Sensory Perception Kozier Scf 2010

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Chapter 38

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Sensory Perception

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Sensory reception

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The process of receiving stimuli or date

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Sensory perception

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Conscious organization and translation of data into meaningful information

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Sensory process requires these 4 aspects to be present

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Stimulus
Receptor
Impulse conduction
Perception

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4 factors influence sensory function

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Developmental stage-age
Culture
Level of stress
Medications and illness
Lifestyle-quality and quantity of stimulation acc

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Awareness

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Ability to perceive env. stimuli and to react appropriately

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6 states of awareness

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Full consciousness
Disoriented
Confused
Somnolent
Semicomatose
Comatose

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Diagnostics RT sensory perception

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Electrolytes-NA+
Blood chem-glucose, BUN
Toxic drug levels
Visual/auditory tests
Neurological tests-CT, MRI

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Diagnostics RT sensory perception

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Vision
Hearing
Smell
Taste
Somatic sensation-touch, light, sensation, vibration

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Gustatory sense

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Taste

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Tactile sense

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Pain
Hot/cold/pain perception
Numbness/tingling

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Olfactory

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Small

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Kenesthetic

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Body part positioning

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Sensory overload

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Inability to process or manage the amo0unt or intensity of sensory stimuli

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3 factors contributing to sensory overload

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Increased quantity or quality of internal stiuli-pain, dyspenia, anxiety
Increased quantity or quality of external stimuli-noise, intrusive diag. studies
Inability to disregard stimuli selectively-nerve distrubances, stimulating medications

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Clinical manifestations of sensory overload

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fatigue, sleeplessness
Irritability, anxiety
Disorientation
Reduced problem solving ability Increased muscle tension
Scattered attention

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Sensory deprivation/deficite

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Impared reception or perception of one or more senses
(blindness, deafness)

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Sensory deficites can lead to both:

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Sensory deprivation or sensory overload

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Risk factors for sensory deprivation

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Nonstimulating envoronments
Impared vision or hearing
Mobility restriction
Inability to process stimuli
Emotional disorders
Limites social contact
Isolation precautions

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Manifestations of sensory deprivation

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Yawning, drowsiness, sleep
Decreased attention span, concentration, probl solvng
Impaired memory; periodic disorientation, general confusion, nocturnal condusion
Preoccupation with somatic complaints
Hallucinations/delusions
crying and annoyance
Apathy and emotional liability

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Nursing Diagnosis
Disturbed sensory perception

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Change in the amount or patterning of incoming stimuli accompanied by by a diminished, exaggerated, distorted, or impaired response to such stimuli

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Nursing Diagnosis
Accute confusion

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Abrupt (Temporary)onset of a cluster of global, transient changes and disturbance in attention, cognition, motor activity, or sleep/wake cycle

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Nursing Diagnosis
Chronic confusion

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Irreversible, long term or progressive deterioration of intellect and personality characteristics. Decreased ability to interpret env stimuli
Memory, orientation, behavior

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Nursing Diagnosis
Impaired memory

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Temporary or permanent
Inability to remember or recall bits of information or behavvioral skills
RT pathophysiological or situational casuses

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Outcome Criteria
For
Sensory Deprivation or
Sensory Overload

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Prevent injury
Maintain the function or existing senses
Develop an effective communication mechanism
Prevent sensory overload or deprivation
REduce social isolation
Perform ADL independently and safely

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Nursing interventions
for
Sensory overload or deprivation

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Promote healthy sensory function
Adjust environmental styimuli
Manage acute sensory deficites

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Cognitive Process
Is the perception of combined information from

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Exteroceptors
Interoceptors
Proprioceptors

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To assess cognitive process you must look at a combination of:

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Speech
Consciousness
Thoughts
Memory

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Anatomical structors of Cognition

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Organs of the senses
Reticular formation
Cerebral cortex

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FActors influencing cognitive function

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Age
Blood flow to brain
Nutrition and metabolism
Fluid and electrolyte balance
Sleep and rest]
Self concept
Infection
Degenerative process
Pharmacologic agents
Head trauma
Env stress
Cultural comprehension
Language barriers
Willingness to communicate

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The earliest sign of altered cognition from low O2 levels or electrolyte imbalance will be exhibited as

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Lethargy
Confusion
Impaired thinking

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Manifestations of
Altered Cognitive Function

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Acute confusion
Chronic Irreversible Confusion
Sensory Perceptual Alterations
Impaired Language Skills
Disorganized Thinking
Impaired Thought Process

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Accute confusion-aka

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Delirium

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Chronic irreversible confusion-aka

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Dementia

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Delusions

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False beliefs

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Hallucinations

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Misperception of 5 senses

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Contextual problems

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Unorganized thoughts

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Altered level of arousal

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Lethargy or coma

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Delirium

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Altered beliefs

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Memory impairment

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Altered memory

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Aphasia def

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Any defect or loss of the power to express oneself or comprehand language due to cortex injury

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Impaired communication can include these aphasias:

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Expresive-Speaking
Receptive-comprehnding
Anomic-retrieve words
Global-all communication