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Sensory Impairments

Sensory Impairments . Lisa Flatt, RN, MSN, CHPN. Be able to:. Assess vision, hearing, taste, smell, touch and balance Identify the way to reorient to person, place, time and situation Define components of sensory dysfunction assessment State nursing care of patients with sensory dysfunction.

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Sensory Impairments

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  1. Sensory Impairments Lisa Flatt, RN, MSN, CHPN

  2. Be able to: • Assess vision, hearing, taste, smell, touch and balance • Identify the way to reorient to person, place, time and situation • Define components of sensory dysfunction assessment • State nursing care of patients with sensory dysfunction

  3. Definitions to know • See Page 111

  4. Eyes and Ears • Most impact • Proprioception (posture, equilibrium movement) – is maintained by ears and eyes • Eyes and ears send messages to cerebellum in relationship to coordination & perception and provide feedback for movements of the body in space (think of a baby’s head wobble – not related to the neck muscles)

  5. Parts is Parts -- EYES • Eye parts • Outer protection - sclera, cornea, iris, ciliary body • Inner area - retina • Alterations of parts • Presbyopia, hyperopia, myopia, astigmatism, macular degeneration, cataracts, glaucoma, conjunctivitis, corneal abrasions, detached retina; retinopathy

  6. Parts is Parts - EARS • Ear Parts • External ear – auricle auditory canal, tympanic membrane • Internal ear – eustachian tuve, semicircular canan, acoustic nerve • Alterations of Parts • Otitis media, otitis external, cholesteatoma, otosclerosis, masses, cerumen imopaction, prebycusis, Meniere’’s disease, labyrinthitis, hearing loss (conductive or sensorineural), tinnitus

  7. Leading cause of blindness worldwide? • Name it conjunctivitis • Why untreated • Treatment – cheap eye drops

  8. Clinically you will see: • Neurovascular deficits- injury to neurologic and vascular systems at one time • What may have happened bleeds, clots • Disease states HTN, CVA, TIA • Numbness, tingling is called neuropathy

  9. And more…. • Signs of impaired vision are: squinting, balance issues, moving furniture is bad, glasses, headaches, double vision, cloudy, hazy

  10. And more……. • Signs of impaired hearing are: what?, looking at face, leaning, balance, sounds, repeating stuff, loud talkers

  11. Factors that influence, Psychological • Psychological- PTSD, depression • Sensory deprivation – lack of stimulation • Sensory overload – too much stimulation • Social isolation – no people interaction, 4000 facebook friends • Paranoia – they want me, vulnerability, weakness

  12. More factors: • Socioeconomic—can’t afford stuff • Environmental –train tracks, work • Chronic illness - no money • Medications – cannot afford

  13. The Illustrious Nursing Process the Eyes have it! • Assessment • PERRLA • Eye movement • Visual fields – metric ophthalmoscopy – papilledema – tonometry – noncontact tonometry – accommodation - refraction • Slit Lamp exam • Color vision test • Amsler grid • Fluorescent angiography • Functional visual acuity (Snellen chart)

  14. The Ears Have it! • Hearing tests (audiometry, tympanogram, functional hearing) • Weber test • Physical exam • Platform posturography • Sinusoidal harmonic acceleration (rotary chair)

  15. Analysis/Nursing Diagnosis

  16. Planning

  17. Implementation

  18. Evaluation

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