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NUR 643 How would you explain the appropriate technique for a nursing student to perform an ear exam correctly?
NUR 643 How would you explain the appropriate technique for a nursing student to perform an ear exam correctly
NUR 643 Week 2 DQs
Week 2 DQ 1 As an instructor, you are working with a nursing student in the second year of a 4-year nursing program. The student does not perform an ear exam correctly. How would you explain the appropriate technique to examine the ears?
An ear exam is a thorough check of the ears. It is done to screen for ear problems, such as hearing loss, ear pain, discharge, lumps, or objects in the ear. An ear exam can find problems in the ear canal, eardrum, and middle ear. These problems may include infection, too much earwax, or an object like a bean or a bead.
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During an ear exam, a tool called an otoscope is used to look at the outer ear canal and eardrum. An otoscope is a handheld tool with a light and a magnifying lens. It also has a funnel-shaped viewing piece with a narrow, pointed end called a speculum. A pneumatic otoscope has a rubber bulb that your doctor can squeeze to give a puff of air into the ear canal. The air helps the doctor to see how the eardrum moves.
Visual loss is common after head trauma, but its diagnosis is often delayed. The clinical assessment is complicated by the fact that trauma patients may be unconscious and unable to provide a clinical history. Examination can be limited by lack of cooperation, concomitant physical injuries, and decreased level of consciousness. Alternatively, the traumatic event may seem minimal in relation to the visual loss, and the patient may be neurologically intact. Obvious evidence of trauma in the form of ocular or periorbital hemorrhage, laceration, or ecchymosis may be absent, and the injury causing the visual loss may be concealed. A wide range of lesions can result in visual loss, and the visual system can be affected at multiple levels (Table 1). A careful examination combined with appropriate neuroimaging should elucidate the nature of the visual loss and guide initiation of optimal management.1-6 The aim of this review is to help neurologists develop a rational approach to evaluating the patient with post-traumatic visual loss.