1. SENSORY PERCEPTION

2. DEFINE AND DESCRIBE THE CONCEPT OF SENSORY PERCEPTION

3. Definition Sensory perception is the ability to receive sensory input and, through various physiological processes in the body, translate the stimulus or data into meaningful information. Note: Concept focus is on physiologic processes; it does not include psychiatric applications (e.g., auditory, tactile, visual hallucinations, psychosis).

4. Goals for This Concept Presentation 1.Define and describe the concept. 2.Notice the risk factors impaired sensory perception. 3.Recognize when an individual has impaired sensory perception. 4.Provide appropriate nursing and collaborative interventions to optimize sensory perception.

5. OBJECTIVES 1.Explain the concept of Sensory (including definition, antecedents, and attributes). 2.Analyze conditions which place a patient at risk for sensory perception imbalance. 3.Identify when sensory imbalance (negative consequence) is developing or has developed. 4.Discuss exemplars of common sensory perception disorders.

6. Objectives cont’d 5. Apply the nursing process (including collaborative interventions) for individuals experiencing sensory imbalances and to promote normal sensory perception.

7. NEGATIVE SENSORY PERCEPTION CONSEQUENCES Visual impairment 1.Impairments range from minor distortion to complete blindness. 2.Injury and developmental delays may develop. 3.Psychosocial consequences include learning difficulties, depression, anxiety, loss of self-worth, and difficulties with interpersonal relationships.

8. NEGATIVE SENSORY PERCEPTION CONSEQUENCES CONT’D Hearing impairment 1.Impairments range from minor distortions of speech to complete hearing loss. 2.Injury, communication difficulties, and developmental delays may develop. 3.Psychosocial consequences include problems with relationships, learning, and work, isolation, and frustration.

9. NEGATIVE SENSORY PERCEPTION CONSEQUENCES (CONT’D) Impaired taste and smell 1.Impairments can result in anorexia, weight loss, and malnutrition. 2.Food poisoning can occur from the ingestion of spoiled food. 3.Safety risk occurs from environmental dangers. 4.Psychosocial consequences impact one’s quality of life.

10. SENSORY PERCEPTION CONSEQUENCES (CONT’D) Touch impairment 1.Impairments range from minor distortion of touch to a complete loss of touch sensation. 2.Injury (i.e. decreased ability to sense pain, heat, or cold) may develop. 3.Activities of daily living and occupational skills are reduced.

11. POSITIVE SENSORY PERCEPTION CONSEQUENCES Positive Outcomes 1.Distinguish between sharp and blunt objects or hot and cold by touch. 2.Interact to/with others with understanding. 3.Ability to read and commute through visual acuity. 4.Enjoy taste of food.

12. NURSING CARE What needs to be known to care for a patient? ANTECEDENT: A thing or event that existed before or logically precedes another. --What has to occur for sensory perception to be recognized? External stimuli Intact neural system (continued)

13. Intact and functioning, visual, gustatory, auditory and integumentary system. Note: all of the above can be related to issues of the life cycle.

14. ? ATTRIBUTES ? Quality Characteristic Trait An object closely associated to a specific thing

15. Review of Sensory System Vision Hearing Taste Smell Touch

16. Hearing : Normal hearing range in adults is from 0 db hearing level to 25 db hearing level.

17. Vision, visual acuity 20/20

18. INTEGUMENTARY SYSTEM: INTACT The largest organ in the body.

19. Gustatory: Sensations that can be processed by taste (sweet, salt, sour and bitterness).

20. Olfactory: odorants are sensed

21. INTERRELATED CONCEPTS Interrelated Concepts Mobility Nutrition Human Development Comfort Communication Safety Interpersonal Relationships End of Life Intracranial Regulation

22. SUB-CONCEPTS Sub-Concepts Factors Affecting Perception Medication effects Role of Senses in adapting to environment Lack of Stimuli

23. EXEMPLARS Cataracts Eye Injuries Glaucoma Peripheral Sensory Disease Conductive Hearing Loss Macular Degenerative Disease Sensorineural Hearing Loss

24. EXAMINATION OF THE SENSORY SYSTEMS Vision Inspection of the external eye Visual acuity Ophthalmic examination Pupillary response

25. Hearing Evaluation of hearing Inspection of the external ear Inspection of the internal ear

26. Taste and Smell Inspect tongue and oral cavity Inspect nose Check for patency of nasal airway Test tasting ability Test smell

27. Tactile assessment Romberg test for balance Tests of hot and cold, sharp and dull, localization of sensation Monofilament testing

28. COMMON DIAGNOSTIC TESTS Vision Visual fields test, noncontact tonometry Hearing Pure tone air conduction hearing test, otoacoustic emissions (OAEs), auditory brainstem response (ABR)

29. NURSING DIAGNOSIS/PROBLEM LIST Sensory Perception Disturbance/loss of hearing, vision, gustatory, sensation. Altered role performance / inability to perform job or social role/loss of worth. Social Isolation/Lack of social contact/depression/Anxiety. Body Image disturbance/Disturbance in self-perception. Impaired Communication/ Inability to understand or communicate words/problems with receiving words.

30. PROVIDE APPROPRIATE NURSING AND COLLABORATIVE INTERVENTIONS TO OPTIMIZE SENSORY PERCEPTION

31. CLINICAL MANAGEMENT: PRIMARY PREVENTION Use of safety devices Eye protection, hearing protection Silver Nitrate in newborn’s eyes to prevent infection Proactive management of chronic conditions such as heart disease and diabetes

32. CLINICAL MANAGEMENT: SCREENING Collaborative Learning In your learning groups, look up and discuss the national guidelines for vision and hearing across the lifespan. Specific questions to address: 1.At what age should these screenings begin? 2.How often should they occur? 3.How are they performed?

33. COLLABORATIVE INTERVENTIONS Vision Surgery Visual acuity correction, cataract, macular degenerative disease Pharmacotherapy Beta-adrenergic, prostaglandin analogs, adrenergic agonists, carbonic anhydrase inhibitors, antimicrobial, steroidal, analgesic Adaptive methods Eyeglasses, contact lenses, braille, guide dogs

34. COLLABORATIVE INTERVENTIONS (CONT’D) Hearing Surgery Myringotomy, cochlear implants Pharmacotherapy Antimicrobial, steroidal, analgesic Adaptive methods Hearing aids, assistive listening, sign language

35. EXEMPLARS Collaborative Learning In your learning groups, select one exemplar from you Exemplar list and analyze this exemplar related to the following concept perspectives: Scope and category Population at risk and factors Consequences Assessment Clinical management Interrelated concepts

36. REFERENCES Giddens, J.F.. Concepts for Nursing Practice, 1 st Ed., St. Louis: Mosby Elsevier, 2013. Ignatavicius, D.D., Workman M.L., Medical-Surgical Nursing: Patient Centered Collaborative Care, 7 th Ed., St. Louis: Mosby Elsevier, 2013.