audio visual disturbances
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Anatomy and Physiology
EXTERNAL EAR Auricle
Tympanic membrane
MIDDLE EAR Ossicles
Eustachian tube
INNER EAR Semilunar canals
Cochlea
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BALANCEBALANCE
HEARING
FUNCTIONS OF THE EARFUNCTIONS OF THE EAR
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HEARING
88thth CRANIAL NERVECRANIAL NERVE
1. COCHLEAR BRANCH1. COCHLEAR BRANCH
- transmits neuro-impulses from the cochlea to the brainwhere it is interpreted as sound
2. VESTIBULAR BRANCH2. VESTIBULAR BRANCH
- maintains balance & equilibrium
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Anatomy of the Inner Ear
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ASSESSMENT OF THE EAR
OTOSCOPIC EXAMOTOSCOPIC EXAM- visualize the external canal while slowly inserting the speculum
VOICE TESTVOICE TEST Ask the client to block one external canal
The examiner stands 1-2 ft away & quickly whispers a statement
The client is asked to repeat the whispered statement Each ear is tested separately
WATCH TESTWATCH TEST
A ticking watch is used to test the high-frequency sounds
The examiner holds a ticking watch about 5 inches from each
ear & asks the client if the ticking is heard
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ASSESSMENT OF THE EAR
TUNING FORK TESTSTUNING FORK TESTS
A. WEBER TUNING FORK TESTA. WEBER TUNING FORK TEST
Normal result: hearing the sound equally in both ears
FINDINGSFINDINGS
If the client hears the sound louder in 1 ear,- (+) LATERALIZATION(+) LATERALIZATION is present
where the sound is heard the loudest
INTERPRETATIONINTERPRETATION The finding may indicate the client has CONDUCTIVECONDUCTIVE
HEARING LOSSHEARING LOSS in the ear to which the ear is lateralized
The finding may indicate that there is a SENSORINEURALHEARING LOSS in the opposite ear
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WEBER TEST- is a quickscreening test for hearing. It
can detect unilateral (one-sided) conductive hearing lossand unilateralsensorineural hearing loss. The test is named
afterErnst Heinrich Weber
Normal:
Sound heard equally
CONDUCTIVE:
Louder
SENSORINEURAL:
Opposite
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ASSESSMENT OF THE EAR
TUNING FORK TESTSTUNING FORK TESTS
B. RINNE TUNING FORK TESTB. RINNE TUNING FORK TEST
Compares the clients hearing by air conduction & bone conductionAIR CONDUCTIONAIR CONDUCTION is 2is 2--3X longer than3X longer than BONE CONDUCTIONBONE CONDUCTION
NORMAL RESULT:NORMAL RESULT: (+) RINNE TEST(+) RINNE TEST
-- the client normally continues to hear the sound
2x louder in front of the pinna
The examiner records the duration of both phases, bone conductionfollowed by air conduction and compares the times
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A Rinne test should always be accompanied by a Weber
test to also detect sensorineural hearing loss and thus
confirm the nature of hearing loss. The Rinne test wasnamed after German otologist Heinrich Adolf Rinne
Normal:
Sound heard in front of
pinna
Findings:
(+) Rinne test Normal
(-) Rinne test
Conductive
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Otoscope Weber test
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Rinne Test
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VESTIBULAR ASSESSMENT OF
THE EARTEST FOR FALLINGTEST FOR FALLING
The examiner asks the client to stand with the feet together &arms hanging loosely at the sides & eyes closed
The client normally remains erect with slight swaying
TEST FOR PAST POINTINGTEST FOR PAST POINTING NORMAL TEST RESPONSE:NORMAL TEST RESPONSE:
- The client can easily return to the point of reference
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VESTIBULAR ASSESSMENT OFVESTIBULAR ASSESSMENT OF
THE EARTHE EAR
GAZE NYSTAGMUS EVALUATIONGAZE NYSTAGMUS EVALUATION Examine the clients eyes as they look straight ahead, 30
degrees to each side, upward & downward
HALLPIKE MANEUVERHALLPIKE MANEUVER Assesses for positional vertigo or induced dizziness
The client assumes a supine position
The head is rotated to one side for 1 minute
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DIAGNOSTIC TESTS FOR THE EAR
TOMOGRAPHYTOMOGRAPHY- may be performed with or without contract medium
- assesses the mastoid, middle ear & inner ear structures- multiple x-rays of the head are done
ELECTRONYSTAGMOGRAPHYELECTRONYSTAGMOGRAPHY- records changing electrical fields with movement ofthe eye, as monitored by electrodes placed on theskin around the eye
