Nursing Management of Patients with Ear and Hearing Disorders – Flashcards
Unlock all answers in this set
Unlock answersquestion
External Otis
answer
Painful condition caused when irritating or infective agents come into contact with the skin of the external ear Commonly called swimmer's ear Treatment focused on reducing inflammation, edema, and pain with heat, bedrest, limited head movement, topical antibiotic and steroid therapy, and analgesics
question
Malignant External Otis
answer
Involves temporal bone of skull per CT scan Severe, often life-threatening Symptoms: Very painful Foul-smelling drainage Hearing decreased Treatment: Biopsy to r/o cancer IV abx - 6 weeks
question
Furuncle
answer
Localized external otitis caused by bacterial infection of a hair follicle Hearing impaired if the lesion blocks the canal, most commonly cerumen (wax) Treatment with local and systemic antibiotics, heat application, earwick to relieve pain, and possible incision and drainage
question
Cerumen or Foreign Body
answer
Cerumen (wax) is the most common cause of an impacted canal. Other blockages include beads, pencil erasers, insects. Irrigate canal with a mixture of water and hydrogen peroxide at body temperature for impacted cerumen; Cerumenex softens wax. Carefully remove foreign object
question
Patient Education
answer
Clean outside of ears only Do not use q-tips, bobby pins, pencils in ear canal See physician for evaluation of excess earwax or foreign body
question
Otis Media
answer
Three types of otitis media include: Acute otitis media Chronic otitis media Serous otitis media or OME (otitis media with effusion)
question
Nonsurgical Management - Acute Otitis Media
answer
Quiet environment Bedrest with limited head movement Heat and cold applications Systemic and topical antibiotic therapy Analgesics Antihistamines Decongestants
question
Surgical Management - Acute Otitis Media
answer
Myringotomy is a surgical opening of the pars tensa of the eardrum. Operative procedure includes grommet (polyethylene tube) placed through the tympanic membrane. Postoperative care: keep external ear and canal free of other substances while the incision is healing and keep head dry for several days.
question
Chronic Otitis Media
answer
-Eustachian tube dysfunction or post-eardrum perforation -Causes chronic bacterial infections with painless, foul-smelling discharge -May lead to: Polyps Damage to bones of ear with conductive hearing loss Facial paralysis Brain infection
question
Chronic Otitis Media
answer
Treatment: Acetic acid cleansing Antibiotic ear drops May opt for ear tubes or tympanoplasty (eardrum repair) Education for chronic OM patient: Avoid swimming underwater Ear plugs when swimming
question
Mastoiditis
answer
Infection of the mastoid air cells caused by untreated or inadequately treated otitis media Nonsurgical management: antibiotics Surgical management: simple or modified radical mastoidectomy with tympanoplasty Complications: damage to cranial nerves, vertigo, meningitis, brain abscess, chronic purulent otitis media, and wound infection
question
Trauma
answer
Trauma and damage to the eardrum and ossicles may occur by infection, by direct damage, or through rapid changes in the middle-ear cavity pressure. Eardrum perforations usually heal within 2 months. Use preventive measures to protect the ear from trauma.
question
Tympanoplasty
answer
Postoperative care includes antiseptic-soaked gauze packed in the ear canal, clean dressing, client flat with head turned to the side and the operative ear facing up for at least 12 hours after surgery, prescribed antibiotics, activity restrictions.
question
Tinnitus
answer
Continuous ringing or noise perception is one of the most common problems with ear or hearing disorders. Tinnitis cannot be observed or confirmed with diagnostic tests. Attempt to mask the tinnitus with background sound such as music when trying to sleep.
question
Vertigo and Dizziness
answer
Common manifestations of many ear disorders Advise client to: Restrict head motions and move more slowly. Maintain adequate hydration. Take antivertiginous drugs. Prevent loss-of-balance accidents.
question
Labrinthitis
answer
Infection of the labyrinth Meningitis a common complication of labyrinthitis Treatment with systemic antibiotics, bedrest in a darkened room, antiemetics, antivertiginous medications, psychosocial support
question
What is a common complication of labryinthitis?
answer
Meningitis
question
Meineire's Disease
answer
Tinnitus, one-sided sensorineural hearing loss, and vertigo occur in attacks that can last for several days. Disruption of flow of fluids in inner ear Unknown cause Affects men and women equally Symptoms begin @ age 30-60 usually
question
Meinere's Disease Assessment
answer
Feelings of fullness in the ear Tinnitus, as a continuous low-pitched roar or humming sound, is present much of the time, but worsens just before and during severe attacks Hearing loss is worse during an attack Initially, intermittent hearing loss that may progress to permanent loss
question
Meniere's Management
answer
Nonsurgical management includes: quiet environment slow head movements and position changes assist with ambulation sodium restriction cessation of smoking mild diuretics, antihistamines, antiemetics, diazepam
question
meniere's management last resort option
answer
Surgical management is a last resort and consists of labyrinthectomy or endolymphatic decompression with drainage and shunt. Hearing in the affected ear is often sacrificed.
question
Causes of hearing loss in the external ear
answer
Impacted Cerumen Foreign bodies External bodies
question
Causes of hearing loss in the middle ear
answer
Otiits Media Serous Otitis Otosclerosis
question
Causes of hearing loss in the inner ear
answer
Meniere's Disease Noise exposure Presbycusis Ototoxicity
question
Hearing loss
answer
One of the most common physical handicaps in North America. Common causes of conductive hearing loss: any inflammation process or obstruction of the external or middle ear by cerumen or foreign objects ; perforation of tympanic membrane.
question
Hearing loss
answer
Common causes of sensorineural hearing loss: loud noise, drugs, presbycusis, atherosclerosis, hypertension, prolonged fever, Ménière's disease, diabetes mellitus, and ear surgery. Recent studies have shown that chronic otitis media is associated with both conductive and sensorineural hearing loss.
question
Signs of Hearing Loss
answer
Frequently asking people to repeat statements Straining to hear Turning head or leaning forward to favor one ear Shouting in conversation Ringing in the ears Failing to respond when not looking in the direction of the sound Screening is important
question
Communication with the Hearing Impaired Patient
answer
Gain attention Eye contact Reduce background noise Natural speech Rephrase...Don't repeat. Sign language Assistive devices for hearing compensation
question
Treatment of Hearing Loss
answer
Assistive devices Hearing aids Cochlear implants
question
Hearing Aid Patient Education
answer
Encourage to begin using the hearing aid slowly to develop an adjustment to the device Adjust the volume to the minimal hearing level to prevent feedback squeaking Teach the client to concentrate on the sounds that are to be heard and to filter out background noise
question
Reduced Hearing Nursing Interventions
answer
Post-procedure care Pain management Facilitate communication Education for self-care Visual educational materials Verbal feedback from patient after education Support for the difficulty of adapting to loss of hearing
question
Make a table to show conductive or sensourinal disorders
answer
....
