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-Sensory: damage to cochlear cells -Conductive: damage to tympanic membrane -Neural: damage to cranial nerve VIII--HESI Hint: The ear consists of three parts: the external ear, the middle ear, and the inner ear. Inner ear disorders, or disorders of the sensory fibers going to the central nervous system (CNS), often are neurogenic in nature and may not be helped with a hearing aid. External and middle ear problems (conductive) may result from infection, trauma, or wax buildup. These types of disorders are treated more successfully with hearing aids.-HESI Hint: NCLEX-RN questions often focus on communicating with older adults who are hearing impaired-• Speak in a low-pitched voice, slowly and distinctly.-• Stand in front of the person, with the light source behind the client.-• Use visual aids if available. Hyperglycemia (wound healing): increased sugar. High blood glucose contributes to damage of thesmallest vessels, the capillaries. This damage causes permanent capillary scarring, which inhibits the normal activity of the capillary. This phenomenon causes disruption of capillary elasticity and promotes problems such as diabetic retinopathy, poor healing or breaks in the skin, cardiovascular abnormalities, etc.The body’s response to illness/stress is to produce glucose. Therefore, any illness may result in hyperglycemia.Could eventually lead to amputation (Peripheral Artery disease)
Hypothyroidism “Hashimoto Disease”:Hypofunction of the thyroid gland, with resulting insufficiency of thyroid hormone· S/S:o Decrease T4T3o Increase TSHo Bradycardiao Enlarged hearto Lethargic/Slowo Pale, coolo Weight gaino Constipationo Lack of Iodineo Cretinism (lack of TSH @ birth)o Weakness/muscle crampso Dry skino Slurred speecho Intolerance to coldo Goiter if Iodine (low)o Heavy menstrual cycleo Lethargy/apathyo Myxedema(edema in face, thickened tongue)· Treatment:o Levothyroxine (synthroid)Hyperthyroidism “Grave Disease”;Excessive activity of thyroid gland, resulting in an elevated level of circulating thyroid hormones. Possibly long-term or lifelong treatment.· S/S:o Increase T4T3 o Decrease TSHo Increase BMRo Tachycardiao Increase BPo Restlessness, Nervousnesso Diarrheao Flushed / warmo Weight losso Grave’s Disease (Goiter, Exophthalmos)o Thyrotoxicosis(thyroid storm)o Intolerance to heato Bulging eyeso Enlarged thyroido Tremors
o Menstrual cessationo Finger clubbing· Treatment:o ThioamidesPropylthiouracil (PTU)and methimazole (Tapazole) act by blocking synthesis of T3 and T4.HESI Hint Thyroid storm is a life-threatening event that occurs with uncontrolled hyperthyroidism due to Graves disease. Other causes include childbirth, congestive heart failure (CHF), diabetic ketoacidosis, infection, pulmonary embolism, emotional distress, trauma, and surgery. Symptoms include fever, tachycardia, agitation, anxiety, and HTN. Primary nursing interventions include maintaining an airway and adequate aeration. Propylthiouracil (PTU) and methimazole (Tapazole) are antithyroid drugs used to treat thyroid storm. Propranolol (Inderal) may be given to decrease excessive sympathetic stimulation.