Nokea
What aspect should the nurse closely monitor for in clients who have been administered salicylates, loop diuretics, quinidine, quinine, or aminoglycosides?
- A. Signs of hypotension
- B. Reduced urinary output
- C. Tinnitus and sensorineural hearing loss
- D. Impaired facial movement
Correct Answer: C
Rationale: It is important that nurses are knowledgeable about the ototoxic effects of certain medications such as salicylates, loop diuretics, quinidine, quinine, and aminoglycosides. Signs and symptoms of ototoxicity include tinnitus and sensorineural hearing loss. Hypotension, reduced urinary output, and impaired facial movement are not signs of ototoxicity.
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The nurse is teaching a family member how to instill ear drops to the client to remove impacted cerumen. What is important to teach this family member?
- A. Insert the irrigating syringe deeply.
- B. Direct the flow of the ear drops toward the eardrum.
- C. Refrigerate before instillation.
- D. Place the container in warm water before instillation.
Correct Answer: D
Rationale: If irrigation or instillation of liquids is ordered, the liquid should be warmed to body temperature by placing the container in warm water. Cold or hot liquids cause dizziness, and the potential for injury exists if the liquid is hot. The family member should avoid inserting the irrigating syringe too deeply so as not to close off the auditory canal. The family member should direct the flow toward the roof of the canal, rather than the eardrum.
What kind of otitis media is a pathogen-free fluid behind the tympanic membrane, resulting from irritation associated with respiratory allergies and enlarged adenoids?
- A. Purulent otitis media
- B. Infectious otitis media
- C. Serous otitis media
- D. Sterile otitis media
Correct Answer: C
Rationale: Serous otitis media, a collection of pathogen-free fluid behind the tympanic membrane, results from irritation associated with respiratory allergies and enlarged adenoids. The other options are distractors for this question. Purulent otitis media usually results from the spread of microorganisms from the eustachian tube to the middle ear during upper respiratory infections.
The nurse is obtaining subjective data from a client with difficulty hearing. What should the nurse do to facilitate communication with the client? Select all that apply.
- A. Speak clearly at a normal pace.
- B. Avoid gesturing.
- C. Ensure there is adequate natural or artificial light.
- D. Exaggerate pronunciations.
- E. Promote a clear image of the nurse's mouth.
- F. Face the client when speaking.
Correct Answer: A,C,E,F
Rationale: In order to facilitate communication with the client with difficulty hearing, the nurse should speak clearly at a normal pace, ensure there is adequate natural or artificial light, promote a clear image of the nurse's mouth, and face the client when speaking. The nurse should use gestures and facial expressions to enhance what is being said orally. The nurse should not exaggerate pronunciations.
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.
The nurse is evaluating the independent care of a client recovering from a stapedectomy. Which action made by the client indicates a need for further teaching?
- A. The client turns head slowly when family approaches.
- B. The client uses clean technique to clean the wound.
- C. The client takes antibiotics on schedule
- D. The client asks for assistance upon ambulation.
Correct Answer: B
Rationale: The client needs further instructions on using aseptic technique when completing wound care. Using aseptic technique reduces the introduction and transmission of microorganisms and protects the client from introduction of pathogens. The other options are appropriate actions for the client recovering from a stapedectomy to take.