Health Assessment Jarvis: Ch 16 Ears Flashcards

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Questions and Answers

What is the lymphatic drainage of the external ear associated with?

Parotid nodes (correct)

Mastoid nodes (correct)

Superficial cervical nodes (correct)

None of the above

Based on the otoscopic examination findings of a 5-year-old child, what is the most likely diagnosis?

Serous otitis media (correct)

Acute purulent otitis media

Resolving cholesteatoma

Early stages of perforation

What could the ulcerated crusted nodule with an indurated base be indicative of?

Tophus

Keloid

Benign sebaceous cyst

Potential carcinoma (correct)

What is an early sign of otitis media?

Hypomobility Signup and view all the answers

What should the nurse do when seeing dense white patches on the tympanic membrane?

Know these are scars from frequent infections Signup and view all the answers

What is the correct procedure for otoscopic examination on a child under 3 years?

Pulling the pinna down Signup and view all the answers

Which factor places young children at risk for ear infections?

Passive cigarette smoke Signup and view all the answers

What does an area of black and white dots on the tympanic membrane suggest?

Yeast or fungal infection Signup and view all the answers

What should a swimmer do to prevent otitis externa?

Use rubbing alcohol or 2% acetic acid eardrops Signup and view all the answers

What does hearing a buzzing sound indicate?

Tinnitus Signup and view all the answers

What does objective vertigo mean for a patient?

Feels like the room is spinning Signup and view all the answers

What is the appropriate response for sudden hearing loss after an accident?

Notify the health care provider Signup and view all the answers

Which changes in hearing occur with aging? (Select all that apply)

Progression of hearing loss is slow Signup and view all the answers

The portion of the ear that consists of movable cartilage and skin is called the:

Auricle Signup and view all the answers

Which statement about cerumen is correct?

The purpose of cerumen is to protect and lubricate the ear. Signup and view all the answers

The tympanic membrane should appear:

Pearly gray and slightly concave. Signup and view all the answers

Which statement concerning the eustachian tube is true?

It helps equalize air pressure on both sides of the tympanic membrane. Signup and view all the answers

The middle ear functions to:

Conduct vibrations of sounds to the inner ear Signup and view all the answers

Which cranial nerve is responsible for conducting nerve impulses to the brain from the organ of Corti?

VIII Signup and view all the answers

Which statement is true concerning air conduction?

Air conduction is the normal pathway for hearing. Signup and view all the answers

During the assessment of a patient with sensorineural hearing loss, the nurse should:

Ask the patient what medications he is currently taking. Signup and view all the answers

The portion of the ear responsible for the sensation of spinning is the:

Labyrinth Signup and view all the answers

Rubella during the first trimester can damage which part related to the infant's hearing?

Rubella can damage the infant's organ of Corti, which will impair hearing. Signup and view all the answers

A 2-year-old child with frequent ear infections should be informed that:

Your son's eustachian tube is shorter and wider than yours because of his age, which allows for infections to develop more easily. Signup and view all the answers

The most likely cause of progressive hearing loss in a 31-year-old patient is:

Otosclerosis Signup and view all the answers

In a 70-year-old patient, having trouble hearing in large groups may suggest:

Nerve degeneration in the inner ear Signup and view all the answers

The finding of dry, flaky cerumen in a 20-year-old patient is significant because:

Is a normal finding, and no further follow-up is necessary. Signup and view all the answers

An important question for a patient with a suspected perforated eardrum would be:

Is a normal finding, and no further follow-up is necessary. Signup and view all the answers

Pain in the left ear when people speak loudly may indicate:

A characteristic of recruitment. Signup and view all the answers

In taking the history of a 6-month-old infant, the nurse should ask:

Does your baby seem to startle with loud noises? Signup and view all the answers

During an otoscopic examination on an adult, the correct action is to:

Pull the pinna up and back before inserting the speculum. Signup and view all the answers

What indicates the most important reason for assessing drainage from the ear canal after head injuries?

Bloody or clear watery drainage can indicate a basal skull fracture. Signup and view all the answers

In performing a voice test to assess hearing, the nurse should:

Whisper a set of random numbers and letters, and then ask the patient to repeat them. Signup and view all the answers

For a 3-year-old child with a suspected ear infection, the nurse should:

Perform the otoscopic examination at the end of the assessment. Signup and view all the answers

When examining a newborn's ear, which statement is true?

The normal membrane may appear thick and opaque. Signup and view all the answers

What is the expected response when assessing the hearing of a 7-month-old infant by clapping hands?

Turns his or her head to localize the sound. Signup and view all the answers

An 80-year-old patient undergoing an ear examination may show which normal finding?

High-tone frequency loss Signup and view all the answers

If a 23-year-old patient has an auricle that is tender and reddish-blue, what is an important consideration?

