Patho chapter 20
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."
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 some exercises that I'll teach you to help reorient your inner ear and prevent vertigo."
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?
A lifestyle change that would be recommended for a client with Meniere disease is to consume a low sodium diet, related to the medication treatment (diuretics).
The nurse is admitting a client to the acute medicine unit and is reviewing the results of the medication reconciliation. The nurse should recognize which drugs as having the potential for ototoxicity? Select all that apply.
A loop diuretic Aspirin
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?
A surgical method to treat Meniere disease includes the creation of an endolymphatic shunt in which excess endolymph from the inner ear is diverted into the subarachnoid space or the mastoid area. This relieves symptoms associated with Meniere disease, such as 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 is the most common cause of pathologic vertigo and usually develops after the fourth decade of life.
What is the nursing focus when the nurse performs a hearing test on a newborn infant?
Early detection of hearing loss can prevent developmental delay by allowing early intervention. The hearing test on a newborn evaluates the physical ability to respond, not the ability to perform language or communication skills. The test records the infant's ability to perceive sound but does not improve it.
To diagnose a vestibular disorder, which test would be used that assesses the eye movements in response to vestibular, visual, and positional stimulation?
Electronystagmography
For which type of hearing loss should the nurse assess in a child who has had recurrent otitis media since birth?
Hearing loss that is associated with recurrent otitis media is conductive loss.
A client reports occasional ringing in the ears that worsens toward the end of the day. The most important question for the nurse to ask would be:
Medications and stimulants, such as aspirin, caffeine, and nicotine, can cause tinnitus. The client should be questioned to determine if this is a potential cause.
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 caring for a client who has been diagnosed with Meniere disease. The nurse expects which medication will be prescribed to manage the symptoms?
Pharmacologic management includes suppressant drugs such as promethazine
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?
Presbycusis is used to describe degenerative hearing loss that occurs with advancing age. It is characterized by high-frequency hearing loss.
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
Acoustic neuroma tumors affect cranial nerve VIII and are made up of which type of cells??
Schwann cells
What are the clinical manifestations of Ménière disease? Select all that apply.
Severe ringing in the ear(s) Feeling of fullness in the ear(s) Episodes of disabling vertigo Dizziness triggered by turning the head
When a client reports that he feels like he is spinning but the room is stable, the nurse should document the finding as:
The description of feeling like one is spinning but the room is stable is a common description of subjective vertigo.
A client is having difficulty with balance. The nurse understands that the area of the ear that impacts balance is:
The vestibular system maintains and assists recovery of stable body and head position and balance through control of postural reflexes. The vestibular system includes the three semicircular canals.
A 2-year-old child who has had otitis media (OM) for 4 months and been treated with several courses of antibiotics now appears to have some hearing loss. The nurse anticipates that the most appropriate treatment for the child would be:
Tympanostomy tubes should be the next course of action with the child having hearing loss and OM persisting for 4 months or longer. The parents should be taught to continue to monitor for signs of OM.
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?
cute otitis media is characterized by the following key criteria: acute onset of otalgia (or pulling of the ears in an infant), fever, hearing loss, evidence of middle ear inflammation, and middle ear effusion.
The nurse understands that movement of otoliths may result in:
vertigo and nystagmus.
