NUR 155 Exam 3
Sensory Deprivation: A decrease in or lack of meaningful stimuli
Clients at Risk for Sensory Deprivation:
o Confined in a non-stimulating or monotonous environment in the home or health care
agency
o Have impaired vision or hearing
o Have mobility restrictions (quadriplegia or paraplegia with bed rest, traction apparatus)
o Are unable to process stimuli (brain damage or taking meds that affect the CNS)
o Have emotional disorders (depression) and withdraw within themselves
o Have limited social contact with family and friends (clients from a different culture)
Clinical Manifestations of Sensory Deprivation:
o Excessive yawning, drowsiness, sleeping
o Decreased attention span, difficulty concentrating, decreased problem solving
o Impaired memory
o Periodic disorientation, general confusion, or nocturnal confusion
o Preoccupation with somatic complaints, such as palpitations
o Hallucinations or delusions
o Crying, annoyance over small matters, depression
o Apathy, emotional liability
Preventing Sensory Deprivation:
o Encourage the client to use eyeglasses and hearing aids
o Address the client by name and touch the client while speaking if this is not culturally
defensive
o Communicate frequently with the client and maintain meaningful interactions (discuss
current events)
o Provide a phone, radio, TV, clock, and calendar
o Provide murals, pictures, sculptures, and wall hangings
o Have family and friends bring fresh flowers and plants
o Consider having a resident pet such as a fish, cat, or a bird
o Include different textured objects to feel such as a sheepskin pillow, silk scarf, soft
blanket
o Increase tactile stimulation through physical care measures such as back massages, hair
care, and foot soaks
o Encourage social interaction through activity groups or visits by family and friends
o Encourage the use of crossword puzzles or games
o Encourage environment changes such as a walk through a mall, sitting near a window or
at a place on the nursing unit where the client can watch local traffic
o Encourage the use of self-stimulation techniques such as singing, humming, whistling, or
reciting
Sensory Overload: Occurs when a person is unable to process or manage the amount or
intensity of sensory stimuli
3 factors that contribute to sensory overload:
o Increased quantity or quality of internal stimuli (pain, dyspnea, anxiety)
o Increased quantity or quality of external stimuli (noisy health care setting, intrusive
diagnostic studies, contacts with many strangers)
, o Inability to disregard stimuli selectively, perhaps as a nervous system disturbances or
meds that stimulate the arousal mechanism
Patients at Risk for Sensory Overload:
o Have pain or discomfort
o Are acutely ill and have been admitted to an acute care facility
o Are being closely monitored in an ICU and have intrusive tubes such as IVs, catheters, or
nasogastric or endotracheal tubes
o Have decreased cognitive ability (head injury)
Clinical Manifestations of Sensory Overload:
o Complaints of fatigue, sleeplessness
o Irritability, anxiety, restlessness
o Periodic or general disorientation
o Reduced problem-solving ability and task performance
o Increased muscle tension
o Scattered attention and racing thoughts
Preventing Sensory Overload:
o Minimize unnecessary light, noise, and distraction. Provide dark glasses and earplugs
o Control pain
o Introduce yourself by name and address the client by name
o Provide clocks, calendars, equipment, and furniture
o Provide a private room
o Limit visitors
o Plan care to allow for uninterrupted periods of rest or sleep
o Schedule a routine of care so the client knows when and what to expect
o Speak in a low tone of voice
o Provide new info gradually to enable the client to process the meaning
o Describe any tests and procedures to the client beforehand
o Reduce noxious odors. Empty a commode or bedