Hearing- assessment skills
Acute and chronic otitis media
Meniere's disease
Hearing loss
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| 1289962000 | otoscopic examination | inspect tympanic membrane steady the hand to avoid inserting it too far auricle is grasped and pulled back to straighten canal tympanic membrane should be pearly grey note presence of fluid, bubbles, blood or masses free of cerumen - irrigate with warm water | 0 | |
| 1289962001 | cerumen buildup is a common cause of | hearing loss and local irritation | 1 | |
| 1289962002 | whisper test | exclude one ear from testing whispers 30 - 60 cm from nonocluded ear and out of pts sight two words or numbers with accented syllables pt repeats | 2 | |
| 1289962003 | weber test normal conductive hearing loss sensorineural hearing loss | use bone conduction to assess lateralization of sound tuning fork tapping it on knee or hand ad placed midline on pts head or forehead *- will hear it in both ears or describe sound as in middle of head - hears the sound better in the affected ear (hearing loss) - hears the sound in the better hearing ear* | 3 | |
| 1289962004 | rinne test normal conductive hearing loss sensorineural hearing loss | *distinguishing between conductive hearing loss and sensorineural hearing losses* shifts stem of a vibrating tuning fork between two positions - mastoid bone and opening of ear canal when the tone is no longer heard the examiner shifts the tuning fork to the opening of the ear canal and asks the pt if the tone is audible - air conduction is audible longer than bone conduction - sound heard as long or longer in affected ear (hearing loss) - air conduction is audible longer than bone conduction in affected ear | 4 | |
| 1289962005 | hearing screening | Hearing Handicap Inventory for the Elderly (HHIE-S) 5 min - 10 item questionnaire *Assesses how the pt perceives the social and emotional effects of hearing* If hearing is perceived as a problem they are more likely to accept testing and hearing devices The higher the score the greater the greater the handicapping effect of a hearing impairment Audiology referral if score 10 or more | 5 | |
| 1289962006 | outer ear | responsible for collecting, conducting, and amplifying sound waves | 6 | |
| 1289962007 | middle ear | functions include pressure equalization and amplification of sound waves | 7 | |
| 1289962008 | inner ear | two main functions are hearing and equilibrium | 8 | |
| 1289962009 | acute otitis media | acute infection of middle ear lasting less than 6 weeks | 9 | |
| 1289962010 | causes of AOM | strep pneum, haem influenza, contaminated nasopharynx secretions | 10 | |
| 1289962011 | manifestations of AOM | Unilateral pain in the ear. pain/pressure tinnitis (ringing) purulent exudate otalgia (ear ache or pain) otorrhea (drainage) fever / malaise otoscopic reslts - noral tympanic membrane - red and bulging | 11 | |
| 1289962012 | medical management of AOM | can last 3 weeks to 3 months with persistent discharge Systemic antibiotics Analgesics Local heat Antipyretics Antihistamines Decongestants Myringotomy - | 12 | |
| 1289962013 | Myringotomy | incision of tympanic membrane local anaesthetic painless less than 15 minutes heals within 24 - 72 hours appropriate antibiotic therapy | 13 | |
| 1289962014 | chronic otitis media | repeated episodes of acute otitis media causing irreversible tissue and persistent perforation of tympanic membrane and osicles | 14 | |
| 1289962015 | manifestations of COM | minimal degree of hearing loss *persistent and foul smelling otorhea no pain cholesteatoma* - ingrowth of the skin of external layer of eardrum into middle ear making a sac - may cause hearing loss, facial pain, paralysis, tinnitus, vertigo chronic mastoiditis | 15 | |
| 1289962016 | medical management of COM | local treatment of chronic otitis media consists of careful suctioning of the ear under microscopic guidance antibiotic drops or powder for purulent discharge systemic antibiotics are usually not prescribed except in cases of acute infection | 16 | |
| 1289962017 | mastoidectomy | to remove cholestatoma create dry and healthy ear through incision the facial nerve is at risk for injury (not a lot) | 17 | |
