MENIERE'S DISEASE

1.)What are the signs and symptoms according to subjective and objective assesment

•vertigo
•Fluctuating, progressive, unilateral (in one ear) or bilateral (in both ears) hearing loss.
•A sensation of fullness or pressure in one or both ears.
•Unilateral or bilatera ltinnitus
•abnormal side-to-side eye movements, known as nystagmus
•ataxia, or an abnormal, unsteady walking gait

2.) Give atleast 3 Nursing Diagnosis of this specific client then prioritize

• Anxiety r/t the sudden episodes of complete disorientation that cause the person to fall
secondary to vertigo
• Altered comfort r/t the sensation of spinning motion, fluctuating hearing loss, and tinnitus
• Risk for injury r/t the disorder of the inner ear

PRIORITIZATION

NURSING PROBLEM RANK JUSTIFICATION

Anxiety r/t the sudden 1 The nature of the problem high.
episodes of complete It is considered as an actual
disorientation that cause the factor. It belongs to the basic
person to physiologic need in Maslow’s
fall secondary to vertigo Hierarchy of Needs. In terms of
the resources, both the client and
the nurse have sufficient
resources.

Altered comfort r/t the 2 The nature of the problem is

sensation of spinning motion,
fluctuating hearing loss, and
tinnitus
Risk for injury r/t the disorder
of the inner ear
medium. It is considered as an
actual factor. It belongs to the
physiologic needs in Maslow’s
Hierarchy of Needs.
In terms of the resources, both
the client and the nurse have the
resources.
3 The nature of the problem is low
because it only requires minimal
nursing support. It is considered
as an potential factor. In terms of
the resources, both the client and
the nurse have the resources.
3.) What are the Nursing Interventions including the Health Teaching Plan

A.) Anxiety r/t the sudden episodes of complete disorientation that cause the person
to fall secondary to vertigo

Interventions

•Provide accurate, consistent information regarding prognosis of the disease.

Avoid arguing about patient’s perceptions of the situation

•Provide open environment in which the patient feels safe to discuss feelings or to
refrain from talking

•Explain procedures, providing opportunity for questions and honest answer

•Maintain a calm manner while interacting with patient.

•Encourage patient to talk about anxious feelings and examine anxiety-provoking

situations if able to identify them. Assist patient in assessing the situation realistically and
recognizing factors leading to the anxious feelings. Avoid false
reassurances

B.) Altered comfort r/t the sensation of spinning motion, fluctuating hearing loss, and
tinnitus

Interventions

•Provide a quiet and peaceful environment

•Provide time to rest and promote general comfort measures

•Stay with the patient who appeared anxious

•Assess the patient’s power needs or needs for control.

•Enhance the patient’s sense of autonomy. Do this by involving the patient in

decision making, by giving information, and by enabling the patient to control the
environment as appropriate. Encourage patient to identify strength
C.) Risk for injury r/t the disorder of the inner ear

Interventions

•Maintain a safe environment

•Assist with ambulation and self care activities as needed

•Keep side rails raised and bed in low position

•Encourage patient to drink prescribed fluid amounts. If oral fluids are tolerated,
provide oral fluids patient prefers. Place at bedside within easy reach. Provide
fresh water and a straw. Be creative in selecting fluid sources (e.g., flavored
gelatin, frozen juice bars, sports drink).

•Assist patient if unable to feed self and encourage caregiver to assist with
feedings as appropriate

4.) After the intervention what are the intended outcome/s

5.) Pathophysiology