Age Related Changes, Ear Disorders
What are some age related changes you may find in the outer ear?
Pinna enlarges and grows hair
ear lobes can elongate
cilia lining the ear canal become coarse and stiff
cerumen may accumulate, become dry and harden
Manifestation of ear disorders:Tinnitus
Common cause is ototoxic medications, name a few
salicylates - asprin
NSAIDs
vancomycin, gentamicin, tobramycin
furosemide
quinine
Manifestation of ear disorders: Vertigo
What diet restrictions will you educate your patient with vertigo about?
sodium restriction, nicotine, alcohol, and aspartame
How does conductive hearing loss manifest?
equal loss of hearing at all sound frequencies
What is presbycusis hearing loss?
hearing loss associated with old age
What are some age related changes you may find in the middle ear?
stiffening of the tympanic membrane
calcification of the ossicles (three small bones - hammer, anvil, stirrup)
Manifestation of ear disorders: Vertigo
what is it?
Sensation of movement when not moving
Manifestation of ear disorders: Vertigo
safety precautions you should take for veritgo
fall precautions and change position slowly
How would you treat conductive hearing loss?
treat cause, hearing aid may help
How does presbycusis hearing loss manifest?
difficult to hear high pitched sounds
background noise interferes with distinguishing speech
may also experience tinnitus
What are some age related changes you may find in the inner ear?
presbycusis - form of sensorineural hearing loss
Manifestation of ear disorders: Vertigo
s/sx of vertigo
spinning, tumbling forward/backward, feeling tilted or room spins around them
can cause N/V and falls
Hearing loss is most common in the elderly, what factors put you at risk of developing hearing loss?
noises, medications, congenital diseases
What is sensorineural hearing loss?
disorders affecting the inner ear, auditory nerve, or auditory pathways of the brain
often damage to the hair cells of the organ Corti
damage from loud noises, medications, tumors or disease
Common treatment for presbycusis
hearing aid to amplify sounds
Manifestation of ear disorders:Tinnitus
What is tinnitus?
perception of sound in the ear without stimuli from external environment
Manifestation of ear disorders: Vertigo
Cause of vertigo
related to issue with semicircular canals or CNS
How would hearing loss manifest in clinically
straining to hear, inappropriate answers to questions, irritability and social withdraw
How does senorineural hearing loss manifest?
speech discrimination difficult, especially noisy environments
hearing loss in high frequencies
Medical plan of care for hearing loss:
what diagnostics used?
what treatments?
Diagnostics:
general ear exam, h&p, hearing acuity, special studies
Treatment:
removal of obstruction, treatment of infection, discontinuing ototoxic drugs, surgery to repair middle ear
Manifestation of ear disorders:Tinnitus
S/sx of tinnitus
ringing, buzzing, roaring, clicking, whistling, or hissing
Manifestation of ear disorders: Vertigo
Treatment of vertigo
treat the underlying cause
medications:
- meclizine
- diazepam
What is conductive hearing loss?
most common due to physical obstruction of external ear canal (cerumen, foreign body, etc)
perforated tympanic membrane
infection or trauma of ear canal or middle ear
What treatment options are available for sensorineural hearing loss?
cochlear implant, hearing aid (minimally helpful)
Nursing management for hearing loss:
how would you promote health?
how would you communication?
Health:
hearing protection, turn down music, no objects in ears, hearing evaluations
Communication:
face patient, reduce background noise, speak slower and lower, flash lights