SENSORY FUNCTIONING CHAPTER 44
THE SENSORY EXPERIENCE The sensory experience consists of 2 components: Reception: Conscious process of receiving thru the senses about the external or internal environment Perception: Conscious process of interpreting data from the senses
THE SENSORY EXPERIENCE EXTERNALY: Maintain contact with the outside environment using the 5 senses (vision, hearing, taste, smell, touch) plus stereognosis (the sense that perceives the solidarity of objects, their size, shape, and texture).
THE SENSORY EXPERIENCE INTERNALLY: Individuals orient themselves internally by kinesthetic senses(awareness of positioning of body parts and body movement) and visceral senses (inner organs).
AROUSAL MECHANISM To receive stimuli and respond appropriately, the brain must be alert or aroused. This is the task of the reticular activating system (RAS). Simply stated, this network of nerve fibers, located in the brainstem, receives messages from the 5 senses, decides which ones to send on to the cerebrum, messages from the cerebrum are then sent back, causing appropriate responses. (very simplified explanation, review A&P Nervous System for more details).
DISTURBED SENSORY PERCEPTION When a person is admitted to a health care agency (hospital, nursing home, rehab unit,etc), they may be confronted with stimuli that is totally foreign to them. Sights, sounds, odors, etc which they are not familiar, multiple diagnostic tests, unfamiliar faces, etc will likely result in disturbed sensory perceptions.
HOW CAN THE NURSE REDUCE DISTURBED SENSORY PERCEPTION? Be sensitive as to how all of the incoming stimuli is affecting the patient : (fear, anxiety, anger, withdrawal, etc) Pay attention to the patient s needs for: (privacy, social interaction, rest, etc) Think about what you could do in those situations
SENSORY DEPRIVATION Sensory deprivation occurs when an individual experiences decreased sensory input or input that is monotonous, unpatterned, or meaningless. These individuals may experience perceptual, cognitive, and emotional disturbances.
INDIVIDUALS AT HIGH RISK FOR SENSORY DEPRIVATION INCLUDE: Individuals on bed rest, institutionalized patients, or someone in isolation. Someone with spinal cord injuries, brain damage, confusion, disorientation, taking prescribed or recreational drugs. Those with impaired vision or hearing, and those with affective (mental)disorders
SENSORY OVERLOAD Sensory overload occurs when an individual experiences so much sensory stimuli that the brain is unable to either respond meaningfully or ignores the stimuli. The individual will feel out of control. The amount and type of stimuli necessary to produce sensory overload will vary from one individual to another.
INDIVIDUALS EXPERIENCING SENSORY OVERLOAD INCLUDE: Individuals coming from a quiet environment with unvarying stimuli, being hospitalized, poked, tested, questioned by strangers, combined with sights, sounds, and odors unfamiliar to them, quickly results in sensory overload. The responsibility of the nurse is to de-stress the individual and help them gain control of their environment.
SENSORY DEFICITS Impaired or absent functioning in one or more of the 5 senses is termed sensory deficit. Examples include: Impaired sight or hearing Altered taste Numbness and paralysis Altered tactile perceptive Impaired kinesthetic sense
FACTORS AFFECTING SENSORY STIMULATION The amount and quality of stimuli needed by an individual to maintain brain sensoryresponse/arousal will vary from person to person. Factors that influence the amount and quality of stimuli include: Developmental considerations, culture, personality, lifestyle, stress, illness, and medication