click below
click below
Normal Size Small Size show me how
Menier
Question | Answer |
---|---|
Meniere’s disease | intermittent but progressive deterioration of hearing & balance |
Key features | tinnitus, one-sided sensorineural hearing loss, vertigo |
Pathology | overproduction or decreased reabsorption of endolymphatic fluid; results in distortion of the inner-canal system |
Distortion effects | decreased hearing from dilation of cochlear duct, vertigo from damage to vestibular system |
S/S of “attack” | intense vertigo lasting 3-4 hours, nausea, vomiting, nystagmus, severe headache |
Non-surgical/Nursing education | make slow head movements (prevents increase in vertigo), NaCl/fluid restriction (reduces amt. of endolymphatic fluid, quit smoking (reduce vessel constriction |
Drug therapy goal | control vertigo & vomiting, restore normal balance |
Mild diuretics | Decrease endolymph volume |
Nicotinic acid | Vasodilating effects |
Antihistamines | reduce severity/stop acute attach |
Antiemetic | control N/V |
Benzos | calms pt, controls vertigo & N/V, allows quiet rest during attack |
Surgical management | last resort; indicated when medical therapy is ineffective & significant hearing loss |
Labyrinthectomy | radical resection of vestibular nerve/total removal of labyrinth; foot of stapes is moved aside and labyrinth is removed |
Endolymphatic decompression | early in course of disease; drainage of endolymphatic sac w/ shunt placement |
Endolymphatic decompression (POST OP) | reassure pt that post-op vertigo is temporary due to movement of vestibular structures |
No SMOKING | smoking results in constriction of blood vessels |