A nurse is caring for a client following cataract surgery. Which of the following comments from the client should the nurse report to the client's provider?

Choice A Reason: This is incorrect because Ménière's disease is not caused by an allergic response. Ménière's disease is a disorder of the inner ear that causes vertigo, tinnitus, hearing loss, and a feeling of fullness in the ear. The exact cause of Ménière's disease is unknown, but it may be related to fluid imbalance, infection, trauma, or autoimmune reaction.

Choice B Reason: This is correct because diphenhydramine can help offset the nauseous feeling. Diphenhydramine is an antihistamine that blocks histamine receptors in the brain and inner ear, which can reduce nausea and vomiting associated with vertigo.

Choice C Reason: This is correct because anticholinergics will help you rest. Anticholinergics are a class of drugs that block acetylcholine receptors in the brain and body, which can have sedative effects and reduce motion sickness. Diphenhydramine has anticholinergic properties.

Choice D Reason: This is correct because diphenhydramine can help reduce vomiting episodes. As mentioned above, diphenhydramine can reduce nausea and vomiting by blocking histamine receptors in the brain and inner ear.

Choice A reason: This is correct because avoiding swimming underwater can help prevent the worsening of Meniere's disease. Meniere's disease is a disorder of the inner ear that causes episodes of vertigo, tinnitus, hearing loss, and fullness in the ear. Swimming underwater can increase pressure in the ear and trigger an attack. The nurse should advise the client to avoid activities that involve changes in altitude or pressure, such as flying, diving, or climbing.
Choice B reason: This is incorrect because wearing earphones when in crowded places can worsen Meniere's disease. Earphones can increase noise exposure and damage hearing, which is already impaired by Meniere's disease. The nurse should advise the client to avoid loud noises and use hearing aids if needed.
Choice C reason: This is incorrect because keeping eyes open during an acute attack can increase vertigo and nausea. Vertigo is a sensation of spinning or moving when still, which can be caused by Meniere's disease. Keeping eyes open can make vertigo worse by creating a visual mismatch with vestibular signals from the inner ear. The nurse should advise the client to close their eyes or focus on a stationary object during an attack.
Choice D reason: This is correct because sitting or lying down if whirling occurs can help prevent falls or injuries due to vertigo. Whirling is another term for vertigo, which can affect balance and coordination. Sitting or lying down can reduce movement and stabilize posture during an attack. The nurse should advise
the client to avoid driving or operating machinery when experiencing vertigo.
Choice E reason: This is correct because we do not know the exact cause of Meniere's disease. Meniere's disease is thought to be related to abnormal fluid balance or pressure in the inner ear, but what triggers this condition is unknown. The nurse should educate the client about possible risk factors, such as genetics, infections, allergies, autoimmune disorders, or head trauma, but also acknowledge the uncertainty and variability of the disease.
Choice F reason: This is incorrect because damage to the ear from excess noise is not the cause of Meniere's disease. Damage to the ear from excess noise can cause noise-induced hearing loss, which is a type of sensorineural hearing loss that affects the cochlea or the auditory nerve. Meniere's disease is a type of mixed hearing loss that affects both the cochlea and the middle ear. The nurse should not confuse or misinform the client about the cause of their condition.