Sensory Alteration in Nursing
Chapter 49: Sensory Alteration
Slide 2: Terminology – The Senses
Let’s start with the basic senses you’ll hear about in this chapter:
The 7 Main Senses:
Sight / Visual → Eyes (seeing)
Hearing / Auditory → Ears (hearing)
Touch / Tactile → Skin (feeling)
Smell / Olfactory → Nose (smelling)
Taste / Gustatory → Tongue (tasting)
Position & Motion / Kinesthetic → Sense of body movement and balance
Example: Knowing where your feet are without looking.
Size, Shape & Texture / Stereognosis
Ability to recognize objects by touch (with eyes closed).
Example: Reaching into your bag and knowing it's a key without looking.
Summary:
This chapter isn’t just about the 5 basic senses—it includes your sense of movement and your ability to feel objects without seeing them.
Slide 3: How Normal Sensation Works
To feel, sense, and respond to the world around you, your body uses 3 steps:
1. Reception
This is when your sense organs receive stimuli.
Example: Your eyes receive light, your skin feels pressure, your ears hear sound.
2. Perception
Your brain interprets the information.
Example: Your brain realizes, “That’s a loud sound” or “That’s the smell of cookies.”
3. Reaction
Your body responds to the sensation.
Example: You cover your ears, smile, or pull your hand away from something hot.
Simple Example:
You touch a hot pan → (Reception)
Your brain says “That’s HOT!” → (Perception)
You pull your hand away → (Reaction)
Slide 4: Sensory Alterations – When Something Goes Wrong
This slide introduces the 3 main types of sensory problems you’ll see in patients.
1. Sensory Deficits
A problem with one or more senses.
The sense may be weakened, damaged, or completely lost.
Examples:
Vision loss
Hearing loss
Numbness in hands or feet (common in diabetics)
2. Sensory Deprivation
When the person doesn’t get enough sensory input (not enough stimulation).
Can lead to:
Confusion
Depression
Anxiety
Common in patients who are:
In isolation
Blind or deaf
In a quiet hospital room for too long
3. Sensory Overload
Too much sensory input at once.
The brain can’t process everything.
Leads to:
Irritability
Anxiety
Restlessness
Common causes:
Noisy hospital rooms
Too many visitors
Beeping machines
In Simple Terms:
Deficit = Something’s missing.
Deprivation = Not enough stimulation.
Overload = Too much stimulation.
Slide 5: Factors That Influence Sensory Function
Some things can make a person’s senses better or worse. These are the key factors nurses watch for:
1. Age
Babies are still developing senses.
Older adults may lose some senses:
Vision (like cataracts or glaucoma)
Hearing (like presbycusis)
Taste and smell often weaken too.
2. Meaningful Stimuli
Things that stimulate the senses in a good way:
Family photos
Music
Talking with loved ones
Without these, people may feel bored, sad, or disconnected.
3. Amount of Stimuli
Too little = boredom or sensory deprivation.
Too much = sensory overload (stress, confusion).
4. Social Interaction
Talking, laughing, and spending time with others keeps the senses active.
Isolation or loneliness can dull a person’s senses and affect mental health.
5. Environmental Factors
Things like:
Hospital noise
Poor lighting
Unsafe walking paths
These can harm sensory function or make patients feel overwhelmed or unsafe.
6. Cultural Factors
Some cultures:
Are more expressive (loud music, bright colors).
Others may value quiet or personal space.
Always be culturally sensitive in how you provide care.
Summary:
A person’s age, environment, culture, and how much stimulation they get all affect how their senses work.
Slide 6: Critical Thinking – Use Your Nursing Brain
This slide reminds you that when you're caring for someone with sensory issues, you need to connect what you know and make thoughtful decisions.
What Should You Do as a Nurse?
1. Use Your Knowledge
Understand:
How sensory deficits work (like what happens when someone loses vision or hearing).
What factors affect a person’s ability to sense (like age, illness, or the hospital environment).
How to use therapeutic communication to help the patient feel heard and supported.
2. Think Critically
Don’t just follow steps—ask questions and analyze the situation.
Use what you’ve assessed to:
Plan the right care
Put it into action
Evaluate if it’s helping
Simple Example:
If a patient is hard of hearing, don’t just talk louder—assess their hearing aid, face them when speaking, and make sure their environment is quiet enough to hear you.
Slide 7: Critical Thinking (Continued)
This slide is just a continuation and reinforcement of Slide 6, so the key message is:
Use Critical Thinking to Deliver Safe and Effective Care
That means:
Understand the patient’s sensory issue (vision, hearing, etc.).
