Heent Health
-
Upload
eric-tucker -
Category
Documents
-
view
215 -
download
0
Transcript of Heent Health
-
8/9/2019 Heent Health
1/71
diannemaydee (tm) 2008
BY:
DIANNE MAYDEE MANDAL RN, USRN, REMT-B, AREMT-B
http://stuffednurse.blogspot.com
-
8/9/2019 Heent Health
2/71
diannemaydee (tm) 2008
`
thisis a copy of my old supplemental slides
which I used to give to my students from
almost 2 years ago . I don'tuse this at all at mylectures, simply because I don't rely on using
slides during lectures... because lecturers
must know their concepts by heart and must
not read slides nor notes during the actual
lecture presentation.
-
8/9/2019 Heent Health
3/71
diannemaydee (tm) 2008
ASSESSMENT and
PROCEDURES
-
8/9/2019 Heent Health
4/71
diannemaydee (tm) 2008
` 1. Normal visual acuity as measured with a Snelleneye chartis 20/20. What does a visual acuity of 20/30indicate?
` A at 20 feet, an individual can only read letterslarge enoughto be read at 30 feet
` B. at 30 feet, an individual can read letters largeenoughto be read at 20 feet
` C. an individual can read 20 out of 30 total letterson the chart
` D. an individual can read 30 out of 50 total letterson the chart at 20 feet
-
8/9/2019 Heent Health
5/71
diannemaydee (tm) 2008
`
2. Damagetoth
evisu
al area ofth
e occipit
allove of cerebrum, on the leftside, wouldproduce whattype ofvisual loss?
` A. left eye only
` B. right eye only
` C. medial half ofthe right eye and lateralhalf ofthe left eye
` D. medial half ofthe left eye and lateral half
ofthe right
-
8/9/2019 Heent Health
6/71
diannemaydee (tm) 2008
` 3. Which cranial nerve transmitsvisual
impulses?
` A. I (olfactory)` B. II (optic)
` C. III (oculomotor)
` D. IV (abducens)
-
8/9/2019 Heent Health
7/71
diannemaydee (tm) 2008
` 4. Intraocular pressure is measured clinicallyby tonometer. Whattonometer reading wouldbe indicative of glaucoma?
` A. pressure of10 mmHg
` B. pressure of15 mmHg
` C. pressure of 20 mmHg
` D. pressure of 25 mmHg
-
8/9/2019 Heent Health
8/71
diannemaydee (tm) 2008
`
5. A nu
rseis
revi
ewing
the record of
theclient with a disorderinvolving the inner
ear. Which ofthe following would the nurseexpectto see documented as an assessmentfinding in this client?
` A. severe hearing loss` B. complaints ofsevere pain in the affected
ear` C. complaints of burning in the ear
` D. complaints oftinnitus
-
8/9/2019 Heent Health
9/71
diannemaydee (tm) 2008
` 6. When the nurse preparesthe client orthemyringotomy, the best explanation asto thepurpose forthe proceduresisthatit will:
` A. prevent permanenthearing loss
` B. provide a pathway for drainage
` C. aid in administering medications
` D. maintain motion ofthe ear bones
-
8/9/2019 Heent Health
10/71
diannemaydee (tm) 2008
` 7. A nurse isinstilling an otic solution into an adultclients left ear. The nurse avoids doing which ofthefollowing as part ofthis procedure?
` A. warming the solution to room temperature` B. placing the clientin a side lying position withthe
ear facing up
` C. pulling the auricle backward and upward
` D. placing the tip ofthe dropper on the edge ofthe
ear canal
-
8/9/2019 Heent Health
11/71
diannemaydee (tm) 2008
` The cranial nerve thatis responsible forsalivation, tearing,taste, and sensation in the earisthe _____________________
nerve.
` vestibulocochlear` The vestibulocochlear (VII) cranial nerve is responsible forhearing and equilibrium.
` oculomotor` The oculomotor (III) cranial nerve is responsible forthe
musclesthat move the eye and lid, pupillary constriction, andlens accommodation.
` trigeminal` The trigeminal (V) cranial nerve is responsible for facialsensation, corneal reflex, and mastication.
` facial` The facial (VII) nerve controls facial expression and muscle
movement.
