Chapter 48

Sensory Alterations

Caution to those with seizure disorders

or motion sickness.

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 Normal Sensation

• Reception
– Perception
– Reaction

– Receptive and expressive aphasia- in

expressive use charts in receptive use
short questions, gestures and repeat.

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 Sensory Alterations

• Sensory deficits
• Sensory deprivation
• Sensory overload

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 Common Sensory Deficits

• Visual
– Presbyopia
– Cataract
– Dry eyes
– Open-angle glaucoma
– Diabetic retinopathy
– Macular degeneration

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 Common Sensory Deficits
(cont'd)
• Auditory
– Presbycusis
– Cerumen accumulation

Taste
– Xerostomia

• Balance
– Dizziness and disequilibrium

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 Common Sensory Deficits
(cont'd)
• Neurological
– Peripheral neuropathy
– Stroke (CVA)

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 Factors Affecting Sensory
Function
• Age- decreased sensitivity to pain,
pressure and temperature
• Persons at risk—older adults
• Meaningful stimuli
• Amount of stimuli
• Family factors

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 Factors Influencing Sensory
Function

• Social interaction
• Environmental factors
– Work risks, noise, movement, light
• Cultural factors
• Race, age, and gender

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 Assessment
• Sensory alterations history (rubella in
pregnancy could cause auditory
impairment)
• Mental status
• Physical assessment
• Ability to perform self-care
• Health promotion habits
• Presence of hazards
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 Assessment (cont'd)

• Communication methods
• Social support
• Use of assistive devices
• Other factors: pathology, medications
—mycins (auditory nerve)
• Client expectations
• Look for altered spatial perception
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• Spatial slide

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 Nursing Diagnoses
Safety is Always the top Priority

• Impaired communication
• Risk for injury
• Situational low self-esteem
• Disturbed sensory perception
• Social isolation

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 Implementation:
Health Promotion
• Screenings: prenatal, hearing, vision
(age relevant)
• Preventive safety at home, school,
recreational activities
• Use of eyeglasses, contact lenses,
and hearing aids
• Promoting meaningful stimulation

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 Vision
• Minimize glare
• Encourage use of eyeglasses,
contact lenses, magnifiers
• Obtain large-print reading materials
• Use brighter colors (red, yellow,
orange)
• How often to be checked based on
age, race, and gender
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If the patient is legally blind inform them of the environment
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Great for the patient with temporary vision loss

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 Hearing
• Amplify telephones, televisions, and
radios
• Reduce extraneous noise
• Check for impacted cerumen
• Encourage use of hearing aid
• Speak directly at the client
• How to speak to them– hands and
expression.
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 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

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 Touch

• Provide touch therapy

• Turn and reposition client
• Avoid excessive stimuli for
hyperesthetic client

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 Visual Alterations
• Providing a safe environment
– Adequate lighting– good contrast on equipment
that they use
– Promotion of safe driving principles- have car
maintained
– Removal of clutter and loose items
– Use of color contrasts
– Removal of or caution with flammable items
– Administration of eye medications

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 Hearing Alterations

• Providing a safe environment

– Amplification of important environmental
sounds
– Use of lights for alert
– Special telephone communication
system (TTD or TTY)

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 Olfaction Alterations

• Providing a safe environment

– Use of smoke and carbon monoxide
detectors
– Visually check gas stove
– Check appearance and dates of foods

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 Tactile Alterations

• Providing a safe environment

– Reduce the temperature of the water
heater
– Clearly mark faucets as “hot” and “cold”

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 Promoting Communication

• Approaching clients
• Use of alternative methods (sign
language)
• Client education

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 Mini Quiz on Sensory Overload
• Take out a piece of paper
• Write the answers and turn in when leaving

• 1) How do you communicate with receptive aphasia.?

• 2) What is a common visual sensory disturbance?

• 3) Streptomycin may cause what sensory alteration?

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Questions and Answers

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