Read the following case study while considering the questions below: Beverly Jones is an 83-year-old retired nurse who lives independently in her home in Oak Creek. She was a flight nurse in the Korean War and would fly into combat to help evacuate injured soldiers. After the war, she worked at St. Luke’s hospital in the Emergency Department for 20 years and then at a clinic near the airport and close to home for 20 years before retiring. She has never been married and does not have children. Ms. Jones feels healthy at her age. She has a past medical history of hypertension, hypothyroidism, and arthritis. She takes lisinopril 20 mg daily and Lasix 40 mg daily for her hypertension. This combination has well controlled her blood pressure for the past 30 years. About 10 years ago, her physician started her on aspirin for her heart and she takes 325 mg daily. She takes Synthroid 88 mg for her hypothyroidism and 600 mg of ibuprofen BID as needed for her arthritis. She does not drink but has smoked a pack a day for 70 years. You meet Ms. Jones for the first time when she comes in for her annual check-up and flu shot. You notice she asks you to repeat yourself frequently and she turns her head as you move around the room. She does not answer all of your questions appropriately and has difficulty following some of your directions. You are concerned about Ms. Jones’ hearing and complete the HHIE-S. She scores a 28.
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· Individually consider the following questions and submit your thoughts on Blackboard as Lecture Assignment 10 by the start of lecture week 11. Provide at least one paragraph per bullet.
o What age-related changes would you expect to find in the external, middle, and inner ear and nervous system?
o What are Ms. Jones risk factors for hearing loss?
§ Age
§ Environmental noise: planes and guns in war, ambulances in the ER, living and working near the airport
§ Smoking
§ Medication: aspirin, Lasix, ibuprofen, especially for a long time
§ HTN, hypothyroidism
o What behavior cues do you notice and expect to see that indicate a hearing deficit?
§ See Text
o What is the HHIE-S and what does her score indicate?
§ Hearing Handicap Inventory for the Elderly: assesses the presence and functional consequences of hearing loss in cognitively intact older adults
§ 84% probability of hearing impairment- severe handicap- need to refer
o What additional questions would you ask Ms. Jones to assess her hearing?
§ See Text
o What are the different types of hearing loss and how do you differentiate between them?
§ Conductive: problem with external or middle ear
§ Sensorineural: problem with inner ear or neural structures
§ Mixed
§ Noise Induced Hearing Loss
o What interventions could you implement today while Ms. Jones is in the office to help with her hearing loss?
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