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NEC 3 > Meniere's disease & hearing loss > Flashcards

Meniere's disease & hearing loss Flashcards

1
Q

aka as endolymphatic hydrops

A

Meniere’s Disease

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2
Q

What is the other term for Meniere’s Disease?

A

Endolymphatic hydrops

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3
Q

Characterized by symptoms caused by inner disease

A

Meniere’s Disease

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4
Q

What is Meniere’s Disease?

A

characterized by symptoms caused by inner disease

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5
Q

What are the manifestation or symptoms that caused by inner disease in meniere’s disease?

A

-Episodic vertigo
- Tinnitus
- Fluctuating sensorineural hearing loss
- sense of aural fullness

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6
Q

Etiology of Meniere’s Disease

A

-Idiopathic
- Excessive accumulation of endolymph in the membranous labyrinth
- Infections
- Allergies
- Abnormal immune response

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7
Q

What causes of the excessive accumulation of endolymph in the membranous labyrinth?

A

Causes rupture

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8
Q

Clinical Manifestations of Meniere’s Disease

A

-“Drop Attacks”
-“ Whirling in space” feeling
- Fullness in the ear
- Increasing tinnitus
- Muffled hearing

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9
Q

The feeling of being pulled to the ground

A

Drop attacks

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10
Q

What is drop attacks?

A

-The feeling of being pulled to the ground
-May last hours or day

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11
Q

Diagnostics of Meniere’s Disease

A

-Audiography
-Glycerol Test

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12
Q

Demonstrates a mild, low-frequency sensorineural hearing loss

A

Audiography

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13
Q

What is audiography?

A

Demonstrates a mild, low-frequency sensorineural hearing loss

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14
Q

Glycerol (an osmotic) is given orally, followed by serial audiography over 3 hours

A

Glycerol Test

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15
Q

What type of agent is the glycerol test?

A

-Osmotic
-It act as diuretic

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16
Q

What is glycerol test?

A

-Improved hearing supports the diagnosis
-Glycerol (an osmotic) is given orally, followed by serial audiography over 3 hours

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17
Q

Surgical Management of Meniere’s Disease

A

-Endolymphatic Shunt
- Labyrinthectomy

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18
Q

It is a nonablative surgery

A

Endolymphatic Shunt

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19
Q

A small silicone tube is positioned to empty extra fluid

A

Endolymphatic Shunt

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20
Q

What is endolymphatic shunt?

A

-nonablative surgery
-a small silicone tube is positioned to empty extra fluid

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21
Q

Surgical procedure of the temporal bone

A

Labyrinthectomy

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22
Q

Completely destroy the vestibular end organs to eliminate vestibular function

A

Labyrinthectomy

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23
Q

What is labyrinthectomy?

A

-Surgical procedure of the temporal bone
-Completely destroy the vestibular end organs to eliminate vestibular function

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24
Q

Drug Management for Meniere’s Disease

A

-Sedatives
-Benzodiazepines
-Anticholinergics
-Antiemetics
-Antihistamines

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25
Q

What cranial nerve is affected in meniere’s disease?

A

Cranial nerve VIII

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26
Q

What is the function of cranial nerve VIII?

A

Providing the sense of hearing and balance.

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27
Q

What nerve is CN VIII?

A

Vestibulocochlear nerve

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28
Q

Fastest growing and one of the most prevalent, chronic conditions

A

Hearing loss & deafness

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29
Q

Age risk factors of Hearing Loss & Deafness

A

65 years of age and older

30
Q

What is hearing loss & deafness?

A

fastest growing and one of the most prevalent, chronic conditions

31
Q

Etiology of hearing loss & deafness

A

-Age-related presbycusis
-Noise-induced hearing loss

32
Q

Pathophysiology of Hearing Loss & Deafness

A

-Tiny hair cells pick up soundwaves & convert them into electrical signals that the brain can interpret
-Loud sounds destroy the tiny hair cells
-Hair cells don’t grow back once destroyed

33
Q

What are the types of hearing loss?

A
  1. Conductive hearing loss
  2. Sensorineural hearing loss
  3. Mixed hearing loss
  4. Central & Functioning hearing loss
34
Q

Occurs when conditions in the outer or middle ear impair the transmission of sound through air to the inner air

A

Conductive Hearing loss

35
Q

What is conductive hearing loss?

A

Occurs when conditions in the outer or middle ear impair the transmission of sound through air to the inner air

36
Q

Causes of Conductive Hearing Loss

A

-Otitis media with effusion
-Impacted cerumen
-Otosclerosis
-Narrowing of the external auditory canal

37
Q

Characteristics of Conductive Hearing Loss

A

-air bone gap of at least 15 dB
- Patients may speak softly because they hear their own voices
- Patients hear better in a noisy environment

38
Q

Hearing sensitivity is better by bone conduction than by air conduction

A

Air bone gap

39
Q

What is air bone gap?

