An older person reports hearing whistling in both ears when no external sounds are present and is diagnosed with tinnitus. Which of the following are causes of tinnitus? (Select all that apply.)

a. Exposure to loud noises
b. Use of a hearing aid
c. Cerumen buildup
d. Side effects of medications
e. Age-related changes in the middle and inner ear


ANS: A, C, D
Hearing aids are not known as a cause or a trigger to worsen tinnitus and are at times used to am-plify environmental noise to mask tinnitus. Tinnitus is not an age-related change, although it oc-curs in about 11% of individuals who have presbycusis. Exposure to loud noise and cerumen buildup are known to exacerbate or cause tinnitus. Over 200 prescription and nonprescription medications have tinnitus as a side effect. There are also many ototoxic medications.

Nursing

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