Sensory Perception Auditory

Question 1

Why is Sensory perception so important?

Answer 1

You have to be able to give information and data to the pt (med admin, discharge planning, teaching)

Question 2

Cranial nerve 2

Answer 2

Optic -visual acuity

Question 3

Cranial nerve 3

Answer 3

Oculomotor - opening of eye lids , eye movement

Question 4

Cranial number 4

Answer 4

Eye movement

Question 5

Cranial nerve 6

Answer 5

Abducens - eye movement

Question 6

Cranial nerve 7

Answer 6

Facial movement and eye lid closing ( not chewing)

Question 7

Cranial 8

Answer 7

Auditory - vestibule cochlear - hearing and balance

Question 8

Normal hearing can hear

Answer 8

Leaves rusting or bird song

Question 9

Broad clinical manifestations

Answer 9

Ineffective communication ( lead to withdrawal) (embarrassed)
Suspicion ( if pt dont know who you are)
Loss of self esteem
And insecurity

Can write, request a family member to stay with pt if possible

Question 10

What can you do to make pt feel comfortable with hearing loss

Answer 10

Can write or request a family member to stay with pt

Question 11

Hearing loss types

Answer 11

Conductive
Sensorineural
Mixed

Question 12

conductive

Answer 12

Outer and middle ear

Question 13

Sensorineural

Answer 13

Inner ear damage ( nerve pathways) cranial # 8 is going to be what is damaged

Question 14

Mixed

Answer 14

Both conductive and sensorineural at the same time

Question 15

Assessment of hearing loss

Answer 15

Otoscope
Webers test
Rivne’s test

Question 16

Assess for hearing loss

Answer 16

Tinnitus or ringing of the ears
And vertigo ( room spinning while you are still) ( high fall risk if they do have it )

Question 17

What can tinnitus cause

Answer 17

Suicidal thoughts or attempts

Question 18

What are we assessing for for hearing loss?

Answer 18

Tinnitus

Question 19

What do we want to have when dealing with a pt with tinnitus

Answer 19

High fall risk
Bed alarms
Have someone in room every time they get up
Want PT working with this pt teaching rehabilitation

Question 20

Conductive hearing loss

Answer 20

Fluid inflammation in ear (pediatric more than adult population)
Poor Eustachian tube function
Impacted cerumen
Tumors /object present
Middle ear disease
Otosclerosis

Question 21

Rule of thumb

Answer 21

Don’t put anything smaller than your elbow in your ear

Question 22

How to teach pt to clean their ears at home

Answer 22

Put peroxide in ears for 10 minutes and turn to the other side and do the other one

Question 23

Otosclerosis

Answer 23

Genetic problem that prevents sound waves from being transmitted
It is the result of bony overgrowth or overgrowth of tissue

Question 24

Conductive hearing loss

Answer 24

something that is blocking sound waves from entering the ear (ear wax, scar tissue , too much fluid)

Question 25

Patients actually hear better in noisy environments

Answer 25

Bone better than air conduction

Question 26

How to treat conductive hearing loss

Answer 26

Treat cause (removal of tumor or ear wax, bone build up)
If its scar tissue you can recommend hearing aid

Question 27

Sensorineural hearing loss

Answer 27

Illlness or genetics
Loud noises
Ototoxicity
Aging

Question 28

Why does illness or genetic cause sensorineural hearing

Answer 28

If you have genetic disposition and nerve did not form like it should you you will already have it

Question 29

what jobs from loud noises can cause sensorineural hearing loss

Answer 29

From construction workers, MRI workers, hospital machinery, loud music, airport

Teach ear plugs

Question 30

What medications can cause ototoxcity. (Sensorineural hearing loss)

Answer 30

Vancomycin, gentamicin(antibiotic) , cisplatin(cancer medication) , furosemide(loop), quinine (malaria) aspirin

(may cause permanent hearing loss)

The sooner you stop medication the sooner hearing loss will stop

Question 31

What can aging cause?

Answer 31

Sensory neuro loss, degeneration, compromise vascular supply in the ear

Question 32

Menderes syndrome

Answer 32

Dilation of the endolymphatic system Over production or Decrease reabsorption of endolymphatic fluid

Question 33

S/s of menieres syndrome

Answer 33

Ringing of ears or tinnitus
Vertigo
Lateral sensory hearing loss

Attacks can last for days or if they have attacks frequent enough they can cause permanent damage.
At first it will last for several days but over time it will be more in length

Question 34

Upon Assessment of menieres syndrome

Answer 34

Fullness of ears
Tinnitus
Vertigo
Nausea and vomiting
Nystagmus ( eyes moving back n forth)
Severe headaches

Question 35

Nursing precautions for meniere’s syndrome

Answer 35

Fall risk ( ed rest and quite enviroment)
Assist with walking
Move their head slowly
Instruct the pt to stop smoking
Fluid restriction
Avoid. TV with flickering lights ( can make symptoms worse)
Control n/v
Give mild diuretics to help with fluid volume
Vestibular rehabilitation

Question 36

Last resort of menieres syndrome

Answer 36

Cutting cranial # 8 and placing a shunt in there

Question 37

Post op interventions for menieres syndrome

Answer 37

Havie packing and dressing on ear, speak to pt on side of unaffected ear, perform neuro examinations, maintain safety, assess when ambulating, encourage pt to use bed side comrade, administer anti vertigo and antmetic ( for n&v)

Question 38

Nursing care

Answer 38

Assessment
Safety measures ( teach back )
Dietary (adequate hydration )
Medication
Surgery ( pre op post op )
Hearing aides ( how to clean, change batteries or charge)
Community resources ( case managers- insurance)
Communication techniques

Question 39

Communication technique

Answer 39

Talk low and slow , don’t yell
writing method