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NURS2518 : The Older Client > Week 3 - sensory perception > Flashcards

Week 3 - sensory perception Flashcards

1
Q

What is the difference between sensory perception and impaired sensory perception?

A

sensory perception: the ability to receive sensory input through physiological processes in the body, and translating it into meaningful information.
things like vision, hearing, taste, smell and touch

impaired sensory perception: when the five senses are not at optimal function

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2
Q

What does sensory input consist of?

A

pitch
- frequency of waves
-higher pitch = more frequent waves

loudness
- energy of wave

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3
Q

what are the three parts of the peripheral auditory system?

A

external (outer), middle and inner

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4
Q

what cranial nerve is associated with the central auditory system? what is it responsible for?

A

Cranial nerve VIII or 8, balance and hearing

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5
Q

what does the eyes specifically perceive?

A

light waves!

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6
Q

If ric the munch came into your clinic and mentioned that he recently visited a doctor and was said that he’s conjunctiva was inflamed. He asked you want part of the eye is this located?

A

the external eye ya munch

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7
Q

what does the internal eye consist of?

A

the outer sclera (white part) and cornea
the middle layer
inner layer

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8
Q

What does the external eye consist of?

A

eye lid
conjunctiva (thin clear layer that protects the eye)
lacrimal duct (takes tears to nasal cavity)
eye muscles

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9
Q
A
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10
Q

Dr. pepper comes in the office and mentions that he was having eye problems. he went to his colleagues office to see what’s up and he was told his results were 20/200 in his left eye (best eye). what kind of vision is this?

A

mfer is BLINDDDDD babyyyyyy

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11
Q

what disease fall under primary vision impairment?

A

glaucoma, cataracts, retinal detachment and macular degeneration

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12
Q

what disease falls under secondary vision impairment?

A

diabetes and diabetic retinopathy

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13
Q

what are some age related changes in smell, taste and tactile threshold?

A

smell - reduced smell and ability to distinguish smell. starts at age of 60

taste - decrease

tactile threshold - increases, starts at age of 20

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14
Q

true of false: age related changes do not affect all the structures involved in retinal-neural pathways in the absesne of disease

A

false; it does affect

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15
Q

true of false: age related changes are gradual and do not have a major effect on everyday activites

A

trueeeeeee

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16
Q

a patient walk in and the first thing you notice is their upper lid of their eye is drooping. what is the medical term so that you can chart it?

A

senile ptosis

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17
Q

Whats another word for external eye?

A

extraocular

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18
Q

what is the difference between ectropion and entropion?

A

ectro(out) - turning outward of the lower lid

entro(in) - prolonged turning inward of the lower lid

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19
Q

true of false: within the older client, narrowing of the tear duct and reduced production of tear occurs, as well as decrease goblet cells the produce mucin(mucus)

A

true

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20
Q

what changes occur in the internal eye?

A

cornea - opaque and interferes with the passage of light
lens - becomes stiffer and more opaque - decrease response of lens
iris- less flexible
pupil is less responsive
less function of the atrophy of ciliary muscle

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21
Q

Which are some age related changes in the internal eye:
a) artheroschlerosis
b) degeneration of neutrons in the visual cortex
c) thinning and sclerosis of retinal blood vessels
d) number of rods diminsh
e)reduced contrast sensibility

A

all

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22
Q

what are some age related changes on visual function?

A

reduced visual field, finished depth perception, altered colour vision, finished critical flicker fusion, longer processing time for visual info, increase sensitivity to glare and reduced contrast sensitivity

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23
Q

what is presbyopia?

A

near sightedness, loss of elasticity, leads to decrease in the eyes ability to change the shape of the lens to focus on near objects and decrease ability to adapt to light.

within the ciliary body

lens becomes stiffer, denser and more opaque.
leads to seeing darker blues and white light appears more yellowy

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24
Q

What is glaucoma?

A

age related disease,
risk factors: age, genetic predisposition, h bp and diabetes
structure: build up of aqueous fluid (increase intro ocular pressure) enters pressure and damages the optic nerve.

how to assess: loss of peripheral vision and progresses to blindness.

