Ch. 50 Prep U Patients With Hearing and Balance Disorders

A client with a conductive hearing disorder caused by ankylosis of the stapes in the oval window undergoes a stapedectomy to remove the stapes and replace the impaired bone with a prosthesis. After the stapedectomy, the nurse should provide which client instruction? "Shampoo your hair every day for 10 days to help prevent ear infection." "Don't fly in an airplane, climb to high altitudes, make sudden movements, or expose yourself to loud sounds for 30 days." "Lie in bed with your head elevated, and refrain from blowing your nose for 24 hours." "Try to ambulate independently after about 24 hours."

"Don't fly in an airplane, climb to high altitudes, make sudden movements, or expose yourself to loud sounds for 30 days." The nurse should instruct the client to avoid air travel, sudden movements that may cause trauma, and exposure to loud sounds and pressure changes (such as from high altitudes) for 30 days after a stapedectomy. Immediately after surgery, the client should lie flat with the surgical ear facing upward; nose blowing is permitted but should be done gently and on one side at a time. The client's first attempt at postoperative ambulation should be supervised to prevent falls caused by vertigo and light-headedness. The client must avoid shampooing and swimming to keep the dressing and the ear dry.

Which statement describes benign paroxysmal positional vertigo (BPPV)? BPPV is stimulated by the use of certain medications, such as acetaminophen. The onset of BPPV is gradual. The vertigo is usually accompanied by nausea and vomiting; generally, however, hearing is not impaired. BPPV is caused by tympanic membrane infection.

The vertigo is usually accompanied by nausea and vomiting; generally, however, hearing is not impaired. BPPV is a brief period of incapacitating vertigo that occurs when the position of the client's head is changed with respect to gravity. The vertigo is usually accompanied by nausea and vomiting; however, generally, hearing impairment does not occur. The onset of BPPV is sudden and followed by a predisposition to positional vertigo, usually for hours to weeks but occasionally months or years. BPPV is thought to be caused by the disruption of debris within the semicircular canal. This debris forms from small crystals of calcium carbonate from the inner ear structure, the utricle. BPPV is frequently stimulated by head trauma, infection, or other events.

During a pharmacology class, the students are told that some drugs need to be closely monitored. What aspect should the nurse closely monitor for in clients who have been administered salicylates, loop diuretics, quinidine, quinine, or aminoglycosides? Tinnitus and sensorineural hearing loss Impaired facial movement Reduced urinary output Signs of hypotension

Tinnitus and sensorineural hearing loss It is important that nurses are knowledgeable about the ototoxic effects of certain medications such as salicylates, loop diuretics, quinidine, quinine, and aminoglycosides. Signs and symptoms of ototoxicity include tinnitus and sensorineural hearing loss. Hypotension, reduced urinary output, and impaired facial movement are not signs of ototoxicity.

A client comes to the emergency department reporting that an insect has flown into his ear and will not come out. Inspection confirms the presence of the insect. When assisting with removal of the insect from the client's ear, which substance would the nurse expect to be used? tap water sterile water mineral oil normal saline

mineral oil Foreign vegetable bodies and insects tend to swell; thus, irrigation is contraindicated. Usually, an insect can be dislodged by instilling mineral oil, which will suffocate the insect and allow it to be removed using alligator forceps or a loop-wired instrument. Normal saline, tap water, or sterile water would be inappropriate.

A young man has presented for care because he claims that he has experienced hearing loss that he attributes to a summer job at a gravel crusher. On questioning, the clinician learns that the man was provided with hearing protection but was "hit and miss" with using it. What should the clinician teach this patient about sensorineural hearing loss? "Hearing loss like you've experienced is permanent because of the destruction of important cells in your ears." "As long as you're very careful to avoid loud noises, your hearing will probably recover in the following few months." "Unfortunately, your hearing loss is likely to get progressively worse because of the process that this damage started." "You'll likely find that your hearing will improve over the next several years."

"Hearing loss like you've experienced is permanent because of the destruction of important cells in your ears." Noise-induced hearing loss is permanent because the hair cells in the organ of Corti are destroyed. This does not mean, however, that hearing loss is likely to continue on the same trajectory.

