Individuals with no hearing impairment hear about 0 to 15 decibels. The decibel scale is used to measure the intensity of sound.
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.
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, ringing in the ear, is typically the first symptom that presents before hearing impairment starts.
Patients who might not fully realize that their hearing is becoming impaired will ask you to repeat your question or answer questions inappropriately.
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.
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.
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 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.
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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