Think ahead: What risks does this cause?
Risk for falls?
Risk for isolation?
Make a care plan that:
Keeps the patient safe.
Helps them communicate.
Supports their emotional well-being.
Evaluate if the plan is working and adjust if needed.
In Simple Terms:
Use your brain + what you’ve learned to assess, plan, act, and reflect—always with the patient’s safety and quality of life in mind.
Slide 8: Assessment – What to Look For in Patients with Sensory Issues
This is where you begin to collect information about your patient’s sensory function.
1. Through the Patient’s Eyes
Ask the patient:
What are you experiencing?
How is it affecting your life?
Let them describe things in their own words.
2. People at Risk
Who’s most likely to have sensory problems?
Older adults
Patients in ICU
People with neurological or sensory disorders
Patients on certain medications (can affect senses)
3. Sensory Alterations History
Ask about:
Past vision or hearing problems
Use of glasses, contacts, hearing aids
Any recent changes in senses
4. Mental Status
Is the patient:
Alert?
Confused?
Able to follow instructions?
Confusion may be a sign of sensory deprivation or overload.
5. Physical Assessment
Test each sense:
Can they see? Hear? Feel touch? Smell? Taste?
Look for redness, drainage, or damage to ears, eyes, skin, etc.
6. Ability to Perform Self-Care
Can the patient:
Dress themselves?
Eat safely?
Take medications correctly?
Sensory issues may affect independence.
7. Health Promotion Habits
Ask about:
Eye exams
Hearing checks
Dental care (taste)
Do they take care of their senses?
8. Environmental Standards
Is the environment:
Too noisy or too quiet?
Safe and accessible?
Bright enough or too dark?
Slide 9: Continuing Assessment – Sensory Function
These are additional things to check when assessing a patient with actual or potential sensory issues:
1. Communication Methods
How does the patient communicate?
Do they read lips?
Use sign language?
Write things down?
Do they need a translator or communication board?
2. Social Support
Do they have family or friends involved in their care?
Are they isolated or do they have daily social contact?
Support helps prevent sensory deprivation and depression.
3. Use of Assistive Devices
Are they using the right tools?
Hearing aids
Eyeglasses
Walkers or canes
Are those devices clean, working, and being used correctly?
4. Other Factors Affecting Perception
Think about:
Medications (some affect senses or cause confusion)
Sleep deprivation
Substance use
Mental illness
All these can change how a person experiences their environment.
Summary:
This part of assessment checks how the patient connects to others and the world, and whether they have the tools they need to stay safe and engaged.
Slide 10: Nursing Diagnoses – Identifying the Patient’s Problems
After you finish assessing, your next step is to figure out the specific problems your patient is facing because of their sensory alteration.
Common Nursing Diagnoses:
Risk for Injury
They may not see or hear hazards.
Example: Tripping over a cord they didn’t see.
Risk for Fall
Due to poor balance, visual loss, or reduced sensation in feet.
Very common in older adults.
Impaired Verbal Communication
Can’t speak clearly or can’t understand others.
May need alternate ways to communicate.
Impaired Socialization
Patient avoids others due to sensory loss.
May feel lonely or depressed.
Impaired Mobility
Trouble moving safely due to lack of sensory input or assistive device needs.
In Simple Words:
These diagnoses help guide your care plan by naming the specific challenges caused by sensory problems.
Slide 11: Planning – Setting Goals for the Patient
Once you know the patient’s problems, now you plan what to do about them.
1. Outcomes
What do you want to happen?
Set clear, realistic goals like:
“Patient will use hearing aids during waking hours.”
“Patient will safely walk to the bathroom with a walker by end of shift.”
2. Setting Priorities
Ask:
What’s most urgent?
What’s safety-related?
Example:
Preventing a fall comes before teaching about communication tools.
3. Teamwork and Collaboration
Work with:
Speech therapists (communication)
Occupational/Physical therapists (mobility & self-care)
Family members (support at home)
Vision/hearing specialists
Summary:
The planning step is about creating realistic goals, deciding what’s most important, and getting help from the care team to support the patient’s sensory function.
Slide 12: Implementation – Promoting Healthy Senses
In this step, you take action to protect or improve the patient’s sensory function.
1. Screening
Make sure the patient gets regular checks:
Eye exams
Hearing tests
Early detection helps prevent serious issues.
2. Preventive Measures
Teach patients how to protect their senses:
Don’t listen to loud music with earbuds.
Wear sunglasses in bright sun.
