IDENTIFICATION DATA

Name Esther Manohar

Class M.Sc. Nursing 1st year
Subject MSN
Unit XIII
Topic Field Trip
Group M.Sc. Nursing 1st year
Size of group 3
Venue ICU 103
Duration of teaching 30 minutes
Method of teaching Lecture method cum discussion
A/V Aids Handout
Date
Time
Name of the supervisor Mrs. Fareha Khan
Previous knowledge The group has previous knowledge regarding Menier’s Disease.
GENERAL OBJECTIVES

Student point of view

After the class, students will be able to acquire knowledge about Meniere’s Disease.

Student- teacher point of view

The student-teacher will be able to

 demonstrate effective teaching.

 gain confidence in facing the class.
 gain confidence in the effective use of audio-visual aids.
TIME SPECIFIC CONTENT TEACHING- EVALUATION
OBJECTIVES LEARNING
ACTIVITY
Introduction
1 min Meniere’s disease can
develop at any age, but it is
more likely to happen to
adults between 40 and 60
years of age.
The National Institute on
Deafness and Other
Communication Disorders
(NIDCD) estimates that
approximately 615,000
individuals in the United
States are currently
diagnosed with Meniere’s
disease and that 45,500
cases are newly diagnosed
each year.

Announcement of topic
½ min At the end of the Today we will discuss
class students will about Meniere’s Disease.
be able:
2 min To define Meniere's disease is an abnormal inner ear fluid balance caused by Student-teacher defines Define
Meniere’s a malabsorption in the endolymphatic sac. Evidence indicates that Meniere’s Disease by Meniere’s
Disease. many people with Meniere's disease may have a blockage in the using Handout. Disease.
endolymphatic duct.

2 min To explain the CAUSE Student-teacher explains List the types of

 cause of Meniere’s Endolymphatic hydrops, a dilation in the endolymphatic space, the cause of Meniere’s field trip?
Disease. develops. Either increased pressure in the system or rupture of the Disease by using
inner ear membranes occurs, producing symptoms of Meniere's Handout.
disease.

3 min To enumerate CLINICAL MANIFESTATION Student-teacher List the clinical

clinical Meniere's disease involves the following symptoms: enumerates clinical manifestation of
manifestation of  Fluctuating, progressive sensorineural hearing loss. manifestation of Meniere’s
Meniere’s disease.  Tinnitus or a roaring sound. Meniere’s disease by disease.
 Fullness in the ear. using Handout.
 Episodic, incapacitating vertigo.
 Nausea and vomiting.

There are two subsets of the disease, known as atypical Meniere's disease:
Cochlear : Cochlear Meniere's disease is recognized as a fluctuating,
progressive sensorineural hearing loss associated with tinnitus and aural
pressure in the absence of vestibular symptoms or findings.

Vestibular : Vestibular Meniere's disease is characterized as the

occurrence of episodic vertigo associated with aural pressure but no
cochlear symptoms.
2 min. To discuss the The student-teacher Explain the
stages of meniere’s discusses the stages of stages of
disease. meniere’s disease by meniere’s
using handout. disease.

5 min To discuss the Assessment and diagnostic evaluation: Student -teacher How can we
assessment and discusses the assessment diagnose
 History is taken to determine the frequency, duration,
diagnostic and diagnostic evaluation Meniere’s
severity, and character of the vertigo attacks, nausea or
evaluation. by using Handout. disease?
vomiting.
 Evaluation of cranial nerve VIII. Sounds from a tuning fork
(ie, Weber test) may lateralize to the ear opposite the
hearing loss, the affected with Meniere's disease.