-
8/9/2019 Heent Health
12/71
diannemaydee (tm) 2008
` The cranial nerve thatis responsible for musclesthat move the
eye and lidis
th
e _____________________ nerv
e.
` oculomotor` The oculomotor (III) cranial nerve is also responsible for
pupillary constriction and lens accommodation.
` trigeminal` The trigeminal (V) cranial nerve is responsible for facialsensation, corneal reflex, and mastication.
` vestibulocochlear` The vestibulocochlear (VII) cranial nerve is responsible forhearing and equilibrium.
` facial` The facial (VII) nerve is responsible forsalivation, tearing, taste,
and sensation in the ear.
-
8/9/2019 Heent Health
13/71
diannemaydee (tm) 2008
` The cranial nerve thatis responsible for facial sensation andcorneal reflex isthe _____________________ nerve.
` trigeminal` The trigeminal (V) cranial nerve is also responsible for
mastication.
` oculomotor` The oculomotor (III) cranial nerve is responsible forthe
musclesthat move the eye and lid, pupillary constriction, andlens accommodation.
` vestibulocochlear` The vestibulocochlear (VII) cranial nerve is responsible for
hearing and equilibrium.
` facial` The facial nerve is responsible forsalivation, tearing, taste, andsensation in the ear.
-
8/9/2019 Heent Health
14/71
diannemaydee (tm) 2008
GLAUCOMA
-
8/9/2019 Heent Health
15/71
diannemaydee (tm) 2008
` 1. Among the following, the patient with
glaucoma would most likely manifest:
` A. Halos around light` B. Blurring ofvision
` C. Curtainsin the visual field
` D. Floaters
-
8/9/2019 Heent Health
16/71
diannemaydee (tm) 2008
` 2. A clienthasundergone surgery forglaucoma. The nurse provides whichdischarge instructionsto the clients?
` A. wound healing usually takes12 weeks
` B. expected the vision will be permanentlyimpaired
` C. a shield or eye patchshould be worn toprotectthe eye
` D. the sutures are removed after1 week
-
8/9/2019 Heent Health
17/71
diannemaydee (tm) 2008
` 3. A nurse is assigned to care for a clientwho has justundergone eye surgery. Thenurse plansto instructthe clientthat whichofthe following activitiesis permitted in thepostoperative period?
` A. reading
` B. watching television
` C. bending over
` D. lifting objects
-
8/9/2019 Heent Health
18/71
diannemaydee (tm) 2008
` 4. Which assessment findings provide the bestevidence that a client with acute angle-closureglaucoma is responding to drug therapy?
` A. swelling ofthe eyelids decreases
` B. redness ofthe sclera is reduced` C. eye pain is reduced or eliminated
` D. peripheral vision is diminished
-
8/9/2019 Heent Health
19/71
diannemaydee (tm) 2008
` 5. Glaucoma is conservatively managed withmiotic eye drops. Mydriatic eye drops are
contraindicated for glaucoma. Which ofthe
following drugsis a mydriatic?
` A. neostigmine
` B. pilocarpine
` C. physostigmatine
` D. atropine
-
8/9/2019 Heent Health
20/71
diannemaydee (tm) 2008
` 6.G
lau
coma may requi
resu
rgicaltreatment. Preoperatively, the client would be
taughtto expect which ofthe following
postoperatively?
` A. cough and deep-breathing qh.
` B. turn only to the unaffected side
` C. medication forsevere eye pain
` D. restriction of fluids forthe first 24hours
-
8/9/2019 Heent Health
21/71
diannemaydee (tm) 2008
` 7. W
hen
insti
lling eye drop
sfor a cl
ien
twith
glaucoma, what procedure would the nurse follow?
` A. place the medication in the middle ofthe lowerlid, and put pressure on the lacrimal ductafter instillation.
` B. Instill the drug to the outer angle ofthe eye, haveclienttilthead back
` C. instill the drug atthe innermost angle; wipe withcotton away from inner aspect
`
D.insti
ll medica
tion
in m
iddle eye,
have cl
ien
tblinkfor better absorption
-
8/9/2019 Heent Health
22/71
diannemaydee (tm) 2008
` Pathology: impaired outflow of aqueous chamberthroughthe trabecular meshwork and canal ofschlemm resultingfrom narrowed angle between the pupil and lateralcornea IOP, maybe acute or chronic.
