Nokea
A nurse anticipates that an 8-year-old client has otitis externa from symptoms stated on the history. Which symptom(s), from the history and physical examination, would confirm the diagnosis? Select all that apply.
- A. Discomfort in the ear
- B. Redness of the ear canal
- C. Pus noted in the ear canal
- D. Conductive hearing loss
- E. Tympanic membrane may appear normal
Correct Answer: A,B,C,D,E
Rationale: The diagnosis of otitis externa (inflammation of the tissue of the outer ear) is confirmed by reports of pain, discharge from the external auditory canal, aural tenderness (usually not present in middle ear infections), and occasionally fever, cellulitis, and lymphadenopathy. Other symptoms may include pruritus and conductive hearing loss or a feeling of fullness in the ear. On otoscopic examination, the ear canal is erythematous and edematous. Discharge may be yellow or green and foul smelling. In fungal infections, hairlike black spores may be visible.
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A nurse is caring for a 24-year-old female client diagnosed with otosclerosis. Which teaching by the nurse is most accurate?
- A. Symptoms may be accelerated by pregnancy.
- B. Medications can interfere with birth control pills.
- C. Menstrual periods may be longer and more severe.
- D. Females otosclerosis is linked with infertility.
Correct Answer: A
Rationale: The etiology of otosclerosis is unknown; however, it is more common in females than males and usually occurs in the second or third decade of life. It is accurate to instruct female that symptoms of otosclerosis seem to be accelerated during pregnancy.
The nurse is instructing the client with dried cerumen blocking the ear canal on potential methods to reduce symptoms. Which at-home methods of cerumen removal are discouraged?
- A. Instilling 1 to 2 drops of half-strength peroxide in the ear
- B. Using warm glycerin or mineral oil to soften the cerumen
- C. Removing the cerumen by means of a cotton tip applicator
- D. Irrigating the ear with warm water and a rubber-bulb syringe
Correct Answer: C
Rationale: The nurse is an important resource person to consult when a client has an issue with the ear structure or hearing. The nurse is correct to discourage placing anything down the ear canal that could push the cerumen deeper toward or puncture the tympanic membrane. The other options are appropriate to soften and lubricate the cerumen or to irrigate the cerumen from the ear.
A client comes to the walk-in clinic reporting feeling a 'bug in my ear.' What action should be taken when there is an insect in the ear?
- A. Instillation of mineral oil
- B. Instillation of carbamide peroxide
- C. Instillation of hot water
- D. Use of a small forceps
Correct Answer: A
Rationale: Mineral oil is instilled into the ear to smother an insect. Carbamide peroxide is used to soften dried cerumen, and small forceps are used to remove solid objects. Hot liquids cause dizziness and should not be instilled in the ear.
The occupational nurse is advising a client on options to enhance workplace communication because the client has progressive hearing loss. The client works as a customer service representative. In discussing the options with the client, which type would be the last option offered by the nurse?
- A. Battery-operated hearing aid
- B. American sign language
- C. Headsets with amplifiers
- D. Text-based telecommunications
Correct Answer: B
Rationale: Although American sign language is an asset to use for communication, a client with an occupation of customer service representative needs accommodations to be able to understand the spoken word.
The nurse is instructing a client's family members on the most incapacitating symptom of M?©ni?¨re disease. Which nursing instruction associated with the symptom is most helpful?
- A. Assist the client when ambulating.
- B. Keep a bucket beside the bed.
- C. Ensure low lighting in the room.
- D. Sit in front of the client when speaking.
Correct Answer: A
Rationale: The most incapacitating symptom of M?©ni?¨re disease is vertigo. When the client is experiencing vertigo or dizziness, gait becomes unsteady. Having a person assist the client when ambulating is most helpful in preventing falls. Keeping a bucket at the bedside is helpful if the client is experiencing nausea. Photophobia is not a main symptom of M?©ni?¨re disease. If the client experiences hearing loss, being able to see the nurse's lips may be helpful.