Ménière Disease and Hearing Loss

Ménière disease is a disorder of the inner ear that produces episodic, disabling attacks of vertigo lasting minutes to hours, together with hearing that fluctuates, tinnitus, and a sensation of pressure or fullness in the affected ear. Between attacks a patient can appear entirely well, which is part of why the condition is so often misunderstood by families and employers. Two nursing themes run through this lesson. The first is safety. An attack of true rotational vertigo with nausea and vomiting arrives with little warning and removes a person's ability to stand safely. Falls during attacks are a major source of injury, and the risk is highest in older adults, in whom a fall may be the event that ends independent living. Fall prevention here is not routine care — it is the primary intervention. The second is that hearing loss is the part that does not recover. Vertigo attacks typically become less frequent over years; hearing loss accumulates. That asymmetry matters clinically, because the patient's distress is usually about the vertigo while the long-term functional cost is usually the...