Med-Surg Ch 26: The Sensory System: Ear

When assessing a patient who is complaining of ear pain, the most important question would be A. "Have you been listening to loud music?" B. "Have you had a recent upper respiratory infection?" C. "Are you prone to form a lot of wax in your ears?" D. "What have you taken for your pain?"

"Have you had a recent upper respiratory infection?"

A nurse is reinforcing discharge teaching to a client following middle ear surgery. Which of the following statements by the client indicates understanding of the teaching? A. "I will avoid blowing my nose." B. "I should wait until the day after surgery to wash my hair." C. "I will remove the dressing behind my ear in 7 days." D. "My hearing should be back to normal right after my surgery."

"I will avoid blowing my nose." *Clients following ear surgery should be advised to avoid blowing their nose, sneezing, or coughing. This can cause pressure on the client's ear or stitches if in place. This can also cause pain and discomfort to the client following ear surgery *(b)-Avoid showering and washing hair for at least several days up to 1 week following ear surgery. The ear must remain dry during this time. (c)-Middle ear surgery is performed through the tympanic membrane, and the client will have a dry dressing within the ear canal. There is no external excision. (d)-Decreased hearing is expected following middle ear surgery due to presence of a dressing within the ear canal and possible drainage

Which statement by the patient indicates that further teaching is needed regarding home instructions post ear surgery? A. "I should take it easy for the next week." B. "I need to keep my ear dry when I shower." C. "I will be able to fly to see my grandson this weekend." D. "I will keep my head elevated."

"I will be able to fly to see my grandson this weekend." *Changes in altitude will change the pressure in the inner ear and be potentially dangerous to healing. (1, 2, 4) Taking it easy for a week, keeping the ear dry, and keeping the head elevated are appropriate postoperative actions.

What should the nurse tell a patient experiencing hearing loss, they should inquire about a hearing aid? A. "You can wait until your hearing is nearly gone before worrying about it." B. "The earlier your brain is able to adapt to the hearing aid, the easier it will be to use." C. "You might want to get one before you get too old." D. "They don't work very well so I wouldn't spend too much money on it."

"The earlier your brain is able to adapt to the hearing aid, the easier it will be to use." *The sooner a person with a hearing loss obtains and learns to use a hearing aid, the greater the hearing improvement. The brain is better able to integrate thhe hearing aid transmissions when hearing has not been impaired for a very long time.

A patient returns 1 weeks after receiving hearing aids and states, "I guess I may as well return these; I just cannot get used to them." What is an appropriate nursing response? (select all that apply) A. "Maybe a different type of hearing aid would be better for you." B. "You have not been able to hear well for a long time. Adjusting to the way you hear the sound through a hearing aid may take quite a bit of t ime, but it will be worth it!" C. "To adjust to the hearing aids, you must wear them most of the time. Are you able to keep them in most of the time, or so you spend most of your time without them?" D. "My daughter adjusted to hers in just a few days. Something is not right here."

1. "You have not been able to hear well for a long time. Adjusting to the way you hear the sound through a hearing aid may take quite a bit of t ime, but it will be worth it!" 2. "To adjust to the hearing aids, you must wear them most of the time. Are you able to keep them in most of the time, or so you spend most of your time without them?" *It can take several months to realize the full benefit of hearing aids. The more a patient goes without them, the longer it will take to adjust. The patient should be encouraged to keep trying. (1) It is too early to test other aids. Test one hearing aid for several months. (4) People adjust to hearing aids differently.

Otosclerosis is a hereditary condition which causes degeneration of bone in the inner ear. This may result in profound hearing loss. Treatment for this condition includes (select all that apply) A. Correction through use of a hearing aid B. A change in diet C. Surgical correction involving replacing the stapes with a prosthetic device (stapedectomy) D. Sodium

1. Correction through use of a hearing aid 2. A change in diet 3. Surgical correction involving replacing the stapes with a prosthetic device (stapedectomy)

The clinic nurse is checking in a patient with a suspected ear infection. Which of the following does the nurse expect to find upon assessment of the patient's ear? (select all that apply) A. Drainage B. Swelling C. Pain D. Pale skin

1. Drainage 2. Swelling 3. Pain *Pain pccurs with the infection. Itchiness of the ear canal and discharge of liquid or pus may occur. Redness may be present. The skin should not be pale

