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271 Cards in this Set
- Front
- Back
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birth weight
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7lb 8oz
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birth length
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19-21
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doubles birth
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6m
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tripples birth weight
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1yr
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length increases by 1/2
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12m
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post fontanell close
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8wks
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social smile
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2m
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turns head to locate sound
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3m
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moro reflx gone
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4m
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head control
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4m
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peek-a-boo
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6m
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transfer object from hand to hand
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7m
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stranger anxiety
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8m
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tripod
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6m
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fine pincer grasp
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10-12m
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erickson infant
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trust vs mistrust
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Birth length doubles
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4m
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reaches 50% adult height
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2yrs
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throws ball opverhand
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18m
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speak2-3 word sentences
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2yrs
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use scissors
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4yrs
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tie laces
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5yrs
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best time to promote breast feedng
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first 15 min after birth quiet alert state
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brain weights half that of an adult
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6m
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anterior fontanelle close
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12-18m
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babinski leavs
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1yr
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root reflex
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b-3m1
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suck rflex
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b-2-5m
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moro rflx
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b-4m
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asymmetric tonic neck
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b-4m
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palmar grasp
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b-4-6m
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planter grsp
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b-9m
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step
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b-4-8wks
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neck rightint
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4-6m
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parachute side
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6m
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parachute forward
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6-7m
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parchute back
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9-10m
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resp systme reach adult maturity
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7y
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contributes to resp infections of infant
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lack og IhgA
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pulse rate of newborn
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120-140
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1 yr old pulse rate
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100
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bp of newborn
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60/40
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bp 1yr old
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100/50
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first teeth erupt
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6-8m (lower incisors first)
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12m has how many teeth?
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4-8
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stomach capcity at birth
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1/2-1oz
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helps digest after birth
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trypsin
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enzyme amylase and lipase reach adult levels
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5m
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able to conjugate bilirubon
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2wk
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meconium looks like
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dark green - black
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glomeruli reachs full maturity ( so urine SG is low
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2yrs
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physiologic anemia develop
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2-3m ( high hemaglobin concentration is decreased)
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iron stores are sufficient
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unbtil 6-9m
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confirs immunity during 3-6m
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IgG from placenta
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IgM reach adult level
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9m
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sefien trust vs ms trust
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respond to basic needs of infants creats trust
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piagets stage of infant
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sensorinotoer b-2y; sub 1 (0-1m) sub 2 - primary circular (1-4m) sub 3- secondary circular ( 4-8m) sub 4 coordination os schemes ( 8-12m)
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freud stage
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oral
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describe oral
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b-1yr; pleasure focuses on sucking adn ofeeding
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substage 1
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0-1m- reflexes- reflexing sukcing brings pleasure; begin to gain contro, l of reflexes
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substage 2
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primary circular 1-4m- thumb sucking occur sby chance so they continue to do it. imitation begins,
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sub 3
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secinary reaction 4-8m- infant repeat actions to get wanted results liek shakes rattle to make noise
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sub 4
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coordination of secondary schemes 8-12m- coordinates previously learnes schemes with learned behaviors, shake rattle intentionally or cral across room to get object object perm isprecent at 8m
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knows they are seperate from caregiver
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12m
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newborn sees
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nearsight 8-15inch
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recognize by sight the people they kn0o
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1m
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binocularity begins
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6wk, established 4m
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full color vision, distance vision and tracking
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7 m
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rolls from prone to supine
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4m
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supine to prone
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5m
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sits unsupoprted
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8
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crawls
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9m
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pulls to stand
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10
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coos
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1-3m
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makes raspberries laughs loud
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4-5m
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squeeling and yelling
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6m
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babbling with string mamamam dadada
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7-10m
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attach menaign to mama dada
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9-12
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babbles with infelction
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12m
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grasp rattle
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5m
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gross pincer
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8m
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feed self with cup spoon pokes
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12m
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ready to socialize
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2n
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peekaboo
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6-8m
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n anodyne
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criticizing something because it has no strong characteristics and not likely to excite, interest, or upset anyone
- bland |
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toys for 1-4m
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rattle singing high contrast patterns
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toys 4-7m
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fancy rattle esy to hold htings floating squirting toys
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toys 8-12m
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plastic cup bowls bucket, large blocks, stacking toys balls dolls push pull toys
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infant in car seat
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face rear until 12 m adn 20lbs
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when shoudl solid foods be intorduced
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4-6m
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colostrum vs mature breastmilk
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thin water yellow; blueish thin
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when do you intorduce cows milk?
