Hearing Loss and Deafness Chapter 21 Copyright © 2017, Elsevier Inc. All Rights Reserved. Hearing Loss and Deafness Causes of hearing loss Copyright © 2017, Elsevier Inc. All Rights Reserved. Hearing Loss and Deafness Conductive hearing loss Patient often speaks softly Identify and treat cause Suggest hearing aid Types of hearing loss Hearing Loss and Deafness Sensorineural hearing loss Results in ability to hear sound but inability to understand speech Can lead to misunderstanding by others Hearing aids make sounds louder but not clearer Sensorineural hearing loss Caused by Hearing Loss and Deafness Impairment of the inner ear Vestibulocochlear nerve (CN VIII) damage Congenital and hereditary factors Noise trauma Aging (presbycusis) Meniere’s disease Hearing Loss and Deafness Sensorineural hearing loss Ototoxic drugs Aspirin NSAIDs Antibiotics Loop diuretics Chemotherapy drugs Types of hearing loss Hearing Loss and Deafness Mixed hearing loss Central and functional hearing loss Deafness in other family members often present Can be psychologically or emotionally related Hearing Loss and Deafness Types of hearing loss Sudden hearing loss Sudden deafness Unexplained, rapid loss of hearing Usually affects just one ear Medical emergency Nursing/Interprofessional Management Hearing Loss and Deafness Copyright © 2017, Elsevier Inc. All Rights Reserved. This Photo by Unknown Author is licensed under CC BY-SA Hearing Loss and Deafness Clinical manifestations Early signs of hearing loss often go unnoticed by patient Pressure by others is a significant factor in whether help is sought Copyright © 2017, Elsevier Inc. All Rights Reserved. Hearing Loss and Deafness Clinical manifestations The unseen handicap This Photo by Unknown Author is licensed under CC BY-NC-ND Understanding should be validated in patient teaching interactions Obtain interpreter assistance Copyright © 2017, Elsevier Inc. All Rights Reserved. Hearing Loss and Deafness Clinical manifestations Ineffective communication and interaction can be frustrating for both patient and caregiver(s) Withdrawal, suspicion, loss of self-esteem and insecurity are common psycho-emotional Copyright © 2017, Elsevier Inc. All Rights Reserved. complications with advancing hearing loss Hearing Loss and Deafness Tinnitus Perception of noise without an actual source of sound “Ringing in the ears” May be first symptom of hearing loss Most commonly caused by noise More than 200 drugs cause tinnitus Copyright © 2017, Elsevier Inc. All Rights Reserved. Health Promotion Environmental noise control Noise is the most preventable cause of hearing loss Hearing loss caused by noise is not reversible Avoidance of continued exposure to noise levels greater than 70 dB is essential Nursing/and Interprofessional Management Hearing Loss and Deafness Copyright © 2017, Elsevier Inc. All Rights Reserved. Hearing conservation at work Noise exposure analysis Hearing protectors Periodic hearing screening Nursing/Interprofessional Management Hearing Loss and Deafness Education Copyright © 2017, Elsevier Inc. All Rights Reserved. Health Promotion Immunizations Fetal damage can be caused by viruses Regularly scheduled immunizations should be promoted for children and adults Nursing/Interprofessional Management Hearing Loss and Deafness Women of childbearing age need special consideration Copyright © 2017, Elsevier Inc. All Rights Reserved. Ototoxic substances—drugs Ototoxic substances— industrial chemicals Toluene, carbon disulfide, mercury Monitoring is important Nursing/Interprofessional Management Hearing Loss and Deafness Discontinuing drug may be indicated Copyright © 2017, Elsevier Inc. All Rights Reserved. Nursing/Interprofessional Management Hearing Loss and Deafness Assistive devices and techniques Hearing aids Fit by a specialist Provide amplification, sound lateralization, speech discrimination Require a motivated, capable user for optimum success Copyright © 2017, Elsevier Inc. All Rights Reserved. Types of Hearing Aids Copyright © 2017, Elsevier Inc. All Rights Reserved. Nursing/Interprofessional Management Hearing Loss and Deafness Assistive devices and techniques Speech reading also called Lip reading Visual cues associated with speech facilitates understanding for 40% of spoken words Copyright © 2017, Elsevier Inc. All Rights Reserved. This Photo by Unknown Author is licensed under CC BY-NC Nursing/Interprofessional Management Hearing Loss and Deafness Sign language For those with profound impairment Sign language is not universal American sign language (ASL) is used in the United States and in English-speaking areas of Canada Copyright © 2017, Elsevier Inc. All Rights Reserved. Nursing/Interprofessional Management Hearing Loss and Deafness Implantable hearing device or aid Fully implantable Nothing externally visible Partially implantable This Photo by Unknown Author is licensed under CC BY-SA Copyright © 2017, Elsevier Inc. All Rights Reserved. Have an external component worn behind or in the ear This Photo by Unknown Author is licensed under CC BY-SA-NC Nursing/Interprofessional Management Hearing Loss and Deafness Cochlear implant Copyright © 2017, Elsevier Inc. All Rights Reserved. Nursing/Interprofessional Management Hearing Loss and Deafness This Photo by Unknown Author is licensed under CC BY-SA Copyright © 2017, Elsevier Inc. All Rights Reserved. Amplification devices Alerting systems Texting systems Closed caption Specially trained dogs Otosclerosis The mos t common caus e of bilat eral hearing los s in young adult s Tympanum takes on a reddish blush (Schwartz’s sign) Poor air conduction Treated with medications that slow bone resorption, hearing aids, and surgery Copyright © 2017, Elsevier Inc. All Rights Reserved. Gerontologic Considerations Classification of Presbycusis Copyright © 2017, Elsevier Inc. All Rights Reserved.