A client is diagnosed as having serous otitis media. When describing this condition to the client, which of the following would be most accurate? "You have a common infection in one of the bones of your face." "Your eardrum has ruptured because of the extreme pressure in your middle ear from the infection." "It has resulted from the several recurrent episodes of acute otitis media you've had." "You have some fluid that has collected in your middle ear but no infection."

"You have some fluid that has collected in your middle ear but no infection." Serous otitis media involves fluid, without evidence of active infection, in the middle ear. Recurrent episodes of acute otitis media leads to chronic otitis media. An infection of the temporal bone (temporal bone osteomyelitis) is a serious but rare external ear infection called malignant external otitis. Rupturing of the eardrum refers to tympanic membrane perforation.

When preparing a teaching plan for a client diagnosed with otitis externa, the nurse instructs the client to avoid any water sport for which duration? 10 to 14 days 5 to 7 days 7 to 10 days 3 to 5 days

7 to 10 days A client with otitis externa should refrain from any water sport for approximately 7 to 10 days to allow the canal to heal completely. Otherwise, recurrence is highly likely.

The nurse caring for a client with Ménière's disease needs to assist with what when the client is experiencing an attack? Sleeping ADLs Coughing URIs

ADLs The client with Ménière's disease requires a great deal of emotional support because of the unpredictability of the attacks and the resulting impairments. During an attack, the nurse administers prescribed drugs, limits movement, and promotes the client's safety. He or she assists the client with activities of daily living because the least amount of motion can produce severe vertigo. The nurse cannot assist with sleeping, coughing. Option D is a distractor for this question.

A nurse is aware of the significant potential benefits of cochlear implants for certain individuals. Which one of the following individuals is the most appropriate candidate for a cochlear implant? An individual who has not yet experienced hearing loss but who possesses multiple risk factors An individual who has been diagnosed with presbycusis An individual who has longstanding and severe conductive hearing loss An individual who has profound, bilateral, sensorineural hearing loss

An individual who has profound, bilateral, sensorineural hearing loss A cochlear implant is an auditory prosthesis used for people with profound bilateral sensorineural hearing loss who do not benefit from conventional hearing aids. Cochlear implants are not used prophylactically. Presbycusis and conductive hearing loss are not indications for cochlear implants.

High doses of which medication can produce bilateral tinnitus? Dimenhydrinate Promethazine Aspirin Meclizine

Aspirin At high doses, aspirin toxicity can produce bilateral tinnitus. Meclizine and dimenhydrinate are used for nausea and vomiting related to motion sickness. Antiemetics, such as promethazine suppositories, help control nausea and vomiting and vertigo through an antihistamine effect.

A mother brings her daughter to the clinic for an evaluation because the child is complaining of ear pain. Which of the following would lead the nurse to suspect that the child is experiencing otitis externa and not otitis media? Bulging eardrum Ear drainage Fever Aural tenderness

Aural tenderness A client with otitis externa typically experiences aural tenderness. This finding is usually absent in clients with otitis media. Fever and ear drainage may be present with either otitis externa or otitis media. A bulging eardrum would suggest otitis media.

A client you are caring for has a hearing loss. The client tells you he is self-conscious about his hearing loss. What advice should the nurse give a self-conscious client with hearing loss to protect his self-esteem? Avoid excess socializing. Be forthright and inform others about the hearing deficit. Pretend to follow conversations by nodding the head. Follow lip movements closely.

Be forthright and inform others about the hearing deficit. The nurse should encourage clients with a hearing loss to be forthright and inform others about their hearing deficit. Clients should be advised not to hide the fact that they do not understand what has been said and should be encouraged to maintain friendships because a physical impairment is unlikely to affect genuine friendships.