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after 12m
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how much fruit juice
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2-4m after 6m
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establish a bedtime routine
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4m
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wean from bottle
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12-15m
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colic resolves
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3m
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crying increases
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6wks and diminshes by 12 wks (3m)
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wean from pacifier
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6-9m when natural sucking decreases
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toddler ericksons tage
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1-3yr autonomy vs shame and doubt
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describe autonomy vs shame and doubt
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gain basic control over environment
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quadruples birthweight
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30m
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kicks ball
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24m
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3-4 word sentnces
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3yrs
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average toddler gain
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3-5lb er yr
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gain in heing toddler
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3in per yr
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reach half adult height
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2yr
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anterior font closed
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18m
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brian is 90% adult size
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2y
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myelinzation of brian and spinal chord complete
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24m
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helpful when child starts to toddle
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foward and downward parachute
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alveoli reach adult number
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7yr
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bladder and kid reach adult level
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16-24m
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toddlers musculo skelatal appearacne
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swayback potbelly
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describe autonomy vs shame and dowubt
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negativism, withstadns delayed gratification, age 1-3yr, canot take turns until 3yr
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piaget toddler stage
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still sensory motor sub 5 (circular tertiary and sub 6 mental combination) also preoeprational 2-7yt
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substage 5
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tertiarey reaction 12-18m: place item ina n out of ocntianer, use all senses, increase O permanentce. differes self form object
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sub 6
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mental combination 18-24m: imitation is symbolic, sense of ownership, time space and causality increasing and delayed imitation at 2 yr,
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preoperational stage
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2-7y: time space causialtiy, make believe, understands two, make connection between past and current, sorts objects, puzzle with 4 pieces, obkects are different form one another, symbolic thought animism
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walks similar to adult
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3y
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pulls toys while walking climbs stairs with ass
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18m
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runs kicks balls climbs carries hwile walking
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24m
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trycicle, runs, walks up and down with alternate feet
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3yrs
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masters reching grasping releasing stacks ab puts things in slots
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18m
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how many cubes does 18m stack?
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4
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staks 6-7 cubes
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24m also turns knobs
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builds 9-10cubes
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3yrs also holds pencil screws unscrews, copies circle
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toddle vision
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20/50-20/40
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echolalia
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less than 30m
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telegraphic speech
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3y
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studdering onset
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2-4y
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seperation anxiety reemerge
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18-24m and ceases 24-36m
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children 20-40l in car
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foward facing seat with harness
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when can they actually learn to swim
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4yrs
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juice and milk intake intodddlers
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4-6oz; 16-24oz
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full set ofprimary teeth
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30m
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how to diciplne toddler
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time out 2.5-3 yrs, extinction2-3y ( ignoring the behavior)
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preschool yrs
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3-6
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bowel adn bladder control complete
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3yrs
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erickson preschool stag
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initiative vs guit
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describe initiave vs guilt
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please parents, plan activitis, initiates, sexual identity develops, feels bad when theydo something wrong , cooperates sense of purpose
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piaget preschool staeg
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preoperatioanl 2-7
preconceptual 2-4l intuitive 4-7y |
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preconceptual
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2-4: egocentric, animism, understands oppostie by age 4, active imagination, learsn through imitation
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intuitive
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4-7y: knows whrn thigns are right and wrong, tolerates differneces, curious, can quesiton parents values, realistic sense of causality
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freud stage preschool
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phallic 3-7
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phallic stage
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genitalia and mastrbatio, conscious emerging, oepidal stage occurs resolve by end of preschool
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magical thinking
