A client with Meniere’s disease is experiencing severe vertigo. Which instruction would the nurse give to the client to assist in controlling vertigo?
A. Increase fluid intake to 3000 ml a day.
B. Avoid sudden head movements.
C. Lie still and watch the television.
D. Increase sodium in the diet.
Correct Answer: B. Avoid sudden head movements.
The nurse instructs the client to make slow head movements to prevent the worsening of vertigo. Meniere disease is an inner ear disorder characterized by tinnitus, vertigo, and hearing loss. This is thought to occur due to the accumulation of endolymphatic fluid in the cochlea and the vestibular organ.
Option A: Dietary changes such as salt and fluid restrictions that reduce the amount of endolymphatic fluid sometimes are prescribed. Studies of the temporal bone revealed endolymphatic accumulation in the cochlea and the vestibular organ in patients with Meniere disease. Current research links endolymphatic hydrops to a hearing loss of >40dB.
Option C: Lying still and watching television will not control vertigo. If Meniere disease is suspected, the patient should be questioned about the character of vertigo, hearing loss, and earlier episodes. A full otologic history is part of the clinical investigation.
Option D: A sodium restriction diet may be recommended. Low-level evidence suggests that restricting sodium intake may help to prevent Meniere’s attacks. If Meniere disease is suspected, one should perform a full otologic examination, facial nerve testing, and assessment of nystagmus with Frenzel goggles, Rinne, and Weber tests.
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