Hearing Impairment

Question 1

Risk Factors for Hearing Impairment

Answer 1

(1) Family History
(2) Prenatal Infection
(3) Anomalies of the head, face, or ears
(4) Low birthweight
(5) Hyperbilirubinemia
(6) Ototoxic medications
(7) Low Apgar Score
(8) Mechanical Ventilation
(9) Syndrome associated hearing loss
(10) Head Trauma
(11) Bacterial Meningitis
(12) Neurodegenerative Disorders
(13) Persistant pulmonary hypertension
(14) Otitis media with effusion for 3 months

Question 2

Hearing Risk Assessment

Answer 2

Ages 3 months to 4 years
(1) Auditory skill monitoring
(2) Developmental surveillance
(3) Assessment of parental concerns

Age 4 years
(1) Difficulty hearing on the telephone
(2) Difficult hearing people in a noisy background
(3) Frequent asking of others to repeat themselves
(4) Turning television up too loudly

Question 3

Nursing Assessment for Hearing Impairment

Answer 3

Health History:
> Past Medial History
1. Significant for prematurity, genetic defect, ear deformities, hearing impairment (deafness), recurrent ear infections or ear surgeries
> Family History
1. Significant for ear deformities
> History of Present Illness
1. Inquire about the onset, progression and presence of fever, nasal congestion, ear pain, ear pulling, headache, lethargy or behavioral changes
> Treatments used at home

Physical Assessment:
> Inspect ears; note size and shape, position and the presence of skin tags, dimples, or other abnormalities
> Note the presence of cerumen, discharge, inflammation or a foreign body in the ear canal
> Palpate the ears for tenderness over the tragus or pinna
> Note the presence of tenderness over the mastoid area
> Palpate for enlarged cervical lymph nodes