CH 44 Ear Disorders

how many levels of hearing loss are there? What are they?

4; mild, moderate, severe, profound

mild hearing loss

the person will have trouble following a conversation

moderate hearing loss

the person will need a hearing aid to hear normal conversation

severe hearing loss

the person can hear speaking but can’t make out the words, so a hearing aid is needed

profound hearing loss

not the same as being deaf, but the person will need a hearing aid, might use sign language, and might learn how to read lips

conductive hearing loss

Disorder of sound transmission from outer or middle ear to receptors of middle ear 

causes of conductive hearing loss

• Cerumen (wax)

• Infection (otitis media)

sensorineural hearing loss

Disorder of inner ear, auditory nerve, or auditory pathway in the brain

central hearing impairment

a byproduct of sensorineural hearing loss where sounds can be heard but not understood

cause of sensorineural hearing loss

loss of stereocilia in organ of corti

causes of central hearing impairment

• Noise trauma

• Infections 

• Genetic disorders

tinnitus

ringing in the ear that can be continuous or intermittent

causes of tinnitus

• Medication side effects

• Red wine

• Caffeine 

• High BP

• Meniere's disease

vertigo

sensation of the room spinning or of an exaggerated sense of movement or dizziness and may present with nausea and vomiting

what is a big risk associated with vertigo?

falling

causes of vertigo

• Problems with the inner ear

• Meniere's disease

• lightheadedness/disorientation

• Off balance

• Feel drunk 

• Side effects of meds 

• If stand up too quickly

assessments for ear disorders

• Otoscope

• Assess for history of head trauma, exposure to loud noise, aminoglycoside, aspirin, and furosemide

• Pneumatic otoscopy

• Whisper test

• Romberg test

what is otoscope used for?

it visualizes the eardrum, the ear canal, and to see if theres cerumen, foreign materials, or erythema 

why should the nurse assess for aminoglycosides, aspirin, or furosemide?

because they’re ototoxic

what is a pnuematic otoscopy

a puff of air shot into ear to go against tympanic membrane to determine movement

what is a whisper test?

when the nurse stands behind, whisper word, have someone repeat it

what is a romberg test?

• Tests for balance

• Positive test indicates impaired vestibular function (problem of inner ear)

diagnostics for ear disorders

CT or MRI to detect abnormalities

treatments for ear disorders

• Remove foreign objects

• Remove earwax with drops or manually 

• Myringotomy tubes (tubes in the tympanic membrane to allow drainage of fluid, usually little kids)

• Hearing aids

• SNHL can be treated with cochlear implants