Professional Documents
Culture Documents
HEALTH HISTORY
? had undergone surgery in the past, went do German doctors for ear problem on
both sides. She also has asthma. Her father is not known to have a genetic diease and
so with her mother. She doesn’t seem to have food and drug allergies. She had been
taking mefenamic acid for the management of pain she experience whenever her ears
8 years PTA patient had undergone Mastoidectomy on her Left side. 3 years PTA
patient had asthma but did not seek for medical assistant, instead, stayed at home and
went on self medication. 6 months PTA patient was admitted at the german Hospital for
D. CHIEF COMPLAINT
The patient was admitted due to the Chief Complaint pain on both ears. Also,
patient is suffering from hearing loss and also from facial never palsy which is the factor
Middle ear
The middle is a small, air-filled cavity in the temporal bone that is lined by
epithelium. It is separated from the external ear by the eardrum and from
the internal ear by a thin bony partition that contains 2 small membrane-
covered opening: the oval window and the round window. Extending across
the middle ear and attached to it by ligament are the 3 smallest bone in the
body, the auditory ossicles, which are connected by synovial joints. The
bones, named for their shapes, are the malleus, incus, and stapes-commonly
called the hammer, anvil and stirrup, respectively. The “handle” of the
malleus attaches to the internal surface of the eardrum. The head of the
malleus articulates with the body of the incus. The incus, the middle bone in
the series, articulates with the head of the stapes. The base or footplate of
the stapes fits into the oval window. Directly below the oval window is
another opening, the round window, which is enclosed by a membrane,
called the secondary tympanic membrane. Besides the ligaments, 2 tiny
skeletal muscles also attach to the ossicles. The tensor tympanimuscle,
which is innervated by the mandibular branch of the trigeminal nerve or
cranial nerve number 5, limits movement and increases tension on the
eardrum to prevent damage to the inner ear from loud noises.
The stapedious muscle, which is innervated by the facial nerve (cranial nerve
VII), is the smallest of all skeletal muscle. By dampening large vibrations if
the stapes due to loud noises, it protect s the oval window but it also
decrease the sensitivity of hearing. For this reasons, paralysis of the
stapedious muscle is associated with the hyperacusia (abnormally sensitive
hearing). Because it takes a fraction of a second for the tensor tympanic and
stapedious muscles to contract, they can protect the inner from prolonged
loud noises, but not from brief ones such as a gun shot. The anterior wall of
the middle ear contains an opening that leads directly into the auditory
(pharyngotympanic) tube, commonly known as the Eustachian tube. The
auditory tubes, which consist of both bone and hyaline cartilage, connect the
middle ear with the nasopharynx (upper portion of the throat). It is normally
closed at its medial (pharyngeal) end. During swallowing and yawning, it
opens, allowing air to enter or leave the middle ear until the pressure in the
middle equals the atmospheric pressure. When the pressures are balanced,
the eardrum vibrates freely as sound waves strike it. If the pressure is not
equalized, intense pain, hearing impairment, ringing in the ears, and vertigo
could develop. The auditory also is route whereby pathogens may travel from
the nose and throat to the middle ear.
Cholesteatoma form
“Subjective”
Dili na gyud siya maka dungog sir as verbalized by significant other
Objective
Deaf
Doesn’t look relax
Interventions Rationale
Position client to see surroundings and activities. Provides sensory input for stimulation
Provide uninterrupted sleep and rest periods. Reduces sensory overload, enhances orientation
and coping abilities
Evaluation: at the end of 2 days intervention, patient had not learned how to
communicate and still in denial stage.
Nursing Diagnosis: Low self esteem related to situational crises
Objectives: at the end of 2 days intervention, patient will be able to accept the
situation in her life and develop realistic plans in adapting new role in life
Subjective
Permi lagi na siya guol ug nawong sir, unya usahay pud maghilak na siya
Objectives
Lack of eye contact
Anxious
Weak
Intervention Rationale
Encourage SO to treat client as normally as Involving client in family unit reduces feelings of
possible social isolation, helplessness, and uselessness
Visited patient very often There are time that patient is alone,
to provide company for the patient,
so she may feel she’s not alone
Interact to patient as if no health problem exist For patient to regain the confidence
she once lost
Evaluation: at the end of 2days intervention, patient still in denial stage and
doesn’t like to mingle with me or other people around