Cerumen Impaction Final

8/4/2019 Cerumen Impaction Final

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Laguna State Polytechnic UniversitySta. Cruz, Main Campus

Sta. Cruz, Laguna

College of Nursing

S. Y 2010-2011

CERUMEN IMPACTION

MASSES OF THEEXTERNAL EAR

Submitted by:Del Mundo, Rose Ann

Gauna, NergelynSawadjaan, Glaiza

Submitted to:Prof. Janice Bernardo


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Bibliography

Cerumen Impaction

Introduction http://www.drugs.com/cg/cerumen-impaction.html

Antomy and physiology Essential of human anatomy and physiology(eightedition) Author: Elaine N. Marieb

Pathophysiologyhttp://bestpractice.bmj.com/best-

practice/monograph/1032/basics/pathophysiology.html

Medical managementhttp://www.drugs.com/cg/cerumen-impaction.html

Nursing diagnosismedical-surgical nursing(volume 1)

Brunner and Suddarths

Massess of external ear

Introduction http://www.earsite.com/tumors/cholesteatoma.html Antomy and physiology Essential of human anatomy and physiology(eight

edition) Author: Elaine N. Marieb Diagnostic test http://www.earsite.com/tumors/cholesteatoma.html Medical managementhttp://www.earsite.com/tumors/cholesteatoma.html

Surgical mangement-http://www.earsite.com/tumors/cholesteatoma.html

Nursing diagnosis

CERUMEN IMPACTION
http://www.drugs.com/cg/cerumen-impaction.htmlhttp://bestpractice.bmj.com/best-practice/monograph/1032/basics/pathophysiology.htmlhttp://bestpractice.bmj.com/best-practice/monograph/1032/basics/pathophysiology.htmlhttp://www.drugs.com/cg/cerumen-impaction.htmlhttp://www.earsite.com/tumors/cholesteatoma.htmlhttp://www.earsite.com/tumors/cholesteatoma.htmlhttp://www.earsite.com/tumors/cholesteatoma.htmlhttp://www.earsite.com/tumors/cholesteatoma.htmlhttp://www.earsite.com/tumors/cholesteatoma.htmlhttp://www.earsite.com/tumors/cholesteatoma.htmlhttp://www.earsite.com/tumors/cholesteatoma.htmlhttp://www.earsite.com/tumors/cholesteatoma.htmlhttp://www.drugs.com/cg/cerumen-impaction.htmlhttp://bestpractice.bmj.com/best-practice/monograph/1032/basics/pathophysiology.htmlhttp://bestpractice.bmj.com/best-practice/monograph/1032/basics/pathophysiology.htmlhttp://www.drugs.com/cg/cerumen-impaction.html


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I. INTRODUCTION

A. Definition Cerumen impaction is the blockage of the outer ear canal by tightly

packed cerumen. The outer ear canal is the tube from the opening of

your ear to the eardrum. Cerumen, also called ear wax, is the yellowishoily substance produced in the outer ear canal. A wet cerumen is stickyand brownish in color, while a dry cerumen is crusty and greyish.Cerumen helps clean out dead skin cells and prevents dirt and waterfrom entering the inner ear. Cerumen may also protect the ear fromgerms, such as bacteria and fungi. Normally, cerumen flows outward tothe opening of the ear where it falls out or gets washed away.Cerumen impaction happens when the wax dries, builds up, and getsstuck along the ear canal.

Causes:

Anything that affects the normal outward flow of cerumen maycause impaction. Cerumen impaction may be more common inmen, elderly, and in people with mental health problems. It is not asign that a person is not clean. The following factors may cause earwax more likely to become impacted:

Advanced age wherein the ears tend to make drier cerumen. Conditions that produce too much cerumen, such as

keratosis and other skin diseases. Narrow or abnormally shaped ear canals.

Wearing a hearing aid. Incorrect use of cotton buds (swabs), or using needles, hair

pins, or other objects to clean the ears.

B. Statistical Data

Cerumen impaction affects between 2 percent to 6 percent of thegeneral population in the United States.

It apparently affects males and females equally.

II. ANATOMY & PHYSIOLOGY


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The external ear (pinna) serves to protect the tympanic membrane (eardrum), as

well to collect and direct sound waves through the ear canal to the eardrum.

About 1 inches long, the canal contains modified sweat glands that

secrete cerumen, or earwax. Too much cerumen can block sound transmission.

Cerumen is the soft yellow wax secreted by glands in your ear canal, morecommonly known as earwax. Cerumen impaction occurs when earwax becomeswedged in (impacted) and blocks the ear canal.

