2. Describe the subjective and objective components of an ear assessment. 3. Identify normal and abnormal ear assessment findings. 4. Describe differences in ear assessment findings associated with aging and ethnicity. 5. Examine the methods used to collect ear assessment data. 6. Identify what should be documented from a subjective and objective ear assessment. Subjective Assessment • Review of system o How do you clean your ears? o Do you use eardrops? Or are you on any other medications? o Are you exposed to loud noises? • Current concern • Past history • Family history • Lifestyle & health practices • Medications Objective Assessment • Inspecting for: o Redness o Drainage or discharge o Inflammation o Proportions, symmetry, size • Palpating for: o Tenderness o Mastoid process o Temperature of pinna and tragus o Lumps or masses Otoscope Insertion • Pull pinna back and up for adult • Pull pinna down for 0-3 years • Tubes are shorter and tubes are more horizontal • Insert otoscope upside down and stabilize with back of hand on cheek o May need to rotate otoscope slightly to visualize all of the tympanic membrane Conductive Hearing Loss • Conductive • Structures of external or middle ear are not functioning effectively o Damage to the pinna • Anything that obstructs transmission of sound o Build of cerumen
o Constant exposure to loud sounds/sensory neural problems Ototoxic Meds • Cause nerve degeneration • Sensorineural o Nerve degeneration or damage impairs transmission to brain &/or brain unable to process neural output • Severe concussions could result in ringing in the ears Tinnitus vs. Vertigo • Tinnitus o Symptom of underlying conditions § E.g. hearing loss, injury, impairment of structures of nerves § Perception of ringing, crackle, or buzzing noise in the ears o Subjective questions: § Have you had any trauma to the ears? § Do you hear ringing? § Is it continuous or intermittent? § One of both ears? § When did it start? § What is the severity? o Objective assessment: § Looking for discharge from the ears § Assess hearing – whisper test • Vertigo o Inner ear contains sensory receptors, relay info: body position to the brain o Symptoms § Impaired balance or feeling of spinning o Subjective questions: § When did it start? § What makes it better? § Is it one ear or both? § Severity of pain? o Objective assessment: § Assess their balance – Romberg test Age Related Degeneration of Hearing • Courser hair in the ears • Osteoporosis in the ear • Shorter canal in children Otitis Media in Children • Why are ear infections more common in children? o They have a more horizontal eustachian tube Whisper Test • Whisper a two-syllabus word in each ear
• Get patient to tap on opposing tragus of ear you’re not whispering in Romberg Test • Get client to stand with feet close together and look straight ahead and then close their eyes • Watch their balance – how much they sway
HEAS 1000 – TOPIC 4.4: Nose, Mouth, Throat Assessment Specific Learning Outcomes 1.
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- Fall '18