` Risk: aging, diabetes, family history
` Dx: tonometry and gonioscopy
` Cardinal sign: severe eye pain, halos, tunnel vision,dilated pupil non reactive to light.
` DOC: Timolol ( to decrease production of aqueoushumor); Pilocarpine ( constriction of pupil); acetazolamide( reduce production of aqueoushumor)
-
8/9/2019 Heent Health
23/71
diannemaydee (tm) 2008
` Nurse concern: Blindness can occurin acute angle if
IIOP persist for 24-48hours; annual eye exam by age 40;
Avoid mydriatrics ( dilates) like Atropine Sulfate; safety
precautions; IEC on meds compliance and systemic
effect of opthalmic beta blocker.
` Surgical operation to drain aqueoushumorin close angle
glaucoma: trabeculectomy, iridectomy, iridotomy
-
8/9/2019 Heent Health
24/71
diannemaydee (tm) 2008
CATARACT
-
8/9/2019 Heent Health
25/71
diannemaydee (tm) 2008
` 1. A cataractis:
` A. an opacity ofthe lens
` B. a thin film overthe cornea` C. A crystallization ofthe pupil
` D. an increase in the density ofthe
conjunctiva
-
8/9/2019 Heent Health
26/71
diannemaydee (tm) 2008
` 2. after a clienthas cataractsurgery, thenurse should:
` A. teachthe client coughing and deepbreathing exercises.
` B. encourage eye exercisesto strengthenthe ocular musculature
` C. keep the clientin supine position withthehead immobilized
` D. advise the clientto refrain from vigorous
brushing ofteeth and hair
-
8/9/2019 Heent Health
27/71
diannemaydee (tm) 2008
` Pathology: progressive opacity ofthe lens from cellular
debris.
` Risk: aging, tobacco smoking, alcoholism, UV rays,
oculartrauma, family history, downssyndrome, rubella,
DM, drugs( corticosteroids, thorazine)
` Dx: slit lamp ( lens opacity and loss of red reflex)
` Cardinal sign: blurred vision, glaring, white or gray
opacity.
-
8/9/2019 Heent Health
28/71
diannemaydee (tm) 2008
Cataracts: causes
CATARAct:
Congenital
Aging
Toxicity (steroids, etc)Accidents
Radiation
Abnormal metabolism (DM, Wilsons, etc)
-
8/9/2019 Heent Health
29/71
diannemaydee (tm) 2008
` DOC: post op meds: analgesics and antiinflammatory
` Surgeries:
Extracapsular extraction: removal of lens nucleus and
cortex
Phacoemulsification: use ofsound wavesto break up lens
Cryoextraction: use of forcep orsuper cooled probestoextract lens
Intracapsular Extraction: removal of entire lens and
capsule.
Las
er removal of len
s.
` Nurse concern: surgical procedures are done in OPD
basis; safety precautions; avoid night driving priorto
surgery
-
8/9/2019 Heent Health
30/71
diannemaydee (tm) 2008
EYE INJURY
-
8/9/2019 Heent Health
31/71
diannemaydee (tm) 2008
` Pathology: injury to part ofthe eye: abrasion, blunt,penetrating, burns.
` Risk: environmental hazards, vehicular accidents, sportsinjuries, physical assault
` Dx: Eye exam, flourescein staining, facial CT scan` Cardinal sign:
Abrasion: photophobia, tearing pain
Blunt:ecchymosis ( black eye)
Penetrati
ng:pain, lo
ssof
vision, lo
ssof eye con
ten
ts
Burns: pain, swollen eyelids, decrease vision withsloughing of conjunctiva
-
8/9/2019 Heent Health
32/71
diannemaydee (tm) 2008
` DOC:
Abrasion: opthalmic ABx
Blunt:acetazolamide
Penetrating: Narcotic analgesics, antiemetics, ABx
Burns: topical anesthetic and ABx
`
Nu
rs
e concerns:Semi Fowlers position
Patch affected eye or bothto decrease movements
Immobilize foreign body with eye shields/paper cups
For chemical burns, irrigate with copious amount ofsterile
water.
