DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION

COLLEGE OF NURSING

PERFORMANCE EVALUATION CHECKLIST

ASSESSMENT OF THE EARS

Date: ___________________

Name: ____________________________________ Year/Sec: ___________ Clinical Group: __________

Not
Procedure Done Remarks
Done
Procedure
1. Introduces self and verifies the client’s identity.
Explains to the client what you are going to do, why
it is necessary, and how the client can cooperate.
2. Performs hand hygiene and observes other
appropriate infection control procedures.
3. Provides for client privacy.
4. Inquires if client has any history of the following:
 Family history of hearing problem or loss
 Presence of any ear problems or pain
 Medication history, especially if there are
complaints of ringing in the ears.
 Any hearing difficulty; its onset, factors
contributing to it, and how it interferes
with activities of daily living.
 Use of a corrective hearing device: when
and from whom it was obtained.
5. Positions the client comfortably – seated, if
possible.
Assessment
Auricles
6. Inspects the auricles for color, symmetry of size,
and position. To inspect position, note the level at
which the superior aspect of the auricle attaches to
the head with relation to the eye.
7. Palpates the auricle for texture, elasticity, and
areas of tenderness.
a. Gently pulls the auricle upward, downward,
and backward.
b. Folds the pinna forward (it should recoil).
c. Pushes in on the tragus.
d. Applies pressure on the mastoid process.
External Ear Canal and Tympanic Membrane
8. Uses an otoscope, inspects the external ear canal
for cerumen, skin lesions, pus, and blood.
a. Attaches a speculum to the otoscope.
b. Tips the client’s head away from the nurse and
straightens the ear canal.
c. Holds the otoscope either right side up, with
the nurse’s fingers between the otoscope
handle and the client’s head, or upside down,
with the fingers and the ulnar surface of the
nurse’s hand against the client’s head.
d. Gently inserts the tip of the otoscope into the
canal, avoids the pressure of the speculum
against either side of the ear canal.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
COLLEGE OF NURSING

9. Inspects the tympanic membrane for color and

gloss.
Gross Hearing Acuity Test
10. Assess the client’s response to normal voice tone. If
the client has difficulty hearing the normal voice,
proceeds with the following test:
a. Performs the watch stick test.
b. Asks the client to occlude one ear. Out of the
client’s sight, places a ticking clock 2-3cm (1-
2in) from the unoccluded ear.
Tuning Fork Test

Perform Weber Test

a. Holds the tuning fork at its base. Activates it by

tapping the fork gently against the back of the
nurse’s hand near the knuckles or by stroking the
fork between the thumb and index fingers.
b. Places the base of the vibrating fork on top of the
client’s head and asks whether the client hears the
noise.
Conduct Rinne Test
a. Ask the client to block the hearing in one ear
intermittently by moving a fingertip in and out of
the ear canal.
b. Hold the handle of the activated tuning on the
mastoid process of one ear until the client states
that the vibration can no longer be heard.
c. Immediately hold still the vibrating fork prongs
infront of the client’s ear canal. Pushes aside the
client’s hair. Asks whether the client now hears the
sound.
11. Document findings in the client record.

Clinical Instructor: _________________________________________