Question

Patient with sensory impairment

a 63-year-old business executive, who came in initially January 2010. He had a right acoustic neuroma treated elsewhere with Gamma Knife stereotactic radiation in 1993, and did well until 2009, when he noted a sudden drop in hearing in his left, only hearing ear. When seen initially in the office, he had a severe hearing loss with no useful hearing in the right ear, and an overall 15% hearing loss in the left ear. He was begun on a diuretic, and was also treated with steroid injections both through the ear drum and by mouth, and his hearing improved back to a very mild 5% loss.

Discussion questions:
1. What are two priority nursing diagnosis for the this patient? Each student must comment on one of your classmate's response. Your comment must say why you agree or disagree with your classmates response. once a student respond to a student response, no one else can select that should for another response.
2. What are two priority nursing diagnosis for the drugs the patient is taking?Each student must comment on one of your classmate's response. Your comment must say why you agree or disagree with your classmates response. once a student respond to a student response, no one else can select that should for another response.

Answer 1

1.Nursing diagnosis on priority basis are

• Impaired hearing related to rafiation as evidenced by low hearing capacity secondary to acoustic neuroma
• Risk for injury ,accident related to loss of hearing as evidenced by deceased hhearing capacity in both ear

2.The nursing diagnosis based on the drug are

• Risk for fluid imbalance (hypovolemia) related to increased renal function as evidenced by increased urine output
• Hearing loss related to cochlear disruption in blood flow as evidenced by side effects of diuretics
• Risk for infection related to decreased immune functioning as evidenced by use of corticosteroid