sensory evolve Flashcards
Sensory input and cognitive ability allow humans to
react to their environment
Alterations are caused by a variety of factors including
traumatic injuries
illnesses
metabolic imbalances
aging
Cognition is
knowing influenced by awareness and judgment
Cognition skills
language,
calculation,
memory,
attention,
reasoning,
learning
problem-solving
decision-making
Sensation is
a feeling, within or outside the body, of conditions resulting from stimulation of sensory receptors
what is plasticity
it refers to the brain ability to change and relocate function if damage occors
cerebrum is divided into four main lobes:
frontal
parietal
temporal
occipital
The frontal lobes of the cerebrum are the areas of the brain responsible for
voluntary motor function
short-term memory
goal-oriented behaviors
eye movements
The parietal lobes are responsible for
receiving
analyzing
responding to somatic sensory input from different parts of the body
temporal lobes are concerned with
auditory stimuli
long-term memory
balance
taste
smell
The occipital lobes process
visual information
stimulus is
a change in the environment sufficient to evoke a response
perception is
The way the brain perceives the information
to recognize and respond to stimuli the person must be
in a state of alertness
sensory adaptation is
During times of alertness, some impulses are ignored by the brain because they are not assigned priority as more important than others
general senses detect
detect touch
pressure
pain
heat
cold
general senses are located
throughout the body in internal organs and tissues such as muscle and skin
the process of sensory receptors
these sensory receptors are stimulated
the impulses travel through sensory pathways up the spinal cord
The impulses then cross over to the other side of the body before reaching the brain
decussate is
when the impluses cross over from one side of the body to another
Specialized receptors are located
sensory organs
Specialized receptors detect
senses of smell
taste
hearing
equilibrium
and vision
special senses are
smell
taste
hearing
equilibrium
vision
Tactile receptors are
those detectable by touch
Tactile receptors are located in
dermis and subcutaneous tissue
what receptors supply the brain about temperature information
warm receptors and cold receptors
the warm receptor respond to
moderatly warm (more than 77F/25C) and less than 46C or 114 F
when the termprture is above 114 f or 46 c the body
senses burning pain
Cold receptors deep in the epidermis react when
the body is exposed to temperatures between 10° C (50° F) and 40° C (104° F).
When the external temperature gets too cold ______ _______is sensed
freezing pain
Olfaction is
the sense of smell
Scents are detected by
chemoreceptors or sensory nerve endings
The chemoreceptors for smell are located
upper nasal passages
gustation is
the sense of taste
gustation require that chemoreceptors
come in direct contact with the stimulus
sensory receptors for taste are located
in taste buds on the tongue
the roof of the mouth
the throat
The sense of hearing occurs through
the workings of the outer, middle, inner ears
Sound waves are collected by
outer ear collected Sound waves causing the eardrum to vibrate
The vibrations of the eardrum cause the three small bones, in the middle ear to vibrate
The inner ear is composed of a complicated set of labyrinths, which are intricate communicating passageways
then receptor cells carry the information to the brain
auricle is
outer ear
ossicles are
the three small bones in the middle ear
labyrinths is
intricate communicating passageways
labyrinths are located in
inner ear
semicircular canal do what
it has receptor cells that interpret the head position and maintain equilibrium
equilibrium is
state of balance
retina is
innermost layer of the eye
Light stimuli enter the eye through
cornea and then the lens.
Photoreceptors in the retina do what
detect visual images by perceiving light waves, which are different lengths for different colors
Two types of photoreceptors are
rods and cones
rods and cones are present in
the retina
Rods help with
vision in the periphery and in dim light
Cones detect
color and detail
Symptoms of cognitive impairment include
disorientation
loss of language and/or simple arithmetic skills
poor judgment
memory loss
Delirium is
reversible state of acute confusion
Delirium is charactrized by
disturbance in consciousness or a change in cognition that develops over 1 to 2 days and is caused by a medical condition
signs and symptoms of delirium
Fluctuating awareness
impairment of memory and attention
disorganized thinking, hallucinations
disturbances of sleep-wake cycles
Some causes of delirium are
drug or alcohol use
the side effects of medication
infections
fluid and electrolyte imbalances
low oxygen level
pain
Delirium may occur in patients in the intensive care unit (ICU) because
sensory overload
Depression is
mood disorder characterized by a sense of hopelessness and persistent unhappiness
Signs and symptoms of depression are
loss of interest,
sadness for an extended period of time
decreased self-esteem
sleeping too much or insomnia
changes in eating patterns
Major depression is characterized by
symptoms on most days for 2 weeks
Persistent depressive disorder is when
symptoms are present for at least 2 years but might vary in severity.
