Hearing loss
Caused by: obstruction by impacted cerumen, infection with labrynthitis, otosclerosis, trauma/scarring of tempanic membrane, congenital malformations
Conductive hearing loss
Uses a tuning fork with handle placed in center of forehead. Determines normal hearing or hearing loss in both ears at once
Webber
Caused by increased fluid in middle ear, inflammation, or vascular disorder that reduce blood supply to cochlea
dizziness and vertigo
Hardening of cerumen, loss of elasticity in the tympanic membrane, loss of receptor cells in organ of corti, Decreased nerve fibers in vestibulocochlear nerve. SOFTEN EARWAX BEFORE REMOVING to prevent further damage
Changes with aging
Avoid heavy lifting, do not drink through straw, avoid bending, Place cotton ball with petroleum jelly in the ear when showering, avoid flying until surgeon allows it, cough or sneeze with mouth open
Home care
Caused by: presbycusis, heredity, ototoxic drugs, tumor (acoustic neuroma), Meniere disease, loud noise exposure, infection (measles, mumps, meningitis), rubella in utero
sensorineural hearing loss
Tuning fork used to determine if hearing loss is conductive or sensorineural. Handle Placed at mastoid bone and beside the ear. Sound lateralization to good ear= sensorineural, to bad ear= conductive
Rinne
Causes: inflammation of middle ear caused by bacteria or viruses. Common in infants in young children.
Signs and symptoms include impaired hearing, tinnitus, pain, fever, headache, pulling the ear (babies)
Treated with antibiotics, ear drops and analgesics to reduce pain
Otitis media
Ensure hearing aid is on, sit facing person with light to your face, sit 2.5-4ft away, short, simple sentences, Use short, simple sentences, avoid chewing gum, smiling and covering mouth when talking
Communicating with the hearing impaired
Positioning after surgery
Head elevated or side lying on UNAFFECTED side
Increased risk of ototoxicity due to a combination of taking meds for chronic conditions and decreased liver and kidney function which allows drugs to accumulate
Older adult risk for ototoxicity
Uses ear phones and either sounds at different pitch (pure tone) or speech is played (speech). Patient either signals when sound is heard or repeats what is spoken to determine degree of hearing loss in each ear
Audiometry
S/S: dizziness, tinnitus, unilateral hearing loss, poor balance. This is common in people with chronic ear disorders and allergic symptoms involving the upper respiratory tract
Meniere's Disease
Have person lay down and remain still. Low sodium diet, and limit fluid intake. Smoking cessation and stress management should be encouraged
positional vertigo
Inability of patient to close the eyes, wrinkle forehead, or pucker lips
Signs of nerve damage to monitor post-op
Drugs that can cause ototoxicity
antibiotics, loop diuretics, NSAIDs, salycilates (aspirin), narcotic analgesics
Each ear is irrigated first with cold and then with warm water to determine vestibular response. Normal response= nystagmus, vertigo, nausea, vomiting, falling. Abnormal= decreased response
Caloric testing
Hearing loss associated with aging
Presbycusis
Treatments may include, low sodium diet, diuretics, valium, and antihistamines
Meneire's
Raising side rails, assist with walking, prevent quickly turning head from side to side, rise slowly
Safety precautions for balance problems (post op)
Sustained exposure to noise levels above this volume can result in hearing loss
85 dB
Blood is drawn and sent to lab to look for antibodies to syphilis
Rapid Plasma Reagin (RPR) blood test
Myringotomy (incision into the eardrum) with tube placement and Tympanoplasty to repair ruptured eardrum may be used
Repeated ear infections
Bones in inner ear degenerate excess bone forms and causes footplate of stapes to be fixed in place so it no longer vibrates. Stapedectomy: stapes may be removed and replaced with a prosthetic one
otosclerosis
Why should excessive drainage and signs of infection be reported immediately?
Because the ear is so near the brain