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Visual and Auditory ProblemsMedical-Surgical Nursing

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_______ involves inflammation or infection of the epithelium of the auricle and ear canal.
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External otitis
What causes swimmer's ear?
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Frequent swimming alters the normal flora of the ear making it susceptible to infection
What bacteria are the common culprits of external otitis?
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Pseudomonas Aeruginosa, klebsiella, proteus, E. coli and S. aureus
What are the most common fungal causes of external otitis?
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Candida albicans and aspergillus organisms
__________ is an infection caused most commonly in elderly patients with diabetes by P. aeruginosa. It can spread from the external ear to the parotid gland and temporal bone.
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Malignant external otitis
_______ is one of the first signs of external otitis.
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Otalgia (ear pain), especially when manipulating the auricle or tragus
A patient comes into the clinic complaining of ear pain. She tells you anytime something brushes her ear it is really painful and this morning she noticed a greenish drainage on her pillow. You strongly suspect she has external otitis caused by the _________ organism.
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Pseudomonas (greenish, musty exudate is a hallmark of this type of infection)
_________ paralysis can occur from malignant external otitis.
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Facial nerve
What are signs and symptoms of an external otitis infection?
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Pain, fever, swelling of the ear canal which can cause dizziness and block hearing, serosanguineous or purulent drainage is sometimes present
Why is a wick of cotton placed in the canal as part of the treatment of external otitis?
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It helps deliver the antibiotic drops to the ear
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Cotton wicking should be used with caution in patients who are...
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Young children, confused or psychotic. They may push it in further
What antibiotics are commonly used to treat external otitis?
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Polymyxin B, Neomycin/Neosporin, and chloramphenicol
______ is commonly used to treat a fungal external otitis infection.
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Nystatin (Mycostatin)
Corticosteroids can be used to treat the inflammation of external otitis unless the infection is caused by...
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A fungus
What are some important teaching points regarding the use of ear drops to treat infection?
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Hands should be washed before and after instillation, the drops should be room temp., the tip of the dropper should not touch any part of the ear, the ear should be positioned so the drops run down the canal and that position should be maintained at least 2 minutes. Careful handling/disposal of any material with drainage is important.
A patient comes in with an insect lodged in the canal of her ear. You know the best way to get it out is to first...
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Immobilize the insect using mineral oil or lidocaine
A patient comes into the clinic for a routine health assessment. During your assessment of the ears, the patient says, "They should be clean as a whistle, I use Q-tips everyday!" You recognize the importance of what client teaching?
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Ears should only be cleaned with a washcloth and finger. Q-tips can cause serious injury to the tympanic membrane and ossicles and in some cases has caused facial nerve paralysis. In addition, Q-tips can impact cerumen against the tympanic membrane and reduce hearing.
Which part of the ear is most likely to develop cancer?
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The superior border of the auricle (most commonly basal or squamous cell cancers)
The most common problem of the middle ear is...
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Acute otitis media
_________ is the most common drug used for antibiotic therapy for acute otitis media in the US.
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Amoxicillin
A ________ involves an incision of the tympanum to release increased pressure and exudate from the middle ear. A tympanostomy tube is put into place to facilitate further drainage.
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Myringotomy
  
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