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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.
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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 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 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.
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.