Benign paroxysmal positional vertigo (BPPV)
Pathophysiology: triggered by certain changes in head position, such as tipping the head up or down. It's rarely serious unless it increases the risk of falling.
Medications:
If you decide to wait it out, certain modifications in your daily activities may be necessary to cope with your dizziness. Use two or more pillows at night. Avoid sleeping on the "bad" side. In the morning, get up slowly and sit on the edge of the bed for a minute. Avoid bending down to pick up things, and extending the head, such as to get something out of a cabinet. Be careful when at the dentist's office, the beauty parlor when lying back having ones hair washed, when participating in sports activities and when you are lying flat on your back. Similarly be cautious with chiropractic treatments that may jostle the head.
Symptoms tend to wax and wane. Motion sickness medications are sometimes helpful in controlling the nausea associated with BPPV but are otherwise rarely beneficial.
As BPPV can last for much longer than 2 months, in our opinion, it is better to treat it actively and be done with it rather than taking the wait/see approach.
Medical Interventions:
Benign paroxysmal positional vertigo may go away on its own within a few weeks or months. But, to help relieve BPPV sooner, your doctor, audiologist or physical therapist may treat you with a series of movements known as the canalith repositioning procedure.
the canalith repositioning procedure consists of several simple and slow maneuvers for positioning your head. The goal is to move particles from the fluid-filled semicircular canals of your inner ear into a tiny bag-like open area (vestibule) that houses one of the otolith organs in your ear where these particles don't cause trouble and are more easily resorbed.Each position is held for about 30 seconds after any symptoms or abnormal eye movements stop. This procedure is usually effective after one or two treatments.
Nursing Interventions/Patient Teaching:
Pertinent assessment and findings:
Signs and symptoms of dizziness that are prompted by eye or
head movements and then decrease in less than one minute
• Dizziness with specific eye movements that occur when you lie on
your back with your head turned to one side and tipped slightly over the edge of the examination bed
• Involuntary movements of your eyes from side to side (nystagmus)
• Inability to control your eye movements
Nursing Considerations:
• Dizziness
• A sense that you or your surroundings are spinning or moving (vertigo)
• A loss of balance or unsteadiness
• Nausea
• Vomiting
• Be aware of the possibility of losing your balance, which can lead to falling and serious injury.
• Sit down immediately when you feel dizzy.
• Use good lighting if you get up at night.
• Walk with a cane for stability if you're at risk of falling.
• Work closely with your doctor to manage your symptoms effectively.