Using a pneumatoscope, the nurse discovers that a patient's tympanic membrane (TM) does not move. The nurse would conduct further assessment for which condition?
1. Rupture of the TM
2. Fluid behind the TM
3. Presence of an umbo
4. Nystagmus
1
Rationale 1: If the TM does not move when air is introduced into the ear canal, it is possible that the TM is ruptured.
Rationale 2: Presence of fluid behind the TM would not result in immobility of the TM.
Rationale 3: The umbo is a normal portion of the ear structure. It would not cause the TM to be fixed and immovable.
Rationale 4: Nystagmus is movement of the eye and would not be associated with fixed and immovable TM.
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