Which assessment data would the nurse expect as the chief complaint from a client who is experiencing an acute exacerbation of Ménière’s disease?
A. Vertigo
B. Dizziness
C. Severe ear pain
D. Sudden deafness
Correct Answer: A. Vertigo
Ménière’s disease is characterized by sudden, severe episodes of vertigo during which the client has a sensation of spinning. 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 B: Dizziness is not vertigo and must be distinguished from true rotational vertigo. Red flags for a central origin of vertigo, according to Harcourt et al., are neurological symptoms or signs, acute deafness, new type or onset of headache, or vertical/torsional/rotatory nystagmus.
Option C: A feeling of pressure but not pain is also characteristic. 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.
Option D: Hearing loss is progressive, not sudden. Audiometric evaluation is mandatory in all patients with Meniere disease. Fluctuating low frequency unilateral sensorineural hearing loss is characteristic of the disease. The hearing loss can progress to all frequencies.
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