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preschool things thoughts are ll powerful
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cognitive devl of preschool
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magical htinking, imaginary friend, transduction, animism
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5yr old vision
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20/40 -20/30 color vision intact
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booster seats
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40-80lbs
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night mare
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scary or bad dream follwoed by awaken, wkae sup parent after, usually second half of night, craing may be scared after, repsonsive to parents soothing, hard to go back to slwwp, may remember dreeam
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night terror
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partial arousal from deep sleep, screaing thrashing, about an hour after falling sleep, looks wide eyes talks thrashs sits up, unaware of parents presence, rapidly goes back to sleep without full awaken, no memory
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lying is common
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preschool yrs
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school age
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6-12
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growth of school age
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sex characteristic
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brain growht complete
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10yrs
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what happens to teeth in school age
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alll 20 are loss replaced by 28-32 permanent
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preadolescentt
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between middle child and 13 bday
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prepubescent
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2 yrs before pubery characterized by dev of 2ndary sex, rapid growth for gorls and continued growth for boys
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IgA, IgG reach adult
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10yrs
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erickson school age staeg
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industyr vs ifneriority
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industry vs inferiority
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scoail physical and learnign skills, interest in how things work, clubs sports, increase knowledge and interation, needs support when unsuccessful,
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piaget school age
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concrete operational
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concrete operatioanl
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learns manipulating object, cannot think abstract, understands time, add subtract, collecting items, can reverse thought process, principle of conservation
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freud school age
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latency: tranquility time between oedipal stage and adolescence, dev social skills relate tosame sex- brownies boy scout
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visual acuty
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20/20 vision by 7 yrs
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ride in front seat
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12yrs
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highest incidence of pedestrian related injury
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5-9
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night terros and sleep wakin resolved
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8-10 occur 6-8yrs
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latchkey child
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both paretns in work, return home alone more prone ot misbehavior and take risk. maturiy not age determin when you stay home,
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lying stealing, cheating
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between 6-8 doesnt understand ownership may steal because they liek ti, stealing in 8-10 desire item oor try to impress, 10-12 same as 8 but also to supplement thei inadequateincome
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lying
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common in 6-8 its common but nees to kno what truth is. in 8-12 lie becaue unable to meet expectations and to impress
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cheating
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before 7 just wants to win, between 8-12 cheating is understoog but done becuz of peer pressure,
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adolecent age
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11-20
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puberty
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earlier in grls . 9-10 and boys 10-11
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boys first ejaculation
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late puberty
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PHV
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12yrs in grls and boys 14
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areola and papula seperate from breast to form secondary mound
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middle adolescence 14-16
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erickson adolescence stage
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idenentity v role confusion
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identity vs role ocnfusion
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body changes, mood sqings, master skills with peers, definig bounderies with parents, emancipation,
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early
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11-14: master skills with peers, definig bounderies with aprents, identify with same sex, earlys tage of emanicpation
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middle
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14-16: adjust to changes, need for acceptance by peer is highest, interest ina ttractin opposite sex, greatest confict wiht aprents
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late
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17-20: secure iwth body, idealistic career goals, importance of individual friendship, emancipation almost omplete
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piaget adolecent
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formal operations early mid late
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early F. operations
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eger to apply limited abstract thinking
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middle formal oeprational
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14-17 thinks they are invincible, likes making independant decision
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late formal operations
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abstract thinking is established, critical thinking is established, less risky behavir
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2m follow objects
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180 degrees
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whisper test
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4yrs+
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weber test
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6y+
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rinne test
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6y + to pass air conduction should be twice as lon as bone
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aafter 3 visual test
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tumbling E
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snellen chart used
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6+
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whose at risk for iron def
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6m, adolescent growth spurt, pregnant
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when do u screen iron?