A middle-aged female patient is being treated with the Epley maneuver, which is designed to reposition the canalith by having the patient perform quick movements of the head. The nurse should recognize that this patient likely has a history of what health problem? Benign paroxysmal positional vertigo (BPPV) Otalgia Acoustic neuroma Presbycusis

Benign paroxysmal positional vertigo (BPPV) Repositioning techniques can be used to treat vertigo, such as the Epley maneuver. The maneuver is designed to reposition the canalith and involves quick movements of the head. The noninvasive procedure is performed by placing the patient in a sitting position and turning the head to a 45-degree angle on the affected side and 30 to 45 degrees backward. Then the patient is quickly moved to the supine position. This technique is not used in the treatment of otalgia, presbycusis, or acoustic neuroma.

Following a motorcycle accident, a 17-year-old boy is brought to the emergency department. He has sustained multiple traumas, including a head injury. What physical assessment findings related to the ear should be reported by the nurse immediately? The tympanic membrane is pearly gray. The malleus can be visualized during otoscopic examination. Clear, watery fluid is draining from the ear. Tenderness is reported by the patient when the mastoid area is palpated.

Clear, watery fluid is draining from the ear. In the patient experiencing acute head trauma, the presence of clear, watery drainage from the ear should be reported at once. The fluid is likely to be cerebrospinal fluid associated with skull fracture. The ability to visualize the malleus is a normal physical assessment finding. The tympanic membrane is normally pearly gray in color. Tenderness of the mastoid area usually indicates inflammation. This should be reported but is not a finding indicating urgent intervention.

A client who has been fitted with a hearing aid comes for a follow-up evaluation. During the visit, the client states, "I've noticed that I still don't seem to hear well enough. The hearing aid doesn't seem to make the sounds louder." Which of the following might the nurse determine as the possible cause? Ear mold is loose. Client has cerumen in the ear. The client has an ear infection. The mold is not properly fitted.

Client has cerumen in the ear. The client reports that the hearing aid is not helping, such that the sounds are not loud enough. This statement is consistent with inadequate amplification. Cerumen in the ears is a possible cause. A loose ear mold would cause a whistling noise. An improperly fitted mold or middle ear infection would lead to pain from the mold.

The nurse is caring for a client experiencing hearing loss. The nurse uses the otoscope to assess the ear canal and tympanic membrane and notes a significant accumulation of cerumen. Which documentation of hearing loss type would be most accurate? Sensorineural Central Mixed Conductive

Conductive Conductive hearing loss occurs from an obstruction in the outer or middle ear such as from cerumen. Mixed hearing loss is a combination of conductive and sensorineural problems. Central hearing loss involves injury or damage to the nerves or the nuclei of the central nervous system. Sensorineural involves damage to the inner ear.

Loud, persistent noise has been found to have which of the following effects on the body? Select all that apply. Increased blood pressure Decreased gastrointestinal motility Constriction of peripheral blood vessels Increased heart rate Dilation of peripheral blood vessels

Constriction of peripheral blood vessels Increased blood pressure Increased heart rate Loud, persistent noise has been found to cause constriction of peripheral blood vessels, increased blood pressure and heart rate (because of increased secretion of adrenalin), and increased gastrointestinal activity, well as disturbed patterns of sleep.

A patient with significant and increasing sensorineural hearing loss has opted not to have surgery and has chosen instead to focus on aural rehabilitation with an emphasis on auditory training. What will be the primary focus of the patient's rehabilitation? Learning to use sign language effectively Developing effective skills and strategies for listening Developing coping techniques for dealing with a lack of communication Developing nonverbal communication techniques

Developing effective skills and strategies for listening Auditory training emphasizes listening skills, so the person who is hearing-impaired concentrates on the speaker. Speech reading (formerly known as lipreading) can help fill the gaps left by missed or misheard words. This particular form of training does not have a primary emphasis on coping techniques, nonverbal communication, or sign language.

Which term refers to an altered sensation of orientation in space? Ataxia Tinnitus Dizziness Nystagmus

Dizziness Dizziness may be associated with inner ear disturbances. Tinnitus refers to a subjective perception of sound with internal origin. Nystagmus refers to involuntary rhythmic eye movement. Ataxia is the failure of muscle coordination and may be present in clients with vestibular disease.

