Sensory deprivation Introduction An individual senses are essential for growth, development and survival.

Sensory stimuli give meaning to events in the environment. Any alteration in peoples sensory functions can affect their ability to function within the environment. For example, many clients have impaired sensory functions that put them at risk in the health care setting; nurse can help them find ways to function safely in this often confusing environment. Definition: Sensory deprivation is a state in which the overall quality or diversity of sensory input is decreased. People often compensate for an overall reduction in stimuli by increasing internal stimuli. -Black M.Jayee, 1997 Components of the sensory experience person. The sensory process involves two components 1) Sensory reception 2) Sensory perception

1) Sensory reception Sensory reception is the process of receiving stimuli or data. These stimuli are external or internal to the body. a) External stimuli Visual, auditory, olfactory (smell), tactile (touch) and gustatory (taste) b) Internal stimuli Gustatory (taste) It can be external as well as internal stimuli. Kinesthetic

Its refers to awareness of the position and movement of body parts. Example, a person walking is aware of which leg is forward. Sterognosis: The awareness of an objects size, shape, and texture. Example, a person holding a tennis ball is aware of its size, round, shape and soft surface without seeing it. Visceral It refers to any large organ within the body visceral organs may produce stimuli that makes a person aware of them. Example, a full stomach. 2) Sensory perception Sensory perception involves the conscious organization and translation of the data or stimuli into meaningful information For an individual to be aware of the surroundings, four aspects of the sensory process must be present. a) Stimuli: An agent or act that stimulates a nerve receptor b) Receptor A nerve cell acts as receptor by converting the stimulus to a nerve impulse, most receptors are specific, that is sensitive to only one type of stimulus, such as visual, auditory, or touch. c) Impulse conduction: The impulse travels along nerve pathway to the spinal cord or directly to the brain. For example, auditory impulse travels along the eight cranial nerve to the temporal lobe of the brain. d) Perception Perception or awareness and interpretation of stimuli, takes place in the brain, where specialized brain cells interpret the nature and the quality of the sensory stimuli. The level of consciousness affects the perception of the stimuli.

Factours that influence sensory function: a)Age 1) infants: Infants have immature nerve pathways and are initially unable to discriminate sensory stimuli. Binocular vision begins at 6 weeks of age and is well established by 4 months. During the second month of life, the infant can discriminate shapes, objects and colors.

2) Children Refractive errors are the most common type of visual disorders in the children Hearing loss in infants can occur from a variety of prenatal and postnatal conditions discovering of hearing impairments within the first 6 to 12 months of life is essential. Hearing loss can impair speech development. 3) Adults Visual changes during adulthood includes presbyopia (inability to focus on near objects) and the need for glasses for reading (age 40-50) 4) Older adults: Hearing changes, which begins at the age 30, include decreased hearing activity, speech intelligibility and pitch discrimination. Older adults have reduced visual fields, increased glare sensitivity, impaired night vision, reduced accommodation, and depth perception, and reduced colour discrimination. Older adults experience olfactory changes including a loss or cells in the olfactory bulb of the brain and decrease in the number of the sensory cells in the nasal lining. This change begins around age 50 reduced sensitivity to odors in common. Older adult experience tactile changes including declining sensitivity to pain, pressure and temperature.

 Age causes taste buds to atrophy to loss efficiency in relaying flavor, and to reduce in number. Reduced taste discrimination is common b) Medication: Many medications causes ototoxicity which may affect hearing balance or both. These drugs are amikacin, gentamysin, streptomycin, asprin, ibuprufin etc. Chloramphenical is an antibiotic that can irritate the optic nerve Narcotics analgesics, sedatives, and antidepressant medications can alter the perception of stimuli. c) Environment: Excessive environmental stimuli (e.g. Hospital equipment staff conversation) can result in sensory overload, marked by confusion, disorientation, and inability to make decisions. Restricted environmental stimulation (e.g. Bed rest and isolation) can leads to sensory deprivation. Poor quality of environment (e.g. Reduced lighting, narrow walk ways, and background noise) an worsen sensory impairment. d) Pre-existing illnesses: Peripheral vascular disease can cause reduced sensation in the extremities and impaired cognition. Chronic diabetes can cause reduced vision or blindness. Neurological disorders such as stroke impair sensory reception. e) Smoking Chronic tobacco use atrophy the taste buds, lessening the perception of flavors , long term exposure to tobacco smoke and other toxins interferes with olfactory function. f) Noise level: Constant exposure to high levels ( eg. Construction work) can cause hearing loss.

