Types of hearing loss: - Conductive: Problem with sound transmission through outer/middle ear (cerumen impaction, otitis media, perforated TM, otosclerosis) — often treatable - Sensorineural: Damage to cochlear hair cells or CN VIII (aging/presbycusis, noise, ototoxic drugs, Meniere's, acoustic neuroma) — often permanent - Mixed: Both components present Ototoxic drugs to monitor (NCLEX): Aminoglycosides (gentamicin, tobramycin), loop diuretics (furosemide), cisplatin, aspirin (high dose), quinine — monitor for tinnitus and hearing changes Meniere Disease: - Disorder of endolymphatic fluid excess in the inner ear - Classic triad: 1. Episodic vertigo (spinning sensation, severe) — can last minutes to hours 2. Unilateral fluctuating sensorineural hearing loss 3. Tinnitus (low-pitched roaring or buzzing) - Plus: aural fullness (ear pressure sensation) - Attacks are unpredictable; between attacks patient may feel normal - Treatment: low-sodium diet, diuretics (reduce endolymph volume), antihistamines/antiemetics for acute attacks, meclizine (Antivert), betahistine; endolymphatic shunt for refractory cases Acute Otitis Media (AOM): - Middle ear infection, most common in children aged 6 months–2 years - Peak incidence: winter; more common in formula-fed, daycare, cigarette smoke exposure - Symptoms: severe ear pain...