SAS 10

• After the students have completed the task, the instructor will call 3-5 students to share and read out loud the things they have learned from the session.
• The students will study and read Chapter 12 of their book about this lesson: Anatomy and Physiology.
• Common, or Concerning Symptoms of the Ears include Hearing loss, Earache, Discharge, Tinnitus, and Vertigo.
• Hearing loss can be categorized as conductive loss, which results from problems in the external or middle ear, and sensorineural loss, from problems in the inner ear, the cochlear nerve, or its central connections in the brain.
• Hearing loss may also be congenital, from single gene mutations.
• People with sensorineural loss have particular trouble understanding speech, often complaining that others mumble; noisy environments make hearing worse.
• In conductive loss, noisy environments may help.
• Medications that affect hearing include aminoglycosides, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), quinine, furosemide, and others.
• Symptoms associated with hearing loss, such as earache or vertigo, help you to assess likely causes.
• Family History can include Hearing loss, Otitis media, Allergies, Smoking or exposure to cigarette smoke.
• Past History of the Ear can include Congenital hearing loss, Removal of cerumen, Ear surgery, Trauma or injury to the ear, Infection, Exposure to hazardous noise levels, History of syphilis, rubella, meningitis.
• Common or Concerning Symptoms of the Nose and Sinuses can include Rhinorrhea, Congestion, Epistaxis, and Change in Sense of Smell.
• Common or Concerning Symptoms of the Mouth and Throat can include Sore throat, Hoarseness, Lesions, Sore tongue, Bleeding gums, Toothache, Dysphagia.
• Past History of the Nose and Sinuses can include Sinus infections, Upper respiratory infections, Allergies, Trauma or injury, Nasal or sinus surgery, Polyps, Dental history.
• Lumps on the ear; Abnormalities of the Eardrum; and Patterns of Hearing Loss are topics discussed in chapter 12 of the textbook.
• Inquire specifically about medications that might affect hearing and ask about sustained exposure to loud noise.
• Earache suggests a problem in the external ear, such as otitis externa, or, if associated with symptoms of respiratory infection, in the inner ear, as in otitis media.
• Discharge from the ear can be associated with earache or trauma.
• Upon completion of this lesson, the nursing student can identify the structures and function of the ear, nose, mouth, and throat; collect an accurate health history of the ear, nose, mouth, and throat; describe the physical examination techniques performed to evaluate the ear, nose, mouth, and throat; and perform a complete ear, nose, mouth, and throat examination.
• Unusually soft wax, debris from inflammation or rash in the ear canal, or discharge through a perforated eardrum may be secondary to acute or chronic otitis media.
• Tinnitus is a perceived sound that has no external stimulus and commonly is heard as musical ringing or a rushing or roaring noise.
• Tinnitus may accompany hearing loss and often remains unexplained.
• Occasionally, popping sounds originate in the temporomandibular joint, or vascular noises from the neck may be audible.
• The labyrinth within the inner ear is responsible for hearing.
• Hoarseness can be caused by smoking, voice abuse, increased intake of high-sodium foods, or tuberculosis.
• Past history that can contribute to oral health problems includes sore throat, loss of voice, dental, mouth, or throat surgery, trauma or injury to teeth, mouth, or throat, history of infections, oral cancer, and sexually transmitted disease.
• Family history that can contribute to oral health problems includes allergies, smoking or exposure to cigarette smoke, stroke, tuberculosis, and others.
• When tinnitus is present together with hearing loss and vertigo, this may suggest sensorineural hearing loss, Meniere’s disease, otosclerosis, or other conditions.
• Excessive use of decongestants can worsen symptoms of rhinorrhea due to vasomotor rhinitis, rhinitis medicamentosa, allergic rhinitis, or hay fever.
• The patient with tumor growing on their larynx has stated to the nurse that she has difficulty in swallowing and this must be noted on the chart as dysphagia.
• In conductive hearing loss, the patient will most likely have problems in the auricle, tympanic membrane, ossicles, or all of the above.
• Fever, pharyngeal exudates, and anterior lymphadenopathy, especially when cough is not present, can suggest an infection of Corynebacterium diphtheriae, filterable virus, Haemophilus influenzae, or Streptococcus pyogenes.
• Abnormalities of the Lips; Findings in the Palate, Pharynx, and the Oral Mucosa; Findings in the Gums and Teeth; Findings In or Under the Tongue are topics discussed in chapter 12 of the textbook.
• Otitis media is common among children below 5 years old due to their immature immune system, short auditory canal, frequent insertion of objects into their ears, or short and more horizontal eustachian tube.
• Alcohol, coffee, milk, or carbonated drinks can cause nasal congestion in a patient if taken in excess.
• The nurse has observed for a sore smooth tongue in a patient while doing a physical examination and must suspect for streptococcal infection, nutritional deficiencies, gingivitis, or hypothyroidism.
• Tinnitus is a common symptom, increasing in frequency with age.
• When associated with hearing loss and vertigo, tinnitus suggests Ménière’s disease.
• Vertigo refers to the perception that the patient or the environment is rotating or spinning.
• These sensations point primarily to a problem in the labyrinths of the inner ear, peripheral lesions of cranial nerve (CN) VIII, or lesions in its central pathways or nuclei in the brain.