PrepU Ch. 43- Caring for Clients with Ear Disorders
Which manifestation is the most problematic for the client diagnosed with Ménière disease?
... [Show More] Vertigo
Explanation:
Vertigo is usually the most troublesome complaint related to Ménière disease. Other clinical
manifestations include tinnitus, diaphoresis, and hearing loss.
Which of the following instructions, regarding swimming, should the nurse give to the client who is
recovering from otitis externa? Choose the correct option.
Wear soft plastic ear plugs.
Explanation:
The nurse should advise the client to wear soft plastic ear plugs to prevent trapping water in the ear
while swimming.
Which of the following classification of medications is the most common cause of ototoxicity?
Aminoglycosides
Explanation:
IV medications, especially the aminoglycosides, are the most common cause of ototoxicity, and they
destroy the hair cells in the organ of Corti. Cephalosporins, sulfonamides, and penicillins are not among
the most common causes of ototoxicity.
High doses of which medication can produce bilateral tinnitus?
Aspirin
Explanation:
At high doses, aspirin toxicity can produce bilateral tinnitus. Meclizine and dimenhydrinate are used for
nausea and vomiting related to motion sickness. Antiemetics, such as promethazine suppositories, help
control nausea and vomiting and vertigo through an antihistamine effect.
Which symptoms may a client with Ménière disease report before an attack?
A full feeling in the ear
Explanation:
Clients with Ménière disease experience symptoms of headache and a full feeling in the ear before an
attack. Nystagmus is an episodic symptom that occurs during an attack, and, at times, the client is
symptom free. Ménière disease does not cause low blood pressure or photosensitivity.
The nurse is developing a plan of care for a client with Meniere's disease and identifies a nursing
diagnosis of excess fluid volume related to fluid retention in the inner ear. Which intervention would be
most appropriate to include in the plan of care?
Limit foods that are high in sodium.
Explanation:
Sodium and fluid retention disrupts the delicate balance between the endolymph and perilymph in the
inner ear. Therefore, many clients can control their symptoms by adhering to a low-sodium diet.
Caffeinated fluids are to be avoided because of their diuretic effect. Diuretics, not antihistamines, would
be prescribed to lower the pressure in the endolymphatic system. Foods high in potassium would be
encouraged if the client is prescribed a diuretic that causes potassium loss.
A client who has been fitted with a hearing aid comes for a follow-up evaluation. During the visit, the
client states, "I've noticed that I still don't seem to hear well enough. The hearing aid doesn't seem to
make the sounds louder." Which of the following might the nurse determine as the possible cause?
Client has cerumen in the ear.
Explanation:
The client reports that the hearing aid is not helping, such that the sounds are not loud enough. This
statement is consistent with inadequate amplification. Cerumen in the ears is a possible cause. A loose
ear mold would cause a whistling noise. An improperly fitted mold or middle ear infection would lead to
pain from the mold.
The nurse is caring for a patient with Ménière’s disease who is hospitalized with severe vertigo. What
medication does the nurse anticipate administering to shorten the attack?
Meclizine (Antivert)
Explanation:
Pharmacologic therapy for Ménière’s disease consists of antihistamines, such as meclizine, which
shortens the attack (NIDCD, 2010).
A nurse needs to change a dressing on an abdominal wound for a patient who is hearing-impaired and
whose speech is difficult to understand. Which of the following is the best approach for the nurse?
Write down the steps of the procedure for the patient to read before beginning the treatment.
Explanation:
Written communication is an excellent resource and means of mutual understanding. Distraction is not
appropriate because a hearing-impaired person needs the care provider's full attention. Do not pretend
to understand or complete the person's sentences for them. [Show Less]