Primary open angle - most common
Normal tension glaucoma - intra ocular pressure isn’t high
Acute closed-angle. - medical emergency, sever eye pressure

tonometry - to measure intraocular pressure, IOP

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25
Q

what is cataract?

A

risk factor: advanced age, smoking, prolonged exposure to sunlight, diabetes, corticosteroids

structure: oxidative damage to lens protein, fatty deposits in ocular lens

clouding of ocular lens, “halos” around objects, blurring usually bilateral

intervention: surgery when visual acuity decreases to 20/50. risk of surgery: detached retina post surgery

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26
Q

what are some risk factors of cataracts?

A

too much sunlight, diet, diabetes, hypertension, history of alcohol or tobacco, kidney disease

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27
Q

what can reduce the risk of cataracts?

A

intake of high dietary lutein and zeaxanthin, vitamin C, E copper and zinc

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28
Q

What is macular degeneration?

A

risk factors: advanced age, family history, smoking, obesity and exposure to sunlight

literally it is the degeneration of the macula - the central part of the eye responsible for central vision. photoreceptor cells in early stages, in later stages hemorrhage of blood vessels in the choroid can lead to total blindness

assessment: use of amsler grid- wavy lines + development of AMD

NO CURE

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29
Q

zeaxanthina and no beta carotene can reduce the risk of advanced AMD and later on cure it

A

False; it can reduce but not cure

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30
Q

when you assess for eye comfort, what are you looking for?

A

mild dry eyes (scratching feeling)
moderate dry eyes (discomfort or pain, decreased mucus production)
usually too sensitive to tolerate artificial tears, eye pain associated with pathological conditions

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31
Q

what are some risk factors for impaired vision?

A

population - genetic component
lifestyle - such as smoking, nutrient deficiencies
medications - adverse effects
environment - eye damage from UV, warmer temperatures, prysbyopia
environment conditions that cause dry eyes

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32
Q

what are some interventions to prevent vision loss?

A

prevent vision impairment:
attend no smoking programs, good nutrition and exercise, nutritional considerations such as vitamin C, carotene, zinc and copper

prevention to minimize impact of vision changes:
fall prevention, eye exams regularly

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33
Q

this is the ability to receives stimulation through one’s sensory organs

A

sensation

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34
Q

what does sensation mean?

A

this is the ability to receives stimulation through one’s sensory organs

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35
Q

What does perception mean

A

how one perceives, organizes and interprets

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36
Q

what does sensation + perception

A

refers to the ability to receive sensory input and, through various physiologic in the body, translate the stimulus or data into meaningful information.

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37
Q

refers to the ability to receive sensory input and, through various physiologic in the body, translate and stimulus or data into meaningful information.

A

sensation + perception

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38
Q

Complex physiologic process that allows humans to interact efficiently within the environment provide what ?

A

provide the basis for social interactions, communication, and learning

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39
Q

sensory perception also provides…..

A

a level of protection through detection and reaction to dangers within the environment

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40
Q

true or false. Sensory Perception. A level of protection through detection and reaction to dangers within the environment.

A

true

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41
Q

true or false.impairment of any of the five senses can lead to significant challenges that can negatively impact development, health and well being

A

true

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42
Q

this is the ability to perceive through one’s sensory organs. Can be internal fro within the body or external from outside the body. Includes feelings pain, temperature, light.

A

sensation

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43
Q

Can eyes, ears, nose, touch receptors can be apart of sensation ?

A

yes they are apart of that

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44
Q

what is the external stimuli of sensation?

A

received and processed through five senses : vision, hearing, taste, smell, and touch

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45
Q

what is this describing : bottom-up process by which our senses receive and relay outside of stimuli

A

sensation

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46
Q

how does one receives, organizes and interprets sensation

A

perception

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47
Q

the top-down way our brains organize and interpret that information and put it into context

A

perception

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48
Q

What is the population at greatest risk ?

