Lifespan Week 9 Study Guide PDF

Sensory stimuli give meaning to event in the environment Five sense essential for growth, development, and survival ○ Vision ○ Hearing ○ Touch ○ Smell ○ Taste Sensory perception is protective Sensory reception is the process of receiving stimuli or da...

Sensory stimuli give meaning to event in the environment Five sense essential for growth, development, and survival ○ Vision ○ Hearing ○ Touch ○ Smell ○ Taste Sensory perception is protective Sensory reception is the process of receiving stimuli or data External stimuli ○ Visual ○ Olfactory Ask if olfactory can be internal as well in the muddy points ○ Auditory ○ Tactile ○ Gustatory Can be internal as well ○ Internal stimuli Kinesthetic- awareness of the position and movement of the body parts Balance- sense it vital for movement, position, and coordination Stereognosis- ability to perceive and understand an object through touch Visceral- any organ within the body Example: stomach can make you feel hungry or full Sensory perception involves conscious organization of data or stimuli into meaningful information Four aspects of sensory process ○ Stimulus ○ Receptor ○ Impulse conduction ○ Perception Level of consciousness affects perception ○ Brain adapts to stimuli, does not act on all stimuli immediately Some stored in memory to be used later Non specific alteration in the sensory perception ○ Vertigo Feel of rotation or imbalance Can cause nausea and sometimes difficult to diagnose stoke , head trauma, vestibular infection or calcium crystals within the inner ear. Nystagmus ○ Color blindness ○ Impaired olfaction ○ Taste disturbance Common eye problems are refractive errors ○ Myopia- nearsightedness  ○ Hyperopia- farsightedness ○ Astigmatism- altered vision at any distance ○ Presbyopia- impaired vision related to aging Infants at high risk for visual and or hearing problems ○ Premature ○ Mother infected prenatally with rubella, toxoplasmosis or other virus ○ Congenital, hereditary disorders ○ Genetic abnormalities ○ Absence of other problems or in conjunction with other genetic syndrome Blindness or visual impairments in children ○ Retinopathy of prematurity ○ Low birth weight ○ Congenital cataracts Prenatal visual and hearing disturbances ○ Fetal alcohol syndrome Auditory processing disorder ○ Difficulty differentiating individual sounds in words ○ Older adults cultural , genetic component to visual disorders Open-angle glaucoma is the most prevalent among african americans, hispanic origins Visual impairment due to refractive error is most percent among american indians/native americans Illness that put people at risk ○ Atherosclerosis Restricts blood flow to receptor organs and brain ○ Hypertension If uncontrolled can lead to blindness ○ Strokes causes blindness, hearing loss, changes in smell/taste ○ Controlled diabetes mellitus Leading cause of blindness in the USA ○ Maternal diabetes Increases hearing impairments to fetus ○ Repeated bouts of otitis media in children Damages eardrums Concepts related to sensory reception ○ Cognition ○ Self ○ Safety ○ Stress and coping ○ Infection ○ Communication Health promotion  Avoid exposure to loud noise Safety glasses, goggles Encourage ear protection Hearing ○ Newborns Screened routinely and before discharge ○ Preschoolers/ school age children screen periodically at school/healthcare provider Vision ○ Children should be screened age 3-5 at least once ○ Comprehensive eye exam at age 40 ○ Adults with no comorbidities Exams every 5-10 years Nursing assessment ○ Identification of patients at risk Higher risk Altered mobility Multiple comorbidities Older Involved in contact sports Smokes Comorbidities(medical conditions that coexist alongside a primary diagnosis and affect your health) Vision impairment ○ Diabetes mellitus ○ Heart problems ○ Breathing problems ○ HTN ○ Joint problems ○ Stoke Hearing Loss Diabetes Depression Kidney Disease Dementia Physical assessment ○ Specific sensory tests Visual acuity Hearing acuity Olfactory sense Gustatory sense Tactile sense ○ Perception of heat, cold, light touch, pain, and proprioception  ○ Eye and vision assessment Cardinal fields of vision (pen or finger movement)\ Ophthalmoscope (internal eye structures) Done by a specialist ○ Ear and hearing assessment Otoscope ( external auditory canal, tympanic membrane Level of hearing loss Tuning fork Independent Interventions ○ Managing acute sensory deficits Encourage use of sensory aids Promote use of other senses Communicate effectively Ensure safety Adapting to limits imposed by sensory loss Visually impaired patients may enjoy live music, podcasts, audiobooks Hearing impaired patients may use email, text instead of phone calls ○ Impaired vision Monitor for depression Uncluttered environment with good lighting Clear pathways Organizing things within reach ○ Impaired hearing Devices that amplify sounds or respond to sounds with flashing lights Tv , videos with closed captioning ○ Impaired olfactory Dangers of cleaning with some chemicals Gas appliance in good working order Inspect food for freshness, expiration dated ○ Impaired tactile Adjust temperature on hot water heater to avoid burns Change position to prevent pressure ulcers ○ Impaired balance Uncluttered and good lighting PT/OT Collaborative therapies ○ Vision disorders Optometrist Ophthalmologist Surgery Cataract, glaucoma or laser eye surgery Corneal transplant surgery  Repair detached retinas Eye muscle surgery After direct major injury to eye ○ Alteration in smell and taste Surgery for polyps, deviated septum ○ Hearing disorders Audiologist Otolaryngologist Hearing instrument specialist Physical or occupational therapist American sign language Lip reading classes Infants ○ Vision problems Strabismus- crossed eyed Excessive tearing Amblyopia-lazy eye Nystagmus Myopia Hyperopia Cancer ○ Hearing tests Otoacoustic emission test Auditory brainstem response test ○ Sense of touch Not routinely assessed Nurse can assess via observation\ Vertigo is associated with the following ○ Gender ○ Stress ○ Muscle pain in neck and shoulder area ○ Amount of sleep ○ Migraine ○ Dizziness Pregnant women ○ Tinnitus- ringing in ears ○ Vertigo ○ Heighted sense of smell Nausea vomiting Food cravings Temporary, relieved upon delivery Most common diseases of eye ○ Caracts ○ Glaucoma  ○ Age-related macular degeneration Inflammation of the eye can occur because of ○ Local or systemic allergic reactions ○ Conjunctivitis ○ Uveitis ○ Eye injury ○ Glaucoma ○ Macular edema ○ Dry eye syndrome Cataracts ○ Opacification (clouding) of the lens of the eye that interferes with light and ability to to perceive images clearly ○ Most are the result of aging process ○ Four type of occur independent of aging process Secondary Form after surgery to treat another eye disorder or effect of medication or another primary disorder Traumatic Results from injury to eye Radiation Congenital ○ Risk factors Age Genetics Environmental , lifestyle factors Long-term sun exposure Cigarette smoking Heavy alcohol consumption Eye trauma Diabetes mellitus Medications ○ Prevention No known methods Risk reductions No smoking Refrain from heavy alcohol consumption Protecting eyes from UVB rays Diet with sufficient vitamins C and E, letein, zeaxanthin Glaucoma ○ Primary glaucoma No identified cause Open angle glaucoma Chronic, gradually progressive loss of vision Most common form in adults  ○ Angle closure glaucoma Rapid, permanent vision loss if not treated May have intermittent episodes Episodes associated with factors that cause pupils to dilate. ○ Risk factors Second leading cause of blindness worldwide Age Race Family history Long-term steroid use Eye trauma is secondary glaucoma years later Myopia HTN Thin corneas Diabetes ○ Preventions Regular exams Exercise to lower intraocular pressure Healthy diet High in vitamins, zinc, fatty acids, omega 3 Prevent overexposure to sunlight Refrain from smoking Macular Degeneration ○ Degeneration of macular area of retina Nonexudative (DRY) age-related macular degeneration (AMD) Gradual accumulation of deposits (drusen) Vision loss typically not significant, progresses slowly Exudative (WET) A M D Growth of blood vessels between choroid and retina Distorts vision Bleeding can occur causing acute vision loss ○ Risk factors Aging Race Eye color Family history Seen more in women Smoking Obesity Poor cardiovascular health Excessive UV exposure Heavy alcohol consumption ○ Prevention No smoking  Reducing UV exposure Cataracts ○ Visual acuity decreases Affecting clos/distant vision Causes glare ○ Bilateral unless due to trauma One cataract matures faser Glaucoma ○ Open angle Often asymptotic Blank spots start to appear in visual field ○ Angle closure Can cause intermittent pain, photophobia Seeing halos around lights ○ Acute angle closure Severe eye, face pain Malaise, nausea, vomiting Babropts decrease in visual acuity ○ AMD Blurred vision blind/blurry spots in central visual field Colors less bright Difficulty recognizing faces Rely on peripheral fields Nonpharmacologic therapy ○ Cataracts Magnifying glass Stronger prescription lenses brighter light Anti Glare sunglasses ○ Glaucoma Relaxation,regular exercise to lower intraocular pressure Angle closure is not responsive to exercise ○ AMD Magnifiers Large-print books, magazine High intensity lighting E-readers Audiobooks, podcasts Infants and children ○ Congenital cataracts Lack of reaction to bright light Failure to notice toys/faces Developmental delays ○ Pediatric glaucoma  Difficult to diagnose ○ Juvenile Macular Degeneration Not treatable or preventable Inherited ○ Pregnant women Glaucoma Rare in childbearing age May opt for surgery before ○ Older adults dry eye syndrome Medication Chronic conditions Tremors make drops difficult Cognitive decline may cause forgetting medications Diagnosis ○ Patient advocacy, psychological and emotional support, teaching/learning needs are of high priority ○ Problems of patients with eye diseases may include Anxiety Fear Inadequate health management skills Inadequate health maintenance skills Risk for injury Conductive hearing loss ○ Disruption in transmission of sound Causes Most common: obstruction of external ear canal Impacted cerumen Perforated tympanic membrane Disruption or fixation of ossicles Chronic and untreated ear infections Sensorineural hearing loss Affects inner ear, auditory nerve pathway Causes may be congenital, genetic, or acquired ○ Major cause: noise exposure ○ Ototoxic drugs ○ Prenatal exposure to rubella ○ Infections, tumors, vascular disorders, degenerative diseases ○ Aging Presbycusis ○ Hair cells of cochlea degenerate with aging ○ Begins in early adulthood, progresses through rest of life ○ Higher pitched tones, conversational speed lost initially Congenital hearing loss  ○ Hearing loss in the newborn ○ Cause of hearing loss is genetic ○ Often present as part of a syndrome, such as down syndrome or usher syndrome ○ Infection, maternal diabetes, prematurity, low birth weight, and maternal drug and alcohol use are other causes Risk factors ○ Age Infants and children Family history NICU stay for more than 5 days Infection while in utero Craniofacial abnormalities Otitis media Prevention ○ Noise induced hearing loss (NIHL) Associated with prolonged exposure to sounds more than 85 dB Use of ear buds/headphones ○ Ototoxic medications Aminoglycosides Platinum analogs Loop diuretics Others (chloroquine, quinine, salicylates)