43. ASSESSMENT AND CONCEPTS OF CARE FOR PATIENTS WITH EAR AND HEARING PROBLEMS. HEARING LOSS:

Which step is a correct part of the procedure the nurse uses to instill eardrops into a client's ears?

Tilt the client's head in the opposite direction of the affected ear.

Which specific assessment will the health care provider look for in a client, after asking the nurse to obtain a pneumatic otoscope?

Mobility of the eardrum

When the nurse is completing a client's history, which associated factors may contribute to the development of tinnitus? Select all that apply

Otosclerosis Drugs such as aspirin and NSAIDs Ménière disease Continuous exposure to loud noise

Which questions will the nurse ask to assess a client's auditory sensory perception? Select all that apply.

"Are you having any pain or itching in your ears?" "Do you have a hearing problem now?" "Have you had any ear trauma or surgery?" "Have you been exposed to loud noises in your work?" "Have you had problems with excessive ear wax?"

Which question will the nurse ask a client with Ménière disease who is prescribed meclizine to determine if the drug is providing the desired therapeutic effect?

"Has the medication helped to relieve your dizziness and nausea?"

Which response indicates to the nurse that a client understands information provided about the diagnosis of acoustic neuroma?

"The tumor is benign but possible neurological damage sounds scary."

What priority teaching will the nurse provide to an assistive personnel (AP) who will help with morning care for a client with vertigo episodes?

"There is a high risk of falls, so follow fall precautions with this client."

Which nonsurgical actions does the nurse expect to perform when caring for a client with otitis media? Select all that apply.

Allowing the client to rest Applying low heat to help relieve pain Providing a quiet environment Administering antihistamines to decrease fluid in the middle ear Giving systemic antibiotic therapy

Which information will the nurse include when teaching a client how to use a hearing aid? Select all that apply.

Avoid exposing the hearing aid to extreme temperatures. Turn the hearing aid off when not in use. Avoid using hair spray and cosmetics that might come into contact with the receiver. Keep extra batteries on hand and change the battery as needed. Adjust the volume to the lowest setting that allows you to hear.

Which priority teaching points will the nurse include for a client after myringotomy surgery? Select all that apply.

Avoid straining when having a bowel movement. Avoid excessive coughing for 2 to 3 weeks. Avoid people with respiratory illnesses or infections. Report excessive drainage immediately to your health care provider.

Which client will the nurse expect has the highest risk for developing hearing loss related to occupation?

Bartender who works in a night club with live music

Which sounds would the client report to the nurse as most difficult to hear when just beginning to notice some hearing loss?

Cell phone ringing with low-frequency tones

With which condition must the nurse be extra vigilant and cautious if a client is prescribed an ototoxic drug?

Chronic glomerulonephritis

Which action by a client indicates to the nurse the highest likelihood of hearing impairment?

Client tilts the head to one side and leans forward.

For which client does the nurse forgo using an otoscope to examine the ears?

Client who is confused and unable to sit still

For which client will the nurse recommend playing soft music during sleeping hours?

Client with continuous tinnitus

Which structure does the nurse expect to be impaired in a client who has a sensorineural hearing loss?

Eighth cranial nerve

When administering which drug to a client will the nurse be sure to monitor carefully for ototoxicity?

Furosemide

Which are the classic symptoms of Ménière disease that the nurse recognizes in a client?

Hearing loss Unpredictable episodes of vertigo Tinnitus

Which precaution will the nurse remind the client about after stapedectomy surgery?

Improvement in hearing may not occur until 6 weeks after surgery.

Which action must the nurse teach a client to avoid to prevent harm after recovering from the inflammation of external otitis?

Inserting cotton-tipped applicators into the ears after bathing

Which signs and symptoms will the nurse recognize as indicators that a client has otitis media? Select all that apply.

Intense ear pain Nausea and vomiting Headache Tinnitus Dizziness

What is the nurse's best rationale for irrigating an older adult's cerumen impaction with fluid that is at body temperature?

It reduces the chance of stimulating the vestibular sense.

Which condition does the nurse suspect when assessment of a client reveals lymph node tenderness behind the ears?

Mastoiditis

Which hearing test will the nurse use to compare a client's hearing by air conduction with hearing by bone conduction?

Rinne test

Which action does the nurse expect next when a client with mastoiditis does not respond to IV antibiotics?

Surgical removal of the infected tissue

What actions will the nurse take to enhance communication with a hearing-impaired client? Select all that apply.

Talk with the client in a quiet room with minimal distractions. Sit in adequate light. Face the client while speaking. Use short, simple language.

Which priority teaching points will the nurse include when instructing a client about home management of Ménière disease? Select all that apply.

Teach the client to move or turn the head slowly. Tell the client about the importance of reducing intake of dietary salt. Instruct the client to avoid caffeinated beverages. Discuss smoking cessation programs with the client. Teach the client to avoid standing on ladders or chairs.

What is the nurse's best interpretation when a client with otitis media states that the affected ear feels better, but on assessment pus and blood are found?

The eardrum has perforated.

Which techniques will the nurse use to perform an otoscopic assessment on a client?

The nurse holds the otoscope upside down like a large pen.

Which are age-related changes in the ears and hearing that the nurse would expect in an older adult client? Select all that apply.

Tympanic membrane loses elasticity and may appear dull and retracted Cerumen is drier and impacts more easily, reducing hearing function The ability to hear high-frequency sounds is lost first

Which priority teaching points will the nurse be sure to include when instructing a client about how to irrigate his or her ears for cerumen removal? Select all that apply.

Use tap water that feels just barely warm to you. If the earwax is thick and sticky, place drops of mineral oil into the ear an hour or so before irrigating the ear. The safest type of ear syringe to use is one that has a right angle or "elbow" in the tip. Insert the syringe tip only about an inch into your ear canal. Apply gentle but firm continuous pressure, allowing the water to flow against the top of the canal.