Carbamide peroxide (Debrox)

1. Earwax removal 2. Teach patients that side effects are rare and include redness, itching, or rash 3. Do not give if patient has any symptoms of infection or any discharge from the ear because this may cause damage to the middle or inner ear 4. To avoid dizziness, give the drug while the patient is lying down and the affected ear is turned upward 5. Do not share with other patients 6. Do not insert the tip of applicator into the ear canal to avoid contamination of the tip or damage to the ear 7. Make sure that the drug is room temperature. (Drugs that are too cold or too warm can cause dizziness, nausea, and even burns to the ear) 8. May hear a bubbling sound after drops are instilled 9. Flush the ear with warm water after application of drug with a bulb syringe or the syringe provided by the manufacturer

A nurse is reviewing the medical health record of a client who has severe otitis media. Which of the following are expected findings? (select all that apply) A. Enlarged adenoids B. Report of recent colds C. Client prescription for daily furosemide D. Light reflex visible on otoscopic exam in the affected ear E. Ear pain relieved by meclizine

1. Enlarged adenoids 2. Report of recent colds *Enlarged tonsils and adenoids are a finding associated with a middle ear infection. Frequent colds are findings associated with a middle ear infection. *(c)-Furosemide is an ototoxic medication and can cause sensorineural hearing loss, but taking furosemide does not cause a middle ear disorder. (d)- light reflexes are absent or in altered positions in a client who has a middle ear disorder. (e)-Meclizine is prescribed to relieve vertigo for inner ear disorders, but does not relieve the pain of a middle ear infection

A patient suffering from vertigo caused by positioning is taught to try exercises at home, including which of the following? (select all that apply) A. Epley maneuver B. Brandt-Daroff exercise C. Foster maneuver D. Semont maneuver

1. Epley maneuver 2. Brandt-Daroff exercise 3. Foster maneuver 4. Semont maneuver *A series of head movements that can be done at home called Epley maneuver, Brandt-Daroff exercise, Foster maneuver, or Semont maneuver, which can be helpful in moving the calcium crystals causing BPPV

When teaching the elderly patient about care of his hearing aid, you would include which action(s) (select all that apply) A. Keep the battery in the hearing in the hearing aid B. Clean the ear mold regularly with alcohol C. Never put the hearing aid in water D. Open the battery cover when the hearing aid is not in the ear

1. Keep the battery in the hearing in the hearing aid 2. Clean the ear mold regularly with alcohol 3. Never put the hearing aid in water 4. Open the battery cover when the hearing aid is not in the ear

A 59-year-old patient with labyrinthitis is requesting to get up to go to the bathroom. What nursing interventions are appropriate? (select all that apply) A. Medicate for nausea B. Medicate for pain C. Assist patient with ambulation D. Keep the room light dim E. Have the patient sit up slowly F. Have the patient close their eyes when moving the head

1. Medicate for nausea 2. Assist patient with ambulation 3. Have the patient sit up slowly *Nausea is common, and particularly when moving, premedication is appropriate. The patient will probably be dizzy and needs assistance for safety. Sitting up slowly from a lying position can minimize the severity of the vertigo. (2) There is no indication that pain medication is needed. (4) Photophobia is not a symptom of labrynthitis. (6) Closing the eyes will not prevent vertigo.

The nurse is performing an assessment on a patient with labyrinthitis. Which symptom(s) would likely to be noted? (Select all that apply.) A. Nausea B. Nystagmus C. Loss of hearing D. Ear pain E. Extra production of cerumen

1. Nausea 2. Nystagmus 3. Loss of hearing *Labyrinthitis refers to an inflammation of the vestibular portion of the labyrinth of the inner ear. Manifestations include sensorineural hearing loss, nystagmus, and nausea. There is no increase in production of cerumen or ear pain.

The nurse reads in the chart that a patient has been diagnosed with conductive hearing loss. The nurse knows that which factors(s) are involved in this diagnosis? (Select all that apply.) A. Presbycusis B. Obstruction by cerumen C. Loud noise exposure D. Otosclerosis E. Trauma to the tympanic membrane

1. Obstruction by cerumen 2. Otosclerosis 3. Trauma to the tympanic membrane *Conductive hearing loss may be caused by otosclerosis, obstruction by impacted cerumen, or trauma and scarring of the tympanic membrane. Presbycusus and loud noise exposure contribute to sensorineural hearing loss.

