BSC NURSING II YEAR

1. Mr. Manikandan.T,
RN., RM., M.Sc(N)., D.C.A .,(Ph.D)
Assistant Professor,
Dept. of Medical Surgical Nursing,
VMCON, Puducherry.

2. DEFINITION
• Inflammation of ear the inner ear or the
nerves that connect inner ear to the brain

3. CAUSES /RISK FACTORS
• Upper respiratory infection – common cold, flu
• Virus
• bacteria
• Middle ear infection
• Meningitis
• Head injury
• Smoking
• Alcohol
• Stress
• Allergy

4. CLINICAL FEATURES
• Dizziness
• N/V
• Hearing loss
• Vertigo
• Tinnitus
• Loss of balance (Nytagmus)
• Hearing problem

5. DIAGNOSIS
• H.C
• P/E
• CT
• MRI
• EEG
• Electronystagmography (eye movement)
• Audiometry

6. MANAGEMENT
• IV - Antibiotics
• Vomiting – ondensatron - ante emetics
• Vertigo – Tab. Cinnerazine (Calcium channel
blocker)
• Anxiety - benzodiazepines
• Depression – SSRI (Citalopram, fluoxetine)
• Allergy – diphenhydramine (anti histamine)
• Antiviral
• Fluid replacement

7. vestibular rehabilitation therapy
• Cawthrone – cooksey exercise
• In bed or sitting
– Eye movements -- at first slow, then quick
• up and down
• from side to side
• focusing on finger moving from 3 feet to 1 foot away from face
– Head movements at first slow, then quick, later with eyes
closed
• bending forward and backward
• turning from side to side.
• Sitting
– Eye movements and head movements as above
– Shoulder shrugging and circling
– Bending forward and picking up objects from the ground

8. • Standing
– Eye, head and shoulder movements as before
– Changing from sitting to standing position with eyes open and shut
– Throwing a small ball from hand to hand (above eye level)
– Throwing a ball from hand to hand under knee
– Changing from sitting to standing and turning around in between
• Moving about (in class)
– Circle around center person who will throw a large ball and to whom it
will be returned
– Walk across room with eyes open and then closed
– Walk up and down slope with eyes open and then closed
– Walk up and down steps with eyes open and then closed
– Any game involving stooping and stretching and aiming such as
bowling and basketball

9. GAZE STABILIZATION
• Seated on a chair
• Focus on a small target or your thumb at eye
level in front
• Look at the target, turn your head to the left
and continue to look at the target
• Now turn your head to the right while still
focusing on the same target
• Repeat turning your heard left and right for 1
minute

11. CONT.,
• Seated on a chair
• Raise two small targets or thumbs to eye level
and move them slightly apart
• Focus on the target on your left with your eyes,
then turn your head towards the same target
• Then focus on the target on your right with your
eyes, then turn your head towards the same
target
• Repeat the same steps for 1 minute

13. CANALITH REPOSITIONING EXERCISE
• Step 1. First you move from a sitting to a reclining
position with your head turned to the affected side by
45 degrees. Your health provider will help extend your
head over the edge of the table at a slight angle.
• Step 2. With your head still extended over the edge of
the table, you'll be prompted to turn your head slowly
away from the affected side by about 90 degrees.
• Step 3. Roll onto your side. Your head should be slightly
angled while you look down at the floor.
• Step 4. Finally, you return carefully to a sitting position
with your head tilted down and returned to the center
position.

15. brandt-daroff exercises
• Start in an upright, seated position.
• Move into the lying position on one side with
your nose pointed up at about a 45-degree
angle.
• Remain in this position for about 30 seconds
(or until the vertigo subsides, whichever is
longer). Then move back to the seated
position.
• Repeat on the other side.