Any prolonged exposure to extreme cold. Signup and view all the answers

In a 3-year-old boy with a bright red tympanic membrane, the findings are indicative of:

Acute otitis media. Signup and view all the answers

The purpose of tympanostomy tubes in children is to:

Decrease pressure and allow for drainage. Signup and view all the answers

Study Notes

Ear Anatomy and Function

Auricle (pinna) is the external ear made of movable cartilage and skin.
Cerumen (earwax) protects and lubricates the ear; its presence does not indicate poor hygiene.
Tympanic membrane should appear pearly gray and slightly concave, reflecting the otoscope light.

Eustachian Tube

The eustachian tube helps equalize air pressure on either side of the tympanic membrane, crucial during altitude changes.

Middle Ear Functions

The middle ear conducts sound vibrations from the outer ear to the inner ear, enhancing auditory transmission.

Cranial Nerve VIII

Cranial Nerve VIII is responsible for transmitting auditory impulses from the organ of Corti to the brain.

Hearing Loss Assessment

Air conduction is the normal hearing pathway; conductive hearing loss occurs due to mechanical dysfunction in the outer or middle ear.
Sensorineural hearing loss may arise from aging (presbycusis) or ototoxic medications.

Signs of Ear Conditions

Vertigo indicates labyrinth inflammation affecting balance.
Hearing loss related to rubella in pregnancy can damage the organ of Corti in the fetus.
Frequent ear infections in children are often due to anatomic differences; their eustachian tubes are shorter and more horizontal.

Conductive Hearing Loss

Otosclerosis commonly causes conductive hearing loss in young adults, while presbycusis affects older adults.

Pediatric Considerations

Infants should be assessed for hearing response to loud noises as exposure to ototoxic drugs increases risks for hearing deficits.

Otoscopic Examination Techniques

For adults, pull the pinna up and back; for children, perform the examination last to reduce anxiety.
Newborn tympanic membranes may appear thick and opaque.

Symptoms Indicative of Conditions

Bright red tympanic membranes suggest acute otitis media; amber-yellow suggests serous otitis media.
Pain and redness in the auricle may indicate frostbite or external ear infections.

Tympanostomy Tubes

Tympanostomy tubes relieve pressure and allow drainage in children with recurrent ear infections.

Assessment of External Ear

Enlarged superficial cervical nodes indicate inflammation, common in otitis externa.
Crusty nodules behind the pinna in older adults require evaluation for potential carcinoma.

General Facts

High-tone frequency loss is common in older individuals due to presbycusis.
Whisper tests involve repeating random numbers and letters to assess hearing quality.### Carcinoma and Biopsy Referral
A patient presenting with an ulcerated, crusted nodule that has an indurated base, which intermittently bleeds and fails to heal, may have carcinoma.
Referral for a biopsy is essential for proper diagnosis.

Otitis Media Assessment

Early signs of otitis media include hypomobility of the tympanic membrane, indicating increased pressure.
Symptoms can extend to redness and bulging of the membrane.

Tympanic Membrane Examination in Adolescents

Dense white patches on the tympanic membrane indicate scarring from recurrent ear infections.
Scarring does not necessarily affect auditory function.

Otoscopic Examination in Young Children

During an otoscopic exam on children under 3 years, the pinna should be pulled down to ensure proper visualization.

Risk Factors for Ear Infections in Children

Exposure to passive cigarette smoke significantly increases the risk of ear infections in young children.
Other factors such as family history, air conditioning, and cerumen levels may also contribute but are less emphasized.

Fungal Infections in the Ear

Black and white dots on the tympanic membrane and ear canal suggest a yeast or fungal infection (otomycosis).

Prevention of Otitis Externa

Swimmers are advised to use rubbing alcohol or 2% acetic acid eardrops after swimming to prevent otitis externa by drying the ear canal.

Tinnitus Identification

Tinnitus is characterized by internal sounds such as ringing, buzzing, or crackling, often associated with various ear disorders.

Types of Vertigo

Objective vertigo causes the sensation that the room is spinning, while subjective vertigo makes one feel as though they are moving.
True dizziness differs from vertigo; it is a feeling of lightheadedness or unsteadiness.

Sudden Hearing Loss Protocol

Any sudden hearing loss, especially post-trauma, warrants immediate notification to the healthcare provider for potential intervention.

Aging and Hearing Changes

Presbycusis, a common age-related hearing loss, typically begins in middle age and progresses slowly.
It impairs the ability to hear high-frequency sounds and consonants, making speech sound garbled.
Patients may also struggle with sound localization.

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Description

Test your knowledge on Chapter 16 of 'Health Assessment' by Jarvis, focusing on the anatomy and examination of the ears. These flashcards cover essential terms, functions, and nursing procedures related to ear health. Perfect for nursing students preparing for assessments!