The nurse is caring for an older client who presents with dizziness and difficulty hearing. Which of the nurse's assessment findings will require collaboration with the client's primary health care provider? (Select all that apply.)

Question

a. Tympanic membrane is retracted, with multiple air bubbles.
b. The client reports inability to hear high-frequency voices and sounds.
c. Clear watery drainage is present in the ear canal and is positive for glucose.
d. Tympanic membrane is shiny and trans-lucent, with light reflex noted.
e. Hearing test indicates positive Rinne test, with AC > BC noted bilaterally.
f. The client reports dizziness after taking naproxen (Aleve) for arthritis pain.

Answer 1

A, C, F
Aleve can cause ototoxicity, which can present as dizziness. Retraction of the tympanic mem-brane with air bubbles indicates an ear infection, which may be treated with antibiotics. Clear, watery, glucose-positive drainage from the ear canal suggests a basal skull fracture. An inability to hear high-frequency voices and sounds are commonly found in older adults as normal age-related changes. A shiny, translucent, tympanic membrane with a light reflex is a normal as-sessment finding, as is a positive Rinne test with AC > BC noted bilaterally.