Cerumen or earwax has many useful purposes. One of the main uses is that itprotects against infection. It helps fight bacterial ear infections and protects theinside of your ear. Earwax moves out of your ear naturally.

III. PATHOPHYSIOLOGY

Risk Factors: Age narrowed ear canal

Ears that overproducecerumen


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IV. RISK FACTORS:

Presence of water in the canal

Swelling of the cerumen

Trap bacteria in the medial ear

Infection of the canal

Symptoms:

Trouble hearing.

Dizziness.

Otalgia or Ear fullness

Itchiness or pain in the

ears.


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The following factors increase your chance of developing cerumenimpaction:

Individuals who obsessively try to clean their ears and try to removethe wax

A twisted, narrow, or complicated ear canal Ears that overproduce cerumen

Age: affects the elderly and causes hearing loss

V. ASSESSMENT:

Symptoms Justification Trouble hearing.

Dizziness.

Otalgia or Ear fullness or a feelingthat something is plugging up yourear.

Itchiness or pain in the ears.

Ringing in the ears.

> interferes with conduction of soundwaves into the ear.

> swelling of the cerumen.

> If blocked, air cannot get to the middleear to equalise the pressure on theeardrum. This can impair hearing or, if thepressure difference is enough to stretchthe eardrum, cause pain

> perceived when no sound is present

VI. DIAGNOSTIC / LABORATORY TEST

Otoscopy

Otoscopy is an examination that involves looking into the ear with aninstrument called an otoscope (or auriscope).

This is performed in order to examine the 'external auditory canal' thetunnel that leads from the outer ear (pinna) to the eardrum.

Inspection of the eardrum can also provide a lot of information aboutwhat's happening within the middle ear the space within the skull wherethe hearing and balance mechanisms are situated.


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VII.MEDICAL-SURGICAL MANAGEMENT

Pharmacological

GENERIC NAME: CARBAMIDE PEROXIDE OTIC

BRAND NAME(S): Auro, Debrox

USES:

This medication is used to treat earwax buildup.

It helps to soften, loosen, and remove the earwax.

Too much earwax can block the ear canal and reduce hearing.

This medication releases oxygen and starts to foam when it comes in contactwith the skin.

The foaming helps break up and remove the earwax.

HOW TO USE:

Apply this medication into the ear, usually twice daily or as directed by yourdoctor.

Do not use this medication for more than 4 days at a time unless your doctorinstructs you to.

Follow all directions on the product package.

To make sure that the right amount of medication is given, and to avoid touchingthe ear with the dropper, have another person give the drops if possible.

To lower the risk of dizziness, hold the container in your hand for a few minutesto warm it.

To apply ear drops, wash your hands first.

To avoid contamination, do not touch the dropper tip or let it touch your ear or

any other surface. Lie on your side or tilt the affected ear upward. Hold the dropper directly over the ear and place 5 to 10 drops into the ear canal. To help the drops roll into the ear of an adult, hold the earlobe up and back.

In children, hold the earlobe down and back.

Keep the head tilted for several minutes or insert a soft cotton plug in the ear. If there is any wax remaining after treatment, it may be removed by gently rinsing

the ear with warm water or using an ear syringe with a soft rubber bulb.

SIDE EFFECTS:symptoms of a serious allergic reaction, including:

rash,

itching swelling (especially of the face/tongue/throat),

severe dizziness,

trouble breathing.


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Surgical Management

Treatment for a cerumen impaction is mainly to remove the hardened wax.The type of treatment to be used may depend on the patient's age, symptoms, orrisk factors

Wax softeners: Ear drops that are water-based or oil-based may be usedto clear or soften the impacted earwax. This may be used alone or incombination with a procedure to take out the ear wax.

Procedures: When the impaction can be clearly seen, removal may bedone using any of the following:

Irrigation: This procedure may also be called ear syringing.Water that is close to body temperature is used to wash the waxout of the ear canal. Irrigation may not be used on people with

an eardrum tear or infection, or who have had ear surgery.

Suction: A machine that sucks the object out of the ear canalmay be used to remove small formed cerumen plugs. Thisprocedure uses a small plastic tube that goes in the ear and isconnected to the machine.

Instruments: A curette (scoop-like instrument) or forceps(grasping instrument) may be used to remove the impactedcerumen.

Nursing ResponsibilitiesVII. Nursing Diagnosis

Acute pain related to surgery Disturbed auditory sensory perception related to ear disorder Risk for trauma related to impaired balance

Cerumen Impaction Final

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