Chapter 43: Caring for Clients with Ear Disorders

A client diagnosed with arthritis has been taking aspirin and now reports experiencing tinnitus and hearing loss. What should the nurse teach this client?

The hearing loss will likely resolve with time after the drug is discontinued.

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

Vertigo

The nurse is talking with a patient diagnosed with Ménière's disease about the patient's symptoms. What symptom does the patient inform the nurse is the most troublesome?

Vertigo

Which manifestation is the most problematic for the client diagnosed with Ménière disease?

Vertigo

Which instructions regarding swimming should the nurse give to a client who is recovering from otitis externa? Select all that apply.

Wear soft plastic earplugs.

A nurse is preparing a presentation for a local community about hearing loss and prevention. Which of the following would the nurse integrate into the presentation as the most effective preventive measure?

Wearing ear protection when exposed to noise

A nurse needs to change a dressing on an abdominal wound for a patient who is hearing-impaired and whose speech is difficult to understand. Which of the following is the best approach for the nurse?

Write down the steps of the procedure for the patient to read before beginning the treatment.

Loud, persistent noise has been found to cause which symptoms? Select all that apply.

constriction of peripheral blood vessels.

Acoustic neuromas are benign tumors of which of the following cranial nerves?

eighth cranial nerve = VIII

A client is diagnosed with a conductive hearing loss. When performing a Weber test, the nurse expects that this client will hear sound:

on the affected side by bone conduction.

A client has been diagnosed with otosclerosis. The nurse explains to the client that this is a common cause of hearing impairment among adults and is the result of a bony overgrowth of the:

stapes

Which of the following is the treatment of choice for acoustic neuromas?

surgery

A client who has a lengthy history of progressive hearing loss is very forthright about the condition, and the nurse wants to develop a communication strategy for this client's hospital stay. Which communication strategy has proven to be the most effective?

the one the client will use

Instructing a class of sixth graders on the importance of protecting their hearing by avoiding excessive noise, the nurse lists the activities that can destroy hearing. On the list are loud concerts, loud mP3 player volume, loud headphones, etc. The nurse also indicates the signs of hearing impairment so the students can help protect their friends. What are signs of diminished hearing? Select all that apply.

• Turning the head• Asking for words to be repeated

Which precautions should the nurse take when a client is at risk of injury secondary to vertigo and probable imbalance?

Grasp the siderails when rising to a standing position.

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?

"Don't fly in an airplane, climb to high altitudes, make sudden movements, or expose yourself to loud sounds for 30 days."

Which condition is characterized by the formation of abnormal spongy bone around the stapes?

Otosclerosis

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.

The nurse is discharging a client home after mastoid surgery. What should the nurse include in discharge teaching?

"Don't blow your nose for 2 to 3 weeks."

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 some fluid that has collected in your middle ear but no infection."

A client with otosclerosis is having surgery to have a prosthesis inserted to help restore hearing loss. The nurse meets with the client prior to surgery to review what to expect after surgery. What would the nurse include? Select all that apply.

"You will be positioned on the nonoperative side." "Facial nerve function will be assessed by checking symmetry when you smile or frown."

High doses of which medication can produce bilateral tinnitus?

Aspirin

The nurse and a colleague are performing the Epley maneuver with a client who has a diagnosis of benign paroxysmal positional vertigo. The nurses should begin this maneuver by performing what action?

Assisting the client into a sitting position

After mastoid surgery, an 81-year-old client has been identified as needing assistance in her home. What would be a primary focus of this client's home care?

Assisting the client with ambulation as needed to avoid falling

Which instruction regarding swimming should the nurse give to the client who is recovering from otitis externa?

Avoid swimming for 7-10 days

Health teaching for a patient who suffers from motion sickness would include recommending the use of which one of the following over-the-counter drugs?

Dramamine

A nurse practitioner in an emergency room receives a telephone call from a mother whose 4-year-old child has a mosquito stuck in his external ear canal. Which of the following is the best information the nurse could give the mother?

Instill a few drops of warmed mineral oil to cover the insect.

The nurse is caring for a client who has undergone a mastoidectomy. In an effort to prevent postoperative infection, what intervention should the nurse implement?

Instruct the client to protect the ear from water for several weeks.

Which are correct methods for removing a foreign body from the ear? Select all that apply.

Irrigation

The nurse is developing a plan of care for a client with Meniere's disease and identifies a nursing diagnosis of excess fluid volume related to fluid retention in the inner ear. Which intervention would be most appropriate to include in the plan of care?

Limit foods that are high in sodium.

Hearing aids help with which of the following problems?

Makes sounds louder

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)

A client comes to the emergency department, reporting that a bee has flown into his ear and is stuck. The client reports a significant amount of pain. Which of the following would be most appropriate to use to remove the bee?

Mineral oil

Which of the following describes vertigo? Select all that apply.

Objects are moving around him or her Misperception of motion Spinning sensation

A client is experiencing vertigo. Which nursing interventions would be included in the client's plan of care? Select all that apply.

Place pillows on each side of the head to restrict movement. Instruct the client to lie down; apply side rails to bed. Encourage the client to express feelings associated with condition.

Which terms refers to the progressive hearing loss associated with aging?

Presbycusis

Which of the following nursing interventions would most likely facilitate effective communication with a hearing-impaired client?

Reduce environmental noise and distractions before communicating.

A nurse is practicing within a pediatric medicine group. What can the nurse do to maintain hearing within the pediatric client base?

Reduce frequency and severity of ear infections.

A client with a sudden onset of hearing loss tells the nurse that he would like to begin using hearing aids. The nurse understands that the health professional dispensing hearing aids would have what responsibility?

Refer the client to his primary care physician.

Which test uses a tuning fork shifted between two positions to assess hearing?

Rinne

Which nursing diagnosis takes highest priority for a client admitted for evaluation for Ménière's disease?

Risk for injury related to vertigo

Which symptom is related to vertigo?

Spinning sensation

Which statement describes benign paroxysmal positional vertigo (BPPV)?

The vertigo is usually accompanied by nausea and vomiting.

Which term refers to surgical repair of the tympanic membrane?

Tympanoplasty

A client who is a competitive swimmer is diagnosed with swimmer's ear (otitis externa). Which instruction would be least appropriate for the nurse to include when teaching the client about this condition?

Use a hair dryer set on high to dry the ear canal after swimming.