EENT Terminology and Assessments

EYES/EARS/NOSE/MOUTH/THROAT Overview

• Course: CNUR 107, March 2025

Terminology

EYES

• Diplopia: Double vision.

• Strabismus: Misalignment of eyes.

EARS

• Otalgia: Ear pain.

• Vertigo: Sensation of spinning.

• Tinnitus: Ringing or buzzing in ears.

• Presbycusis: Age-related hearing loss.

NOSE, MOUTH, THROAT

• Dysphagia: Difficulty swallowing.

• Epistaxis: Nosebleeds.

• Sleep Apnea: Interruption in breathing while sleeping.

• Halitosis: Bad breath.

EYES Subjective Data

Health History Questions

• Assess for visual difficulties: decreased acuity, blurring, blind spots, night blindness, double vision.

• Inquire about any pain, redness, or swelling of the eye.

• Note any watering or discharge.

• Gather history of prior eye problems such as glaucoma, cataracts, trauma, strabismus, or diplopia.

• Ask about the use of corrective lenses (contacts/glasses).

• Self-care behaviors: history of regular eye examinations and use of protective eyewear.

• Identify common eye issues prompting care requests.

Additional Subjective Data for Older Adults

• Visual loss and coping methods; impact on activities like reading.

• Difficulty moving, driving, or going upstairs.

• Last glaucoma test; management with eye drops if glaucoma diagnosed.

• Cataract history and vision changes.

• Dryness or burning sensation; management techniques.

Objective Data

Central Visual Acuity

• Snellen Eye Chart: Measure distance vision.

• Near vision assessment.

Visual Fields

• Confrontation Test: Assess peripheral vision against the examiner's.

Extraocular Muscle Function

• Corneal Light Reflex: Checks alignment of eye axes.

• Diagnostic Positions: Test 6 cardinal fields of gaze.

• Inspection & Palpation: Includes external eye structures and anterior eyeball structures.

• Assess pupillary light reflex and accommodation (PERRLA).

Visual Acuity Process

• Position client 20 feet from Snellen chart, verify use of corrective lenses.

• Test one eye; normal: 20/20 vision.

Further Visual Field Testing

Confrontation Test Details

• Client covers one eye; examiner covers opposite eye.

• Check peripheral to midline vision.

Extraocular Muscle Functions

Tests & Findings

• Cover-Uncover Test: Observes eye movement when one eye is covered and uncovered.

• Diagnostic Positions Test: Movement through 6 cardinal positions to evaluate eye tracking.

Inspection & Palpation

• Assess general appearance of external structures (eyebrows, eyelids, lashes, eyeballs).

• Inspect conjunctiva & sclera; palpate lacrimal apparatus.

Anterior Eyeball Inspection

• Cornea should appear smooth and transparent.

• Iris: round, evenly colored, assess pupil reactions.

Older Adult Considerations

• Decreased visual acuity, near vision, peripheral vision impacts functioning.

• Possible dryness/burning; management strategies.

• Common disorders: cataracts, glaucoma.

EARS Subjective Data

Health History Questions

• Inquire about earache, infections, ear discharge, and hearing difficulties.

• Ask about tinnitus and vertigo.

• Assess ear cleaning methods and use of protective gear.

Objective Data for Ears

Inspection & Palpation

• Inspect external structures and conduct otoscopic examination.

• Assess hearing acuity via whispered voice test.

Otoscopic Examination Steps

• Hold otoscope appropriately while inspecting the external ear canal and tympanic membrane.

• Assess tympanic membrane characteristics: translucent, light reflex position.

Hearing Acuity Assessment

Whispered Voice Test Procedure

• Client positioned an arm's length away; test each ear individually.

Older Adult Ear Considerations

• Presbycusis: Age-related hearing loss requires annual assessment post age 65.

Communication Strategies for Individuals with Hearing Impairment

• Ensure clarity of speech and visibility of mouth and gestures.

• Use writing/images to supplement verbal communication.

NOSE, MOUTH, THROAT Anatomy Overview

Nose

• Filters, warms, and moistens inhaled air; sensory organ of smell.

Mouth

• First segment of digestion, airway for respiration, contains taste buds.

Throat (Pharynx)

• Divided into oropharynx and nasopharynx; contains tonsils and eustachian tube openings.

Subjective Data for Nose, Mouth, Throat

• Assess nasal symptoms, mouth sores, throat pain, and oral care practices.

Additional Subjective Data for Older Adults

• Inquire about dryness and oral health conditions.

Objective Data for Nose and Throat

Inspection and Palpation

• Assess external nose structure and patency of nostrils.

Sinus Assessment

• Palpation of frontal and maxillary sinuses; client should feel firm pressure.

Mouth Inspection Details

• Evaluate lips, teeth, gums, tongue, buccal mucosa, and palate for abnormalities.

Throat Inspection

• Use penlight for tonsil grading and assess for posterior wall lesions.

Older Adult Health Considerations

• Diminished senses of smell and taste; increased risks due to reduced saliva production.

Health Promotion Strategies

• Focus on access to eye, dental, and hearing care; awareness of available community services.

Social Determinants of Health

• Consider barriers for low-income individuals regarding necessary health services.

• Utilize nursing assessments for identifying and addressing potential problems in patients.