Download Auditory Alterations

Pediatric Problems
 Otitis Media
 Foreign bodies
-beads, pencil erasers, insects
 Treatment
-carefully remove foreign body (if able)
-seek medical care
Ménière's Disease
• Ménière's Disease: entire inner ear canal
system affected
• Population at risk:
- usually first occurs in people aged
20 – 50 yrs old
-more common in men and in white
people
• S & S: three main features
-Tinnitus
- one-sided sensorineural hearing loss
- vertigo
Treatment for Ménière's Disease
 Nonsurgical management includes:
-slow head movements
-diet and lifestyle changes
-smoking cessation.
Drug Therapy
• Nicotinic Acid
• Antihistamines:
-diphenhydramine hydrochloride (Benadryl)
• Antiemetics:
-chlorpromazine hydrochloride (Thorazine)
• Intratympanic therapy: gentamicin & steroids
• Other Measures: Meniett device
Meniett’s Device
 Treatment with Meniett’s device
-tympanostomy tube inserted into eardrum
-pulses of pressure delivered to inner ear
-self directed for 5 mins. TID
-studies shown effective in reducing vertigo *
*Gates,G., Verrall,A., Green,J.D., Tucci, D.L., & Telian,
S.A.(2006). Meniett clinical trial:Long –term follow-up.
Archives of Otolaryngology-Head and Neck Surgery,
132(12), 1311-1316.
Ménière’s Disease: Surgical
Management
 Endolymphatic decompression.
 Surgical management: last resort because
hearing in the affected ear is often lost from the
procedure
 Labyrinthectomy
Hearing Loss
 Types of hearing loss
 Conductive r/t inflammation or obstruction of external
or middle ear
 Sensorineural r/t loud noise, drugs, medical problem
Population at risk: older adult
Anatomy of Hearing Loss
Treatment for Hearing Loss
 Non-surgical
-hearing aids
-assistive devices using amplifiers
 Surgical Interventions
-tympanoplasty
-stapedectomy
Tympanoplasty
Nursing Interventions: Pre-op
 Free of infection
 Ear flushes
 Pt. Education: post op expectations
-hearing diminished initially
-medications
Nursing Interventions Post-op
 Monitor dressings
 Avoid increased pressure on ear
 Medications
 Positioning

-Tympanoplasty: lie flat with operative ear face up
 Potential complication for stapedectomy

-Assess for facial nerve damage or muscle weakness
Community-Based Care
 Home care management
 Health teaching
 Health care resources
 Worldwide
http://www.wfdeaf.org/
NURSING DIAGNOSES FOR
ALTERED HEARING
 Risk for injury related to altered
auditory perception
 Social Isolation related to decreased
hearing
 Anxiety related to loss of hearing