If untreated, squamous cell carcinoma of the external ear can spread through the temporal bone, causing which effect? Facial nerve paralysis Nystagmus Motor impairment Diplopia

Facial nerve paralysis If untreated, squamous cell carcinomas of the ear can spread through the temporal bone, causing facial nerve paralysis and hearing loss.

Which precautions should the nurse take when a client is at risk of injury secondary to vertigo and probable imbalance? Refrain from looking at one place. Grasp the siderails when rising to a standing position. Keep his or her eyes closed. Immobilize the head to reduce the risk of falling

Grasp the siderails when rising to a standing position. The nurse should have the client use firm supports, such as siderails, whenever arising. There is no need to limit the client's gaze or head movements. Keeping the eyes closed can exacerbate disorientation.

Which precaution should the nurse take when a client is at risk of injury secondary to vertigo and probable imbalance? Encourage the client to move the head slowly Have the client wait for help before moving Restrict the client from focusing on one spot Recommend that the client keep his or her eyes closed

Have the client wait for help before moving The nurse should have the client wait to move until help arrives. Safety measures such as assisted ambulation are implemented to prevent falls and injury. The client should restrict movement. The client should keep his or her eyes open and focus on one spot to reduce vertigo.

A group of 16- and 17-year-old girls are attending a concert. The music at the concert will be 80 to 90 dB. What should the girls be aware of? Sounds in this decibel level are not perceived to be harsh to the ear. Ear plugs will have no effect on decibel levels. Hearing will not be affected by a decibel level in this range. Hearing loss may occur with a decibel level in this range.

Hearing loss may occur with a decibel level in this range. Sound louder than 80 dB is perceived by the human ear to be harsh and can be damaging to the inner ear. The minimum noise level known to cause noise-induced hearing loss, regardless of duration, is about 85 to 90 dB. Ear protection or plugs do help to minimize the effects of high levels of decibels.

A client complains of vertigo. The nurse anticipates that the client may have a problem with which portion of the ear? External ear Inner ear Middle ear Tympanic membrane

Inner ear A client with vertigo experiences problems with the inner ear, which is responsible for maintaining equilibrium. The external ear collects sound; the middle ear conducts sound. The tympanic membrane (eardrum) vibrates in response to sound stimulation.

A client comes to the walk-in clinic complaining of a "bug in my ear." What action should be taken when there is an insect in the ear? Instillation of carbamide peroxide Use of a small forceps Instillation of mineral oil Instillation of hot water

Instillation of mineral oil Mineral oil is instilled into the ear to smother an insect. Carbamide peroxide is used to soften dried cerumen, and small forceps are used to remove solid objects. Hot liquids cause dizziness and should not be instilled in the ear.

A female patient's severe ear infection has resulted in tympanic membrane perforation. The patient's care provider has concluded that surgical repair is unnecessary because the membrane is healing spontaneously. What health education should the nurse emphasize to this patient? The ear should be gently cleaned with a cotton swab once a day. Purulent drainage should be expected for the first week after the injury. Half-strength hydrogen peroxide should be instilled into the ear once a day. It is important to keep the ear canal dry until the membrane has healed.

It is important to keep the ear canal dry until the membrane has healed. While healing, the ear must be protected from water. Purulent discharge indicates infection and would warrant immediate follow-up. Cleaning with a cotton swab could cause injury, and hydrogen peroxide is not indicated.

A patient is participating in aural rehabilitation. The nurse understands that this type of training emphasizes which of the following? Listening skills Social skills Occupational skills Functional skills

Listening skills Auditory training emphasizes listening skills, so the person who is hearing-impaired concentrates on the speaker.

Hearing aids help with which of the following problems? Improves communication skills Improves understanding of speech Improves discrimination of words Makes sounds louder

Makes sounds louder A hearing aid makes sounds louder, but it does not improve a patient's ability to discriminate words or understand speech. Hearing aids amplify all sounds, including background noise, which may be disturbing to the wearer. It does not improve communication skills.

