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Benzodiazepines
University • Administration of Otic Medication
COLLEGE OF - Have patient assume side-lying position with
NURSING
ear to be treated facing up.
La Paz, Iloilo City
NOTES ON MENIERE’S DISEASE - Straighten patient’s ear canal:
Prepared by: MARNI LIEZA G. TICAO Adult/3 y.o. & above gently pull the pinna
of the ear up and back
MENIERE’S DISEASE Infant or Child under age 3 gently pull the
also known as endolymphatic hydrops pinna down and back
- Instill prescribed drops holding dropper 1 cm
described in 1861 by a French physician,
(1/2 in) above ear canal directly toward the
Dr. Prosper Meniere
side.
a disorder of the inner ear due to
- Ask patient to remain in side-lying
distention of the endolymphatic
position for 5 to 10 minutes.
compartment of the inner ear that can
- Apply gentle massage or pressure to
affect hearing and balance
tragus of ear with finger to allow
usually affects adults, slightly more medication to move inward.
males than females, between ages 30 and
60 SURGICAL MANAGEMENT
a. Endolymphatic Sac Decompression
ETIOLOGIC FACTORS
• equalizes the pressure in the
Idiopathic; exact cause is unknown endolymphatic sac
Possible causes: • insertion of shunt or drain into the
• Viral infection of the inner ear endolymphatic sac through a postauricular
• Head injury/Trauma incision
• Immune disease b. Middle and Inner Ear Perfusion
• Endocrine Disorders
• administration of ototoxic medications,
• Vascular Disorders
such as streptomycin or gentamicin, into
• Autonomic nervous system dysfunction
the middle and inner ear by infusion
producing a temporary constriction of blood
• used to decrease vestibular function and
vessels supplying the inner ear
decrease vertigo
• Overproduction or decreased absorption of
c. Intraotologic Catheters
endolymph
• provide a channel from the outer ear to
CLINICAL MANIFESTATIONS the inner ear to deliver medication directly
Triad of Symptoms to the inner ear
d. Labyrinthectomy
Vertigo - Attacks of spinning sensation
• removal of the inner ear sense organ to
Hearing loss
effectively control vertigo
Tinnitus - A roaring, buzzing, or ringing • sacrifices hearing and is reserved for
sound in the ear patients with nonfunctional hearing in the
Other signs and symptoms affected ear
Fullness or blocked feeling in the ear e. Vestibular Neurectomy
Giddiness • selectively severing a nerve from the
Nystagmus affected inner ear organ
Sweating • usually controls the vertigo while
Pallor preserving hearing, but carries surgical
Severe nausea risks
Vomiting
NURSING DIAGNOSES & MANAGEMENT
DIAGNOSTIC PROCEDURES Nursing Diagnoses
a. History • Risk for Injury related to tendency to lose
b. Computed Tomography Scan balance
c. Magnetic Resonance Imaging • Risk for Fluid Volume Deficit related to
d. Electronystamography - A precise and decreased oral intake and loss of fluid
objective diagnostic method of evaluating through emesis
nystagmus eye movements • Risk for Trauma related to impaired balance
e. Electrocochleography - Recording the • Self-Care Deficit: Feeding, Bathing/Hygiene,
electrical activity of the inner ear in Dressing/Grooming, Toileting related to
response to sound labyrinth dysfunction and episodes of
f. Caloric Stimulation - Involves elevating the vertigo
head 30 degrees and irrigating each • Impaired Adjustment related to a required
external auditory canal separately with 30 change in lifestyle
to 50 ml ice water •Anxiety related to threat of, or change in,
g. Rotational Tests - Involves rotation using a health status and disability effects of vertigo
rotatable chair or motor-driven platform • Powerlessness related to feelings of loss of
control
MEDICAL MANAGEMENT
Pharmacologic Methods Nursing Management
To suppress the illusion of motion Teach the patient what to do and not to do
a. Antihistamines meclizine, cyclizine, during an attack to reduce dizziness and
dimenhydrinate, promethazine prevent injury.
b. Anticholinergics scopolamine, atropine DO’s
To relieve nausea and vomiting
a. Antidopaminergics phenothiazines
• Keep the side rails of the bed up to
prevent falls because an attack can begin
quite rapidly.
• Lie on the unaffected ear and look in the
direction of the affected ear to decrease
signs and symptoms.
DONT’s
• Don’t read or expose yourself to glaring
light to reduce dizziness.
• Don’t make sudden position changes or do
any tasks that vertigo makes hazardous.
• Don’t get out of bed or walk without
assistance.