47 Questions
When administering eardrops, the nurse needs to pull the portion of the ear that consists of movable cartilage and skin down and back. What is this portion of the ear called?
Auricle
What is the purpose of cerumen in the ear?
To protect and lubricate the ear
When examining the ear with an otoscope, how should the tympanic membrane appear?
Pearly gray and slightly concave
Which part of the ear should the nurse pull down and back when administering eardrops?
Auricle
Which of the following symptoms is characteristic of a carcinoma behind the pinna?
Crusty nodule with an indurated base that intermittently bleeds
What preliminary analysis can be made based on the description of a 5-year-old child's tympanic membrane being amber-yellow with air bubbles visible behind it?
The child most likely has serous otitis media
What is an early sign of otitis media?
Hypomobility of the tympanic membrane
Which of the following symptoms is not associated with otitis externa?
Tinnitus
What findings are suggestive of serous otitis media in a 5-year-old child?
Amber-yellow tympanic membrane with air bubbles visible behind it
What is the most likely diagnosis for a 65-year-old man with a crusty nodule behind the pinna that intermittently bleeds and has not healed over the past 6 months?
Carcinoma, and the patient should be referred for a biopsy
What is the likely diagnosis for a 5-year-old child with a history of chronic ear infections, reporting occasional hearing loss and a popping sound with swallowing, and with an amber-yellow tympanic membrane?
Serous otitis media
What is a characteristic feature of an ulcerated crusted nodule with an indurated base?
Intermittent bleeding and failure to heal
What is the function of the Eustachian tube?
Equalize air pressure between middle and outer ear
What is the normal pathway for hearing?
Air conduction
What can cause sensorineural hearing loss?
Presbycusis and ototoxic drugs
What can damage the organ of Corti and impair hearing in infants?
Maternal rubella infection in the first trimester
Why are infants more prone to ear infections?
Shorter and wider eustachian tube
What causes conductive hearing loss?
Mechanical dysfunction of external or middle ear
Which part of the ear is responsible for vertigo?
Labyrinth
What happens to the eustachian tube during swallowing or yawning?
It opens
What conducts vibrations of sounds to the inner ear?
Middle ear
What conducts nerve impulses to the brain from the organ of Corti?
Auditory portion of cranial nerve VIII
What can impair hearing in infants if it occurs in the first trimester of pregnancy?
Maternal rubella infection
What is the function of the labyrinth?
Responsible for vertigo
Which condition is a common cause of conductive hearing loss in young adults aged 20-40 years?
Otosclerosis
What is presbycusis?
Gradual sensorineural hearing loss in older individuals
Which type of cerumen is more common in Asians and Native Americans?
Dry, flaky cerumen
What should be the focus of history questions when there is a suspected perforated eardrum?
The relationship between ear pain and discharge
What is recruitment in the context of hearing loss?
Significant hearing loss that becomes painful when speech is at low intensity
What could put a child at risk for hearing deficits during pregnancy?
Exposure to maternal ototoxic drugs or maternal rubella
What is the correct action during an otoscopic examination on an adult?
Pull the pinna up and back before inserting the speculum
Why is assessing for any drainage from the ear canal in a patient with head injuries crucial?
Bloody or clear watery drainage can indicate a basal skull fracture
What does purulent drainage from the ear after trauma suggest?
Otitis externa or otitis media
What does a cerebrospinal leak from the ear indicate after trauma?
A basal skull fracture
What is the correct approach in performing a voice test to assess hearing?
Not shield the lips to muffle the sound
What is the expected response of a 7-month-old infant to a loud sudden noise?
Turning their head to localize the sound
What is a normal finding in an 80-year-old patient's ears?
Increased elasticity of the pinna
What does a bright red tympanic membrane with an absent or distorted light reflex in a 3-year-old indicate?
Chronic ear infections
What is the purpose of tympanostomy tubes?
To relieve middle ear pressure and promote drainage
What are the signs of otitis externa?
Severe swelling of the canal, inflammation, and tenderness
What is the recommended distance for the nurse to stand during the otoscopic examination to ensure the patient can hear whispered sounds?
4 feet away
When is it essential to perform an otoscopic examination in infants and children?
Toward the end of the examination
What should the nurse notice in an infant to indicate normal hearing ability?
Turning their head to localize the sound
What is the purpose of cerumen in the ear?
To trap foreign particles and protect the eardrum
What is the function of tympanic membrane?
To transmit sound vibrations to the inner ear
What are tympanostomy tubes surgically inserted into the eardrum for?
To relieve middle ear pressure and promote drainage
What is the expected response of a 7-month-old infant to a loud sudden noise?
Turning their head to localize the sound
Study Notes
Hearing Loss Assessment and Management
- Otosclerosis is a common cause of conductive hearing loss in young adults aged 20-40 years.
- Presbycusis is a gradual sensorineural hearing loss that occurs in 60% of those older than 65 years, affecting localization of sound in noisy environments.
- Dry, flaky cerumen in the ear canal is more common in Asians and Native Americans, while wet cerumen is typical in Blacks and Whites.
- With a suspected perforated eardrum, a history question should focus on the relationship between ear pain and discharge.
- Recruitment is significant hearing loss that becomes painful when speech is at low intensity and is a characteristic of this condition.
- Exposure to maternal ototoxic drugs or maternal rubella during pregnancy could put a child at risk for hearing deficits.
- During an otoscopic examination on an adult, the correct action is to pull the pinna up and back before inserting the speculum.
- Assessing for any drainage from the ear canal in a patient with head injuries is crucial as bloody or clear watery drainage can indicate a basal skull fracture.
- Purulent drainage from the ear after trauma suggests otitis externa or otitis media, while cerebrospinal leak indicates a basal skull fracture.
- In performing a voice test to assess hearing, the nurse should not shield the lips to muffle the sound.
Ear Examination and Assessment Summary
- Otoscopic examination involves whispering random numbers and letters to the patient and asking them to repeat to test hearing.
- Eardrum assessment is mandatory for infants or children with illness or fever and should be performed toward the end of the examination.
- The appearance of the tympanic membrane in a newborn may appear thick and opaque, with mild redness.
- A 7-month-old infant is expected to turn their head to localize a loud sudden noise.
- For an 80-year-old patient, high-tone frequency hearing loss and increased elasticity of the pinna are normal findings.
- Reddish-blue discoloration and swelling of the auricle in a 23-year-old patient could indicate frostbite from prolonged exposure to extreme cold.
- A bright red tympanic membrane with an absent or distorted light reflex in a 3-year-old may indicate acute otitis media.
- Tympanostomy tubes are surgically inserted into the eardrum to relieve middle ear pressure and promote drainage in children with chronic or recurrent middle ear infections.
- In otitis externa, signs include severe swelling of the canal, inflammation, and tenderness, with lymphatic drainage flowing to the parotid, mastoid, and superficial cervical nodes.
- The nurse should stand approximately 4 feet away to ensure the patient can hear whispered sounds during the otoscopic examination.
- It is essential to perform an otoscopic examination in infants and children with suspected ear infections or illness, and the timing of the examination is best toward the end of the complete assessment.
- The nurse should notice the infant turning their head to localize the sound and respond to their name with a loud sudden noise.
Test your knowledge on assessing and managing hearing loss with questions covering causes, examinations, and management strategies for various age groups and conditions related to ear health.
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