A nurse in a clinic is caring for a client who has Meniere's disease and is experiencing vertigo. Which of the following actions should the nurse recommend to help control the vertigo? (Select all that apply) A. Reduce exposure to bright lighting B. Move head slowly when changing positions C. Do not eat fruit high in potassium D. Plan evenly-spaced daily fluid intake E. Avoid fluids containing caffeine

1. Reduce exposure to bright lighting 2. Move head slowly when changing positions 3. Plan evenly-spaced daily fluid intake *Remaining in a darkened, quiet environment can reduce vertigo, particularly when it is severe. Moving slowly when standing or changing positions can reduce vertigo. Fluid intake should be planned so that it is evenly spaced throughout the day to prevent excess fluid accumulation in the semicircular canals *(c)-The client who has vertigo should be instructed to avoid foods containing high levels of sodium to reduce fluid retention, which can cause vertigo. (e)-The client should avoid fluid containing caffeine or alcohol to minimize vertigo

The nurse observes the health care provider asking the patient to stand with arms out and eyes open. The nurse is aware that the provider is performing which test? (select all that apply) A. Romberg test B. Tuning fork test C. Nystagmus test D. Weber test

1. Romberg test 2. Tuning fork test 3. Nystagmus test *The Romberg test is a test of equilibrium. The patient stands with the feet together, the arms out to the sides, and the eyes open. Note the ability to maintain an upright posture without swaying. The patient is then asked to close the eyes, and posture is observed again. If the patient loses balance, it may indicate a problem with the inner ear or the cerebellum. Tuning forks measure hearing by air conduction or by bone conduction (Weber test and Rinne test). To test for nystagmus (involuntary rhythmic jerking of the eyes, hold a finger directly in front of the patient at eye level

When communicating with a patient who is hearing impaired, you should (select all that apply) A. Sit at eye level facing the patient B. Use a slightly higher tone that usual C. Enunciate clearly D. Speak directly into the patient's ear E. Use simple, short sentences

1. Sit at eye level facing the patient 2. Enunciate clearly 3. Use simple, short sentences *Sitting at eye level facing the patient, enunciating clearly, and speaking in short sentences makes it easier for the person to perceive what is being communicated. (2) Higher tones are not necessarily effective. (4) Speaking directly into the patient's ear is not effective.

The student nurse is assessing a patient receiving multiple medications that are ototoxic. The nurse explains to the student that which of the following signs of ototoxicity should be reported immediately? (select all that apply) A. Tinnitus B. Decreased hearing C. Straining to hear D. Headache

1. Tinnitus 2. Decreased hearing 3. Straining to hear *Any signs of ototoxicity, such as ringing in the ears, subtle changes in hearing ability, and difficulty hearing, should be reported immediately. Headache is not a symptom of ototoxicity

Decreases in hearing often occur with aging because of (select all that apply) A. vascular changes from diabetes B. loss of elasticity of the tympanic membrane C. nerve cell atrophy in the ear and brain D. arteriosclerosis and decreased blood flow

1. vascular changes from diabetes 2. loss of elasticity of the tympanic membrane 3. nerve cell atrophy in the ear and brain 4. arteriosclerosis and decreased blood flow.

Ms. Jaiswal just had a stapedectomy. She has an IV of D5 1/2 hanging and there are 660 mL left in the bag. It is prescribed to run 100 mL/hour. The IV tubing delivers 10 drops per mL. You should set the drip rate at _________ gtts/min.

110

Approximately how many in 1000 babies born in the United States have some form of congenital hearing problem? A. 1 B. 2 C. 100 D. 200

2

The National Institute on Deafness and Other Communication Disorders (NIDCD) reports that what percentage of adults aged 20 to 69 years in the United States show signs of noise-induced hearing loss? A. 10% B. 15% C. 24% D. 48%

24%

The nurse should recognize that sounds of ________ decibels or greater have reached a level that may begin to have an impact on hearing. A. 60 B. 70 C. 80 D. 90

70

After age 75 years of age, about what percentage of the population has some degree of hearing loss? A. 10 B. 25 C. 50 D. 75

75

The nurse is teaching a high school class about hearing loss and the use of ear buds while listening to loud music. The nurse explains that sustained exposure to noise levels above which of the following can cause hearing loss? A. 25 dB B. 50 dB C. 85 dB D. 100 dB