AUDIOMETRYAUDIOMETRY- measures hearing acuity
- uses 2 types: PURE TONE AUDIOMETRY & SPEECH AUDIOMETRYPURE TONE AUDIOMETRY & SPEECH AUDIOMETRY- after testing, audiogram patterns are depicted on a graph to determinethe type & level of hearing loss
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DISORDERSDISORDERSOF THE EAROF THE EAR
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AGING PROCESSAGING PROCESS
INFECTIONINFECTIONMEDICATIONSMEDICATIONS
OTOTOXICITYOTOTOXICITY
TRAUMATRAUMA TUMORSTUMORS
Risk factors of ear disordersRisk factors of ear disorders
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ASSESSMENT OF THE EAR
CONDUCTIVE HEARING LOSSCONDUCTIVE HEARING LOSS- due to any physical obstruction to the transmission of soundwaves
SENSORINEURAL HEARING LOSSSENSORINEURAL HEARING LOSS
- due to a defect in the organ of hearing, in the 8th cranial
nerve, or in the brain itself
MIXED CONDUCTIVE, SENSORINEURALMIXED CONDUCTIVE, SENSORINEURALHEARING LOSSHEARING LOSS
- results in profound hearing loss
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CONDUCTIVE HEARING LOSSCONDUCTIVE HEARING LOSS
- sound waves are blocked to the inner ear fibersbecause of external ear or middle ear disorders
- disorders can often be corrected with no damage to hearing, orminimal permanent hearing loss
CAUSESCAUSESAny inflammatory process or obstruction of the external or middle
ear Tumors
Otosclerosis
A build-up of scar tissue on the ossicles from previous middle earsurgery
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SENSORINEURAL HEARING LOSSSENSORINEURAL HEARING LOSS
- a pathological process of the inner ear or of sensory fibers that
lead to the cerebral cortex
- often permanent- reduce further damage
- attempt to amplify sound as a means of improving hearing
CAUSESCAUSES Damage to the inner ear structures and nerves Prolonged exposure to loud noise
Medications, trauma, infections, surgery Inherited disorders
Metabolic & circulatory disorders Menieres syndrome Diabetes mellitus Myxedema
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MIXED HEARING LOSSMIXED HEARING LOSS-- also known as conductivealso known as conductive--sensorineuralsensorineural hearing losshearing loss
SIGNS OF HEARING LOSSSIGNS OF HEARING LOSS
Frequently asking people to repeat statementsFrequently asking people to repeat statements
Straining to hearStraining to hear
Turning head or leaning forward to favor one earTurning head or leaning forward to favor one ear
Shouting in conversationsShouting in conversations Ringing in the earsRinging in the ears Failing to respond when not looking in the direction of theFailing to respond when not looking in the direction of the
soundsoundAnswering questions incorrectlyAnswering questions incorrectly Raising the volume of the television or radioRaising the volume of the television or radioAvoiding large groupsAvoiding large groups Better understanding of speech when in small groupsBetter understanding of speech when in small groupsWithdrawing from social interactionsWithdrawing from social interactions
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HEARING AIDSHEARING AIDS- used for the client with conductive hearingloss
- can help the client with sensorineural loss,although it is not as effective
- a difficulty that exists in its use is the
amplification of background noise as wellas voices
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COCHLEAR IMPLANTATIONCOCHLEAR IMPLANTATION
- used for sensorineural hearing loss- a small computer converts sound waves intoelectrical impulses
- electrodes are placed by the internal ear with
a computer device attached to the externalear
- electronic impulses directly stimulate nervefibers
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Cochlearimplant
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- leads to degeneration or atrophy of the ganglionic cells inthe cochlea & a loss of elasticity of the basilar membranes
- leads to compromise of the vascular supply to the inner ear
with changes in several areas of the ear structure
ASSESSMENTASSESSMENTgradual & bilateral
no problem with hearing but cantunderstand what the words are
speaker is mumbling
PRESBYCUSISPRESBYCUSIS
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EXTERNAL OTITISEXTERNAL OTITIS
- an irritating or infective agent comes into contact withepithelial layer of the external ear
- this leads to either an allergic response or S/S of infection
