Neurological Disorders Q 14

---

A female client is admitted to the facility for investigation of balance and coordination problems, including possible Ménière’s disease. When assessing this client, the nurse expects to note:

  

     A. Vertigo, tinnitus, and hearing loss.

     B. Vertigo, vomiting, and nystagmus.

     C. Vertigo, pain, and hearing impairment.

     D. Vertigo, blurred vision, and fever.

    

    

Correct Answer: A. Vertigo, tinnitus, and hearing loss.

---

Ménière’s disease, an inner ear disease, is characterized by the symptom triad of vertigo, tinnitus, and hearing loss. The combination of vertigo, vomiting, and nystagmus suggests labyrinthitis. Ménière’s disease rarely causes pain, blurred vision, or fever. Meniere disease is a disorder of the inner ear characterized by hearing loss, tinnitus, and vertigo. In most cases, it is slowly progressive and has a significant impact on the social functioning of the individual affected.

---

Option B: Patients with a definite Meniere disease according to the Barany Society have two or more spontaneous episodes of vertigo with each lasting 20 minutes to 12 hours; audiometrically documented low- to medium- frequency sensorineural hearing loss in one ear, defining and locating to the affected ear on in at least one instance prior, during or after one of the episodes of vertigo; fluctuating aural symptoms (fullness, hearing, tinnitus) located in the affected ear; and not better accounted for by any other vestibular diagnosis.

Option C: Probable Meniere disease can include the following clinical findings: two or more episodes of dizziness or vertigo, each lasting 20 minutes to 24 hours; fluctuating aural symptoms (fullness, hearing, or tinnitus) in the affected ear; and the condition is better explained by another vestibular diagnosis.

Option D: At the emergency room or in the general practice the physician will differentiate between vertigo of central, peripheral, and cardiovascular cause. 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.

---