Etiology: Usually idiopathic.
S&S: Recurrent episodes (20 minutes to several hours) of spontaneous rotary vertigo, fluctuating hearing loss, tinnitus, and a feeling of fullness in the ear, often accompanied by nausea, vomiting, and sweating and sometimes loss of consciousness. After acute symptoms subside, balance is poor and client feels unwell for up to 24 hours
Rx: Low-salt diet, betahistine hydrochloride and a mild diuretic given to reduce number and severity of attacks; vestibular sedative such as prochlorperazine to abort acute attacks. Surgery may be done in refractory cases.
Nursing Process Elements
Help the client identify precipitating events or forewarning of attacks
Client teaching for self-care
• Aim to reduce severity of attacks by taking medication as prescribed when attack starts and lying down on the unaffected side in a quiet, darkened room and avoiding sudden movements and activities including reading
• Try to prevent attacks by avoiding exposure to loud sounds, bright light including sunlight, rapid jerky movements, bending at the waist, or twisting the head, all of which predispose to vertigo
• Encourage avoidance of nicotine, caffeine, and decongestants all of which have a vasoconstrictive effect
• Avoid fatigue and stress
• Use a white-noise machine to mask tinnitus PRN
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