George Handell, 78 years old, has a history of cerumen impaction. The best nursing intervention for Mr. Handell would be to
a. Instruct Mr. Handell to use cotton-tipped applicators to clean the cerumen out of his ears
b. Encourage Mr. Handell to have an audiological examination and to be fitted with hearing aids
c. Schedule appointments on a regular basis with Mr. Handell's physician to have cerumen impaction removed
d. Refer Mr. Handell to a sign language class while he still has some of his hearing intact
C
Impacted cerumen can be removed by a physician or by a registered nurse under the direction of a physician. Most commonly, the external canal is irrigated using a syringe, or the older person is instructed to use an eardrop to soften the cerumen to facilitate its removal. Occlusion of the ear canal with cerumen can cause hearing difficulties; however, these hearing problems resolve after the cerumen is removed. Responses B and D are unnecessary. Response A is incorrect. The use of cotton-tipped applicators to clean the ear canal may increase the older person's hearing difficulties by pushing the cerumen deeper into the ear canal.
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