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9-12m, males 12-18y, adolescent females during all physicals
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htn screening
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begin at 3yrs
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live vaccine
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modifie dliving orgnaism thats weak, produce imune response with no complication of illness
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2 permanent Ci to vaccines
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anaphylactic or systemic allergic reaction, encephalopathy without cause within 7 days of immunization
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diptheria pertussis tetanus
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<7 is DTaP or DT if CI to pertussis, over 7 TdaP becaus efull strength diptheria causes complication in over 7yrs; 4 doses,
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what is TdaP
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also a bopster in older childrn 11-12
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HiB
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causes severe illness in kids <5 not given to 5yrs adn older, 2,4m, 6(maybe) and as soon
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polio vaccine
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IPV, killed vaccine
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MMR
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live virus
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hep A
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inactivated while, hep a is spread though close contact or eating rinking contaminated food water, all chil age 12m, than repeat in 6-12, 2 doses,
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hep B
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if motehrs status is positive or unknown give within 12 hours, 1-2m, adn 6m. if negative-2,4-6
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Varicella
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live, 12-15 who have not had chicekn pox, second dose 4-6y. 2doses
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pneumococcal vaccine
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PCV and PPV. PCV <2m. PPV >2y at high risk
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influenza
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yearly betwen 6-59m. TIV adn LAIV. LAIV 5-49yrs. LAIV can replicate and shed for a week . TIV 6m older cant cause disease
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Rotavirus
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severe gastroenteritis. shed in stool and spread fecal-oral. live vaccine given orally to infants <32 wks. 2 doses do not start later than 12 wks, or give past 32 wks
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HPV
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15-24 common. 3 vaccine beginning at 11, 3rd dose 6mo after
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meningococcal vacine
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spread through direct contact or air dorplet. age 11-12 gets MCV4
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DtaP dose
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5 doses 2m 4m 6m 15-18m 4-6y
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Scarlet fever
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Group A streptococcus (GAS)Bacteria release toxin that causes rash, Airborn/ respiratory tract secretions, Tongue- thick coat of strawberry appearance, than becomes bright red, Pharynx- red and swolen, tonsils- yellow or white spects of pus cervical lymph nodes swollen, Skin- erythematious rash on face trunk or extremities. Looks like usnburn for 5 days followed by disquimatios, Standard and droplet, Penicilin V ( erythromycin if allergic), Fluid intake for fever, humidifier for throat, warm liquids or popsicles
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Cat scratch
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Avoid rough play with cats, wash rash with soap or water , Self limiting in 2-4mo. Antibiotics for lymphadenopathy, Standard- non transmitted between people, Between cat via cat flea ,Bortanella henseli- cats carry it in saliva, Lymphadenopathy
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Diptheria
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Tonsilar and pharyngeal. Neck edematious, lymph noides enlarge. Pseudomembrnae cause airway obstruction and suffocation, Sore throat, fever, swallo becomes hard, Observe resp status is imptnt! Give antibiotics, Droplet precaution and standard, Antibiotics/ airway management, bedrest
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Pertussis
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High humidity environment and suction, fluids, Older than 1mo macrolides like erythromycin, clarimphetical, azithromycin. Younger give azithromycin.. alternate TMP-SMZ, Droplet, standard, Coughing spell lasting 1-4wks,Cold symptoms progressing to paroxysmal cough 10-30x in a row followed by a whopping sound, Cold symptoms 7-10 days, Seizures, pneumonia, encephalopathy and death, <4yrs most severe isn <6mo, Acute respiratory with paroxysmal cough ( whooping cough) and copius secretions.10-30x than whooping sound than redness in face, cyanosis, protrusion of tongue, saliva mucus tears flow, between episode child may rest and appear unaffected,
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Tetanus
