alterations in sensory processes and cognitive functions Flashcards
what is sensory reception
process of receiving data of external and internal environemnt via the senses
what are some different ways of receiving sensory input
-visual
-auditory
-gustatory
-tactile
-olfactory
-kinesthetic
-stereognosis
what is kinesthetic
awareness of body position and movement
what is stereognosis
sense that perceives solidity of objects and their size, shape, and texture
describe functional sensory input
reception -> perception -> reaction
RAS
describe RAS
-poorly defined network, highly selective
-extends from hypothalamus to medulla
-mediates arousal and decides what is important
-optimal arousal state: sensoristasis
-monitors and regulates incoming sensory stimuli
somnolent
extreme drowsiness, but will respond normally to stimuli
stupor
unconscious but can be aroused by extreme and or repeated stimuli
coma
unconscious and cannot be aroused and does not respond to stimuli
what is normal awareness
alert, aware, and responsive
what is sensory deprivation
reduction in or absence of usual and accustomed stimuli
what are some signs and symptoms of sensory deprivation
-anxiety
-depression
-boredom
-unsettled feeling
-hallucinations
what are some causes of sensory deprivation
-altered sensory reception (problem getting stimuli to CNS)
-deprived environments (immobilized, in isolation)
what are some interventions for sensory deprivation
-reorient
-increase meaninful stimuli
-increase visitors and conversation
-music, pet therapy
what is sensory overload
one or more of the sense are overloaded
what are the signs and symptoms of sensory overload
-agitation
-racing thoughts
-confusion
what are some causes of sensory overload
-internal stimuli (pain, nausea, anxiety)
-external stimuli (roommate, environment)
-other: taking in new info
what are some interventions for sensory overload
-treat what you can
-get rid of unnecessary stimuli
-cluster care
-instrictions with 1-2 steps
what is sensory deficit
-impairment, or lack, or senses
-impaired vision, hearing, taste, smell, os tactile perception
-can be reversible or permanent
-interventions: idk I went to the bathroom for this slide
describe sensory processing disorder
-difficulty in the way the brain receives sensory information, or the way the brain organizes and uses that information
-leads to challenges interacting in the environment
which of the following are indications of sensory deprivation? choose all that apply
A i feel anxious all the time
B there is nothing good to watch on TV
C will you please tell that dragon to get off my bed
D make sure you close my door when you leave
E whats the use? nothing ever changes anyway
F does everything in this room make a noise?
A
B
C
E
what are some factors that affect sensory function
-age
-culture
-personality and lifestyle
-stress and illness
-medication
-previous experience
what are some common visual alterations
-presbyopia
-cataracts
-glaucoma
-retinopathy
-macular degeneration
describe presbyopia
change of near vision that comes with age (around 40)
describe cataracts
-clouding of lens of the eye
-can be surgically removed and replaced
-occurs with advanced age (80)
describe glaucoma
-irreversible increased IOP -> optic nerve damage
-managed with eye gtt
describe retinopathy
-noninflammatory change to retina
-lead to partial or complete loss of vision
-can resolve with meds
-can be sudden or happen over time
-can be seen with DM
describe macular degeneration
-loos of central vision
-meds can slow it but there is no cure
what are some common hearing alterations
-presbycusis
-cerumen accumulation
describe presbycusis
-sensorineural -> can also occur from ototxicity, loud noises, or head trauma
-most common, permanent hearing loss
-occurs with age
describe cerumen accumulation
conductive -> sounds cant get through
what are some neurological alterations
-peripheral neuropathy
-CVA/stroke
what is an intervention that is appropriate when caring for a pt who is hearing impaired
position yourself so that light is on your face
describe assessment of sensory alterations
-thorough history
-mental status
-physical assessment
-self-care abilities
-health promotion
-safety
-communication
-support
-other factors
describe implementation with sensory alterations and the nursing process
-health promotion
-screening
-safety
-promoting stimulation and communication