85 dB *Sustained exposure to noise levels of above 85 dB may result in hearing loss. Personal listening devices at high volumes can produce hearing loss with less than 5 minutes of exposure with dB levels of 105 to 110. The higher the sound level, the less time it takes to cause damage

A patient has been scheduled for a myringotomy for treatment of recurring otitis media. Which statement best describes this procedure? A. An incision is made into the eardrum and a ventilating tube is inserted. B. The eustachian tube is dilated with a balloon. C. The tympanic membrane and ossicles are surgically reconstructed. D. The stapes is removed and replaced with prosthetic device.

An incision is made into the eardrum and a ventilating tube is inserted. *For repeated episodes of otitis with fluid, or when the fluid will not resorb, a myringotomy (incision into the eardrum) is done, and a ventilating tube is inserted to drain the excess fluid in the middle ear and to equalize pressure while the eustachian tube is blocked. During a stapedectomy, the stapes is removed and replaced with a prosthetic device. Tympanoplasty involves the surgical reconstruction of the tympanic membrane and ossicles to restore middle-ear function. Dilation of the Eustachian tube with a balloon ("tuboplasty") may be used to drain fluid from the inner ear; however, there is limited experience and no long-term studies indicating outcome.

During the immediate postoperative period following tympanoplasty, what is the priority action by the LPN/LVN? A. Keep the patient on bed rest for the first 24 h. B. Provide cold compresses to be placed on the operative side. C. Position the patient on the operative side. D. Be sure the patient avoids coughing and sneezing.

Be sure the patient avoids coughing and sneezing. *Immediately after tympanoplasty, it is important to avoid coughing and sneezing. The patient will be expected to remain quiet and flat in bed for 4 h postoperatively. The head is turned so that the affected ear is uppermost. Cold compresses are not used in the postoperative period.

For the patient undergoing assessment for a hearing loss, the nurse would explain that electrononystagmography is performed in conjunction with A. caloric testing B. the tuning fork test C. the Rinne test D. an audiogram

Caloric testing.

The physician recommends that a patient have diagnostic testing performed to assess for an alteration in vestibular function of the ears. Based on your knowledge, which test do you anticipate will be ordered? A. Weber test B. Evoked-response audiometry testing C. Calorie test D. Rinne test

Calorie test

A patient with a history of Meniere disease is discussing dietary options with the nurse. The patient demonstrates an understanding of the necessary dietary changes by agreeing to restrict which food item? A. Potassium-rich foods B. Complex carbohydrates C. Canned soups D. Lean meats

Canned soups *A low-sodium diet and niacin (a water-soluble B vitamin) have been shown to be effective in reducing the symptoms of Meniere disease. Canned soups have elevated sodium levels and should be avoided. There is no reason to restrict lean meats, potassium-rich foods, or complex carbohydrates.

Which kind of hearing loss most often occurs from stiffening of the bones of the middle ear or from scarring of the tympanic membrane? A. Tinnitus B. Conductive C. Sensorineural D. Mixed Types

Conductive *Conductive hearing loss most often occurs from stiffening of the bones of the middle ear or from scarring of the tympanic membrane. Tinnitus is ringing in the ears. Sensorineural hearing loss is related to nerve damage

The patient is experiencing frequent attacks of vertigo. When planning care, which activity should the nurse encourage? A. Increase sodium in the diet B. Consider a smoking cessation program C. Increase daily fluid intake D. Drink a glass of red wine before supper

Consider a smoking cessation program *Cessation of smoking will decrease incidence of vertigo in the person with middle-ear disorder. Tobacco is vasoconstrictive and can affect the blood supply to the inner ear and nerves. When increased fluid pressure in the iner ear is suspected as the cause of dizziness, the provider may order a low-sodium diet and limit fluid intake. Alcohol intake does not combat vertigo

When administering ear drops to an adult, you would A. Draw the pinna upward and toward the front of the head B. Draw the pinna upward and toward the back of the head C. Pull the pinna downward and toward the front of the head D. Pull the pinna downward and toward the back of the head

Draw the pinna upward and toward the back of the head *Pulling the pinna up and backward straightens the ear canal on the adult, allowing the drops to coat the whole canal and reach the eardrum. (1) Pulling the pinna toward the front of the head will block the ear canal. (3) Pulling the pinna down and frontward will not straighten the ear canal. (4) Pulling the pinna down and backward will not straighten the ear canal.