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Toxins of clostridium tetani found in soil, dust, feces form human animals like sheep, cattle, chicken dog cat rat- through wound, burn injection, Ineurologic DO. Increased muscle tone and spasms, Breathing problems, fractures, elevated bp, dysrhymia, clotting in bv of lung pneumonia and coma, Initial signs ar eh/a spansms crnakiness cramping of jaw difficulty swollowing stiff neck. Progress descending fashion cause spasm of neck arm leg and stomach, Support resp and CV function. Give tetanus vaccine and ig. Remove organism by debridement, iv antibiotic like metronidazole, Observe for signs of resp distress, mental status is unaffected educate on immunizations and booster every 10 yrs,
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Mumps
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Immunize by 15mo than second between 4-6yrs, Acetaminophen narcotic fluids oce pack to testicles, Standard and respiratory isolation, parotidis, Exposure of infected individuals, low grade fever parotid swelling malaise anorexia h/a abdominal pain , Meningoencephalitis, seiaures auditory neuritis deafness boys will develop orchitis ( inflammation of testes, Fever and paritoditis, Contagious by paramyxovirus
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Poliomyelitis
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Infection poliovirus which is an enterovirus, Invades CNS and progress to paralysis, Direct or indirect contact. Commonly via fecal -oral, oral-oral, Fever fatigue h/a vomit neck stiffness nad limb pain--- tremors paralysis, Paralysis. Positive kernig sign deep tendon reflex hypreactive initially than diminsih. Paralysis is asymetric, Supportive maintian resp status and nutritional stat, bed rest skin care. No cure so vaccinate with IPV
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Rabies
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Educate about care of animal bite cuz death can occur , wound management with soap and water, irrigation with povodone-iodine, Successful animal control. Immunize 1 dose of Ig and 5 dose of rabies over 28days given IM, Hx of bites, exposure to bats, Flue like like fever h/a malaise, pain pruritis at bite site, encephalitis if goes to CNS, Other animals and human through close contact with saliva of rabid animal- wild animals ike racoons skunk bat and fox, ,Viral infect of cns
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Lime most common vecotr in US
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NE,midwest and west coast. April-october any age group highest 5-10yrs good prognosis, Bit ein infected black legged tick, Tick bite and onset of rash 7-14 days after tick bite in early fever malaise malaga arthralgia(joint pain) late- recurrent arthritis weeks-mo after. Rash early- ring like at site of bite erythema migrans. Early diss if multiple areas of this are found, Didoxycycline in older than 8yrs. Cause perm discoloration of teeth less than 8 treat with amoxycilin. 14-21days, Proper removal of ticks because in order to get it ticks have to stay on for 24 hours
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Rocky Mountain Spotted fever
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Can be fatal , Antibiotic. Tetracycline like doxy and chlorempheticol in kids <9 5-10days, Fever h/a n/v anorexia
late sigs – rahs 2-5days after fever ab pain joint pain and diarrhea. Small non itcy on wrist or ankles than spreats all over body include soles and palsm, Cardiopul edema multi organ damage, partial paralysis some neuro , April-sept highest all age in 5-9, Ricketsia-ricketsii carried as a praasite in ticks flezs lice in american dog ticka dn rocky mountain tick are vectors, |
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eye color is determined
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6-12m
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20/20 vision achieved by
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6-7y
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warm compress
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conjunctivitis
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corrective lenses
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astigmatism, refractive error, strabismus
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patching
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strabismus, ambliopia,
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pressure equalizing tubes
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chronic otitis media with effusion
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conjunctavitis
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inflammation of balbar or palpebral conjunctiva, risk factor: <2weeks, daycare preschool attendance, upper URI, pharyngitis, Otitis media
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manage conjunctivitis
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antibiotics,eyedrops with an antihistamines
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patho of conjunctavitis
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when bac or virus comes into contact with palpebral conjunctiva an antigen-antibody reaction ocurs
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difference between bac,viral, allergic conjunctivitis
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alll cunjunctiva is inflamed, discharge- purulentin bac, watery in viral, watery stringy in allergic, mild pain with bac, lymphadenopathy photophobia and tearing viral itching in alelrgic, eyelid edema usually present
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what to look out for with conjunctivitis
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red, edema, tearing, dc eyepain, ithiching, hx of URI, family hx,
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how to manage conjunctivitis
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warm compress, avoid allergens, itching from allergic can be relieved with cool compress
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nasolacrimal duct obstruction
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aka stenosis, chronic tearing, and buildup in lacrimal duct causes mucoid or mucopurulent drain.