-
8/9/2019 Heent Health
33/71
diannemaydee (tm) 2008
MACULARDEGENERATION
-
8/9/2019 Heent Health
34/71
diannemaydee (tm) 2008
` Pathology: gradual failure ofthe outer layer ofthe retinaleading to photoreceptors lost and accumulation of waste
products and toxinsin subretinal spaces: atrophic( dry);
exudative( wet)
` Risk: aging, family history
` Dx: ERG, visual acuity test
` Cardinal sign: loss of central vision; pale yellow spots;
distorted images.
` DOC: N/A
` Tx: laser photocoagulation for wet MD, No Tx for dry MD` Nurse concern: Enhance vision and promote safety at
home; large print books and newspaper.
-
8/9/2019 Heent Health
35/71
diannemaydee (tm) 2008
RETINAL
DETACHMENT
-
8/9/2019 Heent Health
36/71
diannemaydee (tm) 2008
` 1. Atthe time of retinal detachment, a clientmost likely describes whichsymptoms?
` A. a seeing flashes of light
` B. being unable to see light` C. feeling discomfortin light
` D. seeing poorly in daylight
-
8/9/2019 Heent Health
37/71
diannemaydee (tm) 2008
` Pathology: separation ofsensory layer ofthe retinaleading to vitreous fluidsseepage and retinal neuronsischemia and deaths.
`
Ris
k: aging,
trau
ma
` Dx:Opthalmoscope exam
` Cardinal sign: 3Fs: floaters, flashes, folds
` DOC: ABx and anti-inflammatories
-
8/9/2019 Heent Health
38/71
diannemaydee (tm) 2008
` Tx Modalities:
Scleral buckling ( silicon): to produce adhesions
Pneumatic retinopexy: injecting airto vitreousto
force the detached retina back in contact with choroid.
Laser photocoagulation/ cryothermy: creating areas
ofinflammations and adhesion.Surgical manipulations: for detached retina pulled
back in contact with choroid.
` Nurse concern: head is positioned with detached area in
dependent position; avoid bending orsudden head
movement; Patchthe eye; protect from injury.
-
8/9/2019 Heent Health
39/71
diannemaydee (tm) 2008
SENSORINEURAL
HEARINGIMPAIRMENT
-
8/9/2019 Heent Health
40/71
diannemaydee (tm) 2008
` 1. Nerve deafness would most likely result
from an injury or an infection that damaged
the:
` A. Vagus nerve
` B. Cochlear nerve
` C. Vestibular nerve
` D. Trigeminal nerve
-
8/9/2019 Heent Health
41/71
diannemaydee (tm) 2008
` Pathology: damage and degeneration ofhair cells oftheorgan of cortiin the cochlea resulting to hearing loss (initially high pitched tones and conversational speech,then lowertones)
` Risk: aging, ototoxic medications, persistent exposure toloud noise
`
Dx: audiometry; weber and rinne tests` Cardinal sign: deafness and tinnitus` DOC: NA` Tx Modality: cochlearimplants` Nurse concern: hearing aids are nothelpful; avoidshouting, speak in low tone voice withvisual contact;alternative way of communication; use ofshortsentences; home safety; preventsocial isolation.
-
8/9/2019 Heent Health
42/71
diannemaydee (tm) 2008
CONDUCTIVE
HEARINGIMPAIRMENT
-
8/9/2019 Heent Health
43/71
diannemaydee (tm) 2008
` 1. A cl
ien
twith
a condu
cti
onh
earing lo
ssasksthe nurse how a hearing aid improves
hearing. The nurse most accurately informs
the clientthat a hearing aid:
` A. amplifiessound heard
` B. makessoundssharper and clearer
` C. produces more distinct, crisp, speech
` D. eliminates garbled background sounds
-
8/9/2019 Heent Health
44/71
diannemaydee (tm) 2008
` Pathology: interruption ofsound wavesin external ear;with otosclerosisstapes becomesimmobilize againsttheoval window thus decreasing transmission ofsoundstoinner ear.
` Risk: otosclerosis, eartrauma, earinfection, impacted
cerumen, foreign objects, neoplasm, edema ofthe canallining.
` Dx: tympanometry; weber and rinne test
` Cardinal sign: loss ofsound at all frequencies
` DOC: NA
` Tx Modality: hearing aids; stapedectomy
` Nurse concern: Avoid earinjury while swimming orcleaning ear.
