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Concept of Sensory Alteration


Sensory perception depends on the sensory receptors, reticular activating system ... person may enjoy a lifestyle surrounded by many people, frequent changes, bright ... – PowerPoint PPT presentation

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Title: Concept of Sensory Alteration

Concept of Sensory Alteration
  • Normal Sensory Perception
  • Sensory perception depends on the sensory
    receptors, reticular activating system (RAS), and
    functioning nervous pathways to the brain. The
    RAS influences awareness of stimuli, which are
    received through the five senses sight, hearing,
    touch, smell, and taste. Kinaesthetic
  • and visceral senses are stimulated internally.
  • Reticular activating system (RAS)
  • It is responsible for bringing together
    information from the cerebellum and other parts
    of the brain with the sense organs.
  • The RAS is highly selective. For example, a
    parent may be awakened in the middle of the night
    at the slightest murmur of an infant in a bedroom
    down the hall but may sleep through the loud
    traffic noises outside the bedroom window.
    Destruction of the RAS produces coma and an
    electroencephalograph pattern characteristic of

  • Input of Senses
  • Sensory function begins with reception of stimuli
    by the senses.
  • Externally, the senses receiving stimuli are
  • Vision, hearing, smell, taste, and touch.
  • Receptor organs are
  • The eyes, ears, olfactory receptors in the nose,
    taste buds of the tongue, and nerve endings in
    the skin.
  • Internally, the kinaesthetic and visceral senses
    receive stimuli. These receptors are nerve
    endings in the skin and body tissues. The
    kinaesthetic sense influences awareness of the
    placement and action of body parts. The visceral
    sense receives stimuli that affect awareness
    related to the body's large interior organs.
    Vision, hearing, smell, and taste are termed,
    special senses. Touch, kinesthetic sensation, and
    visceral sensation are termed somatic senses.
    After stimuli are received, they are perceived
    with the help of the RAS. Sensory perception is a
    consociates process of selecting, organizing, and
    interpreting sensory stimuli requiring intact and
    functioning sense organs, nervous pathways, and
    the brain.

  • Characteristics of Normal Sensory Perception
  • These are the normal measures in quality and
    quantity of the special and somatic senses.
  • Normal vision is associated with visual acuity at
    or near 20/20, full field of vision, and
    tricolour vision (red, green, blue).
  • Normal hearing is associated with auditory acuity
    of sounds at an intensity of 0 to 25 dB, at
    frequencies of 125 to 8,000 cycles per second.
  • Normal taste involves the ability to discriminate
    sour, salty, sweet, and bitter.
  • Normal smell involves the discrimination of
    primary odours, such as cainphoraceotrs, musky,
    floral, peppermint, ethereal, pungent, and
  • Somatic senses include discrimination of touch,
    pressure, vibration, position, tickling,
    temperature, and pain.

  • Normal Sensory Pattern
  • Sensor stasis
  • Each person has his or her own comfort zone.
    This comfort zone varies from person to person
    and is the range at which a person performs at
    his or her peak. Sensor stasis is a state of
    optimum arousal-not too much and not too little.
    The RAS is viewed by some theorists as a monitor
    for sensor static balance.
  • Adaptation
  • Beyond the point of sensor stasis, sensory
    adaptation occurs. Sensory receptors adapt to
    repeated stimulation by responding less and less.
    Lead time and after burn are two necessary time
    periods crucial to helping a person deal with new
  • Lead time is the time each person needs to
    prepare for an event emotionally and physically.
  • After burn is the time needed to think about,
    evaluate, and come to terms with the activity
    after it happens.
  • The necessary amount of lead time and after burn
    is different for each person. Lead time and after
    burn helps person process stimuli so he or she
    can respond appropriately without becoming

  • Factors Affecting Sensory Perception
  • Environment
  • Sensory stimuli in the environment affect sensory
    perception. For example, a teacher may not notice
    the noise in a consistently noisy environment,
    such as the school cafeteria. But the same
    teacher may perceive a loud television set very
    differently in his or her own home, which is
    usually quiet.
  • Previous Experience
  • It affects sensory perception in that people
    become more alert to stimuli that evoke a strong
  • response. For example, a person may drive to work
    by the same route each day, noticing little along
    the way. A person may listen to the radio
    inattentively until a favourite song is played,
    then listen to every word. A new experience, such
    as hospitalization, may cause a client to
    perceive a barrage of threatening new stimuli.

