hearing loss
speak in deep voice and emphasize beginning word sounds, use visual aids
hearing aid care
keep dry, clean debris, avoid dropping, adjust volume to lowest setting, avoid hairspray etc.
