ears

Question 1

removing cerumen steps

Answer 1

1. fill w warm water and aim toward roof of canal
2. hold head at 20 degree angle and use gentle even pressure
3. if painful, decrease pressure or stop

Question 2

voice test

Answer 2

block 1 ear, stand 2 ft away and whisper

Question 3

conductive loss

Answer 3

obstruction of sound wave transmission

Question 4

sensorineural loss

Answer 4

defect in the cochlea, 8 cranial nerve, or brain-

Question 5

weber test

Answer 5

place fork in middle of head and indicate wh ear sound is louder

Question 6

Rinne test

Answer 6

compares hearing between air and bone conduction
-place fork on mastoid process and ask when no longer heard then quickly move fork to front of pinna until no longer heard

Question 7

hyperacusis

Answer 7

the intolerance for sound levels that don’t bother other people

Question 8

risk factors for hearing loss

Answer 8

air travel, swimming, vitilligo, smoking, B12/folate def, hypothyroidism, atherosclerosis, ototoxic drugs

Question 9

ototoxic drugs

Answer 9

“mycin” antibiotics, lasix, NSAIDS, chemo, aspirin (especially w poor kidney function)

Question 10

test prep

Answer 10

no food several hours before, no caffiene 24-48 hrs before, carefully introduce liquids after

Question 11

external otitis

Answer 11

swimmers ear, comfort measures-apply heat x3/day, minimal head movement, after inflammation solution w 50% rubbing alcohol 25% white vinegar and 25% distilled water

Question 12

common ototoxic sign

Answer 12

tinnitis

Question 13

otitus media

Answer 13

don’t wash hair or shower for several days, keep clean and dry

Question 14

otitis media clinical implications

Answer 14

inflammation of mucosa, pain, conductive hearing loss, distorted/dizzy/tinnitis, systemic manifestations

Question 15

recovery from ear surgery

Answer 15

1. avoid: straining, straws, air travel, resp infection, showers, rapidly moving head
2. when blowing nose-gentle, don’t block nostril, mouth open
3. keep ear dry w cottonball w vasoline-change daily
4. report excessive drainage to HCP

Question 16

dizziness

Answer 16

disturbed sense of a person’s relationship to space

Question 17

vertigo

Answer 17

a sense of whirling or turning in space

Question 18

rn teach when dizzy

Answer 18

restrict head motion, move slow, take meds to decrease effects

Question 19

meniere’s disease

Answer 19

move head slow, no smoke, hydrops diet, pressure pulse therapy, drugs (mild diuretics, nicotine acid, antihistamines)

Question 20

conducive hearing loss causes

Answer 20

• foreign body, perferated tympanic mem, edema, cerumen, infection of middle/external ear, tumor, otosclerosis

Question 21

sensorineural hearing loss causes

Answer 21

loud noise, presbycusis, ototoxic substance, menieres disease, acoustic neuroma, DM, labrynthitis, infection, myxdema

Question 22

conducive hearing loss assessment findings

Answer 22

evidence of obstruction, abnormal tympanic membrane, speaking softly, hears best in noisy environment, rinne test (air better than bone), weber test (lateralization to affected ear)

Question 23

sensorineural hearing loss assessment findings

Answer 23

normal external canal/membrane, tinnitis common, occasional dizziness, speak loudly, hear poor in loud environment, rinne test (air less than bone), weber test (lateralization to unaffected ear)

Question 24

tympanoplasty rn care

Answer 24

keep pt flat w head turned operative side up for 12 hrs post surgery

Question 25

stapedectomy rn care

Answer 25

hearing improvement may not occur for 6 wks, assess for facial nerve damage or muscle weak, asymmetric/drooping features, ask about changes in facial perception of touch and taste, assist w ambulaion, move head slow

Question 26

communication w hearing impaired

Answer 26

stand directly in front of pt, well lit quiet room, have pt attention, direct speech to better ear, don’t shout, have pt repeat statements

Question 27

adaptations for age-related hearing loss

Answer 27

speak in deep voice and emphasize beginning word sounds, use visual aids

Question 28

hearing aid care

Answer 28

keep dry, clean debris, avoid dropping, adjust volume to lowest setting, avoid hairspray etc.