Page 1956 - Saunders Comprehensive Review For NCLEX-RN

1. Description
a. Cerumen, or wax, is the most common
cause of impacted canals.
b. Foreign bodies can include vegetables,
beads, pencil erasers, insects, and other
objects.
2. Assessment
a. Sensation of fullness in the ear with or
without hearing loss
b. Pain, itching, or bleeding
3. Cerumen
a. Removal of wax may be done by
irrigation.
b. Irrigation is contraindicated in clients
with a history of tympanic membrane
perforation or otitis media.
c. If prescribed to soften cerumen, glycerin
or mineral oil is placed in the ear at
bedtime; hydrogen peroxide may also
be prescribed.
d. After several days, the ear is irrigated.

e. The maximum amount of

solution that should be used for
irrigation is 50 to 70 mL.

Inform the client that ear candles should

never be used to remove cerumen. Their use can
cause burns and a vacuum effect, causing a
perforation in the tympanic membrane.

4. Foreign bodies

a. With a foreign object of vegetable
matter, irrigation is used with care,
because this material expands with
hydration.
b. Insects are killed before removal, unless
they can be coaxed out by flashlight or
a humming noise; lidocaine may be
placed in the ear to relieve pain.
c. Mineral oil or diluted alcohol is instilled
to suffocate the insect, which then is
removed using ear forceps.
d. Use a small ear forceps to remove the
object; avoid pushing the object farther
into the canal and damaging the

1956