A 77-year-old patient who is quiet and withdrawn may have a ...

[gbarreiro]

A 77-year-old patient who is quiet and withdrawn may have a hearing deficit related to impacted cerumen. During the nursing assessment, the nurse confirms supporting evidence of the condition when noting
 
  a. frothy drainage from the patient's ears.
  b. patient reports of dizziness.
  c. patient reports of a feeling of fullness in the ears.
  d. gray, metallic-appearing tympanic mem-brane.

Question 2

An older patient is in the family practice clinic reporting increasing joint pain, anorexia, and low-grade fever. The patient has a history of osteoarthritis. What action by the nurse is best?
 
  a. Document the findings on the patient's chart.
  b. Assess for joint deformities and nodules.
  c. Tell the provider the patient needs more pain medicine.
  d. Encourage the patient to ask for physical therapy.

[meryzewe]

Answer to Question 1

C
Patients with cerumen buildup may complain of ear fullness, itching, and difficulty hearing. The patient will not have frothy drainage, dizziness, or metallic-appearing tympanic membrane from cerumen.

Answer to Question 2

B
Osteoarthritis does not include systemic symptoms. The nurse should assess for other causes of joint pain, including rheumatoid arthritis, which is manifested by joint deformities and subcuta-neous nodules. Findings should be documented. The patient may need a change of pain medica-tion. Physical therapy is an appropriate intervention. However, determining the source of the pa-tient's symptoms comes first.