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Care of the Patient with a Sensory Disorder The sensory system constantly gathers information through millions of receptors scattered throughout the body and delivers it to the brain Five major senses: taste touch smell sight hearing
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Chapter 13
Care of the Patient with a Sensory Disorder
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Care of the Patient with a Sensory Disorder The sensory system constantly gathers
information through millions of receptors scattered throughout the body and delivers it to the brain
Five major senses:– taste– touch– smell– sight – hearing
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Normal Aging Crystalline lens of the eye harden and
becomes too large for the eye muscle – loss of accommodation
The crystalline lens also loses some transparency and becomes more opaque – glare begins to be a problem
Pupil becomes smaller and decrease amount of light that reaches the retina – patient needs more light to read
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Normal Aging (con’t) Ear – loses ability to hear high
frequencies and distinguish consonant sounds
Remaining senses have slight changes causing decreased reaction or threshold time – slower responses and diminished sensation
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Laboratory and Diagnostic Examinations After the normal Snellen’s test,
additional eye test may be required – Amsler’s chart – detect defects of the
macular area of the retina– Goldmann perimetry tests – detects
and evaluates intraoccular pressure– Exophthalmometry – measures the
degree of forward placement of the eye– Slit-lamp – examines the conjunctiva,
lens, vitreous humor, iris, and cornea
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Applanation Tonometry
(Figure 13-12)
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Eye Disorders - Nursing Consideration Initial consideration – review of following
items:– Eye pain, pruritus, excessive tearing, floaters,
light flashes, discharge, visual changes, or blind spots
– History of allergies– Current medication, and side effects, for the
eye disorder– Use of glasses or contact lenses– Adequacy of current eyewear prescription– Personal habits related to care of eyewear– Any previous eye injuries or surgeries
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Disorders of the Eye Blindness and near blindness – individuals
with a maximum visual acuity of 20/200 with corrective eyewear and/or visual field sight capacity reduced by 20 degrees
Refractory errors – astigmatism, strabismus, myopia, and hyperopia
Inflammatory and infectious disorders Myopia – elongation of the eyeball Hyperopia – inability to see things at close
range Macular degeneration – slow, progressive
loss of central and near vision
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Other Disorders Glaucoma – elevated pressure within
an eye because of obstruction of the outflow of aqueous humor – Open-angle – common form of the
disease that progresses slowly– Closed-angle – occurs when sudden
blockage occurs– Treatment - Medications and surgery
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Surgery of the Eye Trauma to the eye can result in need for
surgery– Enucleation – surgical removal of the
eyeball– Corneal Transplants – implantation of
donor cornea– Retinal detachment – retina separates
from the choroid in the posterior area of the eye – cryosurgery or scleral buckling are usual treatment
– Vitrectomy – removal of excess vitreous fluid caused by hemorrhage
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Ear Disorders – Nursing Considerations After general assessment, additional
information would include the following:– Occurrence of ear drainage, tinnitus,
vertigo, wax buildup, pressures, pain, and pruritus
– Behavioral clues indicating hearing loss– History of medications used for ear
disorders– Current medications and side effects– Speech pattern abnormalities– Use of assistive hearing device– Home remedies that cause ear trauma
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Disorders of the Ear Inflammatory and infectious –
external otitis, otitis media, and labyrinthitis
Obstructions of the ear – excessive secretions of cerumen or foreign bodies
Noninfectious disorders – otosclerosis (chronic progressive
deafness) – meniere’s – inner ear problem causing
vertigo and tinnitus
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
The Inner Ear
(Figure 13-4)
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Surgery of the Ear Tympanoplasty – designed to restore
or improve hearing with conductive hearing loss
Myringotomy – surgical incision of the eardrum to relieve pressure and purulent exudate
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Nursing Diagnoses Health
maintenance, ineffective
Anxiety Self-care deficit Fear Environmental
interpretation syndrome, impaired
Risk for injury
Home maintenance, impaired
Social interaction, impaired
Loneliness, risk for
Sensory perception, disturbed
Social isolation
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