Pa6ent Profile S.H. is a 25-year-old man who comes to the emergency department with a history of one day of severe ver7go and vomi7ng.
Subjec6ve Data • Has had ver7go spells with right-sided 7nnitus a few 7mes this past month • States he becomes nauseous when he acempts to sit up • Ver7go is worse with head movement • Has been crawling out of bed for fear of falling • Currently repor7ng nausea
Objec6ve Data Physical Examina.on • Blood pressure 139/72, pulse 90, temperature 97.7°F, respira7ons 22 • Spontaneous nystagmus in the right eye • Vomited two 7mes in past 30 minutes • Intermicent diaphoresis Diagnos.c Studies • Audiogram: severe sensorineural hearing loss at 35.0 dB, with a predominance of low frequency
impairment in the right ear • Tuning fork–Weber test: right sensorineural hearing loss
Discussion Ques6ons 1. What is ver7go? How is it different from dizziness?
2. Based on the assessment, what do you think S.H. has and why?
3. What other diagnos7c tests may be ordered for S.H.?
4. The health care provider diagnoses S.H. with Meniere’s disease. What are the common causes of Meniere’s disease?
5. What are the priority nursing diagnoses for S.H?
6. S.H. is being discharged with prescrip7ons for prochlorperazine and diazepam and recommenda7ons to follow up with his primary care provider in 3-4 days. What should your discharge teaching for S.H. include?
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