  • Lifestyle and Habits
  • It affects sensory perception. One person may
    enjoy a lifestyle surrounded by many people,
    frequent changes, bright lights, and noise.
    Another person may prefer less contact with
    crowds, less noise, and a slow-paced routine.
    People with different lifestyles perceive stimuli
  • Cigarette smoking causes atrophy of taste buds,
    decreasing sensory perception of taste. Chronic
    alcohol abuse may lead to peripheral neuropathy,
    a functional disorder of the peripheral nervous
    system those results in sensory impairment.
  • Illness
  • Certain illnesses affect sensory perception.
    Diabetes and hypertension cause changes in blood
    vessels and nerves, leading to visual deficits
    and decreased sensation of touch in the
    extremities. Cerebrovascular disorders impair
    blood flow to the brain, possibly blocking
    sensory perception. Pain, fatigue, and stress
    caused by illness also affect perception of

  • Medications
  • Some antibiotics, including streptomycin and
    gentamicin, can damage the auditory nerve,
    impairing hearing. Central nervous system (CNS)
    depressants, such as narcotic analgesics,
    decrease awareness and impair perception of
  • Variations in stimulation
  • If a person experiences more sensory stimulation
    than he or she is used to or can make sense of,
    distress and sensory overload may occur.
  • On the other hand, if a person experiences less
    than the usual stimulation, that person is below
    his or her optimum state of arousal and may be at
    risk for sensory deprivation.
  • Reactions to sensory overload or sensory
    deprivation are special challenges that nurses
    frequently encounter in themselves and clients.
    Sensory overload and deprivation can lead to
    perceptual, cognitive, and decisional problems.
    When the RAS is overwhelmed with input, a person
    may experience sensory overload and feel
    confused, anxious, and unable to taken
    constructive action . When the RAS fails to
    recognize a stimulus because it is below the
    threshold level or lacks relevant meaning to the
    person, sensory deprivation may occur, and the
    person experiences depression, restlessness, and

  • Sensory overload
  • It occurs when a person is unable to process or
    manage the intensity or quantity of incoming
    sensory stimuli. The person feels out of control
    and overwhelmed by the excessive input from the
    environment. Routine activity in the health
    setting can contribute to sensory overload in
  • These activities fall into three main categories
  • internal factors,
  • information, and
  • environment .
  • Internal Factors
  • such as thinking about surgery or the meaning of
    a medical diagnosis, can contribute to anxiety
    and cognitive overload so that the person cannot
    process additional stimuli. Pain, medication,
    lack of sleep, worry, and brain injury also can
    contribute to a person's vulnerability to sensory

  • Information
  • It is Imparting information to a client may lead
    to sensory overload. Some examples include
    teaching a client about a procedure, informing a
    client about a diagnosis, making requests of a
    client, or helping the client solve a problem.
    Anxiety related to medical diagnosis, prognosis,
    and treatment can contribute to sensory overload.
    Lights and frequent activity may cause sensory
    overload in a premature newborn in the neonatal
    intensive care unit.
  • Environment
  • The environment of the healthcare agency provides
    a higher than usual amount of sensory
    stimulation. A client newly admitted to the
    hospital, for example, may have to cope with
    adjusting to a new roommate, having the
    television on more than usual, bright lights,
    paging systems, meeting many staff members,
    having the bed move up and down at someone else's
    bidding, waiting for someone to answer the call
    light, uncontrolled pain, and having strangers
    touch and not respect private body areas. Clients
    in intensive care units often exhibit symptoms of
    sensory overload because of the high degree of
    light, noise, and activity around the clock.

  • Sensory Deprivation
  • Although sensory deprivation can be thought of as
    the opposite of sensory overload, they share many
  • Sensory deprivation generally means a lessening
    or lack of meaningful sensory stimuli, monotonous
    sensory input, or an interference with the
    processing of information.

