patho, dx
what is the cause of meniere disease?
it's unknown
describe how tinnitus sounds in pts with meniere disease
heard as a low buzzing sound that sometimes becomes a roar
name at least 2 treatments for meniere disease
Labyrinthectomy and labyrinthotomy, vestibular nerve section, endolymphatic shunt,
For an acute attack:
-Atropine, epinephrine, benzodiazepines (diazepam/Valium), antihistamines, antiemetics, anticholinergics, vasodilators, diuretics
BETWEEN attacks:
-Diuretics (reduce fluid buildup), drugs to control vertigo
-Meclizine and transdermal scopolamine – favored bc they’re less sedating (allows the pt to have a normal life)
-Low sodium diet (strict sodium free diet is prescribed if low sodium isn’t effective enough in reducing edema in the inner ear)
-Teach pt to avoid caffeine, alcohol, and nicotine
-Vestibular rehab: exercises to help pt develop tolerance to vertigo – usually taught by PT
-Pressure pulse treatment: device put in the external ear put pressure on the middle ear intermittently - reduces dizziness and tinnitus – used by pt at home 3x per day for 5 mins each time
describe nursing interventions for meniere disease pts struggling with anxiety
Encourage the patient to share concerns and help patient use a variety of coping mechanisms.
alcohol, nicotine, stress, bright lights, and sudden movements of the head
in meniere disease, vertigo is often preceded by a feeling of ______
often preceded by a feeling of fullness and pressure in the ear
what does an endolymph shunt do?
drain excess fluid from the inner ear
Describe a focused assessment for a pt with meniere disease (at least 2 things)
Note any substance or stimuli that can trigger attacks since causes are unknown, document specific symptoms. How the disease affects the pt life, knowledge abt the disease and coping mechanisms used.
meniere disease is common in what population?
young white women
In meniere disease, does hearing loss affect both ears?
no; hearing loss is unilateral
what kind of diet are mineere disease pts placed on?
-Low sodium diet (strict sodium free diet is prescribed if low sodium isn’t effective enough in reducing edema in the inner ear)
-Teach pt to avoid caffeine, alcohol, and nicotine
describe at least 2 interventions for a pt at risk for dehydration
Movement may trigger vomiting so the pt should remain still, the room should be dark and quiet. You should postpone any nonessential care, provide medication for nausea and vomiting. IV infusions are given to provide fluid and medication
In meniere disease, permanent sensorineural hearing loss may occur after __________
after a pt has multiple attacks
sudden movements during vertigo attacks can cause _________
vomiting
what is a vestibular nerve section?
cut the part of the acoustic nerve (vestibulocochlear nerve/cranial nerve VIII) that controls balance
What are some safety measures that can be implemented for pts with sudden attacks of vertigo?
answers vary
how is meniere disease diagnosed
health history and physical - doctor may order radiographs to rule out other diseases that cause similar symptoms and audiograms to reveal loss of hearing low frequency sounds
how long might vertigo attacks occur
several minutes to several hours
which medications used in between acute attacks of meniere disease are favored, and why?
-Meclizine and transdermal scopolamine – favored bc they’re less sedating (allows the pt to have a normal life)
which diagnostic tests cause a vertigo attack in pts with meniere disease?
Caloric test and electronystagmography tests