Treatment for labyrinthitis (Vestibular neurontitis)

FALL RISK!!! 1. Benedryl 2. Antivert 3. Phenergen 4. Ativan 5. Valium 6. Steroids 7. Antibiotics

The nurse is caring for a patient with an inner ear disorder and is aware that the patient is at risk for which of the following? A. Aspiration B. Falls C. Incontinence D. Impaired gas exchange

Falls *Inner ear disorders can cause problems with balance, Dizziness, vertigo, and ataxia can greatly interfere with an individual's ability to work or to perform usual activities of daily living.

A nurse is performing an otoscopic examination of a client. Which of the following is an unexpected finding? A. Pearly gray tympanic membrane (TM) B. Malleus visible behind the TM C. Presence of soft cerumen in the external canal D. Fluid or bubbles seen behind the TM

Fluid or bubbles seen behind the TM *Fluid behind the TM indicates the possibility of otitis media and is not an expected finding

When collecting data from a patient concerning past diagnostic testing for an ear disorder, the patient reports that a needle was used to draw a blood speciment. Which test would use this step? A. Fluorescent treponemal antibody absorption (FTA-ABS) test B. Rinne test C. Electronystagmography D. Calorie test

Fluorescent treponemal antibody absorption (FTA-ABS) test

When providing care to patients, the nurse must recognize the medications that are considered ototoxic. Which medication has this distinction? A. Amoxicillin B. Gentamicin C. Acetaminophen D. Prednisone

Gentamicin

The nurse is preparing to administer otic medications to a 2 year old child. Which step is most correct? A. After the medication is expressed from the dropper, gently force air into the ear canal to promote absorption of the medication B. To reduce loss of medication, encourage the patient to lie down for 15 to 25 minutes after administration C. Gently pull the pinna upward and back during administration D. Gently pull the pinna downward and back during administration

Gently pull the pinna downward and back during administration

While ambulating, a patient with Meniere disease complains of dizziness and vertigo. An immediate nursing action would be to A. Provide oxygen B. Have the patient sit down C. Administer nausea medication D. Notify the health care provider

Have the patient sit down *Although option 3 might also be relevant, safety concerns decree that having the patient sit down to prevent a fall or injury takes priority. The patient may only be dizzy, not nauseated. (1) Meniere disease does not result from oxygen deprivation. (3) Nausea medication may be necessary but will not help immediately. (4) The health care provider does not need to be notified of an expected symptom of the diagnosis.

When a patient is receiving furosemide (Lasix) for a problem with edema, which side effect relative to this drug is important to the patient's health? A. Decreased rate of respirations B. Nausea C. Constipation D. Hearing loss

Hearing loss *Lasix (furosemide) can cause tinnitus and hearing loss. (1) Lasix does not affect respiratory rate. (2) Lasix is not associated with nausea. (3) Diarrhea is associated with Lasix.

A nurse applies a vibrating tuning fork to the middle of a patient's forehead. What response would indicate normal hearing? A. Hearing the sound in the back of the head B. Feeling a vibration but hearing no sound C. Hearing the sound in the middle of the head D. Feeling a vibration and hearing a soundin the temporal area

Hearing the sound in the middle of the head *This is Weber test, and hearing the sound in the middle of the head is normal. (1) Hearing the sound in the back of the head is abnormal. (2) Hearing no sound is abnormal. (4) Hearing a sound in the temporal area is abnormal.

Which finding, if present after a patient has ear surgery, should be reported to the provider as it may indicate facial nerve injury? A. Excessive drainage from the affected ear B. Inability to pucker the lips C. Impaired hearing D. Dizziness and loss of balance

Inability to pucker the lips *Signs of injury to the facial nerve include inability to close the eyes, wrinkle the forehead, or pucker the lips. The patient and family are advised to report such symptoms to the surgeon. Balance is temporarily affected as a result of disturbance to the mechanism that maintains equilibrium. Excessive drainage could be sign of infection and should be reported to the surgeon. Hearing is usually impaired immediately after surgery because of edema or bandages but is expected to improve in time.