Use protective gear at work (earplugs, goggles).
3. Use of Assistive Devices
Encourage proper use of:
Hearing aids
Glasses or magnifiers
Canes or walkers
Make sure they’re clean, working, and used correctly.
4. Promote Meaningful Stimulation
Help stimulate their senses in healthy ways:
Vision – Pictures, windows, well-lit spaces
Hearing – Music, conversation
Taste/Smell – Good meals, familiar scents
Touch – Hugs, textured items, massage
Summary:
Help the patient maintain and use their senses by teaching good habits, offering stimulation, and encouraging proper use of assistive tools.
Slide 13: Making the Environment Safe & Improving Communication
This slide focuses on adapting the patient’s surroundings and communication methods to fit their sensory needs.
1. Establishing Safe Environments
For Visual Loss:
Remove clutter or tripping hazards.
Use bright lighting and contrast-colored items (like black plates on a white table).
Label drawers or doors with large print or braille.
For Hearing Loss:
Face the patient when speaking.
Speak clearly (don’t shout).
Reduce background noise.
Use written communication or gestures if needed.
For Reduced Smell (Olfaction):
Make sure food is fresh (can’t rely on smell to tell).
Label chemicals/cleaners clearly.
Install smoke detectors—they may not smell smoke.
For Reduced Touch (Tactile):
Teach patients to:
Check water temperature to avoid burns.
Inspect skin for injuries they can’t feel (especially diabetics).
Avoid extreme temperatures.
2. Communication
Adjust your communication based on the patient’s needs.
Use:
Hearing aids or glasses
Picture boards
Notebooks
Family/friend interpreters (if trained and approved)
Summary:
A safe environment + adapted communication = a better quality of life and lower risk of injury for patients with sensory changes.
Slide 14: Caring for Patients with Sensory Issues in the Hospital (Acute Care)
Here’s how to help patients with sensory problems while they’re in acute care settings like hospitals.
1. Orientation to the Environment
Help the patient understand where they are.
Point out:
Bathroom location
Call light
Items on their tray/table
Re-orient frequently if the patient is confused or overwhelmed.
2. Communication
Adapt your approach:
Speak clearly.
Use non-verbal cues (gestures, pictures).
Write messages if needed.
Include family if it helps the patient feel more at ease.
3. Controlling Sensory Stimuli
Prevent sensory overload:
Lower the volume of machines/TVs.
Limit how many people are in the room.
Avoid unnecessary lights or alarms.
Prevent sensory deprivation:
Open blinds during the day.
Talk to the patient, even if they’re nonverbal.
Offer stimulating objects (magazines, music, familiar items).
4. Safety Measures
Reduce fall risks:
Call light in reach
Bed in low position
Night light for vision loss
Encourage use of assistive devices.
Summary:
Acute care is about helping the patient feel oriented, calm, and safe, while avoiding too much or too little sensory input.
Slide 15: Long-Term Support for Patients with Sensory Loss
This slide focuses on what happens after the hospital—helping patients maintain independence and adjust to sensory changes in daily life.
1. Maintaining Healthy Lifestyles
Encourage:
Regular exercise (supports circulation and sensory function)
Healthy diet
Avoiding smoking or alcohol abuse (can damage senses)
Keeping up with screenings (eye and hearing exams)
2. Understanding Sensory Loss
Help the patient and family understand the condition:
What it means
How to manage it
What changes to expect
Education reduces fear and helps with adjustment.
3. Socialization
Encourage:
Visits from family and friends
Community programs or support groups
Safe ways to engage with others
Social connection prevents isolation and depression.
4. Promoting Self-Care
Teach patients how to:
Safely dress, bathe, eat, and take meds
Use tools like magnifying glasses, voice reminders, or mobility aids
Goal: Keep the patient as independent as possible
Summary:
After discharge, focus on education, social support, and independence to help the patient live well with sensory changes.
Slide 16: Evaluation – Did the Care Plan Work?
This is where you check your results and see if the goals you made earlier were met.
1. Through the Patient’s Eyes
Ask the patient:
“Do you feel more aware and connected?”
“Are your senses better supported now?”
“Is communication easier?”
Include their feelings, feedback, and concerns in your evaluation.
2. Patient Outcomes
Did your patient:
Use their assistive devices correctly?
Stay safe and avoid falls?
Interact more socially?
Perform more self-care independently?
If yes → continue the plan!
If no → re-assess and adjust your care.
Summary:
The evaluation step is all about checking whether your nursing care helped and what to change if it didn’t.