T4 Bluepint - Ear and Hearing (Josh) Flashcards
Client shows up with genetic deformity of ear. What else should we ask about?
Any kidney or urinary tract problems?
***kidneys / urinary tract develop at same time in utero as the ears
Tympanic Membrane:
In the left ear, the cone of light is at —
In the right ear, the cone of light is at —
7 o’clock
5 o’clock
Diagnostic Testing:
What type of sounds are being tested with a Watch Test?
high frequency sounds
Diagnostic Testing:
With the – Test, the fork is placed in the middle forehead.
Weber
Diagnostic Testing:
Explain the purpose of the Rinne Test?
Tuning fork is placed next to ear and then on bone
Sound waves should be heard via air conduction longer than bone conduction
Menier’s Disease and Labrythitis are — — diseases.
Inner Ear
Diagnostic Testing:
What is the most reliable form of testing?
Audiometry
Audiometry:
Frequency is measured in —
Intensity is measured in —
hertz
decibals
Audiometry:
Normal human speech is — decibals
60
Audiometry:
— is the lowest level of intensity at which pure tones and speech are heard by 50% of time
Threshold
Diagnostic Tests:
What does Tympanometry measure?
mobility of eardrum and middle ear structures
Diagnostic Tests:
Which test detects hearing loss in patients unable to indicate recognition of sound?
Auditory Brainstem-Evoked Response
***electrodes used
Diagnostic Tests:
Which test detects central or peripheral disease of the VESTIBULAR system?
Electronystagmography (ENG)
Diagnostic Tests:
With ENG, where are the electrodes placed and what are the detecting?
around eyes
detecting any nystagmus elicited by stimulation of the acoustic nerve
Diagnostic Tests:
Which test will not allow them to have a pacemaker?
ENG
Diagnostic Tests:
Teaching regarding ENG test?
No pacemaker
NPO several hrs before
No caffeine, ETOH, sedatives, or antihistamines for 24 hrs prior
Diagnostic Tests:
Which test uses warm water to stimulate nystagmus?
Caloric Testing
***same restrictions as ENG
Which meds can be ototoxic ?
Gentamicin
Amikacin
Metronidazole
Forosemide
NSAIDs (ASA or Ibuprofen)
Chemo (Cisplatin)
Tinnitis is a an — ear problem.
inner
Age related changes in the ear and hearing.
Pinna elongated
Hair in ear canal coarser and longer
Cerumen drier and can cause impaction
Tympanic membrane loses elasticity
Hearing acuity decreases
As we age, which types of sounds are lost first?
high frequency sounds
What are the two types of hearing loss?
Conductive
Sensorineural
Types of Hearing Loss:
Which type is caused by a physical obstruction to sound wave transmission?
Conductive
Types of Hearing Loss:
Which type is typically in the Middle and External Ear?
Conductive
Types of Hearing Loss:
— Hearing Loss is a defect in the middle or inner ear.
Sensorineural
Types of Hearing Loss:
Where are the three locations where Sensoirneural Hearing defects can be found?
Cochlear
CN VIII
Brain
Types of Hearing Loss:
Presbycusis (age-related hearing loss) is an example of — — —
Sensorineural Hearing Loss
Ear Irrigation:
How much force should we use?
very little
Ear Irrigation:
Where should we place the stream of water?
above or below the obstruction (not in center)
Ear Irrigation:
Should we dig it out?
no
Ear Irrigation:
What do we do if cerumen doesn’t come out?
Wait 10 mins and try again
Place mineral oil into the ear 3x’s a day for 2 days to soften cerumen, then try again
Vertigo:
What can we do to manage it?
Positional Exercises
Rise slowly from sitting
Avoid caffeine or ETOH
Space fluids evenly throughout day
Vertigo:
If they have a severe episode, what should we tell them to do?
rest in a quiet, darkened room
Vertigo:
Which type of medication can be taken to decrease fluid in semicircular canals?
diuretic
Vertigo:
What should we tell them about their diet?
reduce salt
Vertigo:
What should we teach client about Meclizine?
restrict use in clients with closed angle glaucoma (PACG)
Vertigo:
Inapsine is an antiematic. What should we teach?
watch for postural hypotenstion and tachycardia
Vertigo:
What are s/e of Diphenhydromine?
Urinary retention
Dry mouth
Vertigo:
What diseases are we concerned about with Scopolamine (Anticholinergic)?
Glaucoma
- POAG (restricted)
- PACG (contraindicated)
Vertigo:
If we prescribe Diazepam, what should we be alert to?
if they have PACG (restricted)
Labrynthitis:
What is Labrynthitis a complication of?
chronic otitis media
URI
Mononucleosis
Labrynthitis:
What are symptoms?
Hearing loss
Tinnitus
Nystagmus
Vertigo with NV
Labrynthitis:
What is treatment plan?
Bedrest in darkened room
Antiemetics
Antivertigo
Antibiotics (if bacterial)
Labrynthitis:
If meds don’t work, what is a surgical option?
Labrynthectomy (removal of labrynthine portion of inner ear)
Labrynthitis:
What should we teach the client about postop for Labrynthectomy?
Severe NV postop
Hearing loss expected in affected ear
What is Meniere’s Disease?
vestibular disease due to excess of endolymphatic fluid that distorts the inner canal system
Meniere’s Disease:
How long can attacks last?
days or can be continous
Meniere’s Disease:
What are the symptoms?
Tinnitus
Vertigo
Unilateral Sensorineural Hearing loss
Meniere’s Disease:
Treatment plan
Diet
Fluid
Meds
Surgery
What is Acoustic Neuroma?
benign tumor of CN VIII
Acoustic Neuroma:
Symtpoms
Tinnitus
Sensorineural hearing loss
Mild to Moderate vertigo
Acoustic Neuroma:
What is treatment?
treat symptoms
surgery
Hearing Aids:
What should we teach about caring for them?
Keep dry
Clean with mild soap and water
Clean debris from inner part with toothpick
Avoid exposure to extreme temps
Avoid hairspray, cosmetics, oils, or other hair and face products that might contact the reciever
Surgery:
Which surgeries for Conductive Hearing Loss?
Tympanoplasty
Stapedectomy
Surgery:
Which surgery for Sensorineural Hearing Loss?
Cochlear Implants
Surgery:
What should we teach client about Cochlear Implants?
Unit is not turned on immediately after surgery
External unit is applied 2-6 wks after surgery and processor is programmed
NO MRIs
