Sensory Perception Auditory Flashcards
Why is Sensory perception so important?
You have to be able to give information and data to the pt (med admin, discharge planning, teaching)
Cranial nerve 2
Optic -visual acuity
Cranial nerve 3
Oculomotor - opening of eye lids , eye movement
Cranial number 4
Eye movement
Cranial nerve 6
Abducens - eye movement
Cranial nerve 7
Facial movement and eye lid closing ( not chewing)
Cranial 8
Auditory - vestibule cochlear - hearing and balance
Normal hearing can hear
Leaves rusting or bird song
Broad clinical manifestations
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
What can you do to make pt feel comfortable with hearing loss
Can write or request a family member to stay with pt
Hearing loss types
Conductive
Sensorineural
Mixed
conductive
Outer and middle ear
Sensorineural
Inner ear damage ( nerve pathways) cranial # 8 is going to be what is damaged
Mixed
Both conductive and sensorineural at the same time
Assessment of hearing loss
Otoscope
Webers test
Rivne’s test
Assess for hearing loss
Tinnitus or ringing of the ears
And vertigo ( room spinning while you are still) ( high fall risk if they do have it )
What can tinnitus cause
Suicidal thoughts or attempts
What are we assessing for for hearing loss?
Tinnitus
What do we want to have when dealing with a pt with tinnitus
High fall risk
Bed alarms
Have someone in room every time they get up
Want PT working with this pt teaching rehabilitation
Conductive hearing loss
Fluid inflammation in ear (pediatric more than adult population)
Poor Eustachian tube function
Impacted cerumen
Tumors /object present
Middle ear disease
Otosclerosis
Rule of thumb
Don’t put anything smaller than your elbow in your ear
How to teach pt to clean their ears at home
Put peroxide in ears for 10 minutes and turn to the other side and do the other one
Otosclerosis
Genetic problem that prevents sound waves from being transmitted
It is the result of bony overgrowth or overgrowth of tissue
Conductive hearing loss
something that is blocking sound waves from entering the ear (ear wax, scar tissue , too much fluid)
Patients actually hear better in noisy environments
Bone better than air conduction
How to treat conductive hearing loss
Treat cause (removal of tumor or ear wax, bone build up)
If its scar tissue you can recommend hearing aid
Sensorineural hearing loss
Illlness or genetics
Loud noises
Ototoxicity
Aging
Why does illness or genetic cause sensorineural hearing
If you have genetic disposition and nerve did not form like it should you you will already have it
what jobs from loud noises can cause sensorineural hearing loss
From construction workers, MRI workers, hospital machinery, loud music, airport
Teach ear plugs
What medications can cause ototoxcity. (Sensorineural hearing loss)
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
What can aging cause?
Sensory neuro loss, degeneration, compromise vascular supply in the ear
Menderes syndrome
Dilation of the endolymphatic system Over production or Decrease reabsorption of endolymphatic fluid
S/s of menieres syndrome
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
Upon Assessment of menieres syndrome
Fullness of ears
Tinnitus
Vertigo
Nausea and vomiting
Nystagmus ( eyes moving back n forth)
Severe headaches
Nursing precautions for meniere’s syndrome
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
Last resort of menieres syndrome
Cutting cranial # 8 and placing a shunt in there
Post op interventions for menieres syndrome
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)
Nursing care
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
Communication technique
Talk low and slow , don’t yell
writing method
