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Ear Disorders

Nursing Care of ear disorders

QuestionAnswer
Ear anatomy External-from pinna to tympanic membrane; Middle-includes TM, malleus, incus, stapes; Internal-semicircular canals, cochlea, eustachian tube, nerve
Ear trauma *Do NOT remove object *stabilize in place to lessen further damage *seek medical attention *assess cranial nerves
Conductive hearing loss: External ear blockage check for cerumen, irrigate c warm water aim at top of ear canal (cold water cases dizziness, n/v), caution in perforated ear drum
Conductive hearing loss: Otosclerosis *stapes becomes hardened and doesn't carry waves *familial *usually in females around 20 yrs *tx: surgical implantation of artificial stages (works like a piston)
Sensorineural hearing loss: Noise induced loss *damage to cochlea (noise induces, limit exposure to headphones) *Ototoxic drugs-abx (-mycins) *diuretics-rapid IV lasix <10cc/min always dilute c saline to help slow *chemotherapy medications
Sensorineural hearing loss: Meniere's disease *recurrent vertigo *n/v *hearing loss *hx of falls *unknown etiology-theories about salt/fluid retention; *usually episodic
Nursing care of Meniere's disease *diuretics-b/c of theories *antihistamines-but causes sleepiness *teach safety measures-driving? *salt restrictions
Sensorineural hearing loss: Acoustic neuroma *tumor on cranial nerve #8-vestibular nerve-deals c balance & dizziness *diagnosed c CAT
General post-op care: ear surgery *assess: edema, vertigo, bleeding *use Aseptic technique post op *leave internal dressings in place:REINFORCE PRN *note hearing changes, balance *position depends on surgery, watch gait *safety *avoid coughing, sneezing, nose blowing
Nursing interventions in hearing loss *check for cerumen *talk in low tones *face directly *adequate lighting *reduce background noise *talk in normal tone of voice *don't chew gum *re-word when asked to repeat vs. c confusion-repeat same simple commands
Created by: rlvander
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