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Notes on Sensory Functioning (Page-by-Page)

Page 1

  • Publisher: Wolters Kluwer

  • Slogan: "When you have to be right"

  • Topic: Sensory Functioning

  • Context: Introduction to sensory functioning and its relevance in patient care.

Page 2

Senses involved in sensory reception:

  • Visual (vision)

  • Auditory (hearing)

  • Olfactory (smell)

  • Gustatory (taste)

  • Tactile (touch)

  • Stereognosis (perception of solidity of objects)

  • Kinesthetic and visceral (basic internal orienting systems)

  • Proprioception (sense of body position)

Notes:

  • Stereognosis specifically enables recognition of object size, shape, and texture through touch alone.

Page 3

Question #1: Which of the following interventions would be appropriate to stimulate the sense of stereognosis in long-term care residents?

  • A. Tape pictures of loved ones on the walls.

  • B. Play soft music in the recreation room.

  • C. Prepare a fragrant cup of tea.

  • D. Provide a soft, textured blanket on the bed.

Page 4

Answer to Question #1:

  • Answer: D

  • Rationale:

    • Stereognosis is the sense that perceives the size, shape, and texture of objects, such as a soft blanket.

    • Taping pictures to the wall stimulates the visual sense.

    • Playing music stimulates the auditory sense (sound).

    • Making tea stimulates the olfactory sense (smell) and the gustatory sense (taste).

Page 5

States of Awareness

  • Conscious states: delirium, dementia, confusion, normal consciousness, somnolence, minimally conscious states, locked-in syndrome

  • Unconscious states: asleep, stupor, coma

  • Vegetative state

Notes:

  • Classification of levels of awareness guides assessment and care planning.

Page 6

Factors Contributing to Sensory Alteration

  • Sensory overload: the patient experiences so much sensory stimuli that the brain cannot respond meaningfully or ignore stimuli; patient may feel out of control. Nursing care focuses on reducing distressing stimuli and helping the patient gain control over the environment.

  • Sensory deprivation: environment with decreased or monotonous stimuli; impaired ability to receive environmental stimuli; inability to process environmental stimuli.

  • Sensory deficits: actual loss or impairment of one or more senses (e.g., vision, hearing).

  • Sensory poverty: limited sensory input due to environmental or social factors.

Page 7

Disturbed Sensory Perception

  • Group 1: What is a sensory processing disorder

  • Group 2: What is Sensory Deprivation

  • Group 3: What is Sensory Overload

  • Group 4: What are Sensory Deficits

  • Group 5: What is Sensory Processing Disorder

  • Group 6: What is Sensory Poverty

  • Group 7: Dementia versus Delirium

  • Group 8: Evaluating a Client’s Understanding of Hearing Aid Use

  • Group 9: Laryngectomy (reason for the procedure)

  • Sensory Perception: Evaluating a Client's Understanding of Hearing Aid Use

Page 8

Sensory Overload

  • Definition: The patient experiences so much sensory stimuli that the brain is unable to respond meaningfully or ignore stimuli.

  • Presentation: The patient may feel out of control and exhibit manifestations observed in sensory deprivation.

  • Nursing focus: Reduce distressing stimuli and help the patient gain control over the environment.

Page 9

Sensory Deprivation

  • Definition: Environment with decreased or monotonous stimuli

  • Effects: Impaired ability to receive environmental stimuli; Inability to process environmental stimuli

Page 10

Vision Disorders

  • Myopia: nearsightedness

  • Hyperopia: farsightedness

  • Astigmatism: a refractive error whereby the eye cannot focus light evenly on the retina, causing blurred vision or distortion

  • Presbyopia: decrease in the ability to focus up close or with small print

Page 11

Cataracts are a clouding of the eye's natural lens, which lies behind the iris and the pupil. This condition can lead to blurred or dim vision, increased sensitivity to light, and difficulty seeing at night. Over time, cataracts can cause significant vision loss if left untreated.

Page 12

Smoking

  • Note: Smoking increases the risk of cataracts and diabetic retinopathy.

Page 13

Diabetic Retinopathy

  • Description: Affects blood vessels in the retina and can lead to vision loss and complete blindness

  • Progression: Can advance and damage the optic nerve, causing glaucoma

  • Significance: Leading cause of blindness in adults

Page 14

Glaucoma: Increased Intraocular Pressure

  • Screening: Included as part of a regular eye exam to measure the thickness of the cornea

  • Measurement methods:

    • Noncontact tonometry

    • Applanation tonometry

  • If eye pressure is high or optic nerve looks unusual, the doctor measures cornea thickness using a pachometer

Page 15

Assessment of the Sensory Experience

  • Stimulation

  • Reception

  • Transmission-perception-reaction

  • Defining characteristics of sensory deprivation and overload

Page 16

Improving Sensory Functioning

  • Teach patients and significant others methods for stimulating the senses

  • Teach patients with intact and impaired senses self-care behaviors

  • Interact therapeutically with patients with sensory impairments

Page 17

Stimulating a Patient's Senses

  • GOLL

    • Note: The slide shows the acronym GOLL, but the content or exact meaning is not provided in the transcript.

Page 18

Preventing Sensory Alterations

  • Control patient discomfort whenever possible

  • Offer care that provides rest and comfort

  • Be aware of need for sensory aids and prostheses

  • Use social activities to stimulate senses and mind

  • Enlist aid of family members to participate in or encourage activities

  • Encourage physical activity and exercise

  • Provide stimulation for as many senses as possible

Page 19

Caring for Visually Impaired Patients #1

  • Teach patient self-care behaviors to maintain vision and prevent blindness

  • Acknowledge your presence in the patient’s room

  • Speak in a normal tone of voice

  • Explain the reason for touching the patient before doing so

  • Keep the call light within reach

  • Orient the patient to sounds in the environment

Page 20

Caring for Visually Impaired Patients #2

  • Orient the patient to the room arrangement and furnishings

  • Assist with ambulation by walking slightly ahead of the patient

  • Stay in the patient’s field of vision if the patient has partial vision

  • Provide diversion using other senses

  • Indicate conversation has ended when leaving the room

Page 21

Caring for Hearing-Impaired Patients

  • Teach measures to prevent hearing problems

  • Orient the patient to your presence before speaking

  • Decrease background noises before speaking

  • Check the patient’s hearing aids

  • Position yourself so that light is on your face

  • Talk directly to the patient while facing him or her

  • Use pantomime or sign language as appropriate

  • Write any ideas you cannot convey in another manner

Page 22

Communicating With a Patient Who is Confused

  • Use frequent face-to-face contact to communicate the social process

  • Speak calmly, simply, and directly to the patient

  • Orient and reorient the patient to the environment

  • Orient the patient to time, place, and person

  • Communicate that the patient is expected to perform self-care activities

  • Offer explanations for care

  • Reinforce reality if the patient is delusional

Page 23

Communicating With an Unconscious or Sedated Patient

  • Be careful what is said in the patient’s presence; hearing is the last sense that is lost

  • Assume that the patient can hear you and talk in a normal tone of voice

  • Speak to the patient before touching

  • Keep environmental noises at a low level