*NURSING > ATI MEDICAL SURGICAL > ATI Medical Surgical Nursing, Care of Patients with Ear and Hearing Problems (All)
ATI Medical Surgical Nursing, Care of Patients with Ear and Hearing Problems
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The nurse is caring for a client with external otitis. Which assessment finding indicates to the nurse that the client’s infection has worsened? a. The client now reports tinnitus and vertigo at... night. b. The client now has a positive Rinne test, with AC > BC. c. The tympanic membrane is pearly gray with white patches. d. The auricular lymph nodes have increased in size over the last 24 hours. ANS: D Enlargement of the auricular lymph nodes indicates that the client’s external otitis is becoming more widespread and that current therapy is insufficient. Tinnitus, vertigo, and a positive Rinne test all indicate middle to inner ear problems not related to external otitis media. The tympanic membrane is normally pearly gray in color. White patches on the tympanic membrane are called tympanosclerosis and generally have no clinical importance. DIF: Cognitive Level: Application/Applying or higher REF: N/A TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology) MSC: Integrated Process: Nursing Process (Assessment) [Show More]
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