Momanyi Dennis Nyambane

BSN 3-1

201611275

NURS 65: MEDICAL SURGICAL NURSING

Module 4

ASSESSMENT AND MANAGEMENT OF PATIENTS WITH HEARING AND BALANCE

DISORDERS

Learning Activities

1. A 44-year-old man has recently been diagnosed with Meniere’s disease. Develop a
teaching plan that focuses on control of the patient’s symptoms. Provide rationale for
each component of the teaching plan.

Patient to: Rationale

Ins1.Instruct the client to move the head slowly to prevent worsening of the vertigo.
Instruct the client to stop smoking.

2.Initiate sodium and fluid restrictions as

prescribed. To minimize avoid lose of electrolyte.

3. Encourage the client to use a bedside

commode rather than ambulating to the This is to minimize moving to bathroom
bathroom

4.Avoid monosodium glutamate MSG increases symptoms

5.Avoid Aspirin and aspirin containing Aspirin may increase tinnitus and dizziness.
products

6.Limit alcohol intake Alcohol may change the volume and

concentration of the inner fluid and worsen
symptoms.

7.Drink plenty of fluids daily.Water ,milk and Caffeine is associated with diuretics.
low sugar fruit juices are recommended.
 Avoid caffeine.

2.Discuss the strength of evidence that supports specific dietary strategies for
controlling the symptoms of Meniere’s disease.

1.Limt foods high in salt or sugar and be aware of food rich in hidden salt and sugars

2.Eat meals and snacks at a regular interval to hydrate the body, missing meals may alter
fluid level in the inner ear.

3.Eat fresh fruits, vegetables, and whole grains and limit the amount of canned foods
Canned foods are high in sodium content

4.Drink plenty of fluids daily. Water, milk and low sugar fruit juices are recommended. Avoid
caffeine. Caffeine is associated with diuretics.

3.Make a nursing care plan on a patient having ear disorder. Choose at least three
hearing disorders as your concept and related problem

Risk for injury related to altered mobility due to gait disturbance and vertigo

Assessment Diagnosis Plan Intervention Rationale Evaluation

S Risk for After 8 hours of After 8 hours of nursing Goal met

injury nursing intervention to:
Patient related to intervention the
verbalized altered client will: Assess for vertigo Hx. provides
experiencing mobility as basis
dizziness with evidenced Remain free of information
spinning by vertigo any injuries
sensation with and associated with
though objects dizziness imbalance and/or
moving around falls Assess the ability of This predicts the
them that started activities of the daily possibility of
a few weeks Take prescribed living fall and injury
medications thus placing
appropriately measures

Objective

Patient Teach or reinforce Exercise hasten

appeared dizzy vestibular balance labyrinthine
asking to repeat therapy as prescribed compensation
questions asked which may
by the examiner decrease vertigo
and gait
 disturbance.

T37
Decrease risks
RR 23cpm Encourage to sit down of falling and
when dizzy injury
PR 89 Movement
Advise patient to place aggravates
Bp 130/80mmHg pillow on each side of vertigo
head to restrict
movement
Reduces
Administer prescribed symptoms
antivertigo and advise
to follow prescribed
medication regimen

4. A 20-year-old man, a member of a college swim team, has recurrent external otitis- his
third episode in the past 6 weeks. He is being treated at an ear-nose- throat clinic. Devise
an evidence- based practice teaching plan for this patient.

Patient Education to prevent Otitis externa

i. The patient should be instructed to refrain from any water sport

activities for 7-10 days to allow the canal to heal completely to
avoid recurrence.

ii. Patient to be instructed to protect external canal while showering

or washing hair and wear ear plugs

iii. Patient to be instructed to dry canal with hair dryer on low heat.

iv. Patient to be advised to avoid scratching or inserting objects into

the canal to prevent trauma.

v. Advise patient to follow prescribed drug regimen as prescribed.