Which of the following symptoms would the nurse expect to find when assessing a client with Meniere's disease?

Appeared in: NHM UP Staff Nurse - 2017

Explanation

Tinnitus, the perception of ringing or buzzing in the ear, is a hallmark symptom of Meniere's disease.
Meniere's disease is an inner ear disorder characterized by a classic triad of symptoms: episodic vertigo, tinnitus, and fluctuating sensorineural hearing loss.
These symptoms are caused by endolymphatic hydrops, which is an excess of fluid in the inner ear, increasing pressure on the cochlear and vestibular structures.
A feeling of aural fullness or pressure in the ear often accompanies the other symptoms.

Option A: Epistaxis, or a nosebleed, is related to the nasal passages and has no direct connection to the pathophysiology of the inner ear, which is the site of Meniere's disease.
Option B: Facial pain is not a characteristic symptom of Meniere's disease. The disease affects the vestibulocochlear nerve (CN VIII), not the trigeminal nerve (CN V) which is responsible for facial sensation.
Option C: Ptosis, or drooping of the upper eyelid, is a sign of oculomotor nerve (CN III) palsy or neuromuscular junction disorders like myasthenia gravis. It is not associated with Meniere's disease.

Clinical Relevance

Nursing practice connection: Use the key finding related to Clinical manifestations of Meniere's disease to guide bedside assessment, documentation, and the next nursing action.
A primary nursing responsibility for a patient with Meniere's disease is ensuring safety, especially during acute vertigo attacks, by implementing strict fall precautions.
Patient education is crucial and focuses on dietary modifications, particularly a low-sodium diet, to manage fluid balance and reduce the frequency and severity of attacks.
Nurses should teach patients to avoid known triggers like caffeine, nicotine, and alcohol, which can exacerbate symptoms.

How to Approach the Question

First, identify the key term in the question stem, which is 'Meniere's disease'.
Recall the pathophysiology of this condition: it's an inner ear disorder involving excess fluid (endolymphatic hydrops).
Access your knowledge of the classic triad of symptoms associated with Meniere's disease: vertigo, tinnitus, and sensorineural hearing loss.
Evaluate each option against this classic presentation.
Recognize that 'Tinnitus' is one of the three cardinal symptoms.
Eliminate the other options by identifying their correct associations: Epistaxis (nasal), Facial pain (neurologic/sinus), and Ptosis (neuromuscular/cranial nerve III).

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 1 p. 73-75

E6 Medicine Harrison 22e Part 1 p. 289-291

Practise the full NHM UP Staff Nurse - 2017

Attempt every question from this paper in a timed mock, then review the full solution for each one.