Ménière's Disease

Ménière's disease is an inner-ear disorder linked to a buildup of endolymph, the fluid of the inner ear, that causes attacks of vertigo, hearing loss and tinnitus; it usually affects one ear and has no cure. The classic picture is episodic spinning vertigo, fluctuating sensorineural hearing loss, ringing or roaring tinnitus, and a feeling of fullness or pressure in the ear. Attacks last about 20 minutes to 12 hours and often bring nausea, vomiting and sweating. Safety is the nursing priority, because severe vertigo can cause sudden falls, so the nurse keeps fall precautions in place, helps with walking and changes the client's position slowly. During an attack, the client lies still with eyes closed in a quiet, dim room. Meclizine relieves vertigo but causes drowsiness, diazepam may be ordered for acute attacks, and a diuretic may be given long term with potassium monitoring. Teaching covers a low-sodium diet of about 1,500 to 2,000 mg a day, limiting caffeine and alcohol, sitting down at the first warning sign, and no driving until a week after symptoms resolve.