A

Hearing sensitivity is better by bone conduction than by air conduction

40
Q

What type of hearing loss where patients may speak softly because they hear their own voices

A

Conductive hearing loss

41
Q

What type of hearing loss where patients hear better in a noisy environment

A

Conductive hearing loss

42
Q

Caused by impairment of function of the inner ear or the vestibulocochlear nerve

A

Sensorineural Hearing Loss

43
Q

What is sensorineural hearing loss?

A

Caused by impairment of function of the inner ear or the vestibulocochlear nerve

44
Q

Causes of sensorineural hearing loss

A

-congenital and hereditary factors
- noise trauma over time
- aging (presbycusis)
- Meniere’s Disease
-Ototoxicity (ASA, NSAIDS, Aminoglycosides, Chemotherapy Drugs)

45
Q

Drugs that can cause ototoxicity

A

-ASA
-NSAIDS
-Aminoglycosides
-Chemotherapy drugs

46
Q

Problems of Sensorineural Hearing Loss

A

-Inability to understand speech despite the ability to hear sound
- The lack of understanding of the condition by other people

47
Q

Other problems/characteristics of Sensorineural Hearing Loss

A

-Inability to hear high-pitched sounds
-Muffled sounds

48
Q

Inability to hear high-pitched sounds

A

Sensorineural Hearing Loss

49
Q

Muffled sounds

A

Sensorineural Hearing Loss

50
Q

Combination of Conductive and Sensorineural causes

A

Mixed Hearing Loss

51
Q

Involves the inability to interpret sound, including speech, because of a disorder in the brain

A

Central Hearing Loss

52
Q

What is central hearing loss?

A

Involves the inability to interpret sound, including speech, because of a disorder in the brain

53
Q

Caused by an emotional or a psychological factor

A

Functional Hearing Loss

54
Q

Patient does not seem to hear or respond to pure-tone subjective hearing tests

A

Functional Hearing Loss

55
Q

What is functional hearing loss?

A

Caused by an emotional or a psychological factor

56
Q

What happens to patient in functional hearing loss?

A

Patient does not seem to hear or respond to pure-tone subjective hearing tests

57
Q

What are the classification of hearing loss?

A

-Normal hearing
-Slight hearing loss
-Mild impairment
-Moderate impairment
-Moderately severe impairment
-Severe impairment
-Profound deafness

58
Q

What is the range of normal hearing

A

0-15 dB

59
Q

Range of slight hearing loss

A

16-25 dB

60
Q

Range of Mild Impairment

A

26-40

61
Q

Range of moderate impairment

A

41-55

62
Q

Range of moderately severe impairment

A

56-70

63
Q

range of severe impairment

A

71-90

64
Q

range of profound deafness

A

> 90

65
Q

Clinical manifestations of Hearing loss & deafness

A

-Answering questions inappropriately
-Not responding when not looking at the speaker
-Asking others to speak up
-Showing irritability with others who do not speak up
-Lip reading

66
Q

Nursing Management of Hearing Loss and Deafness

A

-Amplified music (iPods or MP3 Player) should not exceed 50% of maximum volume
-Avoidance of continued exposure to noise levels greater than 70dB
-MMR vaccine
-Avoid ototoxic drugs (ASA, NSAIDS, antibiotics

67
Q

Why MMR vaccine is important in managing patient who have central and functional hearing loss?

A

Rubella causes sensorineural deafness

68
Q

Communication with patients who have hearing impairments (NONVERBAL AIDS) (DUMAM)

A

-Draw attention with hand movements
-Use touch
-Maintain eye contact
-Avoid distracting environment
-Move close to better ear

69
Q

Communication with patients who have hearing impairment (VERBAL AIDS) (SURDS)

A

-Speak normally and slowly
-Use simple sentences
-Rephrase sentence; use different words
-Do not shout
-Speak in normal voice directly into better ear

70
Q

Intervention if CN VIII is affected

A

Let the patient walk with straight lines

71
Q

What are the concern of Meniere’s Disease?

A

Concern is safety because of balance

72
Q

Nursing management of Meniere’s Disease

A

-quiet, darkened room during attacks
-avoid sudden head movements or position changes
-avoid fluorescent & flickering lights
-emesis basin at bedside
-side rails up and the bed low in position when the patient is in bed
-medications are given parenterally
-unsteadiness may remain even after attacks

NEC 3 (16 decks)

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