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Chapter 51
Care of Patients with Ear and
Hearing Problems
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
Conditions Affecting the External and
Middle Ear
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External otitis
Furuncle
Perichondritis
Cerumen or foreign bodies
Otitis media
Mastoiditis
Trauma
Neoplasms
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Types of Interventions
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Infection control (equipment)
Medications
Surgical
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Compare/contrast with surgical interventions for
other types of operative procedures
Patient teaching
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Earwick
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Irrigation of the External Ear
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Otitis Media
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Three types:
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Acute
Chronic
Serous
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Conditions Affecting the Inner
Ear
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Tinnitus
Vertigo and dizziness
Labyrinthitis
Ménière's disease
Acoustic neuroma
Hearing loss
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Acoustic Neuroma
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Anatomy of Hearing Loss
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Types of Interventions
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Medical
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Early detection
 Safety measures (due to hearing loss)
 Dietary (nutrition, hydration)
 Medication
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Surgical
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Hearing aids
Implants (e.g., cochlear devices)
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Types of Interventions (cont’d)
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Communication
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Hearing aids
Lip-reading, sign language
Speech therapy
Community resources
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Support groups
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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An 80-year-old patient presents for his annual check-up. His son
reports that his hearing has significantly diminished over the past
few years. The patient tells the nurse that he believes that his
hearing is “just fine” and that “nothing is wrong” with him.
When the patient states that he feels fine and nothing is wrong with
his hearing, what is the appropriate nursing response?
A. “You are right; there is nothing wrong with you.”
B. “Why don’t you believe what your children are saying about
your hearing?”
C. “Don’t be scared of losing your hearing.”
D. “It must feel frightening to think about losing your hearing.”
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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(cont’d)
The patient is diagnosed with suspected hearing loss. Which
precautions would you teach the patient and his family about ear
care before discharge? (Select all that apply.)
A.
B.
C.
D.
E.
Use cotton swabs to clean your ear canal after every shower.
Avoid exposure to loud music or other noises.
Nothing smaller than a fingertip should be inserted into the ear
canal.
Use an ear irrigation syringe to remove built up ear wax
(cerumen).
Ear plugs should be used when engaging in all water sports to
avoid infection.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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(cont’d)
The patient’s son asks what he can do to better
communicate with his father.
Which teaching is most appropriate?
A. Refer him and the patient to a sign language
class.
B. Encourage the patient to learn to read lips.
C. Direct him to community support groups.
D. Promote family dialogue about hearing aids.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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(cont’d)
A week later, the patient’s hearing is tested by audiometry and it is
determined that he needs a hearing aid.
Which statement indicates the need for additional teaching about
hearing aid care?
A. “I can wear my hearing aid at all times, even when bathing.”
B. “I should check and replace the battery whenever needed.”
C. “I can clean the hole in the hearing aid of debris with a
toothpick.”
D. “I should adjust the hearing aid’s volume to the lowest setting
that lets me hear to avoid feedback squeaking”
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Chapter 51
Audience Response System
Questions
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Question 1
A priority nursing intervention for a patient with
tinnitus is:
A. Evaluate medications for ototoxicity.
B. Encourage music or soft white noise during
sleeping hours.
C. Acknowledge the psychological stressors of
the disorder.
D. Provide education on loudness levels to
prevent hearing loss.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Question 2
A patient is reporting ear pressure, dizziness,
and decreased hearing. What should the nurse
do?
A. Examine the ear for excessive ear wax
(cerumen).
B. Ask the patient if he or she is experiencing
headaches, malaise, or pain.
C. Establish a timeline for the patient’s
symptoms.
D. Examine the patient’s hearing acuity.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Question 3
Which is a nursing intervention for maximizing
communication with a patient with hearing loss
while he or she is under Airborne Precautions?
A.
B.
C.
D.
Speak loudly.
Turn the TV volume down or off.
Speak clearly and slowly.
Ensure that you have the patient’s attention
before speaking.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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