The patient complains to the nurse about a perceived decrease in hearing.When the nurse examines the patient's ear,she notices a large amount of cerumen (ear wax) buildup at the entrance to the ear canal.What should the nurse do?

A) Apply gentle,downward retraction of the ear canal.
B) Tell the patient to use a bobby pin to extract earwax.
C) Teach the patient how to use cotton-tipped applicators.
D) Instill hot water into the ear canal to melt the wax.

When cerumen is visible,gentle,downward retraction at the entrance to the ear canal causes the wax to loosen and slip out.The patient must never use sharp objects such as bobby pins or paper clips to remove earwax;use of such objects traumatizes the ear canal and ruptures the tympanic membrane.Cotton-tipped applicators should be avoided as well because they cause earwax to become impacted within the canal.Instilling cold or hot water into the ear causes nausea,vomiting,or both.