-
8/9/2019 Heent Health
45/71
diannemaydee (tm) 2008
OTITIS MEDIA
-
8/9/2019 Heent Health
46/71
diannemaydee (tm) 2008
` 1.Which of the following management strategiesexplains the purpose of ear tubes in clients withchronic otitis media who have undergonemyringotomy/
` A. to administer antibiotics
` B. to flush the middle ear
` C. to increase pressure
` D. to drain fluid
-
8/9/2019 Heent Health
47/71
diannemaydee (tm) 2008
` Pathology: infection of middle ear leading to impaired equalization ofair pressure: serous, acute
` Risk:
serous: URTI, allergies, edematous eustachian tube
Acute: streptococcal pneumonia/pyrogens; Haemophilusinfluenza
`
Dx: PE andhist
ory` Cardinal sign:
Serous: snapping or popping sound, hearing loss, vertigo
Acute: severe ear pain, pulling of ear by kids, fevertenderness ofmastoid area.
` DOC: Decongestants, ABx, antipyretics, analgesics` Nurse concern: Tympanocentesis; myringotomy ( if withtympanostomy tube, avoid airtravel, swimming or diving); hydrate;complete the ABx therapy
-
8/9/2019 Heent Health
48/71
diannemaydee (tm) 2008
MENIERES DISEASE
-
8/9/2019 Heent Health
49/71
diannemaydee (tm) 2008
` Situation: Irene P is being treated in theemergency room for an acute attack ofMenieressyndrome
` 1. The nurse should recognize thatthe triadofsymptoms associated with Menieres
syndrome is` A. nystagmus, arthralgia, and vertigo
` B. nausea, vomiting, and arthralgia
` C. syncope, headache, and hearing loss
` D. hearing loss, vertigo, and tinnitus
-
8/9/2019 Heent Health
50/71
diannemaydee (tm) 2008
` 2. Patientteaching for Mrs. P includeshelping hertorecognize that
` A. Menieressyndrome is psychogenic and is
brought on by stress` B. most patients can be successfully treated with
a low-salt diet and diuretics
` C. acute infection can precipitate an attack
` D. a labyrinthectomy isthe preferred treatment
for relieving symptoms and restoring hearing
-
8/9/2019 Heent Health
51/71
diannemaydee (tm) 2008
`
3. Nursing intervention during an acute attackincludes:
` A. encouraging the patient to walk
` B. placing the patient in a semi-Fowlersposition
` C. Having the patient lie flat
` D. placing the patient in Trendelenburgsposition
-
8/9/2019 Heent Health
52/71
diannemaydee (tm) 2008
` 4. You are caring for a patient with adiagnosis of Meniere's Disease. Which ofthe following would NOT be an appropriatenursing intervention forthis patient?
` 1. Restrictsaltintake` 2. Give vasodilating drugssuch as
Priscoline or Banthine
` 3. Give diuretics
` 4. Increase carbohydrate intake
-
8/9/2019 Heent Health
53/71
diannemaydee (tm) 2008
` Pathology: overaccumulation of endolymph( fluids) inmembranous labyrinth ofthe inner ear resulting todilation of lymphatic channel and labyrinth dysfunction.
` Risk: middle age, family history
` Dx: Caloric ice watertest, auditory dehydration test, ENG,weber and rinne tests.
` Cardinal sign: endolymphatic hydrops( vertigo, tinnitus,
hearing loss); and,nystagmus, ear fullness andhypotension during acute attack
-
8/9/2019 Heent Health
54/71
diannemaydee (tm) 2008
` DOC: Dramamine
Du
ring ac
ute a
ttack
atrop
ine, d
iazepam, compaz
ine,diphenhydramine, and ABx
Between attacks diureticsOther Tx: Labyrinthectomy, vestibular nerve resection,
endolymphatic sac decompression and shunting.` Nurse concern: Ensure safety during attacks; sodium restricted diet;
avoid substancesthat causesvasoconstriction; If attacks becomes frequent, ensure hydration and
nutrition Signs ofimpending attack: feeling of ear fullness;increa
sing
tinn
itus,verti
go, naus
ea andvom
iting Attack triggers: stress, fatigue, blinking lights, loud noise,
jerky or quick body movements Relaxation techniques
-
8/9/2019 Heent Health
55/71
diannemaydee (tm) 2008
EPISTAXIS
-
8/9/2019 Heent Health
56/71
diannemaydee (tm) 2008
` Gary isseen in the emergency room withthediagnosis of epitaxis.
