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The nurse is caring for a client being treated for M?©ni?¨re disease. Which medication is monitored closely due to its addictive properties?
- A. Meclizine
- B. Hydrochlorothiazide
- C. Diazepam
- D. Promethazine
Correct Answer: C
Rationale: Diazepam is used to treat the client with M?©ni?¨re disease to help control vertigo. Diazepam is a tranquilizer that has addictive properties. The other options, used in the treatment of M?©ni?¨re's disease, do not have any or significant addictive properties.
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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 nursing instructor is teaching pre-nursing students in a pathophysiology class. What would the instructor teach the students about M?©ni?¨re disease?
- A. It is referred to as endolymphatic hydrops.
- B. It originates in the middle ear.
- C. It is referred to as lymphatic hydrops.
- D. It originates in the outer ear.
Correct Answer: A
Rationale: When a person moves the head, the endolymph also moves, and nerve receptors within the membranous labyrinth send signals to the brain about the movement. In M?©ni?¨re disease, an increase in endolymph causes the membranous labyrinth to dilate like a balloon; this is referred to as endolymphatic hydrops. M?©ni?¨re disease does not originate in either the middle or the outer ear, and it is not referred to as lymphatic hydrops.
There are several types of hearing loss. Which type of hearing loss benefits from the use of a hearing aid?
- A. Sensorineural
- B. Conductive
- C. Genetic
- D. Acquired
Correct Answer: B
Rationale: Diminished hearing results from a conductive loss, sensorineural loss, or both. Clients with a conductive hearing loss benefit more from the use of a hearing aid because the structures that convert sound into energy and facilitate perception of sound in the brain continue to function. Genetic and acquired are not types of hearing loss.
Which nursing suggestion would be most helpful to the client with recurrent otitis externa?
- A. Use a cotton applicator to ensure that the ear canal is dry.
- B. Place ear plugs into the ears before swimming
- C. Flush the ear with hydrogen peroxide
- D. Avoid lying on the side of the affected ear
Correct Answer: B
Rationale: The nurse instructs the client to carry out the medical treatment and provides health teaching to prevent recurrence. For example, the nurse advises swimmers to wear soft plastic ear plugs to prevent trapping water in the ear. A cotton tip applicator should not be placed into the ear canal because it could perforate the eardrum. Above all, the nurse advises the client to avoid the use of nonprescription remedies unless they have been approved by the physician and to contact the physician if symptoms are not relieved in a few days.
The nurse is caring for a client in the triage section of a walk-in clinic. Which triad of common symptoms suggests a diagnosis of M?©ni?¨re disease?
- A. Blurred vision, vertigo, nausea
- B. Syncope, vertigo, ear pain
- C. Disorientation, vertigo, nausea
- D. Hearing loss, vertigo, tinnitus
Correct Answer: D
Rationale: Hearing loss, vertigo, and tinnitus are common symptoms of many disease processes but, when placed together, indicate M?©ni?¨re disease. The other options do not include the accurate triad of symptoms.