EMILIO AGUINALDO COLLEGE

Gov. D. Mangubat Ave., Brgy. Burol Main, City of Dasmariñas, Cavite 4114, Philippines
Tel. Nos. (046) 416-4339/41 www.eac.edu.ph
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SCHOOL OF NURSING

ASSESSING THE EARS AND HEARING

NAME: ______________________________________________ SCORE: _____________________
YR/SEC/GRP: _________________________________________ DATE: ______________________

PERFORMED
PLANNING MASTERED COMMENTS
YES NO
 It is important to conduct the ear and hearing
examination in an area that is quiet.
 The location should allow the client to be
positioned in sitting or standing at the same level
as the nurse.
PREPARATION
1. Assemble equipment:
 Otoscope with several sizes or ear specula
 Tuning fork
PROCEDURE
1. Introduce yourself and verify the client’s identity.
Explain to the client what you are going to do,
why it is necessary, and how the client can
cooperate.
2. Perform hand hygiene and observe other
appropriate infection control procedures.
3. Provide for client privacy
4. Inquire if the client has any history of the
following:
 Family history of hearing problems or loss
 Presence of any ear problems or pain
 Medication history, especially if there are
complaints of ringing in the ears (tinnitus)
 Hearing difficulty: its onset, factors
contributing to it, and how it interferes with
activities of daily living.
 Use of corrective hearing device; when and
from whom it was obtained.
5. Position the client comfortably- seated if
possible.
ASSESSMENT
AURICLES
6. Inspect the auricles for color, symmetry in 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. Palpate the auricles for texture, elasticity, and
areas of tenderness.
 Gently pull the auricle upward, downward, and
backward.
 Fold the pinna forward. (it should recoil)
 Push in on the tragus
 Apply pressure to the mastoid process.
EXTERNAL EAR CANAL AND TYMPANIC MEMBRANE
8. Inspect the external ear canal for cerumen, skin
lesions, pus, and blood.
9. Visualize the tympanic membrane using an
otoscope.
 Attach a speculum to the otoscope. Use the
largest diameter that will fit the ear canal without
causing discomfort.
 Tip the client`s head away from you and

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 straighten the ear canal. For an adult, straighten
the ear canal by pulling the pinna up and back.
 Hold the otoscope either (a) right side up, with
your fingers between the otoscope handle and the
client`s head, (b) upside down with your fingers
and the ulnar surface of your hand against the
client`s head.
 Gently insert the tip of the otoscope into the ear
canal, avoiding pressure by the speculum against
either side of the ear canal.
10. Inspect the tympanic membrane for color and
gloss.
GROSS HEARING ACUITY TESTS
11. Assess the client’s response to normal voice
tones. If the client has difficulty hearing the
normal voice, proceed with the following tests.
A. Perform the whisper test to assess high-
frequency hearing.
 Have the client occlude one ear. Out of the client`s
sight, at a distance of 0.3-to-0.6-meter (1 to 2 ft)
whisper s simple phrase (how are you)
 Ask the client to repeat the phrase.
 Repeat with the other ear using a different phrase.
B. Tuning Fork test.
Perform WEBER`S TEST to assess bone
conduction by examining the lateralization
(sideward transmission) of sounds.
 Hold the tuning fork at its base. Activate it by
tapping the fork gently against the back of your
hand near the knuckles or by stroking the fork
between your thumb and index fingers. It should
be made to ring softly.
 Place the base of the vibrating fork on top of the
client`s head and ask where the client hears the
noise.
Conduct RINNES TEST to compare ear conduction to
bone conduction.
 Hold the handle of the activated tuning fork on
the mastoid process of the ear until the client
states that the vibration can no longer be heard.
 Immediately hold the still vibrating fork of the
client`s ear canal. Push aside the client`s hair if
necessary. Ask whether the client now hears the
sound.
Sound conducted by air is heard more readily than
sound conducted by bone.
The tuning fork vibrations conducted by air are
normally heard longer.
12. Document findings in the client record
supplemented by narrative notes when
appropriate.
TOTAL SCORE

EVALUATED BY: CONFORME:

_____________________________ ____________________________________
Signature over Printed Name of the Faculty Signature over Printed Name of the Student

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