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Sensory Perception and Cognitive Process

Senses Visual, auditory, gustatory (taste), tactile (touch), olfactory, kinesthetic (movement), stereognosis (3d. Perception of depth)
Components of Sensation Reception (stimuli i.e. smoke), Perception (receiving & interpreting sensory stimuli i.e. recognize smoke), reaction (i.e. react to smoke)
Sensory Deficit Impairment, or lack of senses.
Sensory Deprivation Reduction or absences of usual and accustomed visual, auditory, tactile, or other stimuli.
Signs and symptoms of sensory deprivation Anxiety, depression, boredom, unsettled feeling, hallucinations
Causes of sensory deprivation Altered sensory reception (e.g. spinal cord injury, brain damage, sleep deprivation). Deprived environments (e.g. patients who are immobilized or isolated)
Sensory Overload Condition in which one or more of the senses are over stimulated. S&S: agitation, racing thoughts, confusion
Causes of sensory overload Pain, medication, lack of sleep, worry. Giving or teaching a patient new information. Lighting, noise, roommate, meeting many staff members, activity around the clock.
Factors Affecting Sensory Function Age, Persons at Risk: elderly, hospitalized. Meaningful stimuli. Amount of Stimuli: Under- and overstimulation. Family Factors: Support systems
Altered thought process Sun-downer's. A&Ox3. Not confused, over-stimulated by hospital.
Most common diagnosis for elderly admitted with change in mental status UTI
ICU Psychosis Altered thought process
Visual alterations Presbyopia (old age), cataract (looks cloudy. Zeus), Glaucoma (progressive and irreversible. pressure on eye), retinopathy (general term for noninflammatory damage to retina) macular degeneration (loss of center vision. see parameter of face but not face)
Hearing alterations Presbycusis (age-related), cerumen accumulation
Neurological alterations Peripheral Neuropathy (fingertips/toes)CVA/stroke
Assessment Thorough history, mental status, physical assessment, self-care abilities, health promotion, safety, communication, support
Implementation Health promotion, screening, safety, promoting stimulation and communication
Cognition The systematic way in which a person thinks, reasons, and uses language. The mental process of knowing, including aspects such as awareness, perception, reasoning, and judgment
Normal cognitive processes Cognition, consciousness, attention, memory, learning, communication, perception of information, thoughts, memory, speech
Characteristics of normal cognition Intelligence, reality perception, orientation, judgment, recall and recognition, language
Normal Cognitive Patterns Attending, perceiving, thinking, learning, remembering, communicating
Factors affecting cognitive function Age, nutrition & metabolism (hypernatremia->confusion), sleep and rest; self-concept, infectious processes, degenerative processes, pharmacologic agents
Other factors affecting cognitive function Head trauma, environmental factors, culture, values, and beliefs
Impaired thought processes Disorganized thinking, altered level of arousal, altered attention, memory impairment
Expressive aphasis (Broca's aphasia) Inability to express words one wants to say (verbal or written). Limited speech; slow or takes great effort; reduced grammar; poor articulation. Person knows what he/she wants to say but can't find words
Receptive aphasia (Wernicke's aphasia) Difficulty understanding verbal or written words. Impaired auditory comprehension and feedback.
Dysarthria- Motor speech disorder (r/t stroke or brain injury) Speech is slurred or garbled, slow, soft
Delirium Acute confusional state; typically sudden onset. Can potentially be reversed; often due to a physiological cause. Requires prompt assessment and intervention.
What are some causes of delirium? Environmental: hospital. 20-40% metabolic. Organ failure. Thyroid. Medications: Antidepressants.
Signs and symptoms of delirium Confusion, hallucinations. Memory deficit.
Dementia Generalized impairment of intellectual functioning: interferes with social and occupational functioning. Gradual onset: progressive and irreversible.
Alzheimer's Disease Most common; cause is unknown. Progressive symptoms. Amnesia: partial/total loss. Agnosia (loss of ability to recognize smell, taste, touch) Apraxia (loss of ability to execute, learn purposeful movement) Aphasia.
Types of dementia Diffuse Lewy Body Disease. Frontotemporal Dementia. Vascular Dementia (2nd most common)
Depression reversible condition. May be mistaken for dementia. Common in the elderly.
Signs and symptoms of depression Sadness, fatigue, anger. Abandoning or losing interest in hobbies, social withdrawal and isolation, weight loss, loss of appetite, sleep disturbances, loss of self-worth, increased use of alcohol or other drugs, fixation on death, suicidal thoughts
Polypharmacy Use of multiple medications by a patient at one time. May lead to drug interactions causing impaired cognitive function. increased risk in older adults.
Alterations in Diagnostic Tests Glucose levels:>70 mg/dL. Electrolytes: Sodium if less than 135 or more than 145-cognitive alteration. Calcium: when >14 mg/dL can cause confusion. Oxygen saturation. Ammonia and Urea: can become elevated with liver or kidney failure. Drug toxicity
Risks for older adults in the acute care setting Dehydration and malnutrition, delirium, nosocomial infection, urinary incontinence, skin breakdown, falls
Physiological concerns of older adults Prevention and management of diseases, nutritional needs, encouraging exercise, assisting with sensory impairments, medication use
Psychosocial concerns of older adults Therapeutic communication, touch, reality orientation, validation therapy, reminiscence, body image interventions
Diagnosis Acute or chronic confusion, impaired memory, impaired verbal communication
Implementation Health promotion, orientation to surroundings, communication methods, safety
Created by: senmark