chapter 13 part 1
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Questions and Answers

When administering eardrops, the nurse needs to pull the portion of the ear that consists of movable cartilage and skin down and back. This portion of the ear is called the:

  • Auricle (correct)
  • Mastoid process
  • Concha
  • Outer meatus

    • What is the purpose of cerumen in the ear?

  • Sticky honey-colored cerumen is a sign of infection.
  • Cerumen is a yellow waxy material that lubricates and protects the ear. (correct)
  • Cerumen is necessary for transmitting sound through the auditory canal.
  • The presence of cerumen is indicative of poor hygiene.

    • When examining the ear with an otoscope, the nurse notes that the tympanic membrane should appear:

  • Pearly gray and slightly concave. (correct)
  • Pulled in at the base of the cone of light.
  • Whitish with a small fleck of light in the superior portion.
  • Light pink with a slight bulge.

    • Which of the following symptoms is not associated with otitis externa?

    <p>Tinnitus</p> Signup and view all the answers

    What does an amber-yellow color of the tympanic membrane suggest?

    <p>Serous otitis media</p> Signup and view all the answers

    What is the preliminary analysis of an ulcerated crusted nodule with an indurated base that intermittently bleeds and has not healed over the past 6 months behind the pinna?

    <p>Potential carcinoma, requiring biopsy</p> Signup and view all the answers

    What are the early signs of otitis media based on findings of the tympanic membrane?

    <p>Hypomobility</p> Signup and view all the answers

    Which structure allows passage of air between the middle and outer ear, helping equalize air pressure?

    <p>Eustachian tube</p> Signup and view all the answers

    What is the normal pathway for hearing?

    <p>Air conduction</p> Signup and view all the answers

    Which type of hearing loss may be caused by presbycusis and ototoxic drugs?

    <p>Sensorineural hearing loss</p> Signup and view all the answers

    Which portion of the ear is responsible for vertigo?

    <p>Labyrinth</p> Signup and view all the answers

    What can damage the organ of Corti and impair hearing in infants if it occurs in the first trimester of pregnancy?

    <p>Rubella</p> Signup and view all the answers

    Why are infants more prone to ear infections?

    <p>Shorter and wider eustachian tube</p> Signup and view all the answers

    When does the eustachian tube normally open?

    <p>During swallowing or yawning</p> Signup and view all the answers

    What conducts nerve impulses to the brain from the organ of Corti?

    <p>Vestibulocochlear nerve</p> Signup and view all the answers

    What is the function of the middle ear?

    <p>Conduct vibrations of sounds to the inner ear</p> Signup and view all the answers

    What results from mechanical dysfunction of the external or middle ear?

    <p>Conductive hearing loss</p> Signup and view all the answers

    What causes conductive hearing loss?

    <p>Problem in the middle or outer ear</p> Signup and view all the answers

    What may cause sensorineural hearing loss?

    <p>Damage to the cochlea</p> Signup and view all the answers

    Which type of hearing loss is associated with otosclerosis?

    <p>Conductive hearing loss</p> Signup and view all the answers

    What is presbycusis?

    <p>Gradual sensorineural hearing loss</p> Signup and view all the answers

    Which type of cerumen is more common in Asians and Native Americans?

    <p>Dry, flaky cerumen</p> Signup and view all the answers

    What should be the focus of history questions with suspected perforated eardrum?

    <p>Relationship between ear pain and discharge</p> Signup and view all the answers

    What is recruitment in the context of hearing loss?

    <p>Significant hearing loss that becomes painful when speech is at low intensity</p> Signup and view all the answers

    What could put a child at risk for hearing deficits during pregnancy?

    <p>Exposure to maternal ototoxic drugs or maternal rubella</p> Signup and view all the answers

    What is the correct action during an otoscopic examination on an adult?

    <p>Pull the pinna up and back before inserting the speculum</p> Signup and view all the answers

    Why is assessing for any drainage from the ear canal in a patient with head injuries crucial?

    <p>Bloody or clear watery drainage can indicate a basal skull fracture</p> Signup and view all the answers

    What does purulent drainage from the ear after trauma suggest?

    <p>Otitis externa or otitis media</p> Signup and view all the answers

    What should the nurse do when performing a voice test to assess hearing?

    <p>Not shield the lips to muffle the sound</p> Signup and view all the answers

    What is the expected response of a 7-month-old infant to a loud sudden noise?

    <p>Turning their head to localize the noise</p> Signup and view all the answers

    What is the purpose of tympanostomy tubes?

    <p>Relieve middle ear pressure and promote drainage</p> Signup and view all the answers

    What are the signs of otitis externa?

    <p>Severe swelling of the canal, inflammation, and tenderness</p> Signup and view all the answers

    What is the normal distance for the nurse to stand during the otoscopic examination to ensure the patient can hear whispered sounds?

    <p>Approximately 4 feet away</p> Signup and view all the answers

    When should the eardrum assessment be performed for infants or children with illness or fever?

    <p>Toward the end of the examination</p> Signup and view all the answers

    What is the expected appearance of the tympanic membrane in a newborn?

    <p>Thick and opaque, with mild redness</p> Signup and view all the answers

    What is the significance of high-tone frequency hearing loss and increased elasticity of the pinna in an 80-year-old patient?

    <p>They are normal findings</p> Signup and view all the answers

    What could indicate frostbite from prolonged exposure to extreme cold in a 23-year-old patient?

    <p>Reddish-blue discoloration and swelling of the auricle</p> Signup and view all the answers

    What may indicate acute otitis media in a 3-year-old?

    <p>Bright red tympanic membrane with an absent or distorted light reflex</p> Signup and view all the answers

    What are the signs of otitis externa?

    <p>Severe swelling of the canal, inflammation, and tenderness</p> Signup and view all the answers

    What is the expected response of an infant to a loud sudden noise?

    <p>Turning their head to localize the noise</p> Signup and view all the answers

    What is the expected response of a 7-month-old infant to a loud sudden noise?

    <p>Turning their head to localize the noise</p> Signup and view all the answers

    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.

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