Worksheet
Patient with Auditory Problems
1. List some ototoxic medications:
Gentamicin, NSAIDS, Lasix, Vancomycin, ….
2. What are the clinical manifestations (signs and symptoms) of otitis media?
Drainage from the ear, pain, hearing difficulties, loss of balance, tenderness, tugging or
pulling on ear, nausea.
3. List medical and nursing treatments for otitis media:
Amoxicillin ear drops, analgesic drops (lidocaine)
Warm or cold compresses, ear drop/medication teaching, room temp solution, monitor for
worsening symptoms, change in drainage, swooshing sound with Tympanic Rupture
4. What are the important points to teach about maintaining ear and hearing health?
Regular otoscope exams, diagnostic test, no Q-Tip use, report any sudden hearing lost along
with ringing in the ears, no loud music (noise control), long term use of ototoxic drug use.
5. Describe Menier’s disease and treatments:
An inner ear disorder that causes episodes of vertigo. (drop attacks) Can be treated by limiting
sodium, caffeine, and nicotine. If it becomes severe surgery is recommended.
Medications that can help: Antihistamines, Sedatives, Antiemetics, Diuretics.
6. What is the difference between conductive and sensorineural hearing loss?
Conductive hearing loss – a condition that affects the outer (external) and middle ear and
impairs the transmission of sound to the inner ear. Caused by cerumen (wax) build up, foreign
object, External otitis. Patient will speak in a low tone voice and can hear better in noisy
environments.
Sensorineural hearing loss – impairment of function of the inner ear or CN IVIII (8) caused by
ototoxicity, congenital factors (genetics), presbycusis. Hearing Aid won’t be of any use because
the patient can hear sound but cannot understand speech and a hearing aid will amplify sound
but does not make speech clearer.
7. Describe BPPV and associated treatments: Episodes of dizziness and a sensation of spinning
with certain head movements.
Treatment: Epley’s Maneuvers
8. What should be taught to the patient receiving hearing aids for the first time? To adjust volume
in a quiet environment, get fitted by a specialist, turn hearing aid on before putting hearing
aid into ear, and to be optimistic because the best results are from motivated optimistic
patients
9. Important terms: presbycusis, vertigo, nystagmus:
Presbycusis – loss of hearing related to age
Vertigo – Patient reports the room, or objects around the room are spinning
Nystagmus – Involuntary movement of the eyes (up, down, left, right, circular motions)
That mimic eye twitches, tested by the 6 cardinal fields of gaze, accommodation test.
Additional Review from Chapter 20
10. Important terms from chapter 20 (eyes): myopia, hyperopia, presbyopia, puncta occlusion
Myopia – nearsightedness (Can’t see far)
Hyperopia – farsightedness (Can’t see nearby)
Presbyopia – loss of accommodation related to age (loss of farsightedness)
Puncta Occlusion – Applying pressure to the Puncta region of the eye to keep medications
localized and to prevent a systemic affect
11. What is the normal range of intraocular pressure (IOP)? 10 – 21 mm HG
12. Describe the 2 types of glaucoma, including S/S and treatments:
Primary (Open Angle) Chronic - has a gradual onset, does not require immediate medical
attention, is not painful, peripheral vision loss, angle is open and drainage system is clogged.
Secondary (Closed Angle) Acute – Requires immediate medical attention, painful, sudden
onset, can result vision loss.
No surgical cure, medications are eyedrops.