https://padlet.com/suzanne_iwata/xmweld6nj8h8 Chapter 64 en-us 2019-03-24 21:29:28 UTC 2023-02-23 00:16:32 UTC hello@padlet.com ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346126724 Reference: TED-Ed (Producer). (2014, January 13). The Mystery of Motion Sickness - Rose Eveleth [Video file]. Retrieved March 27, 2019, from https://youtu.be/gKhE3CMz7Sk]]> 2019-03-28 13:31:37 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346126724 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346131350 (n). A disturbance of equilibrium caused by constant motion

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com

By: Ashley Koehler]]> 2019-03-28 13:39:05 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346131350 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346137917 Vestibular Overstimulation results in...
- Sweating
- Pallor
- Nausea
- Vomiting

Can these S/S continue even if the motion and stimulation is stopped?
Yes, the S/S may persist for several hours after...

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com]]> 2019-03-28 13:49:04 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346137917 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346149251 Motion sickness is a syndrome of some or all of these S/S repeatedly occurring together in situations such as riding in a car, enjoying (or trying to enjoy) a boat ride, flying in a plane, having fun (or not a lot of fun in this case) on Kentwood rides, etc.]]> 2019-03-28 14:06:30 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346149251 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346154352 2019-03-28 14:14:25 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346154352 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346155305 - OTC Anti-Histamines... For relief of nausea/vomiting via blocking the inner ear vestibular pathway conduction
Example: Dimenhydrinate (Dramamine) or Meclizine (Antivert)

- Anticholinergic Medications... Antagonize the Histamine Response
Example: Scopolamine Patches (Transderm Scop)
*Must be applied several hours before the motion causing the sickness occurs & Can cause drowsiness (Don't take if you're driving the car) & dry mouth

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com

]]> 2019-03-28 14:16:03 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346155305 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346160734 2019-03-28 14:26:30 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346160734 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346169943 (n). An abnormality in inner ear fluid balance caused by malabsorption in the endolymphatic sac or a blockage in the endolymphatic duct

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com

By: Ashley Koehler]]> 2019-03-28 14:40:11 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346169943 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346174576 Want some extra practice? An interactive case study can be found in our book on Page 1933

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com]]> 2019-03-28 14:48:07 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346174576 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346176978 The endolymphatic space dilates (Endolymphatic Hydrops) THEN pressure increases in the system OR the inner ear membrane ruptures...
Producing S/S of Meniere's...

Triad of Symptoms:
1. Episodic Vertigo
2. Tinnitus (Unwanted noises in the head or ear)
3. Fluctuating Sensorieneural hearing loss
Also may include:
- Feeling of pressure or fullness in the ear
- Incapacitating vertigo (Often with nausea & vomiting)

Usually 1-2 S/S manifest at the onset of the disease
S/S have a WIDE range of severity (Especially concerning with the vertigo attacks)

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com]]> 2019-03-28 14:52:31 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346176978 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346182253 2019-03-28 15:01:44 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346182253 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346182684 Sometimes, it is classified into two types...

1. Cochlear Meniere
Fluctuating, progressive sensorineural hearing loss associated with tinnitus and aural pressure in the absence of vestibular symptoms or findings
2. Vestibular Meniere
Occurrence of episodic vertigo associated with aural pressure but no cochlear symptoms

These 2 types are classified by their S/S

HOWEVER ALL S/S eventually develop...
Hence why the two types are not distinctly classified

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com]]> 2019-03-28 15:02:32 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346182684 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346185211 2019-03-28 15:07:14 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346185211 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346185733 - Detailed history surrounding the vertigo attacks (Frequency, duration, character, severity, etc.)
       Vertigo attacks = the most troublesome complaint (Can last minutes - hours!)
       Nausea & Vomiting may also occur with vertigo
- Patients may even be awoken at night with feelings of imbalance and disequilibrium, diaphoresis (And these feelings can last days!)
        Most patients feel well between attacks of the disease
- Hearing loss also fluctuates... Tinnitus & Aural Pressure comes and goes as well
        ^ These feelings may occur before or during attacks OR be constant

- Physical Exam
        - Findings usually normal EXCEPT CRANIAL NERVE VIII
        - Performing the Weber Test utilizing a tuning fork... May result in the   
        sounds lateralizing to the ear affected with Meniere's Disease (the ear
        opposite the hearing loss)
- Electronystagmogram... May be normal or exhibit reduced vestibular response
 - Audiogram... Usually reveals a sensourineral hearing loss in the affected ear (Occurs in the low frequencies with progression of the disease)
        - Visualized as a hill/mountain, commonly called "Pike's Peak"... visualized
        below...

