Nokea
The nurse is caring for a client experiencing hearing loss. The nurse uses the otoscope to assess the ear canal and tympanic membrane and notes a significant accumulation of cerumen. Which documentation of hearing loss type would be accurate?
- A. Conductive
- B. Mixed
- C. Central
- D. Sensorineural
Correct Answer: A
Rationale: Conductive hearing loss occurs from an obstruction in the outer or middle ear such as from cerumen. Mixed hearing loss is a combination of conductive and sensorineural problems. Central hearing loss involves injury or damage to the nerves or the nuclei of the central nervous system. Sensorineural involves damage to the inner ear.
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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.
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 who is post-stapedectomy. What would the nurse include in the nursing care?
- A. Place the client on the operative side.
- B. Keep the affected ear packed with cotton.
- C. Encourage the client to exercise within 24 hours.
- D. Assess the facial nerve.
Correct Answer: D
Rationale: After surgery, the nurse positions the client on the nonoperative side and takes care to prevent dislodgment of the prosthesis as a result of coughing, sneezing, or vomiting. Nausea and dizziness are common problems. The nurse assesses facial nerve function by checking symmetry when the client smiles or frowns. The nurse does not keep the ear packed with cotton or encourage the client to exercise.
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 obtaining a history from a client complaining of ear pain and dizziness. Which assessment finding is the best evidence that the client has a perforated eardrum?
- A. Fluid draining in the external canal
- B. Pain has resolved
- C. Elevated white blood cell count
- D. Inflammation and a reddened eardrum
Correct Answer: A
Rationale: Noting the actual fluid in the ear canal alerts the nurse to the fact that there is a perforation in the tympanic membrane. The other options are also signs of a perforation but also signs of otitis media without perforation.