- General information
- Disease of the inner ear resulting from dilation of the endolymphatic system and increased volume of endolymph; characterized by recurrent and usually progressive triad of symptoms: vertigo, tinnitus, and hearing loss
- Incidence highest between ages 30 and 60
- Cause unknown; theories include allergy, toxicity, localized ischemia, hemorrhage, viral infection, or edema.
- Medical management
- Acute: atropine (decreases autonomic nervous system activity), diazepam (Valium), fentanyl, and droperidol (Innovar)
- Chronic
- Drug therapy: vasodilators (nicotinic acid), diuretics, mild sedatives or tranquilizers (diazepam [Valium]), antihistamines (diphenhydramine [Benadryl], meclizine [Antivert])
- Low-sodium diet, restricted fluid intake, restrict caffeine and nicotine.
- Surgery
- Surgical destruction of labyrinth causing loss of vestibular and cochlear function (if disease is unilateral)
- Intracranial division of vestibular portion of cranial nerve VIII
- Endolymphatic sac decompression or shunt to equalize pressure in endolymphatic space
- Assessment findings
- Sudden attacks of vertigo lasting hours or days; attacks occur several times a year
- Nausea, tinnitus, progressive hearing loss
- Vomiting, nystagmus
- Diagnostic tests
- Audiometry: reveals sensorineural hearing loss
- Vestibular tests: reveal decreased function
- Nursing interventions
- Maintain bed rest in a quiet, darkened room in position of choice; elevate side rails as needed.
- Only move the client for essential care (bath may not be essential).
- Provide an emesis basin for vomiting.
- Monitor IV therapy; maintain accurate I&O.
- Assist with ambulation when the attack is over.
- Administer medications as ordered.
- Prepare the client for surgery as indicated (post-op care includes using above measures).
- Provide client teaching and discharge planning concerning
- Use of medication and side effects
- Low-sodium diet and decreased fluid intake
- Importance of eliminating smoking
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