` 1. Itisunlikely thatGaryshistory willincl
ude:
` A. minortrauma to the nose
` B. a deviated septum
` C. acute sinusitis
` D. hypotension
-
8/9/2019 Heent Health
57/71
diannemaydee (tm) 2008
` 2. Which nursing action is best forcontrolling the clients nosebleed?
` A. have the client lay down slowly and
swallow frequently` B. have the client lay down and breathethroughhis mouth
` C. have the client lean forward and applydirect pressure
` D. have the client lean forward and clenchhisteeth
-
8/9/2019 Heent Health
58/71
diannemaydee (tm) 2008
` 3. Which ofthe following medications would
be used within orderto promote
vasoconstriction and control bleeding?
` A. epinephrine
` B. lidocaine
` C. pilovarpine
` D. cylospentolate
-
8/9/2019 Heent Health
59/71
diannemaydee (tm) 2008
` 4. The physician decidesto insert nasal packing. Of
the following nursing actions, which would have thehighest priority?
` A. encourage Gary to breaththroughhis mouth,because he may feel panicky afterthe insertion.
`
B. advi
ceG
aryto expec
tora
teth
e bloodinth
enasopharynx gently and notto swallow it` C. periodically check the position ofthe nasal
packing, because airway obstruction can occurif the packing accidentally slip out of place
` D. take rectal temperature, because he must rely on
mouth breathing and would be unable to keep hismouth closed on the thermometer.
-
8/9/2019 Heent Health
60/71
diannemaydee (tm) 2008
` 5. Upon his discharge, the nurse instructsGary on
the use ofvasoconstrictive nose drops and cautionshim to avoid too frequent, and excessive use tothese drugs, which ofthe following providesthebest rationale forthis caution?
` A. A rebound effect occursin whichstuffnessworsens after eachsuccessive dose
` B. cocaine, a frequentingredientin nose drops, maylead to psychological addiction
` C. these medications may be absorbed
systematically, causing severe hypotension` D. persistentvasoconstriction ofthe nasal mucosa
can lead to alterationsin the olfactory nerve
-
8/9/2019 Heent Health
61/71
diannemaydee (tm) 2008
` Pathology: ruptured vessels of Kiesselbach area in anterior nasalspectrum.
` Risk: nasal trauma, cocaine, URTI, allergies, smoking, use of oxygen,climates and altitude extremes, nasal polyps, deviated nasal septum,HTN, diabetes, blood dyscrasias.
` Dx: PE and History
` Cardinal sign: nose bleeding
` DOC: vasoconstrictors( Neo-Synephrine, adrenaline); analgesics
` Nurse concern: assess respiratory distress; situpright withheadti
lted forward; apply pre
ssure by p
inc
hing
the no
se for 5-
10m
inut
es;encourage to expectorate the blood gently to prevent aspiration;
Caldwell-Luc procedure is cauterization and ligation ofvessels. Afternasal packing, Monitor VS, assess drainage, oral care and humidifierand O2 at bedside.
-
8/9/2019 Heent Health
62/71
diannemaydee (tm) 2008
SINUSITIS
-
8/9/2019 Heent Health
63/71
diannemaydee (tm) 2008
` Pathology: inflammation with resulting infection ofmucous membrane of paranasal sinuses: acute( 3mos)
` Risk: allergies, immunocompromised, viral rhinitis
` Dx: PE, cultures nasal endoscopy
` Cardinal sign: severe pain over affected sinuses, nasaldischarges, malaise.
` DOC: Intranasal corticosteroids, ABx, analgesics
` Surgery: endoscopic nasal surgery, Externalsphenoethmoidectomy, and Caldwell-Luc procedure.
` Nurse concern: Complete the ABx therapy; Comfortmeasures; hazards of decongestants; hydrate client;avoid strenuous activity
-
8/9/2019 Heent Health
64/71
diannemaydee (tm) 2008
OTHER DISORDERS
-
8/9/2019 Heent Health
65/71
diannemaydee (tm) 2008
` 1. Ofthe following terms, which describes a condition characterizedby abnormal spongy bone formation around the stapes?
` A. Otosclerosis
` Otosclerosisis more common in femalesthan males and is frequentlyhereditary.
