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Module 4 (MedSurg 2) > Sensory - Auditory > Flashcards

Sensory - Auditory Flashcards

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1
Q

Sensory Perception

A

the ability to receive sensory input and translate the stimulus/data into meaningful information

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2
Q

Why is sensory perception important in nursing care?

A

understand what you are asking and listening to them
Safety environment such as streets

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3
Q

What are the 12 cranial nerves in order?

A

Olfactory
Optic
Oculomotor
Trochlear**
Trigeminal
Abducens**
Facial**
Auditory (vestibulocochlear)
Glossopharyngeal
Vagus
Accessory
Hypoglossal

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4
Q

Cranial Nerve Function
OLFACTORY

A

smell (not usually tested)

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5
Q

Cranial Nerve Function
OPTIC**

A

Visual acuity

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6
Q

Cranial Nerve Function
OCULOMOTOR**

A

Opening of eyelids, eye mvmt (upward/medial, upward/lateral, medial, downward/lateral)

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7
Q

Cranial Nerve Function
TROCHLEAR**

A

eye mvmt (downward/medial)

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8
Q

Cranial Nerve Function
TRIGEMINAL

A

facial sensation, chewing mvmts

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9
Q

Cranial Nerve Function
ABDUCENS**

A

eye mvmt (lateral)

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10
Q

Cranial Nerve Function
FACIAL**

A

facial muscles mvmt (except chewing muscles) and eyelid closing

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11
Q

Cranial Nerve Function
AUDITORY (VESTIBULOCOCHLEAR)

A

hearing and balance

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12
Q

Cranial Nerve Function
GLOSSPHARYNGEAL

A

taste on the posterior 3rd of the tongue (not usually tested)

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13
Q

Cranial Nerve Function
VAGUS

A

Uvula (palate muscles) and swallowing

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14
Q

Cranial Nerve Function
ACCESSORY

A

shoulder shrug

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15
Q

Cranial Nerve Function
HYPOGLOSSAL

A

tongue mvmt

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16
Q

If you have mild hearing loss, you may not be able to hear

A

birdsongs

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17
Q

If you have moderate to severe hearing loss, you may not be able to hear

A

Conversation (moderate)
Phone (more severe)

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18
Q

If you have profound hearing loss, you may not be able to hear

A

cars and planes

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19
Q

What technique would you use when educating a pt with withdrawn hearing loss?

A

Teach Back “repeat back what I said?”

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20
Q

Hearing Loss
BROAD S/S

A

Ineffective communication leads to
decrease interaction
-withdraw (only nods and smiles)
-suspicion (who are you? - no nurse-pt relationship)
-loss of self-esteem (no autonomy)
-insecurity

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21
Q

If a hearing loss pt is suspicious of you, what way of communicating is effective?

A

writing and drawing
ALS if possible
ask family to stay

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22
Q

Conductive hearing loss occurs causes damage to what parts of the ear?

A

outer and middle

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23
Q

Sensoriurineal hearing loss occurs causes damage to what parts of the ear?

A

inner ear (nerve pathways)

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24
Q

Sensorineural hearing loss is damage to what cranial nerve?