You emphasize safety precautions to an 80 year old female patient with Meniere disease. An appropriate nursing approach would be to A. Use the patient's first name when addressing her B. Include family members in instructions C. Address decision making with the patient D. Set a specific schedule for providing instructions

Include family members in instructions *Including family members when giving safety instructions will help reinforce needed interventions and help keep the patient safe from falls. (1) Using the patient's name will not increase safety. (3) Decision making is not the focus. (4) There is no need to schedule instructions for a specific time.

When a patient experiences dizziness and vertigo, which action should be included in the patient's care? A. Instructing the patient to lie down and remain as still as possible B. Reminding the patient to limit intake of salt C. Telling the patient to increase intake of vitamin B12 D. Encouraging the patient to remain as active as possible

Instructing the patient to lie down and remain as still as possible *The priority goal when caring for the patient experiencing vertigo and dizziness is patient safety. The patient should be encouraged to rest during the episode. Limiting salt is helpful if the patient has been diagnosed with Meniere disease but is not helpful during an acute episode. Vitamin B12 has not been shown to be helpful with Meniere disease.

The patient who has had a stapedectomy should be instructed to A. Keep the head elevated when in bed B. Sneeze and cough with the mouth closed C. Apply the ear protector for sleep D. Sleep with the affected ear up

Keep the head elevated when in bed

The nurse is reviewing the plan of care for a patient following a tympanoplasty. Which intervention should the nurse implement in the immediate postoperative period? A. Keep the patient flat in bed B. Encourage deep breathing and coughing C. Reposition the patient quickly to reduce nausea and vomiting D. Position the patient's head with the affected ear touching the mattress

Keep the patient flat in bed *Postoperative care involves keeping the patient quiet and flat in bed for at least 12 h. Coughing and sneezing should be avoided, or if unavoidable, should be accomplished with the mouth opern to decrease pressure in the ear. Position changes should be accomplished slowly. The head is turned so that the affected ear is uppermost

The nurse would expect to implement which order for the patient with Meniere disease? A. Cefazolin (Kefzol) 1 g q6h IV B. Furosemide (Lasix) 20 mg three times a day C. Morphine 4 mg IV q4h PRN pain D. Ondansetron (Zofran) 4 mg IV q6h PRN nausea and vomiting

Ondansetron (Zofran) 4 mg IV q6h PRN nausea and vomiting

A patient is scheduled for a stapedectomy. The LPN/LVN should understand that this procedure is done when a patient has which problem? A. Meniere disease B. Mastoiditis C. Otosclerosis D. Labyrinthitis

Otosclerosis *Otosclerosis refers to the excess formation of bone in the ears. This impairs hearing. A potential treatment is a stapedectomy. Stapedectomy is not used for mastoiditis, labyrinthitis, or Meniere disease.

If the patient has had a left stapedectomy, which position is indicated? A. Supine with the head of the bed elevated to 90 degrees B. Left side-lying with head of the bed elevated to 90 degrees C. Right side-lying with the head of the bed elevated to 40 degrees D. Right side-lying with the head of the bed elevated to 90 degrees

Right side-lying with the head of the bed elevated to 40 degrees

Which kind of hearing loss is the most common? A. Tinnitus B. Conductive C. Sensorineural D. Mixed Types

Sensorineural *Disorders of the hearing nerve (sensorineural loss) are the most common cause of hearing loss. Conductive hearing loss most often occurs from stiffening of the bones in the middle ear or from scarring of the tympanic membrane. Tinnitus is ringing in the ears

The nurse is caring for a patient who has had a cochlear implant. The nurse understands cochlear implants are appropriate for which type of hearing disorder? A. Sensorineural hearing loss B. Otosclerosis C. Meniere disease D. Conductive hearing loss

Sensorineural hearing loss *Cochlear implants are available for patients who have moderate to severe sensorineural hearing loss. Hearing aids may be beneficial for the person with conductive hearing loss or otosclerosis. Meniere disease treatment is focused on relieving symptoms.