The nurse is caring for a patient with Ménière's disease who is hospitalized with severe vertigo. What medication does the nurse anticipate administering to shorten the attack? Meclizine (Antivert) Furosemide (Lasix) Gentamicin (Garamycin) intravenously Cortisporin otic solution

Meclizine (Antivert) Pharmacologic therapy for Ménière's disease consists of antihistamines, such as meclizine, which shortens the attack (NIDCD, 2010).

Which of the following describes vertigo? Select all that apply. Syncope Misperception of motion Objects are moving around him or her Spinning sensation Fainting

Misperception of motion Spinning sensation Objects are moving around him or her Vertigo is defined as the misperception or illusion of motion of the person or their surroundings. Most people with vertigo describe a spinning sensation or say they feel as though objects are moving around them. Syncope, fainting, and loss of consciousness are not forms of vertigo and usually indicate disease in the cardiovascular system.

Which of the following is an involuntary rhythmic movement of the eyes that is also associated with vestibular dysfunction? Presbycusis Tinnitus Nystagmus Vertigo

Nystagmus Nystagmus is an involuntary rhythmic movement of the eyes; pathologically it is an ocular disorder but is also associated with vestibular dysfunction. Nystagmus can be horizontal, vertical, or rotary, and can be caused by a disorder in the central or peripheral nervous system. Vertigo is defined as the misperception or illusion of motion of the person or their surroundings. Tinnitus is ringing in the ears. Presbycusis is a progressive hearing loss.

The nurse is developing a plan of care for a patient with severe vertigo. What expected outcome statement would be a priority for this patient? Patient will experience no falls due to balance disorder. Patient will have decreased fear and anxiety. Patient will take medications as prescribed. Patient will perform exercises as prescribed.

Patient will experience no falls due to balance disorder. Although all of these are expected outcomes for a patient with vertigo, the priority expected outcome is that the patient will experience no falls due to the balance disturbance, as falls poses the greatest risk to the patient's health.

Which nursing suggestion would be most helpful to the client with recurrent otitis externa? Flush the ear with hydrogen peroxide Avoid lying on the side of the affected ear Use a cotton applicator to ensure that the ear canal is dry. Place ear plugs into the ears before swimming

Place ear plugs into the ears before swimming The nurse instructs the client to carry out the medical treatment and provides health teaching to prevent recurrence. For example, he or she advises swimmers to wear soft plastic ear plugs to prevent trapping water in the ear. A cotton tip applicator should not be placed into the ear canal because it could perforate the eardrum. Above all, the nurse advises the client to avoid the use of nonprescription remedies unless they have been approved by the physician and to contact the physician if symptoms are not relieved in a few days.

Some clients with acoustic neuromas have vertigo. What is a priority nursing action for clients with vertigo? Provide ice to the affected ear. Mobilize the client at every opportunity. Provide small meals of tepid food. Protect the client from injury.

Protect the client from injury. For clients with vertigo, the nurse takes measures to protect the client from injury. Nursing actions do not include providing small meals of tepid food, mobilizing the client at every opportunity, or providing ice to the affected ear.

A nurse is practicing within a pediatric medicine group. What can the nurse do to maintain hearing within the pediatric client base? Increase antibiotic therapy use. Distribute earplugs to all clients. Reduce frequency and severity of ear infections. Prevent fevers.

Reduce frequency and severity of ear infections. Nurses play a pivotal role in preventing hearing loss by reducing the severity and frequency of ear infections among children and advocating for measures that reduce exposure to loud noise. Reducing the severity and frequency of ear infections among children will assist in maintaining hearing.

The nurse is instructing the client with dried cerumen blocking the ear canal on potential methods to reduce symptoms. Which at-home methods of cerumen removal are discouraged? Removing the cerumen by means of a cotton tip applicator Irrigating the ear with warm water and a rubber-bulb syringe Using warm glycerin or mineral oil to soften the cerumen Instilling 1 to 2 drops of half-strength peroxide in the ear

Removing the cerumen by means of a cotton tip applicator The nurse is an important resource person to consult when a client has an issue with the ear structure or hearing. The nurse is correct to discourage placing anything down the ear canal that could push the cerumen deeper toward or puncture the tympanic membrane. The other options are appropriate to soften and lubricate the cerumen or to irrigate the cerumen from the ear.

