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Nursing
Sensory Perception and Cognitive Process
| Question | Answer |
|---|---|
| Senses | Visual, auditory, gustatory (taste), tactile (touch), olfactory, kinesthetic (movement), stereognosis (3d. Perception of depth) |
| Components of Sensation | Reception (stimuli i.e. smoke), Perception (receiving & interpreting sensory stimuli i.e. recognize smoke), reaction (i.e. react to smoke) |
| Sensory Deficit | Impairment, or lack of senses. |
| Sensory Deprivation | Reduction or absences of usual and accustomed visual, auditory, tactile, or other stimuli. |
| Signs and symptoms of sensory deprivation | Anxiety, depression, boredom, unsettled feeling, hallucinations |
| Causes of sensory deprivation | Altered sensory reception (e.g. spinal cord injury, brain damage, sleep deprivation). Deprived environments (e.g. patients who are immobilized or isolated) |
| Sensory Overload | Condition in which one or more of the senses are over stimulated. S&S: agitation, racing thoughts, confusion |
| Causes of sensory overload | Pain, medication, lack of sleep, worry. Giving or teaching a patient new information. Lighting, noise, roommate, meeting many staff members, activity around the clock. |
| Factors Affecting Sensory Function | Age, Persons at Risk: elderly, hospitalized. Meaningful stimuli. Amount of Stimuli: Under- and overstimulation. Family Factors: Support systems |
| Altered thought process | Sun-downer's. A&Ox3. Not confused, over-stimulated by hospital. |
| Most common diagnosis for elderly admitted with change in mental status | UTI |
| ICU Psychosis | Altered thought process |
| Visual alterations | Presbyopia (old age), cataract (looks cloudy. Zeus), Glaucoma (progressive and irreversible. pressure on eye), retinopathy (general term for noninflammatory damage to retina) macular degeneration (loss of center vision. see parameter of face but not face) |
| Hearing alterations | Presbycusis (age-related), cerumen accumulation |
| Neurological alterations | Peripheral Neuropathy (fingertips/toes)CVA/stroke |
| Assessment | Thorough history, mental status, physical assessment, self-care abilities, health promotion, safety, communication, support |
| Implementation | Health promotion, screening, safety, promoting stimulation and communication |
| Cognition | The systematic way in which a person thinks, reasons, and uses language. The mental process of knowing, including aspects such as awareness, perception, reasoning, and judgment |
| Normal cognitive processes | Cognition, consciousness, attention, memory, learning, communication, perception of information, thoughts, memory, speech |
| Characteristics of normal cognition | Intelligence, reality perception, orientation, judgment, recall and recognition, language |
| Normal Cognitive Patterns | Attending, perceiving, thinking, learning, remembering, communicating |
| Factors affecting cognitive function | Age, nutrition & metabolism (hypernatremia->confusion), sleep and rest; self-concept, infectious processes, degenerative processes, pharmacologic agents |
| Other factors affecting cognitive function | Head trauma, environmental factors, culture, values, and beliefs |
| Impaired thought processes | Disorganized thinking, altered level of arousal, altered attention, memory impairment |
| Expressive aphasis (Broca's aphasia) | Inability to express words one wants to say (verbal or written). Limited speech; slow or takes great effort; reduced grammar; poor articulation. Person knows what he/she wants to say but can't find words |
| Receptive aphasia (Wernicke's aphasia) | Difficulty understanding verbal or written words. Impaired auditory comprehension and feedback. |
| Dysarthria- Motor speech disorder (r/t stroke or brain injury) | Speech is slurred or garbled, slow, soft |
| Delirium | Acute confusional state; typically sudden onset. Can potentially be reversed; often due to a physiological cause. Requires prompt assessment and intervention. |
| What are some causes of delirium? | Environmental: hospital. 20-40% metabolic. Organ failure. Thyroid. Medications: Antidepressants. |
| Signs and symptoms of delirium | Confusion, hallucinations. Memory deficit. |
| Dementia | Generalized impairment of intellectual functioning: interferes with social and occupational functioning. Gradual onset: progressive and irreversible. |
| Alzheimer's Disease | Most common; cause is unknown. Progressive symptoms. Amnesia: partial/total loss. Agnosia (loss of ability to recognize smell, taste, touch) Apraxia (loss of ability to execute, learn purposeful movement) Aphasia. |
| Types of dementia | Diffuse Lewy Body Disease. Frontotemporal Dementia. Vascular Dementia (2nd most common) |
| Depression | reversible condition. May be mistaken for dementia. Common in the elderly. |
| Signs and symptoms of depression | Sadness, fatigue, anger. Abandoning or losing interest in hobbies, social withdrawal and isolation, weight loss, loss of appetite, sleep disturbances, loss of self-worth, increased use of alcohol or other drugs, fixation on death, suicidal thoughts |
| Polypharmacy | Use of multiple medications by a patient at one time. May lead to drug interactions causing impaired cognitive function. increased risk in older adults. |
| Alterations in Diagnostic Tests | Glucose levels:>70 mg/dL. Electrolytes: Sodium if less than 135 or more than 145-cognitive alteration. Calcium: when >14 mg/dL can cause confusion. Oxygen saturation. Ammonia and Urea: can become elevated with liver or kidney failure. Drug toxicity |
| Risks for older adults in the acute care setting | Dehydration and malnutrition, delirium, nosocomial infection, urinary incontinence, skin breakdown, falls |
| Physiological concerns of older adults | Prevention and management of diseases, nutritional needs, encouraging exercise, assisting with sensory impairments, medication use |
| Psychosocial concerns of older adults | Therapeutic communication, touch, reality orientation, validation therapy, reminiscence, body image interventions |
| Diagnosis | Acute or chronic confusion, impaired memory, impaired verbal communication |
| Implementation | Health promotion, orientation to surroundings, communication methods, safety |
Created by:
senmark
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