Conditions of the inner ear (Menieres's disease)
Symptoms
Vertigo
Tinnitus
Hearing loss
Pathophysiology
Postulated that tissue changes in the labyrinth trigger production of excess endolymph. Which distorts the contour of the membranous labyrinth and destroys the delicate vestibular and cochlear hair cells.
Risk factors
Ear infections
Foreign bodies
Tumours like cholesteatoma
Prolonged exposure to noise
Poor ear hygiene
Ototoxine medication (streptomycin)
Trauma to the tympanic membrane
Head injury involving there vestibulocochlear nerve.
Causes
Is unknown, but it is thought to be related to the malabsorption of the endolymph in the membranous labyrinth.
Both ears are affected
The excessive accumulation of endolymph results in the dilatation of the membranous labyrinth which impacts on balance.
It affects mainly adults between the ages of 20 and 60 children as young as four years of age and adults as old as 90 have been reported to suffer from the disease
Nursing care plan
Counseling
Symptomatic care should be implemented
Encourage rest
Sedation antiemetic of medications for motion sickness.
The should be kept in a quiet room and comfortable position
The patient must avoid sudden head movement or changes in position to prevent falling
Administer medications.
Medications
Antihistamines
Benzodiazepines
Anticholinergic
Nursing diagnosis (subjective data)
Aural fullness
Tinnitus
Fluctuating hearing loss
Vertigo
A feeling of being pulled to the ground
Objective data
The patient should be referred for audiometric studies and vestibular test. A physical examination should include a neurological examination, because there is an overlap between manifestations of inner ear conditions and central nervous system disorders.