While reviewing the health history of a 72-year-old patient experiencing hearing loss, the nurse notes the patient has had no trauma or loss of balance. What factor is likely to be linked to the patient's hearing deficit? Routine use of quinine for management of leg cramps Recent psychological stressors Allergy to hair coloring and hair spray Recent completion of radiation therapy for treatment of thyroid cancer

Routine use of quinine for management of leg cramps Long-term, regular use of quinine for management of leg cramps is associated with loss of hearing acuity. Radiation therapy for cancer should not affect hearing; however, hearing can be significantly compromised by chemotherapy. Allergy to hair products may be associated with otitis externa; however, it is not linked to hearing loss. Hearing loss is not a common manifestation of stress.

During his annual physical examination, a retired airplane mechanic reports noticeable hearing loss. The nurse practitioner prescribes a series of hearing tests to confirm or rule out noise-induced hearing loss, which is classified as a: Sensorineural loss. Psychogenic issue. Mixed cause. Conduction problem.

Sensorineural loss. Noise-induced hearing loss refers to hearing loss that follows a long period of exposure to loud noise. It is inherent in jobs that involve heavy machinery, noisy engines, and artillery.

What kind of otitis media is a pathogen-free fluid behind the tympanic membrane, resulting from irritation associated with respiratory allergies and enlarged adenoids? Purulent otitis media Infectious otitis media Sterile otitis media Serous otitis media

Serous otitis media Serous otitis media, a collection of pathogen-free fluid behind the tympanic membrane, results from irritation associated with respiratory allergies and enlarged adenoids. The other options are distractors for this question. Purulent otitis media usually results from the spread of microorganisms from the eustachian tube to the middle ear during upper respiratory infections.

A nursing instructor is preparing a class on air and bone conduction of sound. When describing the transmission of sounds by air conduction, which of the following would the instructor include? Sounds travel through the external and middle ears. It is a less efficient pathway for sound. Vibrations bypass the tympanic membrane to reach the inner ear. Vibration of the tympanic membrane diverts sound away from the ossicles.

Sounds travel through the external and middle ears. Sounds transmitted by air conduction travel over the air-filled external and middle ear through vibration of the tympanic membrane and ossicles. Sounds transmitted by bone conduction travel directly through bone to the inner ear, bypassing the tympanic membrane and ossicles. Normally, air conduction is the more efficient pathway.

Which of the following is the treatment of choice for acoustic neuromas? Radiation Chemotherapy Palliation Surgery

Surgery Surgical removal of acoustic tumors is the treatment of choice because these tumors do not respond well to radiation or chemotherapy. There would be no need for palliation.

A nurse has just received a patient into the PACU after a tympanoplasty. What is a tympanoplasty is defined as? Incision into the eardrum Surgical reconstruction of the middle ear bones Incision into the tympanic membrane Surgical repair of the eardrum

Surgical repair of the eardrum Surgical repair of the eardrum is termed tympanoplasty. Ossiculoplasty refers to surgical reconstruction of the middle ear bones and is performed to restore hearing. Tympanotomy or myringotomy is the term used to refer to an incision into the tympanic membrane.

The nurse is caring for a patient with Ménière's disease. The patient is scheduled to go home tomorrow, so the nurse is preparing the patient's discharge teaching. Dietary guidelines will be included. What foods should the patient be instructed to limit or avoid? Frozen yogurt Red meat Citrus fruit Sweet pickles

Sweet pickles The patient with Ménière's disease should avoid foods high in salt and/or sugar; sweet pickles are high in both. Milk products are not contraindicated for the patient with Ménière's. Fresh citrus fruit is permitted. Any type of meat, fish, or poultry is permitted, with the exception of canned or pickled varieties. In general, the patient with Ménière's should avoid or limit canned and processed foods.

A 24-year-old female client is diagnosed with otosclerosis. Which teaching is most accurate? Females otosclerosis is linked with infertility. Medications can interfere with birth control pills. Symptoms may be accelerated by pregnancy. Menstrual periods may be longer and more severe.

