Summary NR 325 ADULT HEALTH 2 ROK 2 Hearing Impaired

NR325 ROK EXAM 2 1 NR 325 ADULT HEALTH 2 ROK 2 Hearing Impaired Gerontologic considerations • External auditory canal narrows; cerumen glands atrophy & produces thicker, drier cerumen • Tympanic membrane is less flexible, & ossicle joints calcify • Cochlear hair cell degeneration & loss of auditory neurons n the organ of the Corti lead to presbycusis, and age-related sensorineural hearing loss, characterized by decreased ability to hear high-frequency sounds & resulting in difficulty hearing & localizing normal speech Meniere’s disease-client education • Disorder of the inner ear in which there is excessive accumulation of endolymphatic fluid in the membranous labyrinth; also called idiopathic endolymphatic hydrops • LOW SODIUM DIET, and if symptoms are severe, fluid restriction • AVOID use of alcohol, caffeine, nicotine • Bedrest to control vertigo; assist with ambulation • MEDICATION THERAPY: o Atropine—to reduce parasympathetic response o CNS depressants—alternative to atropine o Diuretics o Antihistamines—if allergy present o Antivertigo and antiemetics • Take meds as prescribed • Learn signs of impending attack: o Fullness in affected ear o Increasing tinnitus o Headache o Lie down in dark quiet room if home, or pull off road for safety in driving—when attack begins • Avoid sudden movements/position changes; move head slowly, do not get up unassisted during attack • Practice balance training exercises; these consist of moving the head up and down, side to side, and tilting the head to the left and right, repeated 10 times each 2x day Client teaching for eardrops • Clean technique unless tympanic membrane is damaged, then use sterile technique • Side-lying position with ear being medicated uppermost • Clean pinna of ear & opening of external ear canal with solution • Warm medication container in hand or warm H2O for comfort, ear drops must be at least room temp, not straight out of fridge; partially fill the ear dropper with med • Straighten auditory canal by pulling pinna UP AND BACK in ADULT or OLDER CHILD, or DOWN AND BACK in an INFANT or YOUNG CHILD • Hold bottle or dropper ½-inch above ear canal and instill correct number of drops along the side of ear canal • Apply gentle pressure with finger to the tragus of ear to enhance flow of med into canal • Maintain side-lying position for 2-5 minutes for even med distribution • Before pt. rises, loosely place cotton ball at the meatus and leave in place for 20-30 minutes to prevent med loss Client teaching to protect hearing loss