1. Mosby items and derived items © 2005 by Mosby, Inc. Chapter 48 Sensory Alterations

2. Mosby items and derived items © 2005 by Mosby, Inc. Normal Sensation Reception –Perception –Reaction

3. Mosby items and derived items © 2005 by Mosby, Inc. Sensory Alterations Sensory deficits Sensory deprivation Sensory overload

4. Mosby items and derived items © 2005 by Mosby, Inc. Common Sensory Deficits Visual –Presbyopia –Cataract –Dry eyes –Open-angle glaucoma –Diabetic retinopathy –Macular degeneration

5. Mosby items and derived items © 2005 by Mosby, Inc. Common Sensory Deficits (cont'd) Auditory –Presbycusis –Cerumen accumulation Balance –Dizziness and disequilibrium Taste –Xerostomia

6. Mosby items and derived items © 2005 by Mosby, Inc. Common Sensory Deficits (cont'd) Neurological –Peripheral neuropathy –Stroke (CVA)

7. Mosby items and derived items © 2005 by Mosby, Inc. Factors Affecting Sensory Function Age Persons at risk—older adults Meaningful stimuli Amount of stimuli Family factors

8. Mosby items and derived items © 2005 by Mosby, Inc. Factors Influencing Sensory Function Social interaction Environmental factors Cultural factors

9. Mosby items and derived items © 2005 by Mosby, Inc. Assessment Sensory alterations history Mental status Physical assessment Ability to perform self-care Health promotion habits Presence of hazards

10. Mosby items and derived items © 2005 by Mosby, Inc. Assessment (cont'd) Communication methods Social support Use of assistive devices Other factors: pathology, medications Client expectations

11. Mosby items and derived items © 2005 by Mosby, Inc. Nursing Diagnoses Impaired communication Risk for injury Situational low self-esteem Disturbed sensory perception Social isolation

12. Mosby items and derived items © 2005 by Mosby, Inc. Planning Goals and outcomes –Client will demonstrate technique for cleaning hearing aid within 1 week –Client will use appropriate communication skills within 2 weeks Setting priorities Continuity of care

13. Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Health Promotion Screenings: prenatal, hearing, vision Preventive safety at home, school, recreational activities, and work Use of eyeglasses, contact lenses, and hearing aids Promoting meaningful stimulation

14. Mosby items and derived items © 2005 by Mosby, Inc. Vision Minimize glare Encourage use of eyeglasses, contact lenses, magnifiers Obtain large-print reading materials Use brighter colors (red, yellow, orange)

15. Mosby items and derived items © 2005 by Mosby, Inc. Hearing Amplify telephones, televisions, and radios Reduce extraneous noise Check for impacted cerumen Encourage use of hearing aid Speak directly at the client

16. Mosby items and derived items © 2005 by Mosby, Inc. Taste and Smell Provide oral hygiene Prepare well-seasoned foods of different textures Avoid mixing or blending foods Provide aromas of coffee, bread, flowers Remove unpleasant odors

17. Mosby items and derived items © 2005 by Mosby, Inc. Touch Provide touch therapy Turn and reposition client Avoid excessive stimuli for hyperesthetic client

18. Mosby items and derived items © 2005 by Mosby, Inc. Visual Alterations Providing a safe environment –Adequate lighting –Promotion of safe driving principles –Removal of clutter and loose items –Use of color contrasts –Removal of or caution with flammable items –Administration of eye medications

19. Mosby items and derived items © 2005 by Mosby, Inc. Hearing Alterations Providing a safe environment –Amplification of important environmental sounds –Use of lights for alert –Special telephone communication system (TTD or TTY)

20. Mosby items and derived items © 2005 by Mosby, Inc. Olfaction Alterations Providing a safe environment –Use of smoke and carbon monoxide detectors –Visually check gas stove –Check appearance and dates of foods

21. Mosby items and derived items © 2005 by Mosby, Inc. Tactile Alterations Providing a safe environment –Reduce the temperature of the water heater –Clearly mark faucets as “hot” and “cold”

22. Mosby items and derived items © 2005 by Mosby, Inc. Promoting Communication Approaching clients Use of alternative methods (sign language) Client education

23. Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Acute Care Orientation to the environment Comfort measures—stimulation Communication Control sensory stimuli: noise, light, smells Safety measures

24. Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Restorative Care Maintaining a healthy lifestyle Understanding sensory loss Socialization Self-care

25. Mosby items and derived items © 2005 by Mosby, Inc. Evaluation Client care Client expectations