Sensory Function

• Four Conditions to Receive Data

  Stimulus

  Receptor

  Nervous pathway to brain

  Functioning brain to receive and translate impulse into a sensation
• Senses

  Visual: sight/ vision

  Auditory: hearing

  Olfactory: smell

  Gustatory: taste

  Tactile: touch

  Kinesthetic and visceral: basic internal orienting systems(provide occasions of touching/ handling
• Sensory perception

  conscious process of selecting, organizing, and interpreting data from the senses into meaningful information
• Cataract

  clouding of lenses, progressive loss of vision, painless, can happen in one/ both eyes
• Macular degeneration

  loss of vision in older adults, leading cause of blindness in older
• Glaucoma

  increase pressure causes loss of peripheral vision, intolerance to glare (night vision), decrease senses to see depth/ stairs
• Impaired sight

  presbyopia
• Impaired hearing

  presbycusis
• Conscious State

  Delirium, dementia, confusion, normal consciousness
• Unconscious State


  Asleep, Stuporous,Comatose,Vegetative state
• Stuporous

  must be shaken or shouted at to arouse
• Comatose

  cannot be aroused
• Sensory deprivation

  insufficient quantity or quality of stimuli, result from decreases sensory input or monotonous, un-patterned, un-meaningful input

  [ patient on bed rest, isolation, impaired hearing/vision, spinal cord injuries, brain damage/ long term care pt ]
• Signs/symptoms of Sensory deprivation

  experience changes in perception, changes of body image, hallucination, decrease

  attention span, inability to concentrate, irritable/ frosted over small matters, confusion
• Interventions of Sensory deprivation

  keep curtain open/ lights on/ encourage pictures from family and family visits/ place your hand on theirs
• Sensory overload

  TOO MUCH INPUT” excessive stimuli over which a person feels little control the brain

  is unable to meaningfully respond to or ignore stimuli

  [ someone being hospitalized, in ICU]
• Signs/symptoms of Sensory overload

  confused, agitated, hallucinations, unable to problem solve
• Interventions of Sensory overload

  speak slowly, calmly/ cluster tasks all at once/ establish visitor schedules, offer ear plugs and turn TV off, patient needs down time
• Sensory deficits

  impaired or absent functioning in one or more senses

  [ ex. impaired sight/ hearing, altered taste]
• Peripheral neuropathy

  in lower extremities and hands (loss of sensations/nerve pain) *higher risk for falls/ skin integrity issues
• ototoxicity

  Furesomide, cancer chemotherapies, aspirin
• Caring for Visually Impaired

  Announce yourself upon entering roomSpeak in normal tone of voice

  Explain reason for touching BEFORE doing so

  Orient patient to sounds of environment / to room

  Assist with ambulation by walking slightly ahead of them

  Stay in the patients field of vision if he/she has partial vision

  Indicate conversation has ended when leaving the room
• Pantomime

  using different gestures
• Confused patients CAN refuse treatment. What happens if really elevated glucose levels and refuse insulin?* you can try and give at later time after refusal, try again if repeated attempts and refusal is continued, must report to nurse supervisor on what are next steps
• Caring for Hearing Impaired

  Orient patient to your presence before speaking

  Decrease background noises before speaking

  Position yourself so the light is on your face

  Talk directly to the patient while facing them

  Use pantomime or sign language

  Write any ideas that you can’t convey in another manner
• Communicating Confused Patient

  Uses face to face contact

  Speak calmly, simply, and directly to patient

  Orient patient to time, place, person

  Communicate that the patient is expected to preform self-care activities

  Reinforce reality if the patient is delusional
• Communicating Confused Patient

  if patient with psychosis: is really really confused, thinks he’s at the bar, you can reorient them, but if patient starts becoming really agitated, best practice is to stop reorienting and move on to something else
• Communicating with Unconscious Patient

  Careful with what is said in the patients presence [ hearing is last sense that is lost ] * educate family about the importance of this as well

  Assume patient can hear you, and talk in normal tone of voice

  Speak to patient before touching / explain what you are doing prior

  Keep noises low level

  we CANNOT turn off alarms, but we can lower the alarms so as we are able to hear them