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manage NLDO
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wait and see, massage, it should resolve by 23m, clean the eye,
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assess NLDO
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asssess tearing, dc,
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eye lid disorders 3
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hordeolum ( stye) chalazion, blephartis
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what is hordeolum?
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localized infection of sebaceous gland of eyelid follci, cause dby bacteria
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chalazion
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painless infection of meibomian gland
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blephartis
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chronic scaling adn discharge along eyelid margin
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how to you treat assess and manage eyelid DO?
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chalazion is spontaneous resolve, hordeolum and blephartis needs antibiotics, inspect eyelids for redness along eyelid margin and presence of edema in hordeolum adn blephartis. chalazion may appear as a small nodle on lid margin conjunctiva is clear in all 3. use hot moist compress
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what is periorbital cellulitis?
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bacteria infection of eyelid and tissue surrounding gain through abrasion, laceration, insect bite, foreing body impedigo, bacteria release endotoxin that initiate inflammation. redness swelling infiltration of skin
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how do you assess and manage periorbital edema?
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IV antibiotic, pain aroudn eye restrictiv emovement, conjunctiva is clear and no discharge, warm soaks to eye for 20 min every 2-4hrs call doctor if proptosis occur
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how do you treat common eye injuries?
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laceration - sutures, so it doesnt cause ptosis, contusion ( black eye) observation ice adn analgesic, scleral hemorrhage- resolve gradually w/o intervention, cerebral abrasion - self heal or antibiotic, foreign body - remove it, chemical injuries - irrigation
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refractive errors
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qhwn light enters the lense and doesnt bedn appropriately to allow it to fall on retina ; when light focuses in front of the retina it results in myopia (nearsigh)
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hyperopia
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farsigh. many young children are farsighted because depth of eye globe is not fully developed until age 5
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treatment of refractive errors
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eyeglasses or contacts, 12y+ wear contacts
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how do you assess and manage refractive errors?
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complain of eye strain, eye fatigue with reading, like eye ache, pulling sensation, observe for squinting, test visual acuity, treat with eyeglassess adn teach about safety like removing contacts when eye is infected
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astigmatism
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cornea curvature is uneven resulting in irregular quality of vision because light rays are refracted unevenly
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how to assess adn treat astigmatism
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blurred vision? hard to see letters as a whole ability to read is uneffected, h/a, dizziness, eye fatigue or strain, tilt head to focus more effectively. use contacts to smooth out the corneas curvature or glassess
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strabismus
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misalignment of eye exotropia and esotropia. visual dev of each eye preceed at differnet rates. diplopia may result so vision in one eye may be turned off by brain to avoid it. many infants have this but it resolves by 3m.
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assess adn treat strabismus
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patch thestronger eye or eye muscel sx. lenses too. complication include amblyopia and visual defects. parents first to notice eyes dont face same diretion, besides observation use cover test and assess with cornel light reflex. may be treated with patching eye glasses,
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ambliopia
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poor visual dev in otherwise structurally normal eye. dev within the first decade. untreated ambliopia causes vision loss. viison in one eye is loss cuz eye and brain are not working together one eye is stronger than the other resulting in lazy eye. may be caused by strabismus, astigmatism eyetrauma, ptosis or cateracts eventual blindness will occur
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treat and maage amblyopia
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strengthnen weaker eye bypatching, use atropine drops vision terapy or eye muscle sx. begin visual acuity test by age 3
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nystagmus
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rapid irreg movement of eye can occur with cateracts but mostly a neuro problem visuald ev may by harmed cuz it shard for braina dn eye to communicate when eyes are in conitnuous motoin.