  • Sensory deprivation (under stimulation)
  • It can be just as disruptive as sensory
    overload. Cognitive and emotional deterioration
    can occur when stimuli are reduced below a
    person's optimum level of stimulation. One common
    source of sensory deprivation is a sudden
    decrease in stimuli when a person moves from a
    fast- to a slow-paced environment.
  • Each person's tolerance of and reaction to a
    lessening or lack of meaningful sensory stimuli
    differs, but clients with extreme cases
    experience a gross misperception of events and
    personality changes. Any time a client
    experiences an interference with or a diminution
    of sensory input, that person may be at risk for
    sensory deprivation.
  • In the hospital such occurrences fall into two
    general categories
  • altered sensory reception
  • deprived environments

  • Altered sensory reception
  • Occurs in such conditions as spinal cord injury,
  • brain damage, changes in receptor organs, sleep
    deprivation, and chronic illness. The person does
    not receive adequate sensory input because of an
    interference with the nervous system's ability to
    receive and process stimuli.
  • Deprived environments
  • It can have negative effects on a person's sensor
    stasis. A person who is immobilized or isolated
    for any reason is deprived of the usual amount of
    stimulation and may show manifestations of
    sensory deprivation

  • Manifestations of Altered Sensory Perception
  • Anxiety
  • Cognitive Dysfunction, which is a Disturbance in
    remembering, reasoning, and problem solving may
    occur with sensory overload.
  • Hallucination and Delusions (beliefs not based in
    reality) reflect an unconscious need or fear
  • Sensory Deficit
  • Depression and withdrawal

  • Impact on Activities of Daily Living
  • Sensory perception dysfunction may have effects
    on activities of daily living (ADLs). Visual
    deficits cause problems with self-care activities
    as basic as dressing, toileting, and preparing
    meals. Hearing deficits may restrict people from
    watching television, listening to the radio, and
    answering the telephone. Safety hazards also
    exist for who are hearing impaired.
  • People with taste and smell deficits may lose
    interest in eating.
  • Those with sensory deficits involving touch are
    at risk for burns and injuries to the
    extremities. Moving around outside the home may
    be impossible without special aids or help .
  • Many jobs are prohibited for people with sensory
    deficits, and driving may not be allowed.
  • This further restricts the environments in which
    they may move about safely, making them dependent
    on others. If the affected person is the major
    wage earner, a reduction in or loss of income may
  • People with cognitive dysfunction from sensory
    overload or deprivation may exhibit poor judgment
    and problem solving during everyday activities,
    increasing the necessity for family members to
    monitor activities and decisions.
  • All these concerns place more stress on the
    family to cope with sensory
  • dysfunctions.

  • 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
  • Sensory Deprivation
  • Private room
  • Eyes bandaged
  • Bed rest
  • Sensory aid not available (hearing aid, glasses)
  • Isolation precautions
  • Few visitors

  • Diagnostic Statement
  • Sensory/Perceptual Alterations
  • Definition Sensory/perceptual alteration is a
  • state in which a person experiences a change in
    the amount or patterning of oncoming stimuli,
    accompanied by a diminished, exaggerated,
    distorted, or impaired response to such stimuli
    (NANDA, 1999) .
  • Nurse-Client Interaction
  • It promotes sensory health function. Clients at
    risk for sensory deprivation may need frequent
    interaction initiated by the nurse. In any case,
    provide appropriate stimuli, such as addressing
    The Client by name, explaining all activities,
    and, when leaving, acknowledging client that the
    nurse will return. Length, tendency, and content
    of interactions should he based on individual
    needs. Talking to the client, showing the client
    equipment or articles used in care, encouraging
  • the client to smell and taste food that is
    served, and touching the client are appropriate
    stimuli during interactions

  • Nursing Interactions for Altered
  • Sensor- Perception function Stimulation
  • Providing meaningful external stimuli can help a
    client overcome sensor' deprivation or sensory
    deficit as playing the television or the radio
    occasionally. playing tennice,
  • Encouraging use of a clock and calendar,
  • Encouraging the client to dress or the day's
    activities, putting till pictures,
  • Encouraging visitors, opening the drapes, and
    turning on lights.
  • Plan the bed or chair so the client can see or
    hear activities in the area.