` B. Middle ear effusion
`
A middle ear eff
usion
isdeno
ted by fl
uidinth
e middle ear w
ithout
evidence ofinfection.
` C. Chronic otitis media
` Chronic otitis media is defined as repeated episodes of acute otitismedia causing irreversible tissue damage and persistenttympanicmembrane perforation.
` D. Otitis externa
` Otitis externa refersto inflammation ofthe external auditory canal.
-
8/9/2019 Heent Health
66/71
diannemaydee (tm) 2008
` 2. Ossiculoplasty is defined as:
` A. surgical reconstruction ofthe middle ear bones.` Ossiculoplasty is performed to restore hearing.
` B. surgical repair ofthe eardrum.` Surgical repair ofthe eardrum istermed tympanoplasty.
` C. incision into the tympanic membrane.` Tympanotomy or myringotomy isthe term used to refertoincision into the tympanic membrane.
` D. incision into the eardrum.` Tympanotomy or myringotomy isthe term used to refertoincision into the tympanic membrane.
-
8/9/2019 Heent Health
67/71
diannemaydee (tm) 2008
` 3. Which ofthe following terms refersto surgical repair ofthe
tympanic membrane?
` A. Tympanoplasty` Tympanoplasty may be necessary to repair a scarred eardrum.
` B. Tympanotomy
` A tympanotomy is an incision into the tympanic membrane.
` C. Myringotomy` A myringotomy is an incision into the tympanic membrane.
` D. Ossiculoplasty
` An ossiculoplasty is a surgical reconstruction ofthe middle earbonesto restore hearing.
-
8/9/2019 Heent Health
68/71
diannemaydee (tm) 2008
` 4. Ofthe following terms, which refersto the progressivehearing loss associated with aging?
` A. Presbycusis` Both middle and inner ear age-related changes resultinhearing loss.
` B. Exostoses
` Exostoses refersto small, hard, bony protrusionsin the lowerposterior bony portion ofthe ear canal.
` C. Otalgia` Otalgia refersto a sensation of fullness or pain in the ear.
` D. Sensorineural hearing loss` Sensorineural hearing lossis loss ofhearing related to damage
ofthe end organ forhearing and/or cranial nerve VIII.
-
8/9/2019 Heent Health
69/71
diannemaydee (tm) 2008
` 5. When the nurse reviewsthe physician's progress notes forthe patient who hassustained a head injury and seesthatthephysician observed Battle'ssign when the patient wasin the
Emergency Department, the nurse knowsthatthe physicianobserved:
` A. an area of bruising overthe mastoid bone.` Battle'ssign may indicate skull fracture.
` B. a bloodstain surrounded by a yellowishstain on the headdressing.
` A bloodstain surrounded by a yellowishstain on the headdressing is referred to as a halo sign and ishighly suggestiveof a cerebrospinal fluid leak.
` C. escape of cerebrospinal fluid (CSF) from the patient's ear.` Escape ofCSF from the patient's earistermed otorrhea.
` D. escape of cerebrospinal fluid (CSF) from the patient's nose.` Escape ofCSF from the patient's nose istermed rhinorrhea.
-
8/9/2019 Heent Health
70/71
diannemaydee (tm) 2008
` 6. The nurse assessesthe dressing of a patient with a basalskull fracture and seesthe halo sign - a blood stain surroundedby a yellowishstain. The nurse knowsthatthissign :
` A. ishighly suggestive of a cerebrospinal fluid (CSF) leak.` The halo sign - a blood stain surrounded by a yellowishstain ishighly suggestive of a cerebrospinal fluid (CSF) leak.
` may indicate a subdural hematoma..
` The halo sign ishighly suggestive of a cerebrospinal fluid(CSF) leak.
` ishighly suggestive of a cerebral contusion.` The halo sign ishighly suggestive of a cerebrospinal fluid
(CSF) leak.
` normally occurs within 24hours following a basal skullfracture.
` The halo sign ishighly suggestive of a cerebrospinal fluid(CSF) leak.
-
8/9/2019 Heent Health
71/71
di d (t ) 2008
` DIANNE MAYDEE MANDAL RN, USRN, REMT-B, AREMT-B
` http://stuffednurse.blogspot.com
`
Note: this is a copy of my supplemental reviewslides of 2008, I do not use this during my actual
lecture