 An one audiogram typically reveals a sensorineural hearing

loss in the affected ear. This can be in the form of a "Pike's
Peak" pattern, which looks like a hill or mountain, or it may
show a sensorineural loss in the low frequencies. As the
disease progresses, the hearing loss increases.
 Electronystagmogram may be normal or may show reduced
vestibular response.
5 min To describe the MEDICAL MANAGEMENT Student-teacher Discuss the
medical describes the medical medical
Low-sodium (2,000 mg/day) diet.
management. management by using management of
Pharmacologic Therapy handout. Meniere’s
 Antihistamines such as meclizine (Antivert), which suppress Disease.
the vestibular system.
 Tranquilizers such as diazepam (Valium) may be used to
control vertigo.
 Antiemetics such as promethazine (Phenergan)
 Suppositories to control the nausea, vomiting and vertigo .
 Diuretic therapy (eg, hydrochlorothiazide) relieves
symptoms by lowering the pressure in the endolymphatic
system.
 Intake of foods containing potassium (eg, bananas,
tomatoes, oranges) is necessary if the patient takes a diuretic
that causes potassium loss.
5 min To discuss the SURGICAL MANAGEMENT Student-teacher Describe the
surgical discusses the surgical surgical
Endolymphatic Sac Decompression: Endolymphatic sac decom-
management. management by using management of
pression, or shunting, equalizes the pressure in the endolymphatic
handout. meniere’s
space. A shunt or drain is inserted in the endolymphatic sac through
disease.
a postauricular incision. This procedure is first-line surgical
approach to treat the vertigo of Meniere's disease.
Middle and Inner Ear Perfusion: Ototoxic medications, such as
streptomycin or gentamicin, can be given to patients by infusion
into the middle and inner ear. These medications are used to de-
crease vestibular function and decrease vertigo.
Intraotologic Catheters: In an attempt to deliver medication
directly to the inner ear, catheters are being developed to provide a
conduit from the outer ear to the inner ear. The route of the catheter
is from the external ear canal through or around the tympanic
membrane and to the round window niche or membrane. Medicinal
fluids can be placed against the round window for a direct route to
 the inner ear fluids.
Vestibular Nerve Section: It can be performed by a
translabyrinthine approach (ie, through the hearing mechanism) or
in a manner that can conserve hearing (ie, suboccipital or middle
cranial fossa), depending on the degree of hearing loss. Most
patients with incapacitating Meniere's disease have little or no
effective hearing. Cutting the nerve prevents the brain from
receiving input from the semicircular canals.
2 min To enumerate the NURSING DIAGNOSIS Student-teacher Formulate the
nursing diagnosis. enumerates the nursing nursing
 Anxiety related to threat or change in, health status and
diagnosis using Handout. diagnosis for
disability effects of vertigo.
meniere’s
 Risk for trauma related to impaired balance.
disease.
 Ineffective coping related to personal vulnerability and
disabling effects of vertigo.
 Self - care deficit : feeding, bathing/hygiene
,dressing/grooming, toileting , related to labyrinth
dysfunction and episodes of vertigo.
½ min SUMMARY
Today we have discussed
about meniere’s disease,
its definition, causes,
clinical manifestation,
medical and surgical
management.
1 min CONCLUSION
Thus Meniere’s disease
has an enduring physical
and psychosocial impact.
Clinicians who
acknowledge and
respond to an
individual’s subjective
experience of their
 condition may be key to
their engagement in
therapy. Service users
should have a voice in
health service design and
delivery.
1 min Bibliography

1. Harris, L. L., & Huntoon, M. B. (1998). Core

curriculum for otorhino- laryngology and bead/neck
nursing. New Smyrna Beach, FL: Society of
Otorhinolaryngology and Head-Neck Nurses.
National Institute on Deafness and Other
Communication Disorders.

2. (NIDCD). (1998). NIDCD national strategic

research plan. Narberth.

3. PA: National Institutes of Health.

4. Noble, J., Greene, H. L., & Levinson, W. (2001).

Textbook of primary care medicine. St. Louis: C. V.
Mosby.

5. Patton, K., & Thibodeau, G. (2000). Mosby's

Handbook of anatomy & physiology. St. Louis: C.
V. Mosby.

6. Society of Otorhinolaryngology-Head and Neck

 Nurses, Inc. (1996).

7. Nursing practice guidelines for care of the

otorhinolaryngology-head and neck patient. New
Smyrna Beach, FL: Society of Otorhinolaryn-
gology and Head-Neck Nurses. Environment &
Science Education (2014),9,235-245
8. Sharma , S.K. ,and Sharma R., Communication and
Educational Technology , 2nd ed.
India: Elsevier publisher , 2016 , pp. 246

9. Kalambi A., Parashar A., et al. Textbook of Nursing

Education , 1st ed. Delhi: CBS Publishers and
Distributors Pvt. Ltd , 2018, pp. 192

Rufaida College of Nursing

Jamia Hamdard

Lesson Plan
 on
Meniere’s Disease
Submitted To Submitted By
Ms. Fareha Khan Ms. Esther Campbell
Assistant Professor M.Sc. Nursing 1st Year
R.C.O.N. R.C.O.N.