A

older adults

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49
Q

What is the physiological changes that occur with aging :

A

age- related changes

50
Q

true or false. Population at greatest risk : older adults decline occurs in in all five senses

A

true

51
Q

Risk Factors : Impaired Visual Perception

A

congenital conditions and genetics
adverse reactions and side effects of medications
acute injury
chronic medical conditions
lifestyle choices and occupation

52
Q

in the following below match the descriptions it the category of the risk factors for impaired visual perception :

congenital cataracts

common side effects of medications

acute brain injury that affects a part of the brain in relation

diabetes & stroke related to the area of the brain related to sensory perception

smoking- a risk factor for cataracts and macular degeneration
occupations that place eyes at risk ( use of glasses)

A

congenital conditions and genetics

adverse reactions and side effects of medications

acute injury

chronic medical conditions

lifestyle choices and occupation

53
Q

Name some consequences of impaired visual perception

A

delirium ( cognition )
dementia ( cognition )
depression ( cognition/mood & affect)
anxiety ( mood & affect)
loss of slef worth ( congition/mod & affect)

54
Q

true or false. Consequences of impaired visual perception can be seen as instuiting and maintaining meaningful interpersonal relationships ( personhood)

A

true

55
Q

Functional decline can ( functional ability) can be seen as consequences of impaired visual perception

A

true

56
Q

Age-related changes : Impaired Visual Perception
true or false.
Age related loss of elasticity in the lens of the eye leading to an increase in the eyes ability to change the shape of the lens to focus on near objects such as fine prints and decreased ability to adapt to light

A

false, it decreases.

57
Q

Does the lens become stiffer, denser, and opaquer when age related changes are impaired?

A

true

58
Q

true or false. When older and becoming impaired visual perception ,colour vision may be affected by lens opaqueness leading to seeking darker blues and whit light appear more yellowly

A

true

59
Q

Age-related changes : Impaired Visual perception

How does the lower eye change ? and eyelashes ?

A

lower eyelid changes drooping down ( decreased lubrication) and inversion of eyelashes into the eye ( causing irritation and inflammation)

60
Q

Age - related changes : Impaired Visual Perception

narrowing of the tear duct and reduced production of tears lead to

A

dry eye syndrome ( irritation and inflammation )

61
Q

what is Presyobia?

A

is a result of an age related changes ( loss accommodation or ability to focus on object at various distances )

62
Q

this si caused by degenerative changes in the lens and the ciliary body

A

Presbyopia

63
Q

Major disease causes of visual impairment and blindness among older adults :

A

cataracts
macular degeneration
glaucoma
diabetic retinopathy

64
Q

name some risk factors for cataracts :

A

advanced age, smoking, prolonged exposure to sunlight, diabetes, malnutrition, corticosteroids

65
Q

name the pathology of cataract

A

oxidative damage to the lens protein, fatty deposits in the ocular lens

66
Q

what is the assessment for a patient with cataract

A

” clouding “ of the ocular lens, appearance of halos around objects, blurring, decreased perception to light and color, sensitivity to glare

67
Q

what is the intervention for patient who suffers with catarct?

A

surgery when there is safety risks of quality of life. Risk of surgery: detached retina post- surgery ( curtain coming down over line of vision, this is an emergency!)

68
Q

this is when central vision lost

A

AMD ( macular degeneration)

69
Q

what is the risk factors for age related macular degeneration

A

advanced age, family history, smoking, obesity, exposure to sunlight

70
Q

what is the pathology for age-related macular degenration

A

results from systemic changes in circulation, disruption of photoreceptor cells

71
Q

what is the assessment for age- related macular degeneration

A

central vision loss, use of armsler grid ( perception of wavy lines mean beginning of macular degenration)

72
Q

what is the intervention for AMD ( macular degeneration )

A

No cure for amd, managed by medications, laser based treatments

73
Q

is there any cure for AMD ?

A

no there arent any cure

74
Q

Is glaucoma common for older people, and can be connected with blood pressure?

A

this is true

75
Q

what is the risk factor for glaucoma ?

A

age, older women twice as affected as older men, african, asian, or latin american descent

76
Q

what is Pathology for Glaucoma ?

A

Build- up of aqueous fluid in the eye which exerts pressure on and damages the optic nerve , leading to blindness

77
Q

what is the assessment for glaucoma ?

