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Timby/Smith: Introductory Medical-Surgical Nursing, 10/e 01/16 Pg 625

Timby/Smith: Introductory Medical-Surgical Nursing, 10/e 01/16 Pg 625. Unit 10 Chapter 43: Caring for Clients with Ear Disorders By: P.K. Williams, RN. 19 Words to Know 02/16 Pg 624. Acoustic neuroma Cochlear implant Labyrinthitis

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Timby/Smith: Introductory Medical-Surgical Nursing, 10/e 01/16 Pg 625

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  1. Timby/Smith: Introductory Medical-Surgical Nursing, 10/e 01/16 Pg 625 Unit 10 Chapter 43: Caring for Clients with Ear Disorders By: P.K. Williams, RN

  2. 19 Words to Know 02/16 Pg 624 • Acoustic neuroma Cochlear implant Labyrinthitis • Mastoidectomy Mastoiditis Myringotomy • Meniere’s disease Otalgia * Otitis externa • Otitis media Otosclerosis Ototoxicity • Presbycusis Sign language Stapedectomy • Speech reading Tinnitus Tympanotomy

  3. 11 Objectives 03/16 Pg 624 On completion of this chapter, you will be able to: 01 List types of hearing impairment and the acuity levels for each. 02 Name techniques that clients with impaired hearing use to communicate with others. 03 Give examples of support services available for the hearing impaired. 04 Discuss the role of the nurse in caring for clients with a hearing loss. 05 Name conditions that involve the external ear.

  4. 11 Objectives 04/16 Pg 624 06 Explain the technique for straightening the ear canal of adults to facilitate inspection and the administration of medication. 07 Discuss methods for preventing or treating disorders of the external ear. 08 Nameconditions that affect the middle ear. 09 Describe nursing interventions appropriate for managing the care of a client with ear surgery. 10 Explain the pathophysiology of Ménière’s disease, and name some consequences of this inner-ear disorder. 11 Discuss the nursing management of clients with Ménière’s disease.

  5. Hearing Impairment 05/16 Pg 624 • Mild, Moderate, Severe, or Profound • Causes: Excessive noise; Conductive loss; [Sensorineural loss] • Consequences Depend on Age, Severity • <3 years: Affects language development, communication, safety • Medical Management: Hearing aids; Sign language; Speech reading; Technology; Assist dogs • Surgical Management: Cochlear implant; Bone conduction device; Semi-implantable hearing aid • Nursing Management

  6. Cochlear Implant*** 06/16 Pg 626

  7. Impacted Cerumen*** 07/07 Pg 627 • Pathophysiology, Etiology • Interferes with sound carried on airwaves • Assessment Findings • Otalgia; Diminished hearing • Orange-brown accumulation of cerumen • Medical Management: Hydration; Irrigation; Removal (cerumen spoon) • Nursing Management

  8. Foreign Objects*** 08/16 Pg 634 • Pathophysiology, Etiology • Scratched skin; Blunt penetration of eardrum; Local tissue inflammation • Assessment Findings: Discomfort; Diminished hearing; Feeling movement; Buzzing sound • Diagnostic Findings: Inspection (Penlight, otoscope) • Medical Management: Mineral oil instillation (insects); Removal of solid object (small forceps) • Nursing Management

  9. Otitis Externa***09/16 Pg 628 • Pathophysiology, Etiology • Overgrowth of pathogens; Infected hair follicle • Assessment Findings • Redness; Edema; Diminished hearing • Fever; Enlarged lymph nodes behind ear • Diagnostic Findings: Otoscope examination; C & S • Medical Management • Warm soaks; Analgesics; Antibiotics • Nursing Management

  10. Otitis Media***10/16 Pg 629 • Pathophysiology, Etiology • Respiratory allergies; Enlarged adenoids; Eardrum pressure • Assessment Findings: History: Recent upper respiratory infection; Seasonal allergies; Fever; Tinnitus; Malaise; Earache; Diminished hearing • Medical, Surgical Management: Prevention of rupture of the eardrum • Antibiotics; Needle aspiration; Myringotomy; Tympanotomy; Myringoplasty • Nursing Management

  11. Otosclerosis***11/16 Pg 629 • Pathophysiology, Etiology • Decreased vibration of stapes  diminished transmission of sound to inner ear • Assessment Findings: Signs and Symptoms • Progressive, bilateral hearing loss; Nighttime tinnitus; Pinkish-orange eardrum • Diagnostic Findings: Audiometric tests; CT scan • Medical, Surgical Management • Hearing aids; Stapedectomy • Nursing Management

  12. Otosclerosis12/16 Pg 630

  13. Ménière’s Disease 13/16 Pg 631 • Pathophysiology, Etiology • Changes of fluid volume within labyrinth • Assessment Findings • Vertigo; Tinnitus; Hearing loss; N/V • Nystagmus; Preattack headache • Medical, Surgical Management • Low-sodium diet; Bed rest; Medication therapy; Surgery • Nursing Management

  14. Ototoxicity***13/16 Pg 634 • Medications • Salicylates; Loop diuretics • Quinidine; Quinine • Aminoglycosides • Signs and Symptoms • Tinnitus; Sensorineural hearing loss • Vestibular toxicity: Lightheadedness; Vertigo; N/V • Nursing Management

  15. Acoustic Neuroma***15/16 Pg 634 • Pathophysiology, Etiology: Rare; Unknown cause; Cochlear nerve compression; Blood supply interruption • Assessment Findings: Gradual hearing loss; Vertigo; Impaired facial movement, sensation; Tinnitus • Diagnostic Findings: MRI; CSF studies • Medical, Surgical Management:Neurectomy • Retain cranial nerve VIII function • Nursing Management • [Classification of neuroma based on specific portion of nerve effected]

  16. End of Presentation NowNCLEX By: P.K. Williams, RN 16/16 Pg 634 pkwilliams@DNI. edu

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