A

8 vestibulocochlear

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25
Mixed hearing loss occurs causes damage to what parts of the ear?
outer and middle ear ALSO inner ear damage
26
Otoscope
shines light to **visualize and examine** the condition of the **ear canal and drum** -shows causes of symptoms (ache, full, or hearing loss)
27
How do you assess for hearing loss?
Otoscope weber's Rinne's
28
Weber's test process
Strike a tuning fork and place on the forehead an equal distance between both ears - Assess the hearing difference and which one is weaker
29
Weber's test Results **Equal sounds in Both Ears**
Normal hearing
30
Weber's test Results **Sound is heard best in the abnormal ear**
Conductive loss
31
Weber's test Results **Sound will be heard best in the normal ear**
Sensorineural
32
Rinne's test
- differentiates sound transmission via air conduction or bone conduction -done with Weber for sensorineural hearing loss - Quick test for conductive hearing loss
33
Rinne's test Results **bone >/= air conduction**
Conductive hearing loss on that side
34
Rinne's test Results **air >/= bone conduction**
Normal hearing
35
What do you assess for on a auditory impaired pt?
tinnitus (ringing ears) vertigo (spins while still)
36
If you have vertigo, what precaution needs to be taken?
high fall risk - slow rise, **someone in the room every time they get up**, fall bundle PT work with them, patience, bed alarm
37
Otitis media w/ effusion
fluid or inflammation in the ear **peds more than adults**
38
**Poor** Eustachian tube function
No draining of fluid for balance
39
Cerumen
earwax
40
What is a serious adverse reaction of tinnitus?
Suicide idealization and attempts leads to conductive hearing loss
41
Vertigo precautions
high fall risk
42
Vertigo can happen due to which diseases?
43
Conductive hearing loss reasons
Otitis media w/ effusion (fluid or inflammation in the ear) Poor Eustachian tube function (no draining of fluid for balance) impacted cerumen - earwax tumors/objects present middle ear disease otosclerosis **Something is blocking the path of sound from entering the ear drum**
44
Middle ear disease
Chronic otitis media (inflammation of the ear of the middle ear leading to a build-up of fluid behind the eardrum)
45
What is the proper way to educate pts on cleaning their ears?
put hydrogen peroxide in their ears -not QTips-
46
Otosclerosis
genetic problem preventing sounds from being transmitted due to bony overgrowth of tissue
47
Patients actually hear better in noisy environments
Bone is better than air conduction **Conductive Hearing loss**
48
Conductive hearing loss tx
underlying cause recommend hearing aid
49
Conductive patients hear better with
bone than air conduction noisy environments
50
What is the most common type of permanent hearing loss?
Sensorineural
51
Can medicine and surgery fix sensorineural hearing loss?
no
52
Sensorineural hearing loss is caused by
illness genetic (cranial nerve damage) **loud noise** - occupational (MRI, planes) - earplugs **ototoxicity permanent hearing loss through meds** aging – presbycusis
53
What 6 drugs and classes cause sensorineural?
Vancomycin - antibiotic IV Gentamycin - antibiotic IV Cisplatin - CA med Furosemide - loop diuretic Quinine - malaria Aspirin - fever reducer
54
What should you tell the pt when giving them Vancomycin and Gentamycin through IV?
Notify me immediately to stop the infusion if you are experiencing ringing in your ears - Better to catch it early than for hearing loss to be permanent
55
Presbycusis means
**Elderly hearing loss**
56
Presbycusis can cause
sensorineural loss
57
Presbycusis leads to =
- degeneration atrophy of the ganglion cells in the cochlea - compromised vascular supply of the inner ear
58
What is the most common type of permanent hearing loss?
Sensorineural
59
Can surgery and medicine fix sensorineural hearing loss?
NO
60
Meniere's syndrome S/S
tinnitus fluctuating hearing loss (unilateral sensorineural hearing loss) vertigo
61
How long does Meniere's s/s last
hours to days
62
Can Meniere's cause permanent hearing loss?
**Yes over time** if attacks are frequent enough - and gets lengthier over time
63
Meniere's syndrome assessment
feelings of fullness in the ear tinnitus vertigo N/V **nystagmus severe HA**
64
Nystagmus
eye vibrating back and forth
65
Meniere's syndrome is
dilation of the endolymphatic system by overproduction or decreased reabsorption of the endolymphatic fluid
66
Meniere's syndrome interventions
Prevent injury due to vertigo Fall Bundle Bed rest Quiet environment assist with ambulation - PT vestibular rehab Move head slowly - not sharp **Na and fluid restriction** stop smoking **Avoid watching TV with flickering lights** control N/V **Mild diuretics for fluid volume**
67
Meniere's syndrome surgical interventions
Drill out bone and leave shunt to balance fluid Drill around the bone and insert a clip Most severe = cut Nerve #8
68
Meniere's syndrome post-op interventions
packing and dressings on ear speak on the unaffected side pt safety **Perform neuro examinations** assist with ambulation bedside commode antivertigo and antiemetic meds as prescribed
69
Nursing Care for Hearing loss
asess = early detection **difference btw sensorineural and conductive hearing loss** - for tx Safety measures = educate and teach back if unable tell caregiver discharge plan Dietary = nutrition and **hydration** Medication = when to continue Surgery = **hearing aides (clean and change) - DOCUMENT** Community resources = Case Mgrs Communication tech **LOW AND SLOW** Do not yell
70
2. What is Cranial nerve #8 responsible for?
a. Auditory (vestibulocochlear) is responsible for balance and hearing.
71
3. What clinical manifestations are associated with hearing loss?
a. Ineffective communication, Decreased interaction, withdrawal, suspicion, loss of self-esteem and insecurity.
72
4. How do you check if a patient with hearing loss understood what you were communication to them?
a. Have the patient teach back. Also, have a family/friend at bedside to also get education.
73
5. What part of the ear is affected if the patient has conductive hearing loss?
a. Outer and middle ear
74
6. What part of the ear is affected if the patient has sensorineural hearing loss?
a. Inner ear damage (nerve pathways)
75
7. What are two of the priority symptoms that we are assessing for with hearing loss that is caused by compression of cranial nerve #8?
a. Tinnitus and vertigo
76
8. What is tinnitus and what is your priority assessment for the patient suffering with tinnitus?
a. Ringing of the ears can cause suicidal ideation.
77
9. What is Vertigo and what is your priority assessment for the patient suffering with vertigo?
a. Room is spinning while the patient is still. Patient is a high fall risk.
78
10. What are the some of the causes of Conductive hearing loss?
a. Otitis media with effusion, poor eustachian tube function, impacted cerumen, tumors, objects present, middle ear disease, otosclerosis
79
11. What are some of the causes of Sensorineural hearing loss?
a. Illness, genetics, loud noises, ototoxicity, and aging
80
12. What medications cause ototoxicity in sensorineural hearing loss?
a. 1. Vancomycin 2. Gentamycin 3. Cisplatin 4. Aspirin 5. Furosemide 6. Quinine
81
13. True or false: Sensorineural is permanent hearing loss that cannot be fixed by surgery or medicine?
true
82
14. What is Meniere’s disease?
a. Refers to the dilation of the endolymphatic system by overproduction or decrease reabsorption of endolymphatic fluid. (Basically, too much fluid causing pressure on cranial nerve #8.
83
15. What treatments can be done for a patient with Meniere’s disease?
a. Mild diuretics, vestibular rehabilitation, surgery.
84
16. What communication technique is the most effective for a patient with hearing loss?
a. Talk Low and Slow. Can also use written instructions for patient.

Module 4 (MedSurg 2) (36 decks)

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