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Pediatric ProblemsOtitis MediaForeign bodies -beads, pencil erasers, insectsTreatment -carefully remove foreign body (if able) -seek medical care
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Ménière's Disease• Ménière's Disease: entire inner ear canal
system affected • Population at risk:
- usually first occurs in people aged 20 – 50 yrs old-more common in men and in white people
• S & S: three main features -Tinnitus - one-sided sensorineural hearing loss - vertigo
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Treatment for Ménière's DiseaseNonsurgical management includes: -slow head movements
-diet and lifestyle changes -smoking cessation.
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Drug Therapy• Nicotinic Acid
• Antihistamines: -diphenhydramine hydrochloride (Benadryl)
• Antiemetics: -chlorpromazine hydrochloride (Thorazine)
• Intratympanic therapy: gentamicin & steroids
• Other Measures: Meniett device
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Meniett’s DeviceTreatment with Meniett’s device -tympanostomy tube inserted into eardrum -pulses of pressure delivered to inner ear
-self directed for 5 mins. TID -studies shown effective in reducing vertigo *
*Gates,G., Verrall,A., Green,J.D., Tucci, D.L., & Telian, S.A.(2006). Meniett clinical trial:Long –term follow-up. Archives of Otolaryngology-Head and Neck Surgery, 132(12), 1311-1316.
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Ménière’s Disease: Surgical ManagementEndolymphatic decompression.
Surgical management: last resort because hearing in the affected ear is often lost
from the procedure
Labyrinthectomy
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Hearing LossTypes of hearing loss
Conductive r/t inflammation or obstruction of external or middle ear
Sensorineural r/t loud noise, drugs, medical problem
Population at risk: older adult
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Anatomy of Hearing Loss
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Treatment for Hearing LossNon-surgical
-hearing aids -assistive devices using amplifiers
Surgical Interventions -tympanoplasty -stapedectomy
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Tympanoplasty
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Nursing Interventions: Pre-opFree of infectionEar flushesPt. Education: post op expectations
-hearing diminished initially -medications
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Nursing Interventions Post-opMonitor dressingsAvoid increased pressure on earMedicationsPositioning -Tympanoplasty: lie flat with operative ear
face upPotential complication for stapedectomy -Assess for facial nerve damage or muscle
weakness
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Community-Based CareHome care management
Health teaching
Health care resources
Worldwide
http://www.wfdeaf.org/
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NURSING DIAGNOSES FOR ALTERED HEARING
Risk for injury related to altered auditory perception
Social Isolation related to decreased hearing
Anxiety related to loss of hearing