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com]]> 2019-03-28 15:08:15 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346185733 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346199985 DIET and MEDICATION are the two big factors that can successfully manage most cases
Psychosocial Evaluation & Cognitive Therapy if the patient is anxious, uncertain, fearful, depressed, etc.
Conservative Therapy works well for most patients but some may have a severe case and elect to undergo surgery for relief (Endolymphatic Sac Decompression or Vestibular Nerve Sectioning)

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com]]> 2019-03-28 15:33:52 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346199985 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346201459 Low Sodium is key!
Amount of sodium helps regulate the fluid balance within the ear and body...
Sodium & Fluid retention disrupts the balance...
(Delicate balance between Endolymph & Perilymph in the inner ear)

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com]]> 2019-03-28 15:36:21 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346201459 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346206780 - Antihistamines... Shorten the attack
 Ex. Meclizine
- Tranquilizers... Acute instances to help control vertigo
Ex. Diazepam (Valium)
 - Antiemetic Agents... Help control nausea, vomiting, vertigo
Ex. Promethazine suppositories (Phenergan)
- Diuretic Therapy... Helps relieve symptoms by lowering the pressure in the endolymphatic system
Ex. Hydrochlorothiazide (Dyazide), Triamterene, Spironolactone
- Intratympanic Injection... Ablation of the vestibular hair cells
Ex. Gentamicin (Garamycin) Injection
*Risk of significant hearing loss is high with these injections*

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com]]> 2019-03-28 15:44:33 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346206780 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346213625 (n). A ringing or similar sensation of sound in the ears

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com

By: Ashley Koehler]]> 2019-03-28 15:56:18 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346213625 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346217179
Reference: Mayo Clinic (Director). (2019, February 5). Mayo Clinic Minute: Is Tinnitus Causing that Ringing in your Ear? [Video file]. Retrieved March 28, 2019, from https://www.youtube.com/watch?v=IlGVzRBBQFM]]> 2019-03-28 16:02:07 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346217179 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346218436 Roaring, Buzzing, Hissing, etc. in 1 OR both ears

Reference: Hearing HealthCare Centre (Director). (2018, May 2). What Does Tinnitus Sound Like? [Video file]. Retrieved March 28, 2019, from https://youtu.be/83laYgUtbv8]]> 2019-03-28 16:04:55 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346218436 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346220978 - Symptom of an underlying disorder of the ear that is associated with hearing loss
- Ranges from Mild --> Severe
- Affects approximately 25 million individuals in the U.S.
- Most prevalent in adults

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com]]> 2019-03-28 16:10:07 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346220978 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346222986 - Cardiovascular Disease
- Thyroid Disease
- Hyperlipidemia
- Vitamin B12 Deficiency
- Psychological Disorders... Ex. Depression, Anxiety
- Fibromyalgia
- Otological Disorders... Ex. Meniere's Disease, Acoustic Neuroma
- Neurological Disorders... Ex. Head injury, MS
- Ototoxic Substances (Listed below)

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com]]> 2019-03-28 16:13:25 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346222986 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346225511 - Physical Exam... To determine the cause
- Diagnostic Testing... To determine if hearing loss is present
- Audiograph Speech Discrimination Test... Helps determine the cause
- Tympanogram... Helps determine the cause

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com]]> 2019-03-28 16:18:22 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346225511 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346226937 - Some forms are irreversible
- Treatment will determine on the cause and level of hearing loss and tinnitus
- Education & Counseling on ways to adjust to treatment and how to cope and deal with tinnitus

Reference: Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Retrieved March 28, 2019, from the point.lww.com]]> 2019-03-28 16:21:07 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346226937 ashhkoehler https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346229275 2019-03-28 16:25:42 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346229275 suzanne_iwata https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346289947 2019-03-28 18:23:52 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346289947 suzanne_iwata https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346290173 2019-03-28 18:24:18 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346290173 suzanne_iwata https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346290338 2019-03-28 18:24:40 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346290338 luther_johnson213 https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346335487 2019-03-28 20:31:01 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346335487 luther_johnson213 https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346342529 2019-03-28 20:56:03 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346342529 14hunterk https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346350536 2019-03-28 21:35:50 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346350536 14hunterk https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346351568 2019-03-28 21:41:44 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346351568 hjones9664 https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346715828 2019-03-29 22:33:59 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346715828 hjones9664 https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346718805 2019-03-29 23:03:49 UTC https://padlet.com/suzanne_iwata/xmweld6nj8h8/wish/346718805