Solitude & Social interaction Flashcards
what 3 components are involved in perceptual process?
- sensory reception
- sensory perception
- reaction
what is sensory reception?
receiving external & internal stimuli or data (auditory, visual, gustatory, smelling, touch)
ex: internal stimuli (feeling full)
external stimuli (aware of body movement)
what is sensory perception?
able to interpret data into meaningful information (affected by nerves, neurological status, cognitive ability, loc)
What is a reaction?
Response to stimuli. Affected by similar processes as those that affect perception.
A person cannot react to all the stimuli received in daily life.
Brain prevents sensory bombardment by discarding or storing stimuli that are not meaningful.
Factors Influencing Sensory Function?
Age & Developmental stage Culture Level of stress Medications and Illness Life Style (Busy Vs Sedentary)
Age Influencing Sensory Function?
With ↑ age – visual deficits
Presbyopia: loss of ability to see close objects
Cataracts: opacity of the lens= blurring, ↓ vision
Dry eyes
Age: Visual Deficits?
Glaucoma: disturbance in circulation of aqueous fluid:
causes ↑ IOP,↓ acuity and visual field & permanent damage to optic nerve.
Most common cause of blindness ≥ 40
Diabetic retinopathy: complication of DM: Tiny retinal hemorrhages cause blindness
Age: Hearing deficits
Presbycusis: loss of inner ear hearing especially inability to hear high frequency sounds & distinguish from background sounds (very common)
Patients with sensory impairments such as hearing loss = ↑ isolation and stress. (they either talk a lot or become isolated and stop talking all together)
Age: Hearing deficits?
Cerumen (earwax) accumulation: hardens in ear canal = conductive deafness
Otosclerosis (hardening of the ossicles in the labyrinth of the ear = conductive hearing loss)
Otitis media (inflammation of the middle ear)- more common in children; chronic infections can lead to permanent hearing loss.
Culture and Lifestyle?
determines the amount of stimulation that a person considers normal
Stress?
often times patients will feel overwhelmed & want to ↓ their stimuli (ie. ↓ visitors)
Medications?
certain meds can alter patient’s awareness of environmental stimuli. Narcotics & sedatives ↓ awareness of stimuli. Some meds can ↑ sensitivity to light, others can affect hearing if given for long periods.
- Ototoxic meds can cause deafness
Additional Factors?
Balance: Benign positional vertigo
Taste changes (dysgusia)
-Xerostomia: ↓ salivary production=dry PO= can be detrimental side effect of medications = ↓ nutrition intake
-Also taste alterations in patients with cancer = ↓ nutrition intake
Neurological deficit
-Stroke: problems with balance, ↓ in sensation and motor function in affected brain area
General pain & fatigue of illness alter way patients receive and react to stimuli
Sensory Deprivation?
A decrease in meaningful contact (stimuli) with others or when the environment is monotonous or meaningless
▪Reticular activating system is under-stimulated. This ↓stimulation= pt. ↑ aware of remaining stimuli which are often distorted
▪ Patient experiences alterations in perception, cognition and emotion.
sleep/wake controlled by reticular activating system
Risk Factors for Sensory Deprivation?
Patients:
in non-stimulating/monotonous environment (in isolation, on bed rest, mobility restrictions due to stroke or paralysis)
with limited social contacts (new immigrants, or living in isolated locations)
unable to perceive stimuli due to effect of brain damage, medications affecting CNS
unable to receive stimuli due to sensory deficits (hear, visual), effects of treatments, mood (emotional) disorders, language barriers
Signs of Sensory Deprivation?
excessive yawning, sleeping ▪↓ attention span + concentration ▪impaired memory ▪preoccupation with body (ex. heart beat) ▪periodic disorientation or confusion ▪hallucinations or delusions ▪crying & annoyance with small matters ▪apathy (not caring) & emotional lability (unstable mood due to lack of stimulation)
Action Demand Statements?
Prevent effects of sensory deprivation in a ___ y.o. F/M with…. BY:
▪ Encouraging use of adaptive devices
▪ Addressing client by name - using touch if acceptable
▪ Providing frequent meaningful interactions
▪ Providing telephone, radio, TV, clock, calendar
▪ Having artwork, pictures, plants
▪ Increasing tactile stimulation through care measures
▪***Encouraging social interaction
▪Changing environment if possible
Sensory Overload?
▪Occurs when there is an inability to process or manage the amount or intensity of sensory stimuli
▪Excessive sensory stimulation prevents the brain from appropriately responding to or ignoring specific stimuli
Risk Factors for Sensory Overload?
Patients:
▪ with ↑ in quantity/quality of internal stimuli (pain/invasive interventions, anxiety, altered sleep pattern)
▪ with ↑ in quantity/quality of external stimuli (unfamiliar health care environment, ++interruptions, excess light & noise, diagnostic procedures, contacts with many strangers); in ICU or on acute care floor
▪ unable to disregard stimuli due to head injury or medications that ↑ arousal
Sensory Overload-Hospital Sounds according to article?
environment of ICU interferes with sleep, healing, immune response, causes changes in cognitive function
Signs of Sensory Overload?
complaints of fatigue/sleeplessness irritability, anxiety, restlessness disorientation scattered attention + racing thoughts ↓ problem solving ability ↑ muscle tension
Action Demand Statements for sensory overload?
Goal:
Prevent effects of sensory overload in a Y.O. F/M with….
By:
▪Dimming lights at night
▪Planning care to allow for more uninterrupted periods of rest
▪**Treating pain
▪Turning down volumes on monitoring devices
▪Avoiding non-essential noise or conversation
▪Speaking quietly and in unhurried manner
▪Providing explanations about unfamiliar sights & sounds
Sensory Deficits?
▪ Impairment of reception, perception, or both for 1 or ≥ senses
▪ When only 1 sense affected, other senses may become more acute to compensate
oriented to (PPP)??
disoriented = not oriented x3 (if don’t know themselves then their impairment is quite advanced as this is the last to go)
How would you care for a disoriented pt?
▪Wear readable name tag ▪Address by name, frequent introductions ▪Identify time & place ▪Calendar, clock, familiar items in room ▪Speak clearly & calmly ▪Interpret unfamiliar sounds sights & smells ▪Schedule activities at same time each day ▪Tell when leaving & when you’ll return ▪Consistency in caregivers
Caring for a Visually Impaired Patient?
Always announce when you’re entering or leaving room - explain any action you’re about to take
▪Stay in field of vision & minimize glare
▪Ensure glasses are worn (correct prescription & clean)
▪Obtain large print or recorded books
▪Explain sounds in environment
▪Use magnifying glass
▪Clock with large numbers
Caring for a Hearing Impaired Patient?
Talk towards patient’s best ear
▪Ensure hearing aid is in place, battery is working
▪Speak in moderate rate, normal tone (don’t shout!) – speak with lower pitch, if possible
▪Address patient directly with visible lip movement (but don’t exaggerate!)
▪Get attention before speaking, turn off any other distracting sounds
▪Rephrase rather than repeat same words – use simple words & short sentences
▪Have pen and paper available
Goals for patients with impaired sensory function?
Action Demand Statements:
▪ Maintain function of existing senses in a __ y.o. F/M with….
▪ Maintain effective communication mechanisms in a __ y.o. F/M with….
▪ Prevent effects of sensory overload in a __ y.o. F/M with….
▪ Prevent effects of sensory deprivation in a __y.o.F/M with….
▪ Maintain activities of ADL in a __y.o. F/M with….
