Ch.20 Disorders of Hearing and Vestibular Function

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 is caring for a client whose hearing is impaired due to impacted earwax. The nurse understands that the associated deafness is due to:

Conduction disorder

The nurse is teaching a teenaged client strategies to avoid recurrent ear infections. The nurse 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."

The nurse is performing a health history for a 72-year-old client. When reviewing the client's medications, the client states, "I take a 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

The nurse is caring for a pediatric client whose parent reports that the child has been pulling at her ears, has a fever, and has been crying more than usual. The nurse suspects the client may be experiencing which of the following?

Acute otits media

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 this sensation is:

Benign paroxysmal positional vertigo

To diagnose a vestibular disorder, which test would be used that assesses the eye movements in response to vestibular, visual, and positional stimulation?

Electronystagmography

The nursing handoff report includes that a client has presbycusis. Which intervention should the nurse include in the plan of care?

Face the client when speaking

A client in the rheumatologist's office asks the nurse why there is a buzzing in his ears that occurs a couple of times a day. The nurse suspects the client may be suffering from tinnitus and assesses the client for which modifiable causes of tinnitus? Select all that apply

Hypertension Medications Impacted serumen Caffeine intake

The nurse is conducting a community education class on acute otitis media. Which statement by the participants indicates to the nurse that they understand the education?

It can be caused by a bacterial infection

The nurse is conducting a community education class on acute otitis media. Which statement by the participants indicates to the nurse that they understand the education?

It can be caused by a bacterial infection.

Conductive hearing loss can occur for a variety of reasons, including foreign bodies in the ear canal, damage to the ear drum, or disease. What disease is associated with conductive hearing loss?

Paget Disease

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 be suffering from:

Receptive aphasia

A client states that she is often "nauseous and sweaty" when she rides in the back seat of a car. The nurse should explain to the client that her symptoms are caused by which physiologic finding?

Repeated rhythmic stimulation of the vestibular system.

The nurse is assessing a client who came into the physician's office complaining of the room spinning every time the he lies down in bed and also after head movement. The physician suspects the client is suffering from benign paroxysmal positional vertigo (BPPV). The nurse prepares the client for canalith repositioning. Which of the following does this involve?

Several repositioning maneuvers to reposition the otoliths

A young child is flying on a plane for the first time. As the plane begins its decent 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 the air pressure to equalize in the inner ear.

Which condition or situation is a risk factor for the development of acute otitis media in a child?

upper respiratory infection

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

A Weber (tuning fork) test

The nurse is caring for a client who reports, "My ears are constantly ringing!" The nurse will evaluate the client further for the use of which medication?

Acetylsalicylic acid (aspirin)

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 72-year-old client admitted with congestive heart failure tells the nurse that lately he has been having difficulty hearing in the left ear. Which intervention should the nurse implement?

Assess for build up of cerumen

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

A client expresses concern about feeling fullness in the ear. Which additional manifestation leads the health care provider to suspect Ménière disease?

Rotary Vertigo and Tinnitus

The nurse is discussing measures that a client may take to prevent barotrauma related to airplane travel. Which measure will the nurse recommend during changes in air pressure?

Swallowing

A nurse working in a clinic performs screening tests for hearing loss. Which result indicates the client has hearing loss?

The client heard bone conduction longer than air conduction in the Rinne test.

The nurse is preparing a pediatric client for insertion of a tympanostomy tube. The nurse will give which instruction to the parents postprocedure?

The ears must be kept out of water

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

an illusion of motion

The nurse is explaining to the parent of a 5-year-old that the child has otitis media with effusion (OME), noted by otoscopic exam, following an upper respiratory infection. Unlike acute otitis media (AOM), OME does not require treatment with antibiotics because it is usually:

asymptomatic and often self limiting

The nurse is caring for a client whose hearing is impaired due to impacted earwax. The nurse understands that the associated deafness is due to:

conduction disorder

A client tells the nurse that he has hearing loss due to otosclerosis. The nurse realizes that the client has which of the following?

conductive hearing loss

Which cranial nerve is designated as the vestibulocochlear nerve?

cranial nerve VIII

A client's chart documents the finding of cholesteatoma. The nurse interprets this to mean that the client has:

cystlike mass in the middle ear

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

vertigo

While assessing a client with suspected Ménière disease, the nurse would expect which clinical manifestation?

vertigo

The nurse understands that movement of otoliths may result in:

vertigo and nystagmus

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

vestibular apparatus