Chapter 48 Sensory Alterations

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sensory deficity

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a deficit in the normal function of sensory reception and perception

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Common Sensory Deficits: Visual Deficits: Presbyopia

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A gradual decline in the ability of the lens to accommodate or to focus on close objects. Individual is unable to see near objects clearly

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Common Sensory Deficits: Visual Deficits: Cataract

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Cloudy or opaque areas in part or the entire lens that interfere with passage of light through the lens. Cataracts usually develop gradually, without pain, redness, or tearing in the eye.

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Common Sensory Deficits: Visual Deficits: Dry eyes

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Result when tear glands produce too few tears. Common in older adults and resulting in itching, burning, or even reduced vision.

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Common Sensory Deficits: Visual Deficits: Open-angle glaucoma

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An increase in intraocular pressure caused by an obstruction to the normal flow of aqueous humor through the canal of Schlemm. Causes progressive against the optic nerve, resulting in visual field loss, decreased visual acuity, and a halo effect seen around objects if untreated.

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Common Sensory Deficits: Visual Deficits: Diabetic retinopathy

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Pathological changes occur in the blood vessels of the retina, resulting in decreased vision or vision loss.

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Common Sensory Deficits: Visual Deficits: Macular degeneration

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Condition in which the macula loses its ability to function efficiently. First signs may include blurring of reading matter, distortion or loss of central vision, and distortion of vertical lines.

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Common Sensory Deficits: Hearing Deficits: Prebycusis

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A common progressive hearing disorder in older adults.

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Common Sensory Deficits: Hearing Deficits: Cerumen accumulation

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Buildup of earwax in the external auditory canal. Cerumen, which is normally absorbed in a younger person's ear, becomes hard and collects in the canal and causes a conduction deafness

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Common Sensory Deficits: Balance Deficits: Dizziness and disequilibrium

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Common condition in older adulthood, usually resulting from vestibular dysfunction. Frequently an episode of vertigo or disequilibrium is precipitated by a change in position of the head.

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Common Sensory Deficits: Taste Deficit: Xerostomia

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Decrease in salivary production that leads to thicker mucus and a dry mouth. Result of medications such as antihistamines. Can interfere with the ability to eat and leads to appetite and nutritional problems

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Common Sensory Deficits: Neurological Deficits: Peripheral neuropathy

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Disorder of the peripheral nervous system.Commonly caused by diabetes, Guillain-Barre syndrome, and neoplasms. Symptoms include numbness and tingling of the affected area and stumbling gait.

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Common Sensory Deficits: Neurological Deficits: Stroke

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Cerebrovascular accident caused by clot, hemorrhage, or emboli disrupting blood flow to the brain. Creates altered proprioception with marked incoordination and imbalance. Loss of sensation and motor function in extremities controlled by the affected area of the brain also occurs.

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Sensory Deprivation

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when a person experiences an inadequate quality or quantity of stimulation, such as monotonous or meaningless stimuli.

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Three types of sensory deprivation

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1. reduced sensory input(sensory deficit from visual or hearing loss); 2. elimination of order or meaning from input (e.g., exposure to strange environment); 3. restriction of the environment that produces monotony and boredom (e.g., bed rest or reduced environment variation)

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Sensory overload

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when a person receives multiple sensory stimuli and cannot perceptually disregard or selectively ignore some stimuli

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A person's tolerance to sensory overload may vary by

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level of fatigue, attitude, and emotional and physical well-being

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Example of sensory overload

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A client who is hospitalized in an ICU, where the activity is constant. Lights are always on. Sounds can be heard from monitoring equipment, staff conversations, equipment alarms, and the activities of people entering the unit. Even at night, an ICU can be noisy.

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Effects of Sensory Deprivation: Cognitive

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Reduced capacity to learn; Inability to think or problem solve; Poor task performance; Disorientation; Bizarre thinking; Regression; Increased need for socialization, altered mechanisms of attention

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Effects of Sensory Deprivation: Affective

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Boredom; Restlessness; Increased anxiety; Emotional ability; Panic; Increased need for physical stimulation

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Effects of Sensory Deprivation: Perceptual

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Visual/motor coordination; Color perception; Apparent movement; Tactile accuracy; Ability to perceive size and shape; Spatial and time judgement

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___ are unable to discriminate sensory stimuli because nerve pathway are immature

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infants

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Visual changes during adulthood include

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presbyopia (inability to focus on near objects) and the need for glasses for reading.

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Normal changes associated with aging include

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reduced visual fields, increased glare sensitivity, impaired night vision, reduced accommodation and depth perception, and reduced color discrimination.

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Hearing changes, which begin at age 30, include

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decreased hearing acuity, speech intelligibility, pitch discrimination, and hearing threshold.

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Older adults have difficulty discriminating what consonants and high-frequency sounds

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consonants (z, t, f, g) and high-frequency sounds (s, sh, ph, k)

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Proprioceptive changes after age 60 include

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difficulty with balance, spatial orientation, and coordination.

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Older adults experience tactile changes including

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declining sensitivity to pain, pressure, and temperature

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__ __ are a high risk group because of normal physiological changes involving sensory organs.

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Older adults

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Individuals at risk for sensory deprivation are commonly

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those living in a confined environment such as a nursing home.

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The individual who is confined to a _, _, _, and _ is at significant risk for sensory deprivation

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wheelchair, suffers from poor hearing and/or vision, has decreased energy, and avoids contact with other

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otolaryngologist

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the branch of medicine that deals with the anatomy, function, and diseases of the ear, nose, and throat.

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Meaningful stimuli include

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pets, music playing on a cassette player, television, pictures of family members, and a calendar and clock.

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The _ or _ of meaningful stimuli influence alertness and the ability to participate in care.

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presence or absence

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Excessive stimuli in an environment can cause

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sensory overload

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Over-stimulation can be a problem if a client is

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in pain, has many tubes and dressings, or is restricted by casts or traction.

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The absence of meaningful conversation can cause

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a person to become sensorially deprived

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Clients with hearing loss tend to

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decrease time spent with social activities and with verbal communication

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Children with hearing deficits will be

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inattentive, uncooperative, or easily bored

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Occupations and Leisure Activities That Pose Risk for Sensory Alterations: Hearing

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Factory worker; Airport worker; Rock musician; Construction worker with jackhammer; Farmer working with farm machines

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Over-stimulation can be a problem if a client is

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in pain, has many tubes and dressings, or is restricted by casts or traction.

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The absence of meaningful conversation can cause

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a person to become sensorially deprived

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Clients with hearing loss tend to

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decrease time spent with social activities and with verbal communication

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Children with hearing deficits will be

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inattentive, uncooperative, or easily bored

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Occupations and Leisure Activities That Pose Risk for Sensory Alterations: Hearing

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Factory worker; Airport worker; Rock musician; Construction worker with jackhammer; Farmer working with farm machines

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Occupational and Leisure Activities That Pose Risk for Sensory Alterations: Vision

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Exposure to irritating gases; Welder; Exposure to high-speed machinery; Racquetball, squash, or fencing; Motorcycle riding; Power tool use

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Occupational and Leisure Activities That Pose Risk for Sensory Alterations: Peripheral Nerve Injury-Repetitive Motion

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Computer programmer; Manicurist; Factory worker on assembly line

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Occupational and Leisure Activities That Pose Risk for Sensory Alterations: Peripheral Nerve Trauma

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Industrial equipment; Home woodworking