Question

Discussion Topic: What are the different types of hearing loss? Follow the discussion guidelines below.

For the case study section only: Please only provide short answers for the case study No more than 2 -3 sentence response. Answer all the questions in all case study scenarios.

1. Case Study: Childhood Obesity

Mason is a 7-year-old boy who is at his primary care physician for a routine physical examination. Mason’s mother expresses concern about childhood obesity and is worried that he sleeps too much.

Subjective Data: Mason has been eating more than usual. Mason sleeps between 11 and 12 hours a day. Mason plays team soccer.

Objective Data
Height: 121 cm
Weight: 23 kg
Vital signs: temp, 37º C; pulse, 78 bpm; resp, 22 breaths/min; blood pressure, 102/62 mm Hg
Height: 90 cm
Mason has a normal physical examination for his age.
Questions:
What should the nurse tell Mason’s mother when discussing her concerns about childhood obesity?
What can Mason’s mother do to help Mason maintain a healthy weight?
Mason’s mother has questions about his joining a soccer team. What should the nurse tell her?

2. Case Study: Brain Tumor
Caroline is an 11-year-old girl who has an inoperable brain tumor. Caroline has been admitted for palliative care. Her mother, father, and two siblings are with her.
Subjective Data: Caroline complains of a severe headache. She states that she is “afraid to be alone.”
Objective Data
Vital signs: temp, 37.8º C; pulse, 120 bpm; resp, 24 breaths/min; blood pressure, 110/60 mm Hg
Caroline is unable to walk unassisted.
Her pupils are unequal 4 mm right and 6 mm left.
Questions:
What is the most immediate priority for Caroline?
How can Caroline’s nurse help with Caroline’s fears?
How can Caroline’s nurse maintain professional boundaries?

3. Case Study: Hyphema
Johnny is a 10-year-old boy who seeks care after being hit in the right eye with a stuffed snake by his brother 15 minutes before arrival.
Subjective Data: Johnny complains of light sensitivity. Vision in the right eye is blurred.
Objective Data
Vital signs: temp, 36.8º C; pulse, 90 bpm; resp, 18 breaths/min; blood pressure, 110/60 mm Hg
Pupils: Left, 3 mm briskly reactive to light. Right, 3 mm and sluggishly reactive to light
Visual acuity: Right eye unable to see chart; left eye 20/15
Approximately a 30% hemorrhage is noted to the anterior chamber of the right eye with an intact globe.
Questions:
Johnny is at risk for what complications?
What measures may help prevent these complications?
What should the nurse do in this situation? Prioritize these actions.

Answer 1

Hearing loss occurs when there is damage to the ear. Based on the part of the ear that is affected it is classified under four categories:

CONDUCTIVE HEARING LOSS:

In this type, middle ear is affected.

It can be due to rupture of eardrum, infections of middle ear etc.

This could be temporary or permanent.

SENSORINEURAL HEARING LOSS:

It is more common type.

It occurs when there is damage done to hair cells of cochlea.

It involves gradual loss of auditory receptors and sensory nerve endings.

Cochlear implant is recommended as treatment option.

MIXED HEARING LOSS:

This occurs when there is a damage in both inner and middle part of the ear.

NEURAL HEARING LOSS:

It occurs when auditory nerve or vestibulocochlear nerve that is innervating in the inner ear is damaged.

1.CASE STUDY: CHILDHOOD OBESITY

Nurse should explain Mason's mother regarding the causes, risks and preventive measures to reduce weight.

Mason's mother can make a change in his diet by replacing the sugary and high fat products with fresh fruits and vegetables, whole grains, skimmed milk, chicken, fish etc. Encouraging him to be more physically active.

Nurse should tell Mason's mother that participating in a soccer team is a good decision as it helps him to reduce weight and keep him active.

2.CASE STUDY:BRAIN TUMOR

Caroline needs emergency medical attention (neuro and opthalamic consultation) as this prevents occurence of seizures and loss of vision.

Nurse can reassure caroline that she is safe with her even without her family members.Nurse can also make her speak about her feelings as this would help her emotionally.

Nurse should maintain professional boundaries by keeping in mind that the patient and their treatment needs to be prioritized and should not be involved in their personal matters.

3.CASE STUDY:HYPHEMA

Johnny is at risk of developing posterior synechiae ,increased intraocular pressure and optic nerve damage.

Usually the blood is reabsorbed within few days until then eye needs to be protected by wearing an eye shield, avoid light.

The nurse should elevate the head side of the bed.Give him steroid drops to reduce the inflammation and pain in the eye.Advise the parents not to give him aspirin, ibuprofen and other blood thinning drugs that worsens the bleeding.