A

regular screening by eye speciliast, dilated- eye examination ( check status of optic nerve and retina) , tonotmetry ( to measure intraocular pressure, IOP)

78
Q

what is the intervention for glaucoma :

A

chronic : gradual onset - medical theraphy with eye drops ( beta-blockers)
Acute : sudden onset- medications and immediate surgery

79
Q

this has something to do with glucose regulation, and inflammation. Manage as early as you can by maintaining eye check ups

A

diabetic neuropathy

80
Q

What is the risk factors for diabetic neuropathy ?

A

most diabetic patients develop diabetic neuropathy within 20 years of diagnosis

81
Q

what is the pathology of diabetic neuropathy?

A

changes in retinal microvasculature, increased vessel permeability (leakage)

82
Q

what is the assessment for diabetic neuropathy

A

done via funduscopy ( part of the eye exam to visualize fundus )

83
Q

what is the intervention for diabetic neuropathy

A

blood sugar/blood pressure movement, laser-based treatment

84
Q

name some consequences of impaired visual perception:

A

impact on safety
inability to read medication labels
difficulty navigating ( stairs, curbs)
difficulty/inability to drive
higher risk of falls

85
Q

true or false. one of the major consequences of impaired visual perception is the impact of quality of life. It reduces independence, ability to read, etc.

A

true

86
Q

Clinical connection : applying your knowledge into practice

Ms. Simons, a 78 year old woman who has presented to the emergency department after falling when she was walking in her home in the middle of the night. In the E.R, when assisting Ms. Simons to the bathroom, she bumped into the medication cart and moved very hesitantly. When interviewing Ms. Simons, the nurse identifies that she has glasses, but says she has no longer wears them as “ they don’t help, everything’s still blurry.”

What signs do Ms. Simons have potential visual impairment ? What potential consequences of visual impiarment is she at risk for? why?

What are the possible nursing interventions which can be implemented ?

What is the impact of the impaired sensory perception ( visual) to Ms. Simons’ functional ability?

A
  1. Falling
    Bumped into the medication cart
    moved very hesistanly
    she has glasses but says she no longer wear them as they dont help, everything is still blurry

functional decline
safety
impact on quality of life
cognitive decline, delirium, anxiety, depression

2.interventions to prevent delirium
needs an eye examination
needs to be assessed by occupational therapist to address safety issues
possible referral to GPAT ( geriatric program assessment team)

3.as stated earlier, with impaired sensory perception ( visual) , she will likely have decreased functional ability, higher risk of functional ability, higher risk of functional decline, reduced quality of life, higher safety risk

87
Q

impaired auditor perception is another word for

A

hearing loss

88
Q

impaired auditory perception ( hearing loss) causes can be :

A

conductive
sensorineural

89
Q

what does conductive and sensorineural mean?

A

conductive : infection, eardrum perforation, fluid, or cerumen (earwax) accumulation

sensorineural : changes in the inner ear or never
pathway
- prebycusis (eldery hearing)

90
Q

true or false. cerumen impaction is done by a doctor or nurse practitioner

A

true

91
Q

Explain briefly what cerumen impaction is

A

interfered with the conduction of sound through the air in the eardrum

easily said: earwax blockage

92
Q

Cerumen impaction : Individuals at particular risk of impact are

A

individuals who wear hearing aids
older men with large amounts of ear canal tragi ( hairs in the ear)

93
Q

True or false. Cerumen Impaction is most common and not easily corrected.

A

false, though it is common, it is easily corrected

94
Q

what is the intervention for cerumen imapaction

A

remove cerumen ( lavage ) and prevent build up ( oil drops)

95
Q

Older adult who suffers from presbycusis diminished ability to hear high pitched sounds ( frequency), and how do they hear high pitched sounds?

A

this is a true statement, older adults who suffers from presbycusis are people who hears high pitched as distorted. In other word its filtered out

96
Q

______ hearing loss interferes with ability to identify the spatial location of source of speech or noise

A

sensorineural

97
Q

what is presbycusis?

A

a sensorineural hearing loss related to age-related degeneration of the auditory structures

98
Q

True or false. Background nosies further aggravates hearing deficit i.e in health care settings in older adult who suffers from presbycusis.

