AUDITORY NURSING BULLETS
Mastoiditis may be acute or chronic and results from untreated or inadequately treated chronic or acute
otitis media. Interventions focus on stopping the infection before it spreads to other structures.
The inner ear contains the semicircular canals, cochlea, and the distal end of the eight cranial nerves,
and maintains a sense of balance or equilibrium.
Mnires disease has characteristic symptoms that include tinnitus, unilateral hearing impairment,
and severe episodes of vertigo.
The inner ear contains the sensory receptors for sound and equilibrium. Provide safety measures for
the client with an inner ear disorder because the client ay experience vertigo.
Presbycusis is a gradual nerve degeneration associated with aging; it leads to degeneration or atrophy
of the ganglion cells in the cochlea and a loss of elasticity of the basilar membranes.
Hearing impairment occurs with aging; usually high-frequency tones are less perceptible.
Ventilating tubes inserted into the tympanic membranes are tiny, white, spool-shaped tubes. If the
tubes fall out, it is not an emergency but the physician should be notified.
Infants and children have eustachian tubes that are shorter, wider, and straighter, which makes them
more prone to otitis media.
A priority nursing intervention in the care of a client with Mnires disease is instituting safety
measures because severe vertigo can occur.
Instruct the client experiencing an episode of vertigo to avoid watching television because flickering of
lights may exacerbate symptoms.
Because of the vertigo that occurs in the client with Mnires disease, safety is a priority concern.
Myringotomy is commonly performed for clients who experience chronic otitis media. Tympanoplasty
tubes may be inserted into the middle ear to allow continued drainage and to equalize pressure and
allow ventilation of the middle ear.
Administering ear medications is the responsibility of the licensed nurse. This activity cannot be
delegated to unlicensed assistive personnel.
Excessive nose blowing and rapid changes in pressure that occur with nonpressurized air flights can
increase pressure in the middle ear and result in trauma to the tympanic membrane.
A priority nursing intervention in the care of a client with Mnires disease is instituting safety
measures because the client experienced episodes of dizziness.
One ear is tested at a time during a voice test. The ear that is not being tested should be occluded by
the client.
The Rinne tuning fork test compares the clients hearing by air conduction and bone conduction.
Water is never inserted into the ear canal to remove an insect because it would cause the insect to
swell and be more difficult to remove.
A sensorineural hearing loss occurs as a result of a pathological process in the inner ear or of the
sensory fibers that lead to the cerebral cortex.
For the client with mastoiditis, surgical removal (mastoidectomy) of the infected material may be
indicated. Once tissue that is infected is removed, a tympanoplasty is performed to reconstruct the
ossicles and tympanic membranes in an attempt to restore normal hearing.
Damage to the inner ear can result in sensorineural hearing loss. The nurse can teach the client to
protect the inner ear by reducing the amplitude of loud sounds.
Speak in a normal tone of voice to the client with impaired hearing and avoid shouting.
Clients with Mnires disease often experience vertigo and need to be protected from injury.
Tympanoplasty tubes may be inserted into the middle ear during a myringotomy procedure to allow
continued drainage and to equalize pressure and allow ventilation of the middle ear.
In the client with a head injury or the client who underwent cranial surgery, assess drainage from the
ears or nose for the presence of glucose in the drainage; cerebrospinal fluid contains glucose.
Surgical intervention for the treatment of otosclerosis involves removal of the bony growth causing the
hearing loss. Nonsurgical intervention promotes the improvement of hearing through amplification.
A priority nursing intervention in the care of a client with Mnires disease is instating safety
measures.
Mastoiditis may be acute or chronic and results from untreated or inadequately treated chronic or acute
otitis media.
The inner ear maintains sense of balance or equilibrium. For the client with an inner ear disorder,
maintain safety precautions as necessary.
Impacted cerumen can result in a conductive hearing loss, which is a mechanical dysfunction or
blockage of sound waves to the inner ear fibers.
As a result of the aging process, the older client has a decreased response to high-frequency sounds.
Low-pitched voice tones are heard more easily and can be interpreted by the older client.
Mnires disease is characterized by tinnitus, unilateral hearing loss, and vertigo.
Symptoms of an acoustic neuroma usually begin with tinnitus and progress to gradual hearing loss.
This tumor rarely recurs after surgical removal.
Teach the client who needs to use a hearing aid to avoid excessive wetting of the hearing aid and try to
keep the hearing aid dry.
Many people who are hearing impaired spontaneously begin to read lips.
When communicating with a client who is hearing impaired, stand in front of the client and speak in a
normal tone of voice.
Mnires disease is also called endolymphatic hydrops. It refers to dilation of the endolymphatic
system by overproduction or decreased reabsorption of endolymphatic fluid.
Mnires disease is characterized by tinnitus, unilateral sensorineural hearing loss, and vertigo.
For the client with Mnires disease, sodium and fluid restrictions may be prescribed to reduce
endolymphatic fluid production, and the client is instructed to stop smoking because of its
vasoconstrictive effects.
Instruct the client with Mnires disease to move the head slowly to prevent worsening of the vertigo
that accompanies the disease.
Otosclerosis is a genetic disorder of the labyrinthine capsule of the middle ear that results in a bony
overgrowth of the tissue surrounding the ossicles. It causes the development of irregular areas of new
bone formation and causes the fixation of the bones.
When performing a voice test to assess hearing ability, each ear is tested separately.
Tuning fork tests are used to measure hearing on the basis of air conduction or bone conduction. This
includes the Weber and Rinne tests.
Presbycusis leads to degeneration or atrophy of the ganglion cells on the cochlea and a loss of
elasticity of the basilar membranes. It leads to compromise of the vascular supply to the inner ear, with
changes in several areas of the ear structure.
In Mnires disease, the vertigo can be so intense that even while lying down, the client holds the bed
or ground in an attempt to prevent the whirling.
The auditory canal (eustachian tube) allows equalization of air pressure on each side of the tympanic
membrane so that the membrane does not rupture. Opening of a blocked eustachian tube is important
in maintaining this equalization.
The mastoid process, the bony ridge located over the temporal bone, is part of the external ear
structures. Infection of the mastoid process can occur, may be acute or chronic, and results from
untreated or inadequately treated chronic or acute otitis.
Assessment of the ear canal and tympanic membrane is necessary before performing an ear irrigation.
An irrigation is not performed if there is a perforation in the tympanic.
Classic symptoms of Mnires disease include tinnitus, vertigo, and unilateral hearing loss.
Assessment techniques to evaluate the presence of hearing loss should be a component of any health
assessment of an adult.
Assessment questions and physical assessment techniques to evaluate the presence of hearing loss
should be a component of any health assessment.
