Rnsg 1413 Sensory Alteration Presentation-fall 2006[1]

Chapter 48 Sensory Alterations Caution to those with seizure disorders or motion sickness.

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Normal Sensation • Reception – Perception – Reaction – Receptive and expressive aphasia- in expressive use charts in receptive use short questions, gestures and repeat.

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Sensory Alterations • Sensory deficits • Sensory deprivation • Sensory overload

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Common Sensory Deficits • Visual – Presbyopia – Cataract – Dry eyes – Open-angle glaucoma – Diabetic retinopathy – Macular degeneration Mosby items and derived items © 2005 by Mosby, Inc.

Common Sensory Deficits (cont'd) • Auditory – Presbycusis – Cerumen accumulation

Taste – Xerostomia

• Balance – Dizziness and disequilibrium Mosby items and derived items © 2005 by Mosby, Inc.

Common Sensory Deficits (cont'd) • Neurological – Peripheral neuropathy – Stroke (CVA)

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Factors Affecting Sensory Function • Age- decreased sensitivity to pain, pressure and temperature • Persons at risk—older adults • Meaningful stimuli • Amount of stimuli • Family factors

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Factors Influencing Sensory Function • Social interaction • Environmental factors – Work risks, noise, movement, light

• Cultural factors • Race, age, and gender

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Assessment • Sensory alterations history (rubella in pregnancy could cause auditory impairment) • Mental status • Physical assessment • Ability to perform self-care • Health promotion habits • Presence of hazards Mosby items and derived items © 2005 by Mosby, Inc.

Assessment (cont'd) • • • •

Communication methods Social support Use of assistive devices Other factors: pathology, medications —mycins (auditory nerve) • Client expectations • Look for altered spatial perception Mosby items and derived items © 2005 by Mosby, Inc.

• Spatial slide

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Nursing Diagnoses Safety is Always the top Priority

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Impaired communication Risk for injury Situational low self-esteem Disturbed sensory perception Social isolation

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Implementation: Health Promotion • Screenings: prenatal, hearing, vision (age relevant) • Preventive safety at home, school, recreational activities • Use of eyeglasses, contact lenses, and hearing aids • Promoting meaningful stimulation Mosby items and derived items © 2005 by Mosby, Inc.

Vision • Minimize glare • Encourage use of eyeglasses, contact lenses, magnifiers • Obtain large-print reading materials • Use brighter colors (red, yellow, orange) • How often to be checked based on age, race, and gender Mosby items and derived items © 2005 by Mosby, Inc.

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If the patient is legally blind inform them of the environment Mosby items and derived items © 2005 by Mosby, Inc.

Great for the patient with temporary vision loss Mosby items and derived items © 2005 by Mosby, Inc.

Hearing • Amplify telephones, televisions, and radios • Reduce extraneous noise • Check for impacted cerumen • Encourage use of hearing aid • Speak directly at the client • How to speak to them– hands and expression. Mosby items and derived items © 2005 by Mosby, Inc.

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Taste and Smell • Provide oral hygiene • Prepare well-seasoned foods of different textures • Avoid mixing or blending foods • Provide aromas of coffee, bread, flowers • Remove unpleasant odors Mosby items and derived items © 2005 by Mosby, Inc.

Touch • Provide touch therapy • Turn and reposition client • Avoid excessive stimuli for hyperesthetic client

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Visual Alterations • Providing a safe environment – Adequate lighting– good contrast on equipment that they use – Promotion of safe driving principles- have car maintained – Removal of clutter and loose items – Use of color contrasts – Removal of or caution with flammable items – Administration of eye medications

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Hearing Alterations • Providing a safe environment – Amplification of important environmental sounds – Use of lights for alert – Special telephone communication system (TTD or TTY)

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Olfaction Alterations • Providing a safe environment – Use of smoke and carbon monoxide detectors – Visually check gas stove – Check appearance and dates of foods

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Tactile Alterations • Providing a safe environment – Reduce the temperature of the water heater – Clearly mark faucets as “hot” and “cold”

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Promoting Communication • Approaching clients • Use of alternative methods (sign language) • Client education

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Mini Quiz on Sensory Overload •

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Take out a piece of paper Write the answers and turn in when leaving

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1) How do you communicate with receptive aphasia.?

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2) What is a common visual sensory disturbance?

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3) Streptomycin may cause what sensory alteration?

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Questions and Answers

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