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Ear Disorder Dx
- Otoscopy: visualize auditory canal and tympanic membrane
- Voice test: 1-2 feet away and whisper
- Tuning fork tests: Weber & Rinne to determine conductive or sensorineural
- Audiometry: test in sound proof booth (different pitches and volumes)
- Vestibular
- --The Romberg: measures balance and equilibrium
- --Past-point: identifies coordination problems
- --Caloric: evaluates vestibular function
- Tympanometry: distinguishes middle ear disorders
- MRI / X-Ray
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Ear Medication Administration
- Adult: Pinna up and back
- Child: Pinna down and back
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Medications - Infections
PO or into ear (octic use only)
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Medications - Vertigo
- Anticholinergic/antihistime
- Side effects: drowsiness, blurred vision, dry mouth
- Nursing care: safety prec, avoid alcohol/CNS depressants, no pregnancy
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Hearing Loss
- Most common disability in US
- Affects speech development/intelligence
- Speak in normal voice
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Conductive Deafness
- Interference in sound waves
- Ear wax most common cause
- Also perforated ear drum, otitis media, otosclerosis, congenital, foreign boy
- Hearing is present but dimnished - need increased volume
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Sensorineural Deafness
- Degeneration of nerve sensory cell - disturbance of inner ear or transmitting nerve
- Caused by trauma, age, ototoxic drugs, childhood diseases, congenital defects, tumors
- Hearing may be present - hearing aid
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Mixed Deafness
Conductive and Sensorineural
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Functional Hearing Loss
- No organic cause
- Psychogenic
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Central Deafness
- Caused by the brain's inability to interpret the information
- Due to brain injury or stroke
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Deafness S/S
- Hearing assessment
- Loss of high pitched sounds
- Ask about hearing habits
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Deafness Dx
- Weber & Rinne
- Audiometric testing
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Deafness Treatment
- Hearing aids - increase volume
- Cochlear implants
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Cochlear Implants
- Used with sensorineural hearing loss
- Gives sounds (noises like alarms, sirens), not full hearing
- For someone who used to have hearing, remembers sounds
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Mastoiditis
- Inflammation of mastoid sinusus
- Secondary to middle ear infection
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Mastoiditis S/S
- Earache
- Fever
- Headache
- Malaise
- Drainage
- Pain behind ear
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Mastoiditis Treatment
- Antibiotics PO (may be longer than 10 days) or IV if difficult to treat
- Mastoidectomy: sinuses scraped to clear out infection
- Chronic infection - hearing loss
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Mastoiditis Nursing Care
- No bending 2-3 weeks
- Position affected side down
- Avoid constipation
- No flying 4 weeks
- No water in ear
- Monitor drainage
- Monitor for hearing loss
- Antibiotic side effects
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Labrynthitis
Inner ear infection
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Labrynthitis S/S
- Dizziness
- Headache
- Uncoordination
- N&V
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Labrynthitis Nursing Care
- Safety precautions due to dizziness
- N&V
- Dehydration and electrolyte imbalance
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Otosclerosis
Spongy bone around stapes prevent impulses from getting to oval window
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Otosclerosis S/S
- Progressive hearing loss
- Begins in teen years
- Dizziness
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Otosclerosis Treatment
Stapedectomy: remove of stapes/insertion of tissue or prosthesis
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Otosclerosis Nursing Care
- Reduced activity
- Affected side up
- Manage dizziness
- Assess for headache
- Monitor for infection
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Meniere's Disease
Increase of fluid in the inner ear due to overproduction or improper drainage
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Meniere's Disease S/S
- Severe nausea
- Dizziness
- Tinnitus
- Nystagmus
- S/S come and go
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Meniere's Disease Treatment
- Duiretics
- Reduced sodium
- Antivertigo meds
- Insertion of bypass tube
- Surgery to destroy inner ear (causing deafness)
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Meniere's Disease Nursing Care
- Antiemetics
- Low salt diet
- Calm environment
- Get up slowly
- Risk for injury
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