The teaching plan for the discharged patient who has Meniere disease and is prescribed meclizine would probably include which information about the drug? A. It is a cholinergic medication B. It is a vitamin-drug combination C. There are antihistamine side effects D. It can be taken when you have glaucoma

There are antihistamine side effects

The nurse is assessing an 84 year old patient. Which finding is consistent with aging? A. Thick cerumen B. Heightened perception of low-frequency sounds C. Outer ear canal pain D. Increased hair on the pinna

Thick cerumen *Thickened, hard cerumen collections in the outer ear can disrupt sound conduction and impair hearing. Age-related changes may include perception of low-freqiency sounds. Pain in the outer ear is not a normal change related to aging, nor is increased hair on the pinna

A patient with Ménière disease is being treated with furosemide. Following administration of the medication, the nurse should note which reaction? A. Nausea and vomiting B. Tinnitus C. Irritability D. Vertigo

Tinnitus *Loop diuretics have known ototoxicity properties and should be used with caution. Tinnitus may be one of the first symptoms produced by an ototoxic drug. Vertigo, nausea and vomiting, and irritability are expected findings for the patient with Meniere disease.

Older adults are more prone to conductive hearing loss and tinnitus because of A. hypertrophy of the cerumen glands B. Hardened cerumen C. widening of the auditory canal D. Hair loss in the auditory canal

hardened cerumen *With age, cerumen becomes less moist and may harden, making it difficult to be expelled on its own. The hardened cerumen may cause a conductive hearing loss if not removed. (1, 3) With aging, there is not hypertrophy of the cerumen glands or widening of the auditory canal. (4) Aging may cause hair changes in the auditory canal but not resulting in conductive hearing loss.

A nurse is caring for a client who has suspected Meniere's disease. Which of the following is an expected finding? A. Presence of a purulent lesion in the external ear canal B. Feeling of pressure in the ear C. Bulging, red bilateral tympanic membranes D. Unilateral hearing loss

Unilateral hearing loss *Unilateral sensorineural hearing loss is an expected finding in Meniere's disease. *(a)-Meniere's disease is an inner ear disorder. A purulent lesion in the external ear canal is not an expected finding. (b)-A feeling of pressure in the ear can occur with otitis media, but is not an expected finding in Meniere's. (c)-Meniere's disease is an inner ear disorder. Bulging, red bilateral tympanic membranes is a finding associated with a middle ear infection

Arteriosclerosis can cause decreased blood flow to ________, resulting in sensorineural hearing loss. A. Vestibulocochlear nerve B. Tympanic membrane C. Auditory canal D. Bones of the middle ear

Vestibulocochlear nerve *Arteriosclerosis can cause decreased blood flow to the vestibulocochlear nerve (eighth cranial nerve), resulting in sensorineural hearing loss. This often contributes to hearing loss in older adults. Conductive hearing loss is caused by a problem transmitting sound impulses through the auditory canal, the tympanic membrane, or the bones of the middle ear

A patient is suspected of having otosclerosis. Which diagnostic test can be anticipated? A. Amsler grid B. Brainstem-evoked response test C. Calorie test D. Weber's test

Weber's test

Meclizine (Antivert) is a drug that is used for patients with Meniere disease. This drug is used to reduce dizziness and is a(n) A. antihistamine B. corticosteroid C. antihypertensive D. beta blocker

antihistamine

While assessing the patient, the nurse asked if the patient has a son or daughter, and the patient replied "yes" and nodded. The nurse is aware that this may be a sign of A. Hearing loss B. dementia C. loss of consciousness D. ototoxicity

hearing loss *Past experience has taught many people with hearing loss that to ask for repetition of questions irritates people and causes them to think the person is stupid. For this reason, many people who cannot hear well commonly smile and say "yes," when such an answer is either incorrect or inappropriate

When assessing a patient who complains of a mild hearing loss, the nurse should first A. schedule an audiogram B. inspect the ear canal for cerumen C. inquire about past episodes of upper respiratory infection D. irrigate the ear canal for clear vision of the eardrum

inquire about past episodes of upper respiratory infection

You are assigned to care for a patient who has just been diagnosed with Meniere disease. Which diagnosis typically applies to the patient with Meniere disease and has the highest priority? A. knowledge deficit related to new diagnosis B. Anxiety related to hospitalization C. Potential for injury related to impaired balance D. Pain related to disease condition

potential for injury related to impaired balance

When irrigating the ear canal to remove cerumen, aim the stream of water above or below the impaction to allow __________ to push out the cerumen.

the pressure

The order of sound transmission from the outer ear to the brain is (place in order) A. pinna B. tympanic membrane C. middle ear D. organ of Corti E. vestibulochoclear F. medulla oblangata

they are in order