A 76-year-old adult expresses frustration to the nurse regarding ...

[cnetterville]

A 76-year-old adult expresses frustration to the nurse regarding hearing loss despite a lifetime of being conscientious about avoiding known causes of hearing damage. Which of the following age-related changes may result in hearing loss?
 
  A) Degeneration of the inner ear structures
  B) Decreased viscosity and quantity of cerumen
  C) Plaque formation and occlusion of the Eustachian tubes
  D) Hypertrophy of the external ear structures

Question 2

An 85-year-old woman who lives alone says to the nurse, There is nothing I can do about my hearing. I am 85 years old, and I am not really interested in listening to television programs anymore. Which of the following would be the nurse's best
 
  A) You are lucky you still live alone at 85, and I understand why you don't care about the programs on television.
  B) Have you talked with your health care provider about a hearing evaluation? This would determine the problem and possible solutions to it.
  C) I know a hearing aid dealer who offers free testing. Have you thought about trying a hearing aid?
  D) Did you know that there are closed-caption television sets that would allow you to enjoy some shows?

[Zack0mack0101@yahoo.com]

Answer to Question 1

Ans: A
Age-related changes of the inner ear include loss of hair cells, reduction of blood supply, diminution of endolymph production, decreased basilar membrane flexibility, degeneration of spiral ganglion cells, and loss of neurons in the cochlear nuclei. These inner ear changes result in the degenerative hearing impairment termed presbycusis. Cerumen often becomes more viscous with age, and occlusion of the Eustachian tubes is not a normal, age-related change. Changes to the external ear structures are not implicated in age-related hearing loss.

Answer to Question 2

Ans: B
The first step would be to determine what the problem is. Free testing is not comprehensive in its evaluative scope. Telling the client she is lucky to be living alone at 85 years of age is nontherapeutic communication and suggesting that the woman use closed-caption television does not address the hearing issue.