With both types of depression, the symptoms
interfere with daily living
Sensory deprivation is
decreased stimulation from the environment
Sensory deprivation causes
depression from lack of contact with others
Depression usually has _____ onset
rapid
depression is usually reversible with
treatment by eliminating the underlying cause,
providing counseling
prescribing antidepressive agents
Dementia is
permanent decline in mental function has a subtle onset
Dementia is characterized by
decline in many cognitive abilities including
reasoning
use of language
memory
computation
judgment
learning
is dementia reversible
no and it worsen over time
The most common type of dementia is
Alzheimer’s disease
Degenerative, pathologic changes occur in the brain due to
Alzheimer’s disease
amyloid plaques are
protein fragments that build up between the nerve cells of the brain, blocking electrical impulses and chemical connections between neurons
neurofibrillary tangles are
twisted fragments of protein within the cells that clog nerve cells and interrupt nutrient delivery to the brain cells
cerebral atrophy is
decrease in the size of the brain
amyloid plaques neurofibrillary tangles cerebral atrophy all cause
damaging alterations interfere with the communication between nerve cells, causing people with Alzheimer’s disease to lose cognitive function. Eventually, basic functions, such as the ability to feed themselves or control bowel and bladder function, are affected
Several factors may contribute to increased confusion and behavior problems that occur in many Alzheimer’s patients later in the day and into the night:
- Brain changes causing a mix-up between day and night
- Exhaustion at the end of the day of both the patient and the caregiver
- Reduced ability to see due to dim lighting
- Inability to distinguish between dreams and reality
Strategies to deal with sundowning with Alzheimer patients:
- Keep the home well lit during awake hours.
- Keep on a consistent schedule.
- Avoid alcohol, caffeine, and nicotine.
- Approach the patient in a calm, reassuring manner.
- Anticipate needs (toileting, thirst, etc.).
- Reorient the patient to person, place, and time of day.
The second most common type of dementia is
Lewy body dementia
Behavioral problems that arise in dementia patients include
wandering
agitation
repetitive behaviors
sundowning
verbal or physical outbursts
sundowning is
worsening of agitation and confusion in the evening
what causes the bad behaviors from dementia patients
frustration
confusion
fear
anxiety
lack of control
meningitis effects
impair cognitive and sensory functioning
cerebrovascular accident (CVA) occurs when
an area of the brain is deprived of blood flow
CVAs are also called
strokes
CVAs are of two types:
(1) ischemic stroke caused by narrowing of a vessel or embolism (blood clot) blocking a vessel
(2) hemorrhagic stroke caused by bleeding in the brain from a burst aneurysm or traumatic injury
In Stokes the word FAST stand for
Face drooping
Arm weakness
speech
Time and placing a call to 9-1-1
CVAs can cause altered
balance and coordination
If CVAs damage is on the left side of the brain loss of
sensation and motor function is seen in the extremities on the right side of the body and problems with speech occur
If CVAs the damage is on the right side of the brain,
the loss of sensation and motor function affects the extremities on the left side of the body and visual–spatial problems occur
Some speech problems that occur after a stroke or other traumatic brain injury include
different types of aphasia
receptive aphasia also known as
Wernicke aphasia
Wernicke aphasia causes patient to not be able to
comprehend written or spoken language
expressive aphasia also known as
Broca aphasia
In Broca aphasia patients
are able to understand language
unable to answer questions
unable name common objects
unable express simple ideas
Meningitis is an
infection of the lining of the brain caused by a virus or bacteria
meningitis can cause
mental changes
infections to the brain can cause
changes in cognitive abilities that are temporary
When the patient exhibits sudden or rapid changes in behavior or cognition what are the possible causes?
urinary tract infection or pneumonia
Damage to sensory nerve fibers in the arms and legs leads to
peripheral neuropathy
peripheral neuropathy is
damage away from the center of the body
with peripheral neuropathy Patients
may not be able to feel sharp objects or discern extreme hot and cold temperatures, leaving them vulnerable to injury
Peripheral neuropathy occurs in patients with
diabetes mellitus and renal disease.
