Ears

Saturday, 18 June 2022 3:17 pm

Common abnormalities: Otitis media (common among children); Meniere

syndrome (common among adults)
Brief anatomy: External middle internal
Tympanic -starts of the middle ear Cochlea
Semicircular canals- to maintain balance whenever you are dancing etc.
auditory nerve
INNER STRUCTURES
— Vestibules inside are utricle (maintain balance in horizontal level like you can
go back and forward) and saccule (maintain balance in a vertical level like you
ride an elevator when you go up and down
– Semicircular canal- maintain balance when turning, spinning

● Endolymph and perilymph are for transmission of sounds to organ of

hearing which is cochlea then send to the brain through nerve
— have different chemical contents and is separated by a very thin membrane
(ressneir membrane?) and once you destroy it or injury then it’s possible with
the mixing of peri and endo resulting to vertigo for about 30-60 minutes
●
Meniere’s disease
● Called "endolymphatic hydrops"
● Idiopathic: associated with a change in the volume and pressure of the
endolymph and perilymph
● Too many fluids in the ear can rupture the membrane
● 1 risk to develop this is when you have more stressors
● Only one ear is involve ((unilateral)
● Fluid buildup in the endolymph —-> aural fullness, tinnitus, gradual
sensorineural hearing loss: inner ear (two types of hearing loss: inner and
external)
● Tinnitus: subjective ringing, crackling, ringing, buzzing
● Fluid cont. to accumulate because the fluids are chemically different, the
mixture trigger an increase in the vestibular nerve firing rate —-> vertigo
(last for 30-60 minutes) and patient is high risk for fall
● Due to dizziness: darkened the room and ensure a quiet room should
be provided for the patient
● Possible to vomit
● CURE: none but can lead to permanent hearing loss

DRUGS: only relieve discomforts

– sedatives: diazepam (valium, anxionil), cannot be diluted; comes in 5
mg or 2 mg via IVP in 2 to 5 minutes
– Diuretics: hydrochlorothiazide
Lasix/furosemide given to patient with ascites
Mannitol: given to patient with increased pressure in the brain and eyes (IOP
and ICP)
Potassium sparing: Aldactone or spironolactone
– Antihistamine: blocks the effect of H1 in the lungs (first - sedating effect
so the patient is not allowed to drive. and second generation- Benadryl) and
H2- stomach (-tidine are samples; histamine receptors); allergies: urticaria,
rashes, edema esp. in eyes and cheeks; DIPHENHYDRAMINE HCL
– Antivertigo: stops dizziness (main manifestation) meclizine hcl —
postadoxine, bonamine
– Metoclopramide —- plasil
Health teachings
— decrease salt intake: high sodium are canned foods like luncheon meat, milk

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– Metoclopramide —- plasil
Health teachings
— decrease salt intake: high sodium are canned foods like luncheon meat, milk
and milk products like cheese, cottage cheese, boxed foods like Korean
barbeque or meat fish or chicken nuggets, noodles, junk foods. To improve
fluids balance in the inner ear
– Avoid other subs that exacerbate an inner fluid balance: caffeine, nicotine,
alcohol, foods high in carbohydrates, candy
Nursing care:
– during an acute attack of vertigo, keep patient on bed rest with side rails up
cos of risk for fall
– Cal light should be within reach
– Avoid sudden head movements or pos change as this can worsen vertigo by
placing a pillow or rolled blanket on each side of the head to restrict movement
a slight head movement can cause severe nausea and vomiting
– Reduce environmental stimuli like loud noises and bright lights. Have a dim
light and quiet room
– Don’t leave the patient alone cos they might go to the comfort room and fall
– Don’t attempt to drink or sip water as this may trigger nausea and vomiting
– Teach patient who senses an oncoming attack to take prescribed meds, let the
patient lie down or sit in quiet, dim lighted room, tell the patient not to get up
and gradually or slowly get up if possible

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