Solitude & Social interaction

Question 1

what 3 components are involved in perceptual process?

Answer 1

1. sensory reception
2. sensory perception
3. reaction

Question 2

what is sensory reception?

Answer 2

receiving external & internal stimuli or data (auditory, visual, gustatory, smelling, touch)

ex: internal stimuli (feeling full)
      external stimuli (aware of body movement)

Question 3

what is sensory perception?

Answer 3

able to interpret data into meaningful information (affected by nerves, neurological status, cognitive ability, loc)

Question 4

What is a reaction?

Answer 4

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.

Question 5

Factors Influencing Sensory Function?

Answer 5

Age & Developmental stage
Culture 
Level of stress
Medications and Illness
Life Style (Busy Vs Sedentary)

Question 6

Age Influencing Sensory Function?

Answer 6

With ↑ age – visual deficits

Presbyopia: loss of ability to see close objects

Cataracts: opacity of the lens= blurring, ↓ vision

Dry eyes

Question 7

Age: Visual Deficits?

Answer 7

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

Question 8

Age: Hearing deficits

Answer 8

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)

Question 9

Age: Hearing deficits?

Answer 9

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.

Question 10

Culture and Lifestyle?

Answer 10

determines the amount of stimulation that a person considers normal

Question 11

Stress?

Answer 11

often times patients will feel overwhelmed & want to ↓ their stimuli (ie. ↓ visitors)

Question 12

Medications?

Answer 12

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

Question 13

Additional Factors?

Answer 13

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

Question 14

Sensory Deprivation?

Answer 14

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

Question 15

Risk Factors for Sensory Deprivation?

Answer 15

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

Question 16

Signs of Sensory Deprivation?

Answer 16

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)

Question 17

Action Demand Statements?

Answer 17

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

Question 18

Sensory Overload?

Answer 18

▪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

Question 19

Risk Factors for Sensory Overload?

Answer 19

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

Question 20

Sensory Overload-Hospital Sounds according to article?

Answer 20

environment of ICU interferes with sleep, healing, immune response, causes changes in cognitive function

Question 21

Signs of Sensory Overload?

Answer 21

complaints of fatigue/sleeplessness
irritability, anxiety, restlessness
disorientation
scattered attention + racing thoughts
↓ problem solving ability
↑ muscle tension

Question 22

Action Demand Statements for sensory overload?

Answer 22

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

Question 23

Sensory Deficits?

Answer 23

▪ 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)

Question 24

How would you care for a disoriented pt?

Answer 24

▪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

Question 25

Caring for a Visually Impaired Patient?

Answer 25

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

Question 26

Caring for a Hearing Impaired Patient?

Answer 26

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

Question 27

Goals for patients with impaired sensory function?

Answer 27

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….