Ch.

49 Sensory Alterations
Normal sensation o Reception, Perception, Reaction

Sensory Alterations o o Sensory deficits = a deficit in normal function of sensory reception and perception Sensory deprivation = an inadequate quality or quantity of stimulation o 3 types = reduced sensory input, elimination of patterns or meaning form input, restrictive environments o Box 49-2 Pg 1345 Sensory Overload = receiving multiple sensory stimuli and cannot perceptually disregard or selectively ignore some stimuli.

Factors effecting sensory function o Age Infants & children @ high risk b/c genetic, prenatal, & postnatal conditions Visual changes during adulthood: presbiopia (age 40-50), glaucoma, astigmatism Hearing changes begin @ 30 yrs Gustatory & olfactory changes begin @ 50 yrs Proprioceptive changes (difficulty w/ balance, special orientation and coordination) occur after 60 yrs Meaningful Stimuli o Pets, music, tV, pictures of family, calendar and clock Amt of stimuli Social interaction Environmental factors carpal tunnel syndrome alters tactile sensation o one of the most common industrial / work related injuries Cultural factors Box 49-3 pg 1346 o o o o o

o o o o o o

Persons @ Risk o o Older adults Pts in ICU

Sensory alterations hx o Hearing handicap Inventory for the Elderly (HHIE s) o 5 min, 10 item questionnaire o Assesses how pt perceives social and emotional effects of hearing loss Friends and Fam o Best resources for info because pt is often unaware of any change

Mental Status o o Box 49-6 Pg. 1349 MMSE (mini mental state exam) tool to formally use to measure disorientation, altered conceptualization, abstract thinking, change in problem solving abilities

Communication methods o Expressive aphasia = (motor type) inability to name common objects or to express simple ideas in words or writing. o Pt understands but is unable to express an answer Receptive aphasia = (sensory type) inability to understand written or spoken language o Pt is able to express words, but is unable to understand questions or comments of others

Other factors affecting Perception o Medication hx = prescribed and OTC & herbal products

Concept map pg. 1352 IMPLEMENTAION Health promotion 1. Screening for rubella or syphilis in women who are considering pregnancy 2. Advocating adequate prenatal are to prevent premature birth 3. Periodic screening of al children, especially newborns through preschoolers, for congenital blindness and visual impairment caused by refractive errors and strabismus Hearing impairment = most common disability in US Children at risk include: o Those w/ a fam hx o Prenatal infection o Low birth weight o Chronic ear infection o Down Syndrome Children w/ chronic middle ear infections = common cause of impaired hearing

o o

Preventative Safety o Regular immunizations of rubella, mumps and measles

Use of Assistive Devices o o Federal regulations require medical clearance form a physicaina before purchasing a hearing aid. Hearing aides contraindicated for:

o o o o o o o o

Visible congenital/ traumatic deformity of ear Active drainage w/in last 90 days Sudden/progressive hearing loss w/in last 90 days Acute/chronic dizziness Unilateral sudden hearing loss w/in last 90 days Visible cerumen accumulation / foreign body in ear canal Pain/discomfort in ear Audiometric air-bone gap of 15 decibels or greater

Box 49-9 Pg 1358 Adaptations for Reduced Tactile Sensation o Pts w/ reduced sensation in extremities are @ risk for injury form exposure to temp extremes