All right, so now we're going to talk about sensory alteration. All right, so you got your five senses, the sight, which is your visual, hearing is your auditory, touch is tactile, smell is your olfactory, and your taste is your gustatory. Then you got position and motion, kinesthetic. This is the sense that enables a person to be aware of the position and movement of body parts without seeing them.
And then the size, shape, and texture, stereogenesis. This is the sense that allows a person to recognize size, shape, and texture of an object. Normal sensation, reception, stimulation of a receptor such as light, touch, or sound. The perception, integration, and interpretation of stimuli, what you perceive. Reaction.
the only most important stimuli will elicit a reaction. Sensory alterations, sensory deficit. It's a deficit in the normal function of sensory reception and perception.
Deprivation, inadequate quality or quantity of stimulation and sensory overload, reception of multiple sensory stimuli. Factors that influence Sensory function. This is age. You know, hearing starts changing at age 30, so it decreases as we age.
And, you know, kids, they can have sensory overload. It can be from loud noises, from TVs, their iPads or phones and certain foods that they eat. Meaningful stimuli, you know, objects, animals that they possess.
great value to a person. You know, having pictures, it can reduce sensory deprivation. So, you know, people that are in long-term care facilities sometimes having a picture of the family or trying to make it visually kind of like their home can help. Amount of stimuli, excessive can cause sensory overload, especially in kids. Social interactions with family, friends can influence sensory function.
It helps us cope better. Environmental factors, you know, where you work, is it allowed? Is there a lot of noise? Or do you work where you're exposed to different chemicals?
You know, people that have to write a lot. You see carpal tunnel syndrome that can cause numbness to the hands. Cultural factors, you know, African Americans have a higher incidence of glaucoma.
Children that are born from two different races have a higher rate of blindness and visual impairment. Critical thinking, you know, integrate knowledge of the pathophysiology of sensory deficits. Use critical thinking to conduct a thorough assessment. the plan, implement, and evaluate care that enables a patient to function safely and effectively. This is a critical thinking model for assessment of sensory alterations.
Assessment through the patient's people at risk, you know, assess their current sensory status and how it affects their lives. Sensory alterations history on page 1395. That's a good example of questions to ask. The mental status, do a mini mental exam.
You know, are they alert and oriented? Times three. Physical assessment, assess their vision, their hearing, their taste, their sensation. You know, try to.
avoid getting frustrated with patients that can't hear you. Because, you know, a lot of times they'll be like, huh, what did you say? I can't hear you.
You know, their ability to perform self-care, health promotion habits, you know, make sure they're getting their hearing and vision screened regularly, yearly, even kids, every time they go for a well child assessment, they get their vision and hearing screened. Environmental standards, you know, identify possible safety hazards. Examples, you know, do they have poor lighting? Is there uneven walkways at their home?
Are there cords that are laying everywhere that they could, if they don't see them, they could trip and fall over? Do they have handrails or no handrails? You know, if they're in the hospital, make sure they have a call light within reach.
Make sure their bed is in the lowest position. You know, their bedside table was cleaned off within reach and everything's in place where you tell them it's at. Assessment, you know, communication methods. If they have trouble hearing, sometimes they read your lips or, you know, be sure you're face to face with them so that they can know that you're talking to them. Sometimes you have to get pen and paper or like a dry erase board to write things down if they're having a hard time hearing you.
You know, if they have trouble seeing. tone of voice is important. You know, patients with aphasia.
Aphasia, what is that? Trouble speaking. They have a difficulty communicating. Social support.
You know, do they have social support? Do they have family, friends? Assess the use of assistive devices. You know, are they having a hard time using their hearing aids or their glasses?
Other factors affecting perception, you know, sometimes meds and pain can affect this. So be sure to get a good history on all medications, new medicines, over-the-counter medicines, if they're taking any herbs. You know, certain meds can be autotoxic, which can be damaging to the nerve in the ear, especially the antibiotics streptomycin and genomycin. you know need to find out if they've been on any recent antibiotics or finished antibiotics this picture is just shown where a nurse will sit eye level so the patient with hearing impairment can communicate analysis and nursing diagnosis that can have risk for injury risk for fall impaired verbal communication impaired socialization impaired mobility Planning and outcomes, you know, provide appropriate outcomes, set priorities, and teamwork and collaboration.
This is a critical thinking model for sensory alterations planning. Health promotion screening. Advise patients they need yearly screening.
Like I said, even in kids, preventative measures, kids, you know, you can have. Make sure kids aren't playing with sharp objects, sticks, scissors, long pointed toys. Avoid prolonged periods of loud noises. Limit screen time. If you work on a computer, take frequent breaks.
Wear the Blu-ray glasses. You know, use of assistive devices. Do they need help with their hearing aids is a big one.
Promoting meaningful stimulation, vision, wear, you know, be sure to wear sunglasses in the sun, you know. Hearing, make sure that they don't have, their ears aren't impacted. impacted cerumen, that's where you have ear wax that is impacted in the ear and it can cause a decreased hearing.
You know, sometimes they have to use over-the-counter de Broxtraps where they put it in their ear, let it set and it kind of loosens up the wax and one way that they can get out, you can buy ear kits over-the-counter that help irrigate the ear out, but sometimes mixing warm water with hydrogen peroxide, putting it in the ear helps kind of loosen that wax up and get it out. Taste and smell. Make sure they have good or doing good hygiene.
Brushing their teeth twice a day. Touch. You know, some people may need to wear wrist splints if they're having numbness in their head or, you know, their special keyboards when they type.
You know, in some patients, they don't even want to be touched. Health promotion. Establishing safe environments.
Adaptations for visual loss provide safety, have good lighting, make sure there's a clear walkway, there's no rugs or cords in the way. Adaptions for reduced hearing, you know, make sure the doorbells or their phone may need to be amplified so that they can hear it. And now I was told that the... AirPods that we use that they have a thing in them that people with trouble hearing that they can, it amplifies the sound for people that have trouble hearing. The adaptations for reduced olfaction, make sure they have fire alarms in their house if they're having trouble smelling smoke or, you know, gas.
Adaptations for reduced tactile. sensation. This is risk for impaired skin integrity. You know, caution them about heating and cooling devices.
May need to educate to mark their faucets hot or cold because they have a decreased sensation in their skin and they can't feel heat or cold as good as they want or pain. And you know, a lot of times you'll see this. People in their feet if they're diabetic, if they have neuropathy, they lose sensation in their toes and their feet. Communication, teach family members how to communicate effectively.
You may need to use pen and paper or dry erase boards, charts. There's charts that, you know, these patients can point at on if they're having pain, what they want, if they want something to drink, something to eat. You know, make sure if they're...
again, if they're having trouble hearing that you are face level talking, because if you're over there, they can't hear you. You're over there just talking away and they may not know you're even talking to them. Implementation, acute care, orientation to the environment, you know, show them where everything is at.
Keep it objects in the same place so they know where to reach for good communication. Controlling sensory stimuli, keep the noise at a minimum, and always safety measures. Implement restorative and continuing care, maintaining healthy lifestyles, understanding sensory loss.
And, you know, with these patients, it may get worse. So you have to tell them, you know, it may get worse. Maintain socialization, promote self-care.
Evaluation. You know, through the patient's eyes, were their outcomes met? And this is just a critical thinking model for sensory alterations, the evaluation.