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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.