CC: My wife seems to be having trouble hearing me when I talk. She is turning the TV up really loud.
HPI: Mary is an 88-year-old African American (AA) female married for 50 years to Albert. Albert complains that Mary cannot hear or hears but does not understand (especially in a group); turns up radio or television louder to hear (also noted by family, friends, and neighbors); Mary complains of tinnitus; and she feels like people are “mumbling.” Patient takes Ramipril for hypertension (HTN), a baby aspirin for cardio protection, and a statin for hypercholesterolemia. ROS: Ask if Mary has had any exposure to ototoxic drugs or other otic damage in the past. Describe at least three.
PE: What examinations will you perform on the ear? Describe the areas of the ear you will evaluate and what you will expect to find.
What other recommendations will you make (i.e., screening)?
What referrals will you make? Education: Name at least two things you will educate your patient about regarding their hearing.
Plan management
Also included in this section is the reflection. Reflect on this case and discuss whether or not you agree with your preceptor’s treatment of the patient and why or why not. What did you learn from this case? What would you do differently? Also include in your reflection, a discussion related to health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).