در این سمینار ما به نتایج زیر دست پیدا میکنیم

3. در این سمینار ما به نتایج زیر دست پیدا میکنیم (T=5) تعریف کلی از حس و راههای حسی (T=10m) Sensory Alterations (T=10m) ( ICU psychosisمعرفی یک بیماری( کاملی 1388

4. تعریف کلی از حس و راههای حسی تجربهبه حسی چیست؟ 1- دریافت حسی فرایند دریافت اطلاعات از محیت بیرونی یا درونی رادریافت حسی گویند 2-ادراک حسی یک فرایند هوشیارانه در انتخاب ،سازماندهیو تفسیراطلاعات از حسها به اطلاعات معنی دار میباشد کاملی 1388

5. دریافت حسی دریافت حسی توسط گیرنده ها انجام میگیرد علت اصلی تغییر پتانسیل غشا نفوذپذیری گیرنده غشایی استکه امکان انتشار کمابیش یونها از غشا و در نتیجه تغییر پتانسیل غشایی را فراهم میکند کاملی 1388

6. درک حسی در مغز انجام میشود NUR101 FALL 2008 LECTURE # 18 K. BURGER PPP By Sharon Niggemeier RN MS کاملی 1388

7. Sensory Alterations • A change in environment can lead to MORE or LESS normal stimuli. • When stimuli is different from what one is used to it leads to sensory alterations. • Hospitalized patients will experience sensory alterations due to different stimuli loads. • Can result in sensory overload or sensory deprivation کاملی 1388

8. Sensory Overload • Results from being unable to manage sensory stimuli: (too much stimuli) • Pain, dyspnea, anxiety (internal) • Noise,, contact with many strangers (external) • Inability to disregard stimuli: for example meds that stimulate the arousal mechanism, may prevent one from ignoring noise کاملی 1388

9. Assessment: Sensory Overload • Unrealistic perceptions • ،سردرگمیdisoriented, difficulty concentrating, muscle tension • Reduced problem-solving ability • پراکندگی حواس کاملی 1388

10. Sensory Deprivation • Results from decreased sensory input or meaningless input: (too little stimuli) • Isolation/non-stimulating monotonous environment • Impaired ability to receive and/or send stimuli: vision, hearing deficits, speech deficits ( expressive or receptive aphasia) • Inability to cognitively process stimuli-confused, brain injury, meds affecting CNS کاملی 1388

11. Sensory Deficits • Impaired reception, perception or both of the senses • Blindness, deafness, loss of taste, smell, touch • One sense may become more acute to compensate for deficit کاملی 1388

12. Assessing: Sensory Deprivation • Drowsiness/sleeping/yawning • Decreased attention, difficulty concentrating, impaired memory • Disorientation, confusion, hallucinations needs stimulus; body may produce hallucinations to maintain optimal arousal • Crying, annoyance over small matters, depression • Apathy, daydreaming, anger کاملی 1388

13. Risk Factors for Sensory Perception Dysfunction in the Healthcare Environment Sensory Overload • Room close to nurse's station • ICU or intermediate unit • Bright lights • Use of mechanical ventilator • Use of ECG monitor • Use of oxygen • Use of IVs • Other equipment • Frequent treatments

14. Risk Factors for Sensoyr Perception Dysfunction in the Healthcare Environment Sensory Deprivation • Private room • Eyes bandaged • Bed rest • Sensory aid not available (hearing aid, glasses) • Isolation precautions • Few visitors

15. NURSING DIAGNOSIS • Disturbed sensory perception • Social Isolation • Situational low self-esteem • Disturbed thought processes کاملی 1388

16. تشخیصهای پرستاری در اختلالات حسی (مثال) • لامسه ای • من به لمس حساسیت زیادی دارم حتی سنگینی لباسهایم روی پوستم مرا اذیت میکند من سعی میکنم بدنم را هر مقدار که میتوانم • کم حرکت دهم ولی حتی وزش نسیم هم به من غیر ممکن است • محرومیت حسی • اینجا در بیمارستان من فکر میکنم در حال دیوانه شدن هستم به ساعت دیواری که نگاه میکنم تبدیل به یک خورشید چرخان با صورتی غمگین میشود که به من نزدیک شده و من از اینکه خیلی نزدیک شود هراس دارم

17. PLANNING • Client will:Demonstrate understanding by a verbal, written, or signed response (SENSORY DEFICIT) • Client will:Demonstrate relaxed body movements and facial expressions (SENSORY OVERLOAD) • Client will:Remain free from injury کاملی 1388

18. Interventions: Sensory Deprivation • Prevent sensory alteration • Teach self stimulation methods- reading, etc. • Provide stimulation – visual, auditory, gustatory, tactile • Provide reality orientation کاملی 1388

19. معرفی یک سندرم ICU psychosis syndrome کاملی 1388

20. What is ICU psychosis? • ICU psychosis is ICU syndrome. • ICU psychosis is also a form of delirium, or acute mentale failure. How long does ICU psychosis last? • it may last 24 hours or even up to two weeks with fluctuations of the level of consciousness and behavior patterns. کاملی 1388

21. Causes of psychological problems • Sudden and unexpected nature of events • Pain • ICU environmen • Other factors .The loss of control over their lives that patients often feel in an ICU. کاملی 1388

22. What causes ICU psychosis? Environmental Causes • Sensory deprivation (being put in a room often without windows, away from family, friends and all that is familiar) • Sensory overload (being tethered to noisy machines day and night) • Sleep disturbance and deprivation • Continuous light levels • Stress • Lack of orientation • Medical monitoring کاملی 1388

23. What causes ICU psychosis? • Medical Causes • Pain (which may not be adequately controlled in an ICU) • Critical illness: The pathophysiology of the disease, illness or traumatic event - the stress on the body during an illness can cause a variety of symptoms. • Medication (drug) reaction or side effects: • Infection creating fever and toxins in the body.

24. What causes ICU psychosis? • Medical Causes • Metabolic disturbances: electrolyte imbalance, hypoxia (low blood oxygen levels), and elevated liver enzymes. • Heart failure (inadequate cardiac output) • Cumulative analgesia (the inability to feel pain while still conscious) • Dehydration

25. Symptoms of ICU psychosis • extreme excitement • anxiety • restlessness • hearing voices • clouding of consciousness • hallucinations • nightmares • paranoia • disorientation • agitation • delusions • abnormal behavior کاملی 1388

26. Interventions to prevent psychological problems • Pain control、analgesic drugs • Family support • Day-awake,night-asleep • Removing many wires and tubes • Constant and monotonussounds کاملی 1388

27. Interventions to prevent psychological problems • Large clock,calendar and outside window visible to the patients to help with orientation • Personally familiar beside objects such as clock,radio or family photographs. • Use spectacles or hearing aids. Such as radio or television sets to provide meaningful sensory stimuli

28. References • Fundamentals of nursing TAYLOR 2005 • Guyton&hall . Medical physiology 11 TH edition 2006 • Searching of elsevier and other databace کاملی 1388

29. THANK YOU for your attention کاملی 1388