Types of sensory alterations: The sensory alteration is classified in 3 categories, a) Sensory deprivation b) Sensory overload c) Sensory deficits Sensory deprivation Sensory deprivation is generally through of as a decrease in or lack of meaningful stimuli when a person experiences sensory deprivation. The balance in the reticular activating system(RAS) is disturbed. The RAS is unable to maintain normal stimulation to the cerebral cortex, because of this reduced situation, a person becomes more acutely aware of the remaining stimuli and often perceives these in us distorted manner, thus the person often experiences alterations in perception, cognition and emotion. Sensory overload Sensory overload generally occurs when a person is unable to process or manage the amount or intensity of sensory stimuli. Three factours contribute to sensory overload. Increased quality or quality of internal stimuli such as pain , dysponea, anxiety Increased quality or quality of external stimuli such as a noisy care setting. Intrusive diagnostic studies and conduct with many strangers. Inability to disregarded stimuli selectively, perhaps as a result of nervous system disturbances or medications that stimulate the arousal mechanism Sensory deficits: A sensory deficit is any loss in the ability to sense or perceive stimuli. It occurs in the sense organs and is not related to the amount of stimulation in the movement. A person may be born with a sensory deficit (congenital deficit) or deficit may be acquired

suddenly or gradually. If a sensory function is lost gradually. The person may be able to compensate for the loss. Types of sensory deprivation: 1. Reduced sensory input: E.g. Hearing loss and visual loss 2. Elimination of order or meaning from input: E.g. In confusion, exposure to strange environment 3. Restriction of the environment E.g., bed rest or reduced environment variations Management of acute sensory deficits. When assisting clients who have a sensory deficits, the nurse needs to (a) encourage the use of sensory aids to support residual sensory function.(b) promote the use of other senses (c) communicate effectively, and (d) ensuring client safely. Sensory aids to support residual sensory function. Eye glasses, adequate room lighting, reading material with large print, hearing aid good order, lip reading. Promoting the use of other senses. When one sense is lost, the nurse can teach the client to use other sense to supplement the loss. for example the visually impaired client. Stimulation of hearing, taste, small and touch can be encouraged. Diets that includes a variety of flavors, temperatures, and textures can he planned to stimulate the taste buds. Fresh flowers, room fragrances, brewing of coffee, and baking can stimulates the sense of smell.

Communicating efficiency Visual deficit Always announce your presence when entering the clients room and identify yourself by name. Speak in a warm and present tone of voice. Always explain who you are about to do before touching the patient. Indicate when the conversation has ended and when you are leaving the room. Ensuring clients safety. Nurses must implement safety precautions in health care settings for clients with sensory deficits and teach them special precautions to ensure their safety at home. Prevention of sensory deprivation Encourage the client to use glasses and hearing aids Address the client by name and touch the client while speaking if not culturally offensive Communicative frequency with the client and maintain meaningful interaction eg. Discuss current events. Provide a telephone , radio or TV and calendar Have family and friends bring freshly cut flowers and plants Encourage social interaction through activity groups or visits by family and friends Encourage environment changes such as a walk through mall, or for an immobilization client sitting near a window. Prevention of sensory overload: Minimize unnecessary light, noise and distraction provides dark glasses and plugs as needed. Control pain as indicated.

 Providing orientating cues such as clocks, calendars, equipments and furniture in the room. Provide a private room. Limits visitors Describe any tests and procedures to the clients beforehand.

Conclusion The methods of patient care, who have sensory alterations or sensory deprivation are same.

Sub: ANP Unit: 5

Sensory deprivation
(SEMINOR)

SUBMITTED TO MRS.LAKSHMI PRABA SENIOR LECTURER VMACON. SUBMITTED BY E.SELVAMUTHU MSC(N) 1ST YEAR