- the skin becomes red, swollen, & tender to touch on
movement- the excessive swelling of the canal lead to conductivehearing loss
- due to obstruction
- more common in children
- occurs more often in hot, humid environments
- prevention includes the elimination of irritating or infecting agents
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ASSESSMENTASSESSMENT
Pain
Itching
Plugged feeling in the ear
Redness & edema
Exudate
Hearing loss
EXTERNAL OTITISEXTERNAL OTITIS
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Otitis Externa
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EXTERNAL OTITISEXTERNAL OTITIS
NURSING CARENURSING CARE local heat application
Encourage rest
Administer analgesics such as aspirin or acetaminophen (Tylenol) forthe pain as prescribed
Instruct the client that the ears should be kept clean & dry
use earplugs for swimming
cotton-tipped applicators should not be used to dry ear becausetheir use can lead to trauma to the canal irritating agents such as hair products or
headphones should be discontinued
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OTITIS MEDIAOTITIS MEDIA
-a result of a blocked eustachian tube
- a common complication of an ARI- infants & children are more prone
ASSESSMENTASSESSMENT
Fever
Irritability, restlessness & loss of appetite
Rolling of head from side to side
Pulling on or rubbing the ear
Earache or pain Signs of hearing loss
Purulent ear drainage
Red, opaque, bulging or retracting tympanic membrane
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NURSING CARENURSING CARE Encourage oral fluids feed infants in an upright position
avoid chewing during the acute period
local heat
appropriate procedure to clean drainage from theear with sterile cotton swabs
analgesics or antipyretics such asAcetaminophen (Tylenol) to decrease fever & pain
administration of prescribed antibiotics
screening for hearing loss may be necessary
ear drops
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MYRINGOTOMYMYRINGOTOMY
- insertion of tympanoplasty tubes in the middle ear toequalize pressure & keep the ears dry
POSTPOST--OP NURSING CAREOP NURSING CARE Instruct the parents & child to keep the ears dry
Earplugs should be worn during bathing, shampooing &swimming
Diving & submerging under water are not allowed
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Clienteducation post myringotomyClienteducation post myringotomy
AvoidAvoidstrenuous exercisestrenuous exerciserapid head movements, bouncing or bendingrapid head movements, bouncing or bending
straining on bowel movementstraining on bowel movement
drinking through a strawdrinking through a straw
traveling by airtraveling by airforceful coughingforceful coughing
contact with persons with coldscontact with persons with colds
washing hair, showering or getting the head wet for a weekwashing hair, showering or getting the head wet for a week
InstructInstructblow one side at a time with wide mouth openblow one side at a time with wide mouth open
keep ears dry by keeping a ball of cotton coatedkeep ears dry by keeping a ball of cotton coatedwith petroleum jelly in the ear & to change cotton ball dailywith petroleum jelly in the ear & to change cotton ball daily
report excessive ear drainage to the physicianreport excessive ear drainage to the physician
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CHRONIC OTITIS MEDIACHRONIC OTITIS MEDIA- a chronicinfective, inflammatory, or allergic response
involving the structure of the middle ear
- surgical treatment is necessary to restore hearing
- the type ofsurgery can vary & include a simple
reconstruction of the tympanic membrane, a myringotomy, or
replacement of the ossicles within the middle ear
TYMPANOPLASTYTYMPANOPLASTY
- a reconstruction of the middle ear may be attempted to
improve conductive hearing loss
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- may be acute or chronic & results from untreated or inadequately
treated chronic or acute otitis media
- the pain is not relieved by myringotomy
ASSESSMENTASSESSMENT Swelling behind the ear & pain with minimal movement of the head
Cellulitis on the skin or external scalp over the mastoid process
A reddened, dull, thick, immobile tympanic membrane with or withoutperforation
Tender & enlarged post-auricular lymph nodes Low-grade feverAnorexia
MASTOIDITISMASTOIDITIS
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PREPRE--OP NURSING CAREOP NURSING CARE