describe cognitive function
-systematic way in which a person thinks, reasons, and uses language
-the mental process of knowing, including aspects such as awareness, perception, reasoning, and judgment
describe normal cognitive processes
allows knowledge to be gained, manipulated, and expressed
-cognition
-consciousness
-attention
-memory
-learning
-communication
name some cgaracteristics of normal cognition
-intelligence
-reality perception
-orientation
-judgement
-recall and recognition
-language
describe intelligence
ability to acquire and apply knowledge
describe judgement
interpretation and acting appropriately
true or false
when caring for an unconscious pt, the urse should speak loudly and assume that the pt can hear the nurse
false
what are some factors affecting cognitive function
-age
-nutrition and metabolism
-sleep and rest
-self concept
-infectious processes
-degenerative processes
-head trauma
-pharmacologic agents
-envirnmental factors
-culture, values, and beliefs
how can polypharmacy affect cognitive functions
may lead to drug interactions
describe beers criteria
lists meds that shoul not be used (or should be used cautiously) in adults over the age of 65
what are some diagnostic tests used to assess cognitive function
-oxygen saturation
-lab values:
glucose
sodium
calcium
ammonia
urea
WBC, Hgb, Hct
drug toxicity
what are some manifestations of altered cognitive function
impaired though process:
-disorganized thinking
-altered level of arousal
-altered attention
-memory impairment
impaired communication
describe expressive aphasia (brocas aphasia)
-inability to express words on wants to say (verbal or written)
-limited speech; low or take great effort; reduced grammar; poor articulation
-preson knows what they want to say but cant find words
describe receptive aphasia (wernickes aphasia)
-difficulty understanding verbal or written words
-impaired auditory comprehension and feedback
describe dysarthria
-motor speech disorder (r/t stroke or brain injury)
-speech is slurred or garbled, slow, soft
what is delirium
-acute confusional state; typically sudden onset
-can potentially be reversed;often due to a physiological cause
-requires prompt assessment and intervention
-can be hyper or hypo
-can affect anyone of any age
what are the signs and symptoms of delirium
-paranoia
-hallucinations
-altered reality
-impaired memory
describe dementia
-generalized impairment of intellectual functioning;interferes with social and occupational functioning
-gradual onset; progressive and irreversible
what are some signs and symptoms of dementia
-anxiety
-repeated questions
-emotional shit
-socially or sexually inappropriate
-wandering
what are some different types of dementia
-alzheimers (most common + cause is unknown)
-diffuse lewy body disease
-frontotemporal dementia
-vascular dementia
what are the 7As of dementia
-anosognosia (no knowledge of illness)
-aphasia (language issues)
-agnosia (loss of ability to process sensory input)
-apraxia (loss of skilled physical movement)
-amnesia (loss of memory, cant form new ones)
-altered perception
-apathy (loss of interest/enthusiasm)
progressive symptoms
describe depression
-reversible condition
-may be mistaken for dementia
what are the signs and symptoms of depression
-Feelings of sadness, fatigue, anger
-Abandoning or losing interest in hobbies or other pleasurable pastimes
-Social withdrawal and isolation (reluctance to be with friends, engage in activities, or leave home)
-Weight loss, anorexia
-Sleep disturbances (difficulty falling asleep or staying asleep, oversleeping, or daytime sleepiness)
-Loss of self worth (worries about being a burden, feelings of worthlessness, self-loathing
-Increased use of alcohol or other drugs
-Fixation on death; suicidal thoughts or attempts
addressing health concerns of ppl with altered cognition
physiological
-prevention and management of diseases
-nutritional needs
-encouraging exercise
-assisting with sensory impairments
-med use
addressing health concerns of ppl with altered cognition
psychosocial
-therapeutic communication
-touch
-reality orientation
-validation therapy
-reminiscence
-body image interventions
nursing process and cognition
diagnosis
-acute or chronic cognition
-impaired memory
-impaired verbal communication
nursing process and cognition
implementation
-safety
-health promotion
-orientation to surroundings
-communication methods