A

true

99
Q

consequences of hearing loss

A

impact on quality of life
- impairs ability to communicate with others
-social isolation
-leads to depression or ow- self esteem

safety issues
unable to hear
instructions, warnings ( danger)
a car coming when crossing the roads
a phone or a doorbell ringing or knocking

100
Q

True or false: age related changes affect all of the structures involved in retinal-neural pathway but in the absence of disease they are gradual and do not have a major effect on everyday activities

A

true

101
Q

True of false: age related changes to the external ear include: auricle (external ear) gains flexibility, auditory glands narrows, cerumen(earwax) glands decrease (atrophy), in men: tendency to have long thick hair at periphery of the auricle

A

false; auricle loses flexibility

102
Q

true or false: in terms of age related changes of external ear - age related changes prevent the natural expelling of the cerumen

A

true

103
Q

what are some age related changes of the middle ear?

A

tympanic membrane thinner and stiffer ear drum
muscles and ligaments become weaker and stiffer - reduces the effect of the acoustic reflex (an involuntary reflex in response to loud sounds and sounds from ones voice)

104
Q

true or false: some age related changes fo the inner ear: cochlea: reduce blood supply, lose of neutrons in cochlear nuclei, increase in hair cells, fibrous changes in the small blood vessels that supply the cochlea, Prysbycusis- sensorineural hearing loss

A

true except decrease in hair cells

105
Q

true of false: age related changes to inner, middle and external ear influence the sound being sent to the brain, also account for hearing loss experienced in older adults

A

true

106
Q

what cranial nerve is responsible for the auditory nervous system?

A

cranial nerve VIII

107
Q

what are the most common hearing problems in older adults?

A

sensorineural loss - age related changes in middle ear (presbycusis) usually both ears
conductive hearing loss: disruption in the external or middle ear that interferes with the transmission of sound

108
Q

what is otosclerosis?

A

calcification of the middle ear bones

109
Q

what are some difference between sensorineural and conductive hearing impairment?

A

sensorineural hearing loss - decreased ability to hear high pitch sound

  • older adult can hear vowels better then consonants

-messes with the ability to identify the spatial location of the source of speech or noise
-diminished speech discrimination

conductive - reduce ability to hear votes and low pitch sound

-loudness can improve hearing in all frequencies
-background noise, not as big of a problem as sensorineural

110
Q

is it true that: you should never assume hearing loss is because of age until other causes are ruled out

A

true

111
Q

it is true that you can prevent hearing loss by treating/impacting cerumen?

A

yes it is true

112
Q

why should you treat cerumen to prevent hearing loss ?

A

underdiagnosed, can interfere with hearing aide, affects 19-65% of adults over 65 y/o

113
Q

what are some symptoms of excess cerumen?

A

hearing loss, diminished cognitive function and possibly pain, itching, tinnitus, dizziness

114
Q

true or false: Nurses can visualize the tympanic membrane and detect cerumen impaction with a opthamascope

A

false: use otoscope

115
Q

What are some assessment options for the extent of hearing impairment

A

whisper test
finger-rubbing
audiometer - test tone
tuning fork - weber test or rinne test

116
Q

interventions to treat hearing loss: hearing aids - what are they

A

hearing aide: battery operated, amplifier, a microphone and a receiver
Types: Behind the ear, mini behind the ear, in the ear, completely in canal

117
Q

true or false: assistive listening devices enhance face to face communication

A

true

118
Q

what are some ways that you should consider when communicating with the older adult with hearing impairment

A

avoid shouting, position, clear articulation, lower your tone, slow to moderate rate of speech, position according to ear that has best hearing, eliminate environmental noise and distractions, avoid background noise echoing

119
Q

what is population health?

A
  • this is educating everybody about risk of being in a loud environment for extended periods of time
  • Reduces the extent of hearing loss experienced in aging
  • reduces the occurrence of tinnitus
120
Q

what are some risk factors for impaired hearing?

A

male
men with hair in ear
increased age
genetic predisposition
lifestyle such as smoking occupation - exposed to noise
diabetes, hypertension, hypothyroidism, head injury, high fevers, renal failure, cardiovascular disease, brain tumour,

121
Q

what are some meds that can be a risk for impaired hearing?

A

ototoxic medications: common Furoseminide, Ciprofloxacin

NURS2518 : The Older Client (13 decks)

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