Anosmia is
the complete loss of the sense of smell
Anosmia causes
aging
Infections
smoking
cocaine
The number of gustatory cells declines after the age of
50 years
gustatory cells decline causes
decreased ability to distinguish taste
Congenital hearing loss causes
genetic factors
maternal diseases such as rubella or diabetes
lack of oxygen at birth
Otitis media may cause
temporary hearing loss from a buildup of fluid behind the eardrum
conductive hearing loss causes
otitis media
blockage with cerumen
sensorineural is
damage to the receptor nerves or nerve pathways
sensorineural causes
loud noises
adverse reaction to ototoxic drugs
head injuries
certain types of infection
Age-related hearing loss is called
presbycusis
Motion sickness signs and symptoms
dizziness
nausea
vomiting
Patients with fluid buildup or infections of the inner ear may describe
dizziness
lightheadedness
unsteadiness
vertigo
vertigo is
the sensation that objects are moving around the person
tinnitus is
ringing or other abnormal sound in the ear
and progressive hearing loss
cause of tinnitus and vertigo is
excess fluid accumulation in the labyrinth in the inner ear
Myopia is
nearsightedness
Presbyopia is
farsightedness
Presbyopia beging at age
40
cataract is
Clouding of the lens
Cataracts cause
blurring of vision
Glaucoma is
serious medical condition of the eye
Glaucoma causes
increased intraocular pressure, which puts pressure on the optic nerve, leading to loss of peripheral visual fields and possibly blindness
Diabetic retinopathy is
complication of diabetes mellitus in which the blood vessels of the retina become damaged
Diabetic retinopathy causes
loss of vision
Macular degeneration is
loss of vision occurs in the central visual fields
Macular degeneration begings at age of
50
Macular degenerationCauses
diabetes
genetics
smoking
hypertension
some affected patients do not have these risk factors
sensory deprivation causes
person who cannot see, hear, feel, or respond to the environment may feel socially isolated
sensory overload is
overabundance of stimuli
sensory overload causes
noise from machines
pressure from tubes
frequent interactions with health care personnel throughout a 24-hour day
constant lighting
pain
The features of metabolic syndrome are
- High blood pressure
- High fasting blood glucose
- Excess fat around the waist
- Low levels of high-density lipoprotein (HDL) cholesterol
- High levels of triglycerides
Exposure to environmental toxins poses a variety of health risks including
damage to some of the special sense organs
aspirin can cause
tinnitus
Narcotics and some street drugs can cause
confusion, dizziness, and hallucinations
The normal aging process causes neurons to
decrease in numbers
loss of neurons causes
decreased ability to identify sensations such as
pain
touch
pressure
postural changes
As aging occurs it causes
reflexes decrease
muscles atrophy
taste smell and vision decline
neuromuscular control of gait and posture decreases
memory and cognitive impairment may occur
diabetic neuropathy decrease the patient’s ability to
discern touch especially in the lower extremities
Patients who have damage to the brain due to illness or trauma may have
decreased motor functions
patient who has had a CVA or a head injury may
have weakness or paralysis on one side of the body
Patients With Cognitive or Sensory Alterations important points
Family and friends of the patient with dementia will be involved in the day-to-day care of the affected person and, therefore, need to be included in the planning process.
Ensure that full-time caregivers have a support system to avoid caregiver burnout.
The patient with cognitive alterations needs an interdisciplinary team to assess deficits and provide ongoing treatment.
