Master Care for the Hearing Impaired with Picmonic for Nursing RN

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Care for the Hearing Impaired

Caring for those with Plugged-ears
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Hearing impaired patients can sometimes be the most challenging. The majority of our communication is verbal, and hearing impaired patients require a nurse to slow down to insure the patient understands what the plan of care is. There is a variety of reason why hearing impairment might be occurring. They could have conductive hearing loss which could be from otitis media or perforated eardrum, or sensorineural which is form genetics, loud music, or certain medications.
10 KEY FACTS
ASSESSMENT
Normal: 0-15 dB
0 to 15 dB-bell

Individuals with no hearing impairment hear about 0 to 15 decibels. The decibel scale is used to measure the intensity of sound.

Rinne's Test
Rhinosaurus giving Rinne's Test

Part of tuning fork test (comparison of air and bone conduction), place-vibrating fork on mastoid bone (bone conduction), count how long the patient can hear then quickly place fork in front of ear canal (air conduction). Individuals should hear air conduction twice as long as bone conduction.

Weber's Test
Web giving Weber's Test

Part of the tuning fork test (lateralization of sound), place-vibrating fork on top of patient's head (midline). Ask patient if the sound is equal in both ears. Sounds will differ if an ear is hearing impaired.

Tinnitus
Tennis-ball ringing ear

Tinnitus, ringing in the ear, is typically the first symptom that presents before hearing impairment starts.

Difficulty Following Conversations
Can't Follow Conversation-path

Patients who might not fully realize that their hearing is becoming impaired will ask you to repeat your question or answer questions inappropriately.

NURSING CONSIDERATIONS
Face Patient/Speak Clearly
Facing Patient and Speaking through Clear-megaphone

Be sure to face the patient and speak clearly when communicating. This allows for hearing impaired patients to know you are addressing them or a chance to read your lips. There is no need to shout as lower tones are typically easier for patients to hear.

Rephrase Misunderstood Statements
Rearranging Misunderstood Statement

If a patient does not understand something that you have said, rephrase the question or statement. Do not state the same thing twice. Pause and then rephrase.

Repeat Statements Back
Patient Repeating Statement

It is important to have the patient repeat what they understood from the conversation back. This insures that the patient was able to follow along during the conversation.

Hearing Aids
Hearing Aid

Hearing aids come in all shapes and sizes. It is important to keep the hearing aids in a marked container when they are not in use to prevent them from getting lost.

Sign Language
Sign with Sign Language

If a patient understands or uses sign language it is required by the American’s with Disabilities Act, that an interpreter be present for activities related to informed consent and discharge teaching.

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