| 1289962018 | nursing interventions for mastoidectomy | reduce anxiety - reinforce information - expected surgical result - prescribed analgesic taken for first 24 hours after surgery and then prn even though there may be minimal pain - a tympanoplasty may be performed after sx and may experience sharp, shooting pain for 2 to 3 weeks after - pressure dressing removed 24 - 48 hours after surgery - constant throbbing and fever - see doctor - prevent water from entering external canal for 6 weeks (cotton ball with petroleum jelly) - keep post auricle inciscion dry for 2 days - some normal serosanguinous drainage from canal is normal - report facial nerve weakness - avoid heavy lifting, nose blowing 3 weeks | 18 | |
| 1289962019 | conductive hearing loss causes | - external ear disorder -an inability of the sound waves to reach the inner ear Cerumen Foreign body Perforation of TM Edema Tumors Infection Otosclerosis | 19 | |
| 1289962020 | sensorineural hearing loss causes | damage to the cochlea or vestibulocochlear nerve - abnormality or disease of the inner ear or cochlear portion of cranial nerve VIII Prolonged exposure to noise Presbycusis Ototoxic substances Meniere's Disease Acoustic Neuroma DM Infection | 20 | |
| 1289962021 | NIHL | noise induced hearing loss Loss can be sudden, as with acoustic trauma from an explosion. More often a gradual onset that may go unnoticed. NIHL also known as noise induced permanent threshold shift (NIPTS), typically takes *years of exposure*, gradual erosion of hearing that eventually affects communication. Risk of noise-induced progression stops if no longer in noise exposed, but aging invariably worsens loss For most, aging effects aren't significant before age 50+ | 21 | |
| 1289962022 | 4ps NIHL | Painless Progressive Permanent Preventable | 22 | |
| 1289962023 | conductive hearing loss manifestations | Obstruction Abnormal TM Person speaks softly Hearing best in noisy environment | 23 | |
| 1289962024 | sensorineural hearing loss manifestations | N appearance tinnitus/dizziness person speaks loudly hearing best in quiet environment | 24 | |
| 1289962025 | treatment of conductive hearing loss | temporary and/or treatable with antibiotics or surgery For those few people who have uncorrectable conductive hearing losses- hearing aids | 25 | |
| 1289962026 | treatment of sensorineural hearing loss | occur in the inner ear and are almost always permanent and untreatable. Hearing aids will benefit most people with sensori-neural loss, but results can vary. | 26 | |
| 1289962027 | Stapedectomy | Partial or complete stapedectomy with a prosthesis (otosclerosis) for conductive hearing loss | 27 | |
| 1289962028 | Tympanoplasty | Reconstructs the middle ear to improve hearing from conductive loss for conductive hearing loss | 28 | |
| 1289962029 | tympanoplasty preop | Systemic antibiotics Avoid sick people Initial hearing loss normal b/c of packing DB and light coughing | 29 | |
| 1289962030 | Postop tympanoplasty | Packing in ear canal Head flat Operative ear up for at least 12h postop Antibiotics Communicate as with hearing impaired | 30 | |
| 1289962031 | preop Stapedectomy | Systemic antibiotics Avoid sick people Initial hearing loss worse Risks Deafness, vertigo infection, facial nerve damage DB and light coughing | 31 | |
| 1289962032 | postop tapedectomy | Improvement in hearing in 6wks (edema) Damage to cranial nerves VII, VIII and x Vertigo, N and V common Postop teaching | 32 | |
| 1289962033 | Recovery from Ear Surgery | Avoid straining for BM/excessive coughing No straws x 2-3 wks No air travel x 2-3 wks Blow nose one side at a time with mouth open Keep ear dry /c cotton ball coated /c vaseline (change daily) Avoid rapid head mov't and bending over x 3 wks Report excessive ear drainage to MD Telecommunication for the deaf (TDD) | 33 | |
| 1290380676 | merniers disease symptoms | that affects the inner ear. It causes attacks of dizziness (vertigo), nausea and vomiting, a feeling of fullness in the ear, hissing and roaring in the ears, and some hearing loss. | 34 | |
| 1290380677 | cause of Ménière's disease | unknown. The symptoms are believed to be related to having too much fluid in the inner ear. possible blockge in endolymphatic duct | 35 | |
| 1290380678 | medical management of menieres disease | most pts can be treated with diet and meds antihistamines diazepam for vertigo antiemetics diuretic therapy intake foods containing alot of potassium if the pt is taking a diuretic | 36 | |
| 1290380679 | Diet for menieres disease | no aspirin containing meds limit foods high in salt and sugar eat meals and snacks at regular intervals no alcohol lots of water avoid MSG | 37 |
