A nurse is completing an admission assessment on a client who has hearing loss. Which of the following client statements should indicate to the nurse that the client is experiencing manifestations of Meniere’s disease?

"l can't get out of bed because the room is spinning."

"l did feel some fluid dripping from my ear when I laid down."

"Sometimes I feel slightly dizzy when I am in a loud restaurant."

"l often feel like I have cotton balls in my ears."

Answer and Explanation

The Correct Answer is A

A. "I can't get out of bed because the room is spinning": The sensation of vertigo, or the perception of spinning or movement when there is none, is a hallmark symptom of Meniere's disease. This sensation is often severe and can be debilitating, leading to difficulty with balance and mobility. Therefore, the client's statement indicating that they cannot get out of bed due to the room spinning is consistent with manifestations of Meniere's disease.

B. "I did feel some fluid dripping from my ear when I laid down": While fluid leakage from the ear can be a symptom of various ear conditions, such as otitis externa or otitis media, it is not typically associated with Meniere's disease. Meniere's disease is characterized by recurrent episodes of vertigo, hearing loss, tinnitus, and a feeling of fullness or pressure in the ear, rather than fluid leakage.

C. "Sometimes I feel slightly dizzy when I am in a loud restaurant": Feeling slightly dizzy in a loud environment may suggest sensitivity to noise (phonophobia) or a mild form of dizziness such as disequilibrium, but it is not specific to Meniere's disease. Meniere's disease typically presents with severe episodes of vertigo rather than mild dizziness.

D. "I often feel like I have cotton balls in my ears": The sensation of having cotton balls in the ears may indicate a feeling of fullness or pressure in the ears, which is a common symptom of Meniere's disease. However, this symptom alone is not sufficient to diagnose Meniere's disease, as it can also occur in other conditions affecting the middle ear, such as eustachian tube dysfunction or otitis media. Additionally, Meniere's disease is primarily characterized by vertigo, not just ear fullness or pressure.

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Correct Answer is C

Explanation

A. Marfan's syndrome: Marfan's syndrome is a genetic disorder that affects the connective tissue in the body, predisposing individuals to various cardiovascular, skeletal, and ocular abnormalities. While Marfan's syndrome can present with certain cranial and intracranial manifestations, such as dural ectasia and intracranial aneurysms, it is not typically considered a direct risk factor for traumatic brain injury (TBI).

B. Hypercarbia: Hypercarbia refers to elevated levels of carbon dioxide (CO2) in the blood. While severe hypercarbia can lead to cerebral vasodilation and potentially exacerbate intracranial pressure in individuals with traumatic brain injury, it is not considered a direct risk factor for TBI itself.

C. Falls: Falls are a significant risk factor for traumatic brain injury (TBI), particularly in older adults and young children. Falls can occur due to various factors such as environmental hazards, impaired mobility, balance issues, or neurological conditions. Falls are a leading cause of TBI-related emergency department visits, hospitalizations, and fatalities.

D. Ventriculostomy: Ventriculostomy involves the placement of a catheter into the ventricular system of the brain to monitor intracranial pressure (ICP) or drain cerebrospinal fluid (CSF). While ventriculostomy is a procedure commonly performed in the management of severe traumatic brain injury to monitor and manage intracranial pressure, it is not a risk factor for TBI itself.

A. "l need to walk slowly as I lose my balance often." B. "l don't go out much because of the pain in my legs." C. "It makes me sad that I can't keep up with my grandchildren." D. "l have a small-healed area on my spine that is painful."

Correct Answer is A

Explanation

A. "I need to walk slowly as I lose my balance often": This statement indicates a potential safety concern related to balance issues while walking. Loss of balance can increase the risk of falls, especially in individuals with peripheral artery disease (PAD) who may already have compromised circulation and reduced sensation in their legs. The nurse should report this statement to the provider for further evaluation and intervention to prevent falls and promote safety.

B. "I don't go out much because of the pain in my legs" : While this statement suggests that the client experiences pain in their legs, it does not directly indicate a safety concern that requires immediate reporting to the provider. Pain management strategies may be discussed with the provider to address this issue.

C. "It makes me sad that I can't keep up with my grandchildren" : While this statement reflects emotional distress related to the client's inability to participate fully in activities with their grandchildren, it does not indicate a specific safety concern that requires reporting to the provider. However, addressing the client's emotional well-being is important for overall holistic care.

D. "I have a small-healed area on my spine that is painful" : This statement describes a painful area on the client's spine but does not directly relate to potential safety concerns associated with PAD. The nurse may further assess this issue and include it in the client's overall assessment, but it does not require immediate reporting to the provider for safety concerns related to PAD.

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A nurse is completing an admission assessment on a client who has hearing loss. Which of the following client statements should indicate to the nurse that the client is experiencing manifestations of Meniere’s disease?

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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