Chapter 20: Disorders of Hearing and Vestibular Function

Which cranial nerve is designated as the vestibulocochlear nerve?

Cranial nerve VIII

The nurse is teaching a client who has tinnitus about suggested dietary modifications. The most important information for the nurse to include would be:

Cut down on takeout meals because of high amounts of monosodium glutamate.

The nurse understands that vestibular rehabilitation includes:

Exercise in balance retraining

The nurse understands that movement of otoliths may result in:

Vertigo and nystagmus

The police transported to the ER a client who was attempting to walk but kept falling down and reporting a horrible spinning feeling, diaphoresis, and vomiting. Drug and alcohol tests were negative. The client states that it feels like his ears are going to explode, especially with head movement. The nurse notes that the client is also having difficulty hearing. Which condition does the nurse suspect?

Meniere disease

Select the statement that BEST describes Meniere disease.

Meniere disease is a disorder on the inner ear due to distension of the endolymphatic compartment of the inner ear, causing hearing loss, vertigo, and tinnitus.

A client is having difficulty with balance. The nurse understands that the area of the ear that impacts balance is:

Vestibular apparatus

The nurse is caring for a client who has been diagnosed with presbycusis. The nurse understands that with this disorder, the client experiences which of the following?

Difficulty hearing high-pitched frequencies

Which hearing test would be prescribed to help differentiate conductive from sensorineural hearing loss?

A Weber (turning fork) test

The nurse is caring for a client who has been diagnosed with Meniere disease. The nurse understands which medications may be prescribed for diagnostic purposes?

-Glycerin -Furosemide -Urea

The nurse is performing a health history for a 72-year-old client. When reviewing the client's medications, the client states, "I take baby aspirin every day, but I'm worried. I heard that aspirin can cause hearing problems!" What is an appropriate response by the nurse?

A baby aspirin is a low dose that is considered to be safe.

Although both vertigo and dizziness can result from peripheral or central vestibular disorders, vertigo is distinctly different because it causes:

An illusion of motion

What is the most important instruction for the nurse to give a client experiencing an acute attack of Meniere disease?

Ask for help when getting up

A 26-year-old client who has recently traveled by airplane complains of pain in his right ear. The nurse suspects which condition?

Barotrauma

A client reveals that, when in bed, changes in head position cause brief periods of vertigo, usually lasting less than 1 minute. Which condition is the client MOST likely experiencing?

Benign paroxysmal positional vertigo

The nurse is working at a first aid station in an amusement park. A 45-year-old client arrives reporting severe dizziness after a ride on the roller coaster. The nurse understands that a common cause of the sensation is:

Benign paroxysmal positional vertigo

A client, who travels frequently for work, reports intense ear pain during ascent from and descent into airports. The health care provider will recommend which category of medications to help alleviate this symptom?

Decongestant nasal spray such as phenylephrine

The nurse is educating a client diagnosed with Meniere disease on lifestyle modifications to reduce the frequency and/or intensity of exacerbations. Which should the nurse include?

Decrease dietary intake of sodium

The nurse is teaching a teenaged client strategies to avoid recurrent ear infections. The nurse understands understands that further teaching is required when the client states:

I will dry the inside of my ears thoroughly with cotton-tipped applicators after swimming.

While on an ocean cruise, a person develops malaise and nausea/vomiting. The nurse notes the client's blood pressure is 88/52 mm Hg; pulse is 110 bpm; and skin is moist with perspiration. Which diagnosis is associated with these clinical manifestations?

Motion sickness

The nurse is conducting the Rinne test. What is included in this test?

Placing a vibrating turning fork on the client's mastoid bone and in front of the ear in an alternating fashion.

The nurse is caring for a client who has been diagnosed with Meniere disease. The nurse expects which medication will be prescribed to manage the symptoms?

Promethazine

The nurse is treating a client with a history of chronic alcohol abuse. The client's spouse tells the nurse that the client has no difficulty speaking and responds when spoken to but is having difficulty understanding what is being said. The spouse asks if the nurse believes the client needs a hearing aid. The nurse explains to the spouse that the client probably does not require a hearing aid but may suffer from:

Receptive aphasia

The nurse is caring for an older adult client with a suspected diagnosis of presbycusis. Select the MOST likely manifestation.

Sensorineural hearing loss caused by natural aging

A young child is flying on a plane for the first time. As the plane begins its descent for landing, his ears begin to hurt. The flight attendant sees that he is in pain and tells him to swallow until the pain goes away. Which structure is the child using to equalize the pressure and relieve the pain?

Swallowing pulls air through the eustachian tubes, allowing air pressure to equalize in the inner ear.

A client with a diagnosis of benign paroxysmal positional vertigo (BPPV) is receiving teaching from her physician about her diagnosis. The client is eager to avoid future episodes of vertigo and has asked the physician what she can do to prevent future episodes. How can the physician best respond?

There are exercises that I'll teach you to help reorient your inner ear and prevent vertigo.

The nurse is preparing a client for surgical procedure to create an endolymphatic shunt. The nurse understands that this procedure aims to relieve which symptoms?

Vertigo