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infantile glaucoma
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autosomal recessive DO common in interrelated relationshp. obstruction of aqueous humor flow adn increase intraocular pressure that result in large prominent eyes . vision loss form corneal scarring, optic nerve damage, or commonly amblyopia.
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how to asses and manage infantile glaucoma
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surgical intervention via goniotomy - removal of obstruction of aqueous humor, assess family hx, infant closes eyes most of time or rubs the eyes. observe for corneal enlargement and clouding eye may appear to be enlarged, photophobia, tearing or conjunctivitis and eyelid squeezing or spasm. main goal of nursing care is postop care. they eye will be patched post op and child on bedrest, may need restriants avoid roughhousing and contact sports for aatleast 2 wks, posibility that 3 or 4 operations would be needed
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congenital cataract
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opacity of the lense present at birth. ambliopia may develop is the complication, sx as early as 2wks than fitted with cotnact lens best visual outcome occurs when cataract are removed before 3m.
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Retinopathy of prematurity ROP
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rapid growth of retinal blood vessels in premature infant. in fetus retinal vascularization begins 4m and complets at 9m or afte rbirth. premature infant is born with incomplete revascualrization yet new vessels continue to grow between vascular and nonvascularize retina
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risk factor ROP assess and manage ROP
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low birhtweight, early gestaitonal age, hypothermia. complicaiton - myopia glaucoma and blindness. strabismus even if its regressed.make sure premature infants are screened
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what is legal blindness?
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vision less than 20/200 or peripheral less than 20degrees. vision impairment is caused by refractive error, astigmatism, strabismus, amblyopia, nystagmus, i. glaucoma, con cateract ROP adn retinoblasmtoma
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Otitis media
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inflamaiton of middle ear with presence of fluid. divided into AOM, OME
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acute otitis media
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from infection of fluid in mid ear. esp between 6-12m. most sig risk factors is eustachian tube dysfuncion and susceptible to recurant upper resp infection
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how do you get AOM?
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URI preceeds it. fluid and pathogens travel up from nasopharyn invading middle ear space. fluid behind ear drum has hard time drainig back. gain acess to E. tube where they proliferate and invade mucosa. commonly fom H influeza. viral resolve spontanoeus. after clearance of infection fluid remains sometimes for several months (OME)
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complicaion of AOM
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hearin loss, speech delay, tympanosclerosis, perforation, acute mastoiditis, IC infection
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how do youa ssess and manage AOM?
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viral is spontaneous, pain management. note acute or rapi d onset of fever, otalgio, fussy, crying inconsolably, batting ot tugging at ears, poor feeding, lethargy, hard to sleep hard to awaken, fluid drainign from ear. the tympanic membrane will be dull or opaque eardrum is immobile, tympanometry is used to dx OME and not AOM
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how to manage and assess aom
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supportive, analgesic, heat or cold compress, benzocain to numb, bresfedhave lower incidence,
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OME evaluate hearing if lasts longer than 3m
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fluid in middle ear without sign or symptomss of infection. complication is AOM, hearing loss and deafness. asymptomatic and poppinf sensation or fullness behind eardrum. dull opaque TM that may be white grey or bluish tympanometry used to dx OME. may take months to resolve. spontanoeus. dont feed infant supine avoid bottle propping,
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otitis externa
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swimmers ears infectiona nd inflammation of external ear
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conductive hearing loss
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when transmission of sound through middle ear is disrupted like in OME. when fluid fills middle ear the TM cant move porperly and partial or complete hearing loss occurs
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sensorineural hearing lsos
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damage to hair ells in cochlea or along auditory pathway from use of otoxic med, infection
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