Chapter 37: Sensory Perception
Copyright © 2014 Pearson Canada Inc.
37-3
4. During the physical examination, the nurse assesses vision and hearing, and the olfactory, gustatory,
tactile, and kinesthetic senses. Specific sensory tests include visual acuity (Snellen chart or other
reading materials) and visual fields; hearing acuity (response to conversation, whisper, Weber and
Rinne); olfactory sense (identification of aromas); gustatory sense (identification of three tastes); and
tactile tests (light touch, sharp and dull sensations, two-point discrimination, hot and cold sensation,
vibration sense, position
sense, and stereognosis). The various tests are described in Chapter 28.
5. The nurse identifies clients at risk for sensory-perceptual alterations need to be identified to ensure
preventative measures are initiated. Box 37.1 describes clients at risk for sensory alterations.
6. The nurse assesses the client’s environment for quantity, quality, and type of stimuli. For example, the
nurse would look for the presence of a radio or other auditory device, television, clock or calendar,
reading material, number and compatibility of roommates, and number of visitors. In the client’s
home, the nurse notes the presence of a video/DVD player, pets, bright colours, and adequate lighting.
To assess a health-care environment for excessive stimuli, the nurse would consider factors such as
bright lights, noise, therapeutic measures, and frequency of assessments and procedures. Box 37.1
reviews Clients at Risk of Sensory Deprivation and Overload (p.1104).
7. In evaluating the client’s social support network, the nurse assesses whether the client lives alone, who
visits and when, and any signs indicating social deprivation, such as withdrawal from contact with
others to avoid embarrassment or dependence on others, negative self-image, reports of lack of
meaningful communication with others, and absence of opportunities to discuss fears or concerns that
facilitate coping mechanisms.
S
UGGESTIONS FOR CLASSROOM ACTIVITIES
• Ask students to select partners and practice special physical assessments related to sensory function
(e.g., Snellen vision screening, visual fields, Weber and Rinne tests).
S
UGGESTIONS FOR CLINICAL ACTIVITIES
• Have the students perform a sensory assessment on assigned clients and report findings in clinical
conference.
L
EARNING OUTCOME 4
Identify the clinical signs and symptoms of sensory overload and sensory deprivation (p.1100-1101).
C
ONCEPTS FOR LECTURE
1. Sensory overload generally occurs when a person is unable to process or manage the amount or
intensity of sensory stimuli. Clinical manifestations of sensory overload include complaints of fatigue
and sleeplessness; irritability, anxiety, and restlessness; periodic or general disorientation; reduced
problem-solving ability and task performance; increased muscle tension; and scattered attention and
racing thoughts. Review Clinical Manifestations box Sensory Overload (p.1101).
2. Sensory deprivation is thought of as a decrease in or lack of meaningful stimuli. Clinical
manifestations of sensory deprivation include excessive yawning, drowsiness, and sleeping; decreased
attention span, difficulty concentrating, and decreased problem solving; impaired memory; periodic
disorientation, general confusion, or nocturnal confusion; preoccupation with somatic complaints, such
as palpitations; hallucinations or delusions; crying, annoyance over small matters, and depression; and
apathy and emotional liability. Review Clinical Manifestation box Sensory Deprivation (p.1100).
S
UGGESTIONS FOR CLASSROOM ACTIVITIES
• Invite a panel of nurses who practice in critical care and in nursing home settings to discuss
interventions used to prevent or reduce sensory overload or deprivation in their settings.
• Create case studies and ask students to identify if the case is sensory deprivation or overload. Discuss
nursing interventions to prevent or decrease the risks of sensory deprivation or overload.