Chapter 42 Hearing, Speech, & Vision Problems Key Terms Cerumen Deafness Hearing loss Tinnitus Vertigo Hearing & Vision Sight and hearing allow communication, learning, and moving about. Important for self-care, work and many other activities. Have a role in safety and security Many people have some degree of hearing or vision loss. 1
Common causes Birth defects Accidents Infections Diseases Aging Ear Disorders The ear functions in hearing and balance. Otitis Media Is infection (itis) of the middle (media) ear It is chronic or acute Can damage the tympanic membrane (eardrum), or the ossicles permanent hearing loss can occur Fluid builds up in the ear. Pain (earache) and hearing loss occur. Doctor orders antibiotics 2
Meniere s Disease A chronic disorder of the inner ear. The increase fluid causes pressure in the middle ear. Tinnitus, hearing loss, and vertigo occur Whirling and spinning sensations are felt. Severe dizziness (vertigo) causes nausea & vomiting. Lasting a few minutes to many hours Treatment Medications, fluid restriction and a low-salt diet are usually ordered. Safety is needed during vertigo. The person must lie down. Falls are prevented. Bed rails are used according to the care plan The head is kept still. The person moves slowly, & avoid bright lights Hearing Loss Means difficulty hearing normal conversation. Losses range vary from mild to severe. Occurs in all age groups. Males are a greater risk. 3
Common causes Age-related changes Noise exposure to a very loud sound just once can cause hearing loss. Or it can occur over a long time. Causes cont. Loud music, headphones, traffic, airplanes, power tools, and industrial machines are some examples of harmful noise. Infections, heart conditions, stroke, head injuries, tumors, drugs, heredity, birth defects. Temporary loss from earwax (cerumen) Effects on the Person A person may not notice gradual hearing loss. Others may see change in the person s behavior or attitude. They may not relate hearing loss to the changes. Hearing is needed for speech 4
Symptoms Speaking too loudly Leaning forward to hear Turning and cupping the better ear toward the speaker. Answering questions or responding inappropriately. Asking for words to be repeated. Communication Hearing-impaired persons may wear hearing aids or read lips. Manual alphabet Sign language examples 5
Hearing Aids Makes sound louder It does not cure or correct the hearing problem. The person hears better because the device makes the sound louder. Background noise and speech are louder. Hearing aids cont. Sometimes the device does not seem to work properly. Try this: Check to see that it is on Check the battery position Insert a new battery if needed Clean the ear mold if necessary Hearing aids are costly handle with care Eye Disorders Vision loss can occur at all ages Problems range from mild vision loss to complete blindness Can be sudden or gradual in onset. One or both eyes can be affected. 6
Cataracts The lens of the eye becomes cloudy (opaque) Light cannot enter the eye The term comes from the Greek word waterfall, trying to see is like looking through a waterfall. Page 683, fig. 42-7 S/S Cloudy, blurry, or dimmed vision Colors seem faded Sensitivity to light and glares Poor vision at night Halos around lights Double vision in affected eye Risk factors A family history Diabetes Smoking Alcohol use Prolonged sunlight exposure High B/P, obesity, eye injuries, surgeries 7
Treatment Surgery is the only treatment The lens is removed and a plastic lens is put into the eye. Special instructions after surgery must be followed. Keep shield in place, do not rub, or bump the eye. Do not shower or shampoo. Report any c/o pain, or eye drainage. Glaucoma Fluid pressure within the eye increases. This damages the optic nerve. Vision loss with eventual blindness occurs Onset is gradual or sudden Peripheral vision is lost. Is a major cause of vision loss Risk Factors African-Americans over 40 Family history 8
Treatment Drug therapy And possible surgery The goal would be to prevent further damage to the optic nerve. Prior damage cannot be reversed. Diabetic retinopathy Complications of diabetes Tiny blood vessels in the retina are damaged Risk factors Anyone with diabetes 9
Treatment Control diabetes Blood pressure Blood cholesterol Age Related Macular Degen. P. 684 Risk factors Treatment Low Vision P. 685 Risk factors Treatment 10
Blindness Birth defects, accidents, & eye disease are among the many causes. Some people are totally blind, while others have some usable vision but cannot read newsprint. The legally blind person sees at 20 feet what a person with normal vision sees at 200 feet. Cont. Loss of sight is serious. Adjustments are difficult and it take a long time. Special education and training are needed. Moving about, ADL s, reading Braille, & a guide dog all require special training. Impaired Vision & Blindness Caring for blind and visually impaired persons Page 686-687 Box 42-6 Figure 42-10 Braille, page 688, fig. 42-12 11
Corrective Lenses Eyeglasses: lenses are hardened glass or plastic. Clean them daily and as needed. Wash with warm water. Dry with a soft tissue. Plastic scratches easily. Use special cleaning solution, tissues & cloth. Contact Lenses Contact lenses: fit on the eye. They are easily lost. Depending on the type, they can be worn for 12-24 hours, 1 week, or longer. Remove and clean according to manufacture s instruction Artificial Eyes Removal of an eyeball is sometimes done because of injury or disease. The person is fitted with an ocular (eye) prosthesis. It matches the other eye in shape and color. Some are permanent implants. Others are removable. The person is taught how to remove, clean and insert it. 12
Care of a Prosthesis This is the persons property and must be protected from loss or damage. If it is your responsibility to care for the eye prosthesis, you will be instructed on how that is to be done. 13