Adult I - Sensory Function

Sensory Reception

Visual, Auditory, Tactile, Olfactory, and Gustatory processes.

Sensory Perception

Processing of sensory reception into meaningful information - includes 4 parts.

Kinesthesia

Visceral

Properioception

Stereogenesis

Stereognosis

Perception of solidity, size, shape, and texture through touch.

Kinesthetic

Perception of body movement and position - ex: walking.

Visceral

Perception of internal body sensations and organs, such as hunger and thirst and anxiety - aka “pit in stomach”.

Proprioception

Awareness of subconscious body position and movement in space - ex: balance.

4 Conditions to Receive Data

1.) A stimulus takes place - ex: touching a hot stove

2.) The receptors convert stimulus into a nerve impulse.

3.) Impulse travels to brain.

4.) The brain receives and translates the impulse to a sensation - ex: PAIN!

Reticular Activating System - RAS

Monitors sensory stimuli, which then maintains/enhances arousal. The prime arousal state of RAS = Sensoristasis.

Factors Affecting Sensory Stimulation/Tolerance (6)

• Developmental considerations

• Cultural considerations

• Personality and lifestyle

• Stress and illness

• Medications

• State of Awareness

States of Awareness

Conscious vs. Unconscious

Conscious

• Delirium

• Dementia

• Confusion

• Somnolence

• Normal

• Minimally conscious

• Locked-in syndrome

Unconsciousness

Asleep, Stupor, Coma, Vegetative State

Developmental Considerations

Sensory functions decline with age or chronic illness - which means increasing stimuli.

For children, increasing stimuli/play helps development. However, with NICU patients - less stimuli is better to replicate the womb.

Cultural Consideration

Ex: touching is offensive in one culture, whereas welcomed in the next.

Personality/Lifestyle

Ex: One person may like a spontaneous schedule, whereas another person may want a strict schedule.

Stress and Illness

Sensory overload from other stress + illness may affect the reception and perception, making an individual slower to function.

Medication

May affect the reception and perception process - ex: sedatives or narcotics.

Assessing Sensory Function (9) aka: How the 5 Senses Function

• persons at risk - geriatric

• mental status

• ability to perform self-care

• environmental hazards

• social support

• sensory alteration history

• physical assessment

• communication method

• assistive devices

Sensory Deficit

Deficit in sight, hearing, balance, taste, or speech.

Sensory Deprivation

Inadequate stimulation for individual from the external environment.

Sensory Deprivation TX

Stimulate 5 senses + emotional and cognitive input.

Sensory Overload

Multiple sensory stimuli being received, and not being able to efficiently respond or ignores. Causes feeling of being overwhelmed.

Sensory Overload TX

Provide a stable, consistent schedule for the patient. Help patient remove or reduce any other stimuli - ex: ear plugs for noise.

Aphasia

Inability to speak, interpret, or understand language.

Expressive Aphasia

Inability to name common objects or express simple ideas in words or writing.

Sensory/Receptive Aphasia

Inability to understand written or spoken language.

Effects of Sensory Deprivation and Overload

Similar effects. Perceptual, cognitive, and emotional disturbances + distress.

Goals for Sensory Alteration Patients (8)

1. Know person, place, and time.

2. Respond appropriately to sensory stimuli.

3. Demonstrate functioning of senses.

4. Exhibit arousal = brain receives and meaningfully organizes patterns.

5. Patient will feel safe and in control.

6. Can identify stimuli.

7. Can demonstrate + describe self-care behaviors specific to impairment.

8. Acceptance of deficit.

Interventions to Improve Function

• Teach how to stimulate the senses

• Teach modified self-care behaviors

• Interact as needed with the deficit

Care of Visually Impaired Patients

• Communication of actions + self!

• Stimulate other senses

• Make environmental accommodations

• Stay in field of vision - if applicable

Care of Impaired Hearing Patients

• Be visible to the patient - especially your face!

• Write + sign language where you can

• Decrease background noise

Care of Confused Patients

• Communication!

• Face the patient

• Speak calmly + directly

• Reorient patient as needed

Care of Unconscious Patients

• Communicate all actions!

• Speak normally and assume you’re being heard

• Control environment noises