A speech therapist is consulted for patients with hearing deficits, impaired cognition, or aphasia.
A patient who has had a stroke benefits from consultation with an occupational therapist for adaptations necessary to maintain activities of daily living (ADLs).
A physical therapist may be consulted for transfer and ambulation training.
For the patient with cognitive or sensory alterations, care may be delegated to unlicensed assistive personnel (UAP) after assessment by the nurse.
Consultation with social services to arrange home care specialists may be needed for patients with cognitive or sensory alterations that interfere with safe self-medication.
The nurse, in consultation with the primary care provider (PCP), ensures that any patient with cognitive changes has had a
thorough workup including a history,
physical
blood work
urinalysis
other diagnostic studies as necessary
The hospitalized patient with cognitive alterations is oriented by
use of a clock or calendar and statements about
location or name of the hospital
why the patient is at the facility
avoid ….. for patints who cognitive alterations
The patient’s environment is kept as consistent as possible and moving the patient from room to room is avoided to prevent confusion
loud noises and bright lights
If the patient has expressive aphasia ask questions
that can be answered with yes or no
or use a communication board with pictures
Ethical, Legal, and Professional PracticePatients With Dementia
For dementia patients who do not establish a health care power of attorney in the early stages of the disease while still capable of reasoning and making decisions, the court can declare a patient incompetent in the later stages of the disease and appoint a guardian or authorize a person through a health care power of attorney to make health care decisions for the patient. Often, the person appointed or authorized is a family member.
Ethical issues arise for patients with dementia, such as how much they should be told about their illness and who should make care decisions if no one has been appointed.
The nurse can provide support and tips for the caregiver, such as
- Take care of your own physical, mental, and spiritual health.
- Ask for help or find a support group.
- Do something for yourself daily that brings you joy.
- Utilize available resources.
- Seek professional help if needed.
- Be realistic about the goals for your loved one
Patients With Tactile Alterations you have to
tests the temperature of bath water
Frequent monitoring of the extremities is indicated
Any changes indicating decreasing sensation or circulation are reported to the PCP
If the patient can move the affected extremities, active range-of-motion exercise is encouraged to stimulate circulation
Patient Education and Health LiteracyHealth Promotion
Promoting healthier lifestyles to older adults is an important nursing consideration. Hearing and vision examinations are part of health promotion.
Interventions to encourage healthy lifestyles include education regarding nutrition, exercise, smoking cessation, and the importance of health screening.
Knowledge and preparation help to reduce frustration and give caregivers of dementia patients realistic expectations
Health education and promotion of healthy lifestyles in older adults should be a key nursing intervention in the inpatient setting as well as in the outpatient and community settings.
patient with equilibrium alterations is instructed to
call for assistance when ambulating to prevent injury
patient with equilibrium alterations have to have
basin on the bedside withing easy reach
if patient has equilibrium alterations you should
Keep the lights dim and noise at a minimum may relieve some of the symptoms
obstacles are kept off the floor to prevent tripping and falls
patient with a visual alteration is
oriented to the placement of items in the hospital room so its best not to move them around
also keep patients needs witing easy reach and confirm they know the location
Care for the visually impaired patient involves some simple steps that can enhance the patient’s experience and facilitate the nurse–patient relationship:
- Maintain adequate lighting and minimize glare.
- Make sure that the patient is wearing eyeglasses or contact lenses if prescribed.
- Use large print or clear handwriting with a bold-tipped marker or pen when giving written instructions.
- Use photos, pictures, diagrams, or audiotaped instructions if necessary.
Sensory overload is common in which unit in hospital
ICU
when a patient has reduced taste and is finding food less appealing you should instruct the patient o
avoid blending or mixing food
reality orientation helps
restore sense of reality
improve level of awareness
promot socialization
elevate independent functioning
minimize oconfusion
what is one way to determine spital perciption of the patient
having patient draw the face of a clock
which patient that are at most risk for sensory deprivaton
isolated patients
hypocalcemia causes
tactile distubances such as tingling and numbness in fingers and around the mouth
hypocalcemia is caused by
high/ low levels of electrolytes
