Management of Patients with Multiple Sensory Deficits
Identify three initial nursing diagnoses for Mrs. Henson and list the defining characteristics that would support each of your identified nursing diagnoses.
The three initial diagnoses for Mrs. Henson would be to observe her responses when initiating conversation or talking to her, determine if the patient has cerumen impaction, and performing a whisper test. These diagnoses are aimed at determining the patient’s ability to hear and respond to the nurse and others. Observing the patient when having a conversation will allow the nurse to gauge the patient’s facial expression and attention. The patient could be getting distracted due to her other ailments and conditions and this might be the reason she is not able to hear instructions being given. Nurses are trained to be more patient with patients with hearing aids because they might lose attention. Observing the patient when talking to her will allow the nurse to see if the patient is receptive to what she is being told. The lack of reception and response would mean that the patient does not hear what she is being told and there is a need for further testing. This would also allow the nurse to rule out other issues like fatigue as reported by the physical therapy assistant. Elderly patients might fail to follow instructions being given when they are tired and this might be caused by fatigue. Therefore, it is vital that we rule out the possibility of the patient being fatigued.
The second diagnosis would be determining if the patient has cerumen impaction. This is a buildup of secretions and sloughed epithelial cells. This accumulation could result in symptoms like hearing loss, dizziness, otorrhea tinnitus, or other symptoms. Cerumen could also prevent the necessary assessment of the ear canal. Cerumen which is basically a buildup of ear wax can happen to anyone, but it is most likely to occur in people who use hearing aids. In order to diagnose for cerumen impaction, the nurse will make use a special instrument called an otoscope to be able to see if there is any wax buildup in the ear. Hearing aids users are most at risk of this because the hearing aids might be pushing the wax further inside the ears. Hearing aids also prevent the ear wax from being removed naturally by motions like chewing...
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