Stereognosis
perception of solidity of objects
Proprioception
a sense at a subconscious level with regards to movement of the body
Levels of Unconsciousness
- asleep
- stupor
- coma
- vegetative state
Levels of Consciousness
- locked in syndrome
- dementia/confusion
- somnolence
- delirium
- normal
Sensory perception
conscious process of selecting, organizing, and interpreting data from the senses into meaningful data
Sensory reception
- process of receiving data about the internal or external environment through senses
Stupor
can be aroused by repeated and/or extreme stimuli
Coma
cannot be aroused and does not respond to stimuli
Vegetative state
cannot be aroused.
- sleep wake cycles, withdraws to noxious stimuli, occasional nonpurposeful movement, random smiling or grimacing
Somnolence
- extreme drowsiness but will respond normally to stimuli
Sensory deprivation signs and symptoms
- drowsiness, excessive yawning
- hallucinations/illusions
- decreased attention span, inability to focus
- crying, panic, depression
Sensory overload
excessive stimuli over which a person feels little control, the brain is unable to meaningfully respond to or ignore stimuli
- bright lights, frequent examinations, monotonous noises
Sensory deficit
- impaired or absent functioning in one or more senses
- impaired sight/hearing, numbness, paralysis
Factors affecting sensory stimulation
- developmental considerations
- culture
- personality/lifestyle
- stress and illness
- medications
Caring for visually impaired patients
- acknowledge your presence in the room, introduce yourself
- speak in a normal tone of voice
- explain reason for touching pt BEFORE touching them
- keep call light close
- clear pathways
- assist with ambulation
- indicate when leaving room
- orient pt to sounds/furniture in room
Caring for hearing impaired patients
- decrease background noise
- check hearing aids
- position yourself so your face is in light
- talk directly to pt, clear and concise sentences
- sign or pantomime
- write anything you cannot convey
Communicating with confused patients
- frequent face to face contact
- speak calmly, simply, and directly to pt
- orient and reorient pt to environment
- orient to time, place, person
- offer explanations for care
- emphasize pts strengths rather than weaknesses
- use objects from pts past
- reinforce reality if pt is delusional
Communicating with unconscious patients
- assume they can hear you
- speak in normal tone of voice
- speak to the pt before touching them
- keep environmental noises low
Glaucoma
- increased IOP causing atrophy and cupping of the optic nerve head
- visual deficits can progress to blindness
- loss of peripheral vision, intolerance to glare, ⬇️ perception of contrast and night vision
Cataracts
- clouding of lens causing painless, progressive loss of vision
Macular degeneration
- most common cause of legal blindness in older adults
- development of drusen deposits causing central vision loss
- risk factors: smoking, excessive sunlight exposure
Presbyopia
- loss of elasticity in the lens leading to decreased ability to change shape of lens to focus on near objects (fine print)
Presbycusis
- loss of high- frequency, sensorineural hearing
- gradual onset, progressive, bilateral
Sensorineural Hearing Loss
- damage to inner ear, cochlea, or 8th cranial nerve
- hereditary causes, viral/bacterial infections, trauma, tumors, noise, ototoxic drugs, Meniere disease
