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Published by faitheee

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Published by: faitheee on Sep 15, 2009
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Assessment Test :1.Voice Whisper test2.Weber Test3.Rinne Test4.Audiometry5.Electronystagmography- changes in electrical potential6.Tympanography ( impedance tomography )- air  pressure is manipulated in a sealed canal.- measures middle ear muscle reflex to soundstimulation,
A.Description1..Conductive Hearing Loss - occurs when auditory stimuli are notadequately transmitted through the auditory canal, tympanicmembrane, middle ear, or ossicles to the inner ear.B.ETIOLOGY1.cerumen impaction- usually occurs in persons who naturally producelarge amounts of cerumen.2.external otitis media- (bacterial and fungal), excessive moisture in theauditory canal (swimmer’s ear), and trauma3.serous otitis media- result from Eustachian-tube obstruction, suddenchanges in atmospheric pressure, allergy and viral disease4.suppurative otitis media- may follow viral disease, tympanicmembrane perforation or prolonged forceful nose blowing.
> common in infants and young children because of their immatureand relatively poorly draining Eustachian tubes.5.otosclerosis- a hereditary condition; it affects women twice as oftenas men and typically develops between ages 15 and 30.6. trauma / tumorsC.PATHOPHYSIOLOGY
External Ear conditionsMiddle ear conditions
( impacted cerumen, otitis externa)trauma, otitis media, otosclerosistumorsEustachian tube dysfunctions↓↓↓Disruptive conduction of vibration ↓↓↓Impaired/interrupted mechanism /transmission of sound waves↓↓↓Hearing LossSymptoms : Diminished HearingSoft Spoken VoiceClinical manifestations :a.cerumen impaction- some degree of hearing loss
external otitis media- itching, pain and watery or purulentdischarge, crust, edema in the auditory canalc.serous otitis media- sterile fluid accumulation, plugged feelingin the ear, reverberation of the client’s own voice and hearingloss.d.Suppurative otitis media- pus accumulation, throbbing ear  pain, fever, hearing loss, nausea and vomiting, increased feeling
of pressure in ear, possible tympanic ear membrane rupture, bright red, bulging retracted membraneComplication- tympanic membrane rupturee.Otosclerosis- mixed hearing loss or sensorineural hearing lossand tinnitusMedical Management/Treatment:a. HEARING AIDS b. Other Aids : Alert and signal devices, assisted – listening devices fromtelephone companiesD.NURSING MANAGEMENT:1.Instruct the client about the correct way to remove impacted cerumena.soften cerumen with instilled peroxide or glycerol preparations b.irrigate the ear in 2 or 3 days to remove the waxc.instruct and keep otic solution in the ear for 15 min. by titlingthe head sideways or by putting cotton in the ear d.notify the health care provider if inflammation or irritationoccurse.not to use to solution for more than 4 consecutive days2.Provide care to a client with tympanic-membrane perforationa.maintain strict asepsis b.do not irrigate the eac.protect water from contamination by having client wear ear  plugs & bathing capd.recognize that the client is at risk for labyrinthitis or meningitise.use a message board if necessaryf.insert a hearing aid if indicated

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