ASSESSMENT FOR EAR DISORDERS

ASSESSMENT DOCUMENTATION
No drainage or cerumen is present in the ear
canals.

Conversation includes behavioral cues of

effective hearing.

During the whispered voice test, the patient

correctly reports at least three out of a possible
six numbers for both ears.

Patient demonstrates good balance and a

coordinated gait.

Hearing Test

Nurses perform a basic hearing assessment during conversation with the patient. For example, the
following patient cues during normal conversation can indicate hearing loss:

 Lip-reads or watches your face and lips closely rather than your eyes
 Leans forward or appears to strain to hear what you are saying
 Moves head in a position to catch sounds with the better ear
 Misunderstands your questions or frequently asks you to repeat
 Uses an inappropriately loud voice
 Demonstrates garbled speech or distorted vowel sounds

WHISPER TEST

The whispered voice test is an effective screening test used to detect hearing impairment if performed
accurately. Complete the following steps to accurately perform this test:

 Stand at arm’s length behind the seated patient to prevent lip reading.
 Test each ear individually. The patient should be instructed to occlude the nontested ear with
their finger.
 Exhale before whispering and use as quiet a voice as possible.
 Whisper a combination of numbers and letters (for example, 4-K-2), and then ask the patient
to repeat the sequence.
 If the patient responds correctly, their hearing is considered normal; if the patient responds
incorrectly, the test is repeated using a different number/letter combination.
 The patient is considered to have passed the screening test if they repeat at least three out of
a possible six numbers or letters correctly.
 The other ear is assessed similarly with a different combination of numbers and letters.