Meniere's Disease and Vertigo on the NCLEX

Excess fluid in the inner ear. The triad makes the diagnosis; safety during the attack makes the question.

The triad

1. Episodic vertigo (the room spins), lasting minutes to hours, often with nausea and vomiting. 2. Tinnitus (roaring or ringing). 3. Fluctuating sensorineural hearing loss, usually one ear, often with a feeling of fullness in that ear. Between attacks the patient can feel normal. Hearing loss can become permanent over years.

During an attack: safety first

The patient does not walk unassisted. Falls are the danger. Lie still in a quiet, dark room, head still, no sudden movements. Side rails up, bed low, call light in reach, assist to the bathroom. Antiemetics and vestibular suppressants as ordered. The attack passes; the fall injury does not.

Between attacks: the diet

The problem is endolymph volume, so the diet targets fluid retention: low sodium is the core teaching, and many plans also limit caffeine, alcohol, and nicotine. Spread fluid intake evenly through the day. A diuretic (often hydrochlorothiazide) is commonly prescribed to reduce inner-ear fluid.

Med basics

Meclizine (antihistamine) suppresses vertigo: warn about drowsiness, no driving until effects are known. Antiemetics for the vomiting. Benzodiazepines short-term for severe attacks. Refractory disease has procedural options (intratympanic injections, surgery), but the NCLEX focus stays on diet, safety, and meclizine.

Frequently asked

Attack starts while the patient is walking in the hall. First action?

Help them sit or lie down immediately, then get assistance. Preventing the fall outranks everything else.

Why does salt matter to an ear problem?

Meniere's is excess endolymph fluid. Sodium drives fluid retention, so restricting it reduces the pressure that triggers attacks.

Quick check

Loading a question…

How ready are you right now?

10 real NCLEX questions, free, in your browser. See how close you are to ready and which subjects are costing you.

Try 10 questions free