Symptoms may be accelerated by pregnancy. The etiology of otosclerosis is unknown; however, it is more common in females than males and usually occurs in the second or third decade of life. It is accurate to instruct females that symptoms of otosclerosis seem to be accelerated during pregnancy.

The nurse is working in the emergency department when a physician asks for help as the client is performing a Romberg test. In which position would the nurse stand to be most helpful? The nurse would stand laterally to the client, opposite side to where the physician is standing. The nurse would stand directly in front of the client. The nurse would stand between the client and physician. The nurse would stand across the room but in direct alignment from the client.

The nurse would stand laterally to the client, opposite side to where the physician is standing. The Romberg test is used to evaluate a person's ability to sustain balance. The client stands with the feet together and arms extended. In the event that the client begins to sway (an abnormal result), the nurse is most helpful to stand on the lateral side of the client, opposite side to where the physician is standing to ensure that the client does not fall.

Which term refers to surgical repair of the tympanic membrane? Ossiculoplasty Tympanoplasty Myringotomy Tympanotomy

Tympanoplasty Tympanoplasty may be necessary to repair a scarred eardrum. A tympanotomy, or myringotomy, are incisions into the tympanic membrane. An ossiculoplasty is a surgical reconstruction of the middle ear bones to restore hearing.

A patient has been referred to a specialist by his primary care provider because he is suspected to have an acoustic neuroma. What signs and symptoms most likely prompted the care provider's referral? Unilateral tinnitus and hearing loss Vertigo that is unresponsive to medication Chronic tympanic perforation A history of clear discharge from one of the patient's ears

Unilateral tinnitus and hearing loss The most common assessment findings of patients with acoustic neuromas are unilateral tinnitus and hearing loss with or without vertigo or balance disturbance. Vertigo is rarely attributable to a neoplasm. Acoustic neuromas are not accompanied by clear discharge or chronic tympanic perforation.

A middle-aged male patient has sought care from his nurse practitioner claiming, "This ringing in my ears is enough to drive me crazy the last few weeks." The nurse recognizes the presence of tinnitus and should assess for which of the following factors that can contribute to the problem? Select all that apply. Neurological disorders Otologic disorders Stress and anxiety Use of ototoxic medications Family history

Use of ototoxic medications Otologic disorders Stress and anxiety Neurological disorders Underlying disorders that contribute to tinnitus may include thyroid disease, hyperlipidemia, vitamin B12 deficiency, psychological disorders (e.g., depression, anxiety), fibromyalgia, otologic disorders (Ménière's disease, acoustic neuroma), and neurologic disorders (head injury, multiple sclerosis). Family history is not identified as a risk factor for tinnitus.

Acoustic neuromas are benign tumors of which of the following cranial nerves? VII VIII V VI

VIII Acoustic neuromas are slow-growing, benign tumors of cranial nerve VIII, usually arising from the Schwann cells of the vestibular portion of the nerve.

When caring for a client after ear surgery, what is an important aspect of nursing care? Assess social support. Feed small frequent meals to minimize nausea. Fit for a hearing aid. Validate client's feelings of discomfort.

Validate client's feelings of discomfort. Validate client's feelings of discomfort. This measure promotes the nurse-client relationship and reassures the client that his or her needs are important.

A client is diagnosed with Meniere's disease. The nurse would most likely expect the client to report which of the following? Nausea Vertigo Ear fullness Tinnitus

Vertigo Although tinnitus, nausea, vomiting and ear fullness may be noted, vertigo is usually the most troublesome and common complaint associated with Meniere's disease.

Which manifestation is the most problematic for the client diagnosed with Ménière disease? Hearing loss Tinnitus Diaphoresis Vertigo

Vertigo Vertigo is usually the most troublesome complaint related to Ménière disease. Other clinical manifestations include tinnitus, diaphoresis, and hearing loss.

The parent of a young client with severe hearing loss is quite concerned about the child's future independence because of impaired hearing. Which type of hearing loss is usually irreversible? sensorineural noise exposure tinnitus conductive

sensorineural