Prepare the client for surgical removal of the infectedmaterial
Monitor for complications
SIMLPLE OR MODIFIED RADICAL MASTOIDECTOMYSIMLPLE OR MODIFIED RADICAL MASTOIDECTOMYWITH TYMPANOPLASTYWITH TYMPANOPLASTY is the common treatment
Once tissue that is infected is removed, tympanoplasty isperformed to reconstruct the ossicles & the tympanicmembranes, in an attempt to restore normal hearing
MASTOIDITISMASTOIDITIS
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MASTOIDITISMASTOIDITIS
COMPLICATIONSCOMPLICATIONS D
amage to the abducens & facial cranial nerves Damage exhibited by inability to look laterally (cranial nerve
VI) & a drooping of the mouth on the affected side (cranialnerve VII)
Meningitis
Chronic purulent otitis media Wound infections
Vertigo, if the infection spreads into the labyrinth
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OTOSCLEROSISOTOSCLEROSIS
- bony overgrowth of the tissue surrounding the ossicles
- causes the devt of irregular areas of new bone formation & causesfixation of the bones
- stapes fixation leads to CONDUCTIVE HEARING LOSSCONDUCTIVE HEARING LOSS
- if the disease involves the inner ear, SENSORINEURAL HEARINGSENSORINEURAL HEARINGLOSSLOSS is present
- common to have bilateral involvement, although hearing lossmay be worse in one ear
- cause is unknown, although has familial tendency- nonsurgical intervention promotes the improvement of hearing through
amplification- a PARTIAL STAPEDECTOMY or COMPLETE STAPEDECTOMYPARTIAL STAPEDECTOMY or COMPLETE STAPEDECTOMY
WITH PROSTHESIS (FENESTRATION)WITH PROSTHESIS (FENESTRATION) may be surgically performed
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OTOSCLEROSISOTOSCLEROSIS
ASSESSMENTASSESSMENT Slowly progressing conductive hearing loss
Bilateral hearing loss
A ringing or roaring type of constant tinnitus
Loud sounds heard in the ear when chewing
Pinkish discoloration (SCHWARTZES SIGN)(SCHWARTZES SIGN) of the tympanicmembrane
- indicates vascular changes in the ear
(-) Rinne test
Weber test shows lateralization of the sound to the ear withthe most conductive hearing loss
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Stapedectomy for Otosclerosis
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FENESTRATIONFENESTRATION-- removal of the stapes with a small hole drilled inremoval of the stapes with a small hole drilled inthe footplate & a prosthesis is connectedthe footplate & a prosthesis is connectedbetween thebetween the incusincus & footplate& footplate
-- sounds cause the prosthesis to vibrate in thesounds cause the prosthesis to vibrate in thesame manner as the stapessame manner as the stapes
COMPLICATIONSCOMPLICATIONS Complete hearing lossComplete hearing loss
Prolonged vertigoProlonged vertigo
InfectionInfection
Facial nerve damageFacial nerve damage
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LABYRINTHITISLABYRINTHITIS
- infection of the labyrinth that occurs as a
complication of acute or chronic otitis media
ASSESSMENTASSESSMENT Hearing loss that may be permanent on the
affected side
Tinnitus
Spontaneous nystagmus to the affected side
Vertigo
Nausea & vomiting
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LABYRINTHITISLABYRINTHITIS
PREPRE--OP NURSING CAREOP NURSING CARE
Monitor for signs of meningitis, the most commoncomplication
- evidenced by headache, stiff neck lethargy
Administer systemic antibiotics as Rx
Advise client to rest in bed in a darkened room
Administer antiemetics & antivertiginous medications as Rx
Instruct the client that the vertigo subsides as inflammationresolves
Instruct the client that balance problems that persist mayrequire gait training through physical therapy
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MENIERES SYNDROMEMENIERES SYNDROME- a syndrome also called ENDOLYMPHATICENDOLYMPHATICHYDROPSHYDROPS
- refers to dilation of the endolympathic system by eitheroverproduction or decreased reabsorption of endolymphatic
fluid- characterized by tinnitus, unilateral sensorineural hearing loss,& vertigo
- symptoms occur in attacks & last for several days, & the clientbecomes totally incapacitated
- initial hearing loss is reversible, but as the frequency of attackscontinues, hearing loss becomes permanent- repeated damage to the cochlea caused by increased fluidpressure leads to the permanent hearing loss
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MENIERES SYNDROMEMENIERES SYNDROME
CAUSESCAUSES
Any factor that increases endolymphatic secretion inthe labyrinth
Viral & bacterial infections
Allergic reactions
Biochemical disturbances
Vascular disturbances producing changes in themicrocirculation in the labyrinth
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MENIERES SYNDROMEMENIERES SYNDROME
ASSESSMENTASSESSMENT Feelings of fullness in the ear
Tinnitus, as a continuous low-pitched roar or humming sound- is present most of the time but worsens just before &
during severe attacks Hearing loss is worse during an attack
Vertigo- periods of whirling which might cause the client to fall to theground
- sometimes so intense that even when lying down, the clientholds the bed or ground in an attempt to prevent the whirling
Nausea & vomiting
Nystagmus
Severe headaches
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MENIERES SYNDROMEMENIERES SYNDROME
NONNON--SURGICAL MANAGEMENTSURGICAL MANAGEMENT Preventing injury during vertigo attacks Providing bed rest in a quiet environment
Provide assistance while walking
Instruct the client to move the head slowly Initiate Na & fluid restrictions as Rx
Instruct to avoid smoking Administer
Nicotinic acid (Niacin) as Rx
antihistamines as Rxantiemetics as Rxtranquilizers & sedatives as Rx
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MENIERES SYNDROMEMENIERES SYNDROME
SURGICAL MANAGEMENTSURGICAL MANAGEMENT-- performed when medical therapy is ineffective & the
functional level of the client has decreased significantly
ENDOLYMPHATIC DRAINAGEENDOLYMPHATIC DRAINAGE& INSERTION OF THE SHUNT& INSERTION OF THE SHUNT- may be performed early in the course of the disease to assistwith the drainage of excess fluids
RESECTION OF
THE VESTIBULAR NERVERESECTION OF
THE VESTIBULAR NERVE LABYRINTHECTOMYLABYRINTHECTOMY
- removal of the labyrinth may be performed
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MENIERESMENIERES
SYNDROMESYNDROMEPOSTPOST--OP NURSING CAREOP NURSING CARE
Assess packing & dressing on the ear Speak to the client on the side of the unaffected ear
Perform neurological assessments
Maintain side rails
Assist with ambulating
Encourage the use of bedside commode
Administer antivertiginous& antiemetic medications as Rx
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$FRXVWLF$FRXVWLF1HXURPD1HXURPD- a benign tumor of the vestibular or acoustic nerve- causes damage to hearing & to facial movements & sensations- treatment includes surgical removal of the tumor viacraniotomy
- care is taken to preserve the function of the facial nerve
- the tumor rarely recurs after surgical removal
ASSESSMENTASSESSMENT Symptoms usually begin with tinnitus & progress to gradual
sensorineural hearing lossAs tumors enlarges, damage to adjacent cranial nerves occurs
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- foreign objects placed in the external canal may exert pressureon the tympanic membrane & cause perforation
- if the object continues thorough the canal, the bony structuresof stapes, incus & malleus may be damaged
- a blunt injury to the basal skull & ear can damage the middleear structures through fractures extending to the middle ear
- excessive blowing & rapid changes of pressure that occur withnon-pressurized air flights can increase pressure in the middleear
- depending on the damage to the ossicles, hearing loss may ormay not return
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TRAUMATRAUMA
NURSING CARENURSING CARE Tympanic perforations usually heal within 24 hours
Surgical reconstruction of the ossicles & tympanicmembrane through tympanoplasty or myringotomymay be performed to improve hearing
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CERUMEN &CERUMEN &
FOREIGN BODIESFOREIGN BODIES
CERUMEN/EAR WAXCERUMEN/EAR WAX-- the most common cause of impacted canals
FOREIGN BODIESFOREIGN BODIES-- can include vegetables, beads, pencil erasers & insects
ASSESSMENTASSESSMENT Sensation of fullness in the ear with or without hearing loss Pain, itching or bleeding
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CERUMENCERUMEN
NURSING CARENURSING CARE Removal of the wax by irrigation is a slow process
Irrigation is C/I in clients with a hx of tympanic membraneperforation
To soften cerumen, add 3 gtts of glycerin to the ear @ hs& 3 gtts of hydrogen peroxide BID
After several days the ear is irrigated 50-70 ml of solution is the maximal amount a client can
tolerate during an irrigation sitting
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NURSING CARENURSING CARE If the foreign matter is vegetable, irrigation is used with care
- the material expends with hydration
Insects are killed before removal unless they can be coaxedout by flashlight or a humming noise
Mineral oil or alcohol is instilled to suffocate the insect whichis then removed with ear forceps
Use small ear forceps to remove the object & avoid pushingthe object farther into the canal & damaging the tympanicmembrane
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OTIC MEDICATIONSOTIC MEDICATIONS
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IRRIGATION OF THE EARIRRIGATION OF THE EAR Irrigation of the ear needs to be prescribed by MD
Ensure that there is direct visualization of the tympanic membrane
Warm irrigating solution to 100 F- solutions not close to the clients body temp will cause ear injury,nausea & vertigo
Irrigation must be done gently to avoid damage to the eardrum
When irrigating, dont direct irrigating solution directly toward theeardrum
If perforation of the eardrum is suspected, irrigation is not done
MEDICATIONS THAT AFFECTMEDICATIONS THAT AFFECT
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ANTIBIOTICSANTIBIOTICS Amikacin (Amikin)
Chloramphenicol
- Chloromycetin- Chloroptic- Ophthoclor
Erythromycin- E-Mycin- ERYC- Ery-Tab- PCE Dispertabs
- Ilotycin Gentamicin (Garamycin)
Streptomycin sulfate(Streptomycin)
Tobramycin sulfate (Nebcin)
Vancomycin (Vancocin)
MEDICATIONS THAT AFFECTMEDICATIONS THAT AFFECT
HEARINGHEARING
DIURETICSDIURETICS Acetazolamide (Diamox) Furosemide (Lasix) Ethacrynic acid (Edecrine)
OTHERSOTHERS Cisplatin (Platinol, Platinol-AQ) Nitrogen mustard
Quinine (Quinamn) Quinidine
- Cardioquin- Quinaglute- Quindex
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ANTIANTI--INFECTIVEMEDICATIONSINFECTIVEMEDICATIONS
- Kill or inhibit the growth of bacteria- Used for otitis media or otitis externa
- C/I if a prior hypersensitivity exists
SIDE EFFECTSSIDE EFFECTS
Overgrowth of non-susceptible organisms
NURSING CARENURSING CARE Assess V/S
Assess for allergies & pain
Monitor for nephrotoxicity Instruct the client to report dizziness, fatigue, fever, or sore throat
- indicative of superimposed infection
Instruct to complete the entire course of medication
Instruct to keep the ear canals dry
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ANTIANTI--INFECTIVE MEDICATIONSINFECTIVE MEDICATIONS
EXAMPLESEXAMPLES Amoxicillin (Amoxil)
Ampicillin trihydrate (Polycillin)
Cefaclor (Ceclor)
Clindamycin HCl (Cleocin)
Trimethoprim (TMP) & Sulfamethaxazole (SMZ)- Bactrim, Cotrim, Septra
Erythromycin (Ilotycin, E-Mycin)
Penicillin V potassium (Pen V)
Loracarbef (Lorabid) Clarithromycin (Biaxin)
Polymyxin B sulfate (Aerosporin)
Tetracycline HCl (Achromycin)
Acetic acid and Aluminum acetate (Otic Domeboro)
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ANTIANTI--HISTAMINES &HISTAMINES &
DECONGESTANTSDECONGESTANTS
- Produce vasoconstriction- Stimulate the receptors of the respiratory mucosa- Reduce respiratory tissue hyperemia & edema to open obstructedeustachian tubes
- Used for acute otitis media
SIDE EFFECTSSIDE EFFECTS Drowsiness Blurred vision Dry mucous membranes
NURSING CARENURSING CARE Inform the client that drowsiness, blurred vision, & dry mouth may occur
Instruct the client to increase fluid intake unless C/I & to suck on hardcandy to alleviate dry mouth
Instruct the client to avoid hazardous activities if drowsiness occurs
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EXAMPLESEXAMPLES
Tripolidine & pseudoephedrine (Actifed)
Naphazoline HCl (Allerest, Albalon)
Chlorpheniramine (Chlor-Trimeton, Teldrin)
Brompheniramine (Bromphen, Dimetane)
Terfenadine (Seldane)
Clemastine (Tavist)
Cetirizine (Zyrtec)
Astemizole (Hismanal)
LOCALLOCAL
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LOCALLOCAL
ANESTHETICSANESTHETICS- Block nerve conduction at or near the application site to control pain
- Used for pain associated with ear infections
MEDICATIONMEDICATION :: Benzocaine (Americaine Otic; Tympagesic)Benzocaine (Americaine Otic; Tympagesic)
SIDE EFFECTSSIDE EFFECTSAllergic reaction Irritation
NURSING CARENURSING CARE Monitor for effectiveness if used for pain relief
Assess for irritation or allergic reaction
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&(580,12/
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8/9/2019 Audio Visual Disturbances
73/73
CERUMINOLYTICCERUMINOLYTIC
MEDICATIONSMEDICATIONS
EXAMPLESEXAMPLES Carbamide peroxide (Debrox)
Boric acid (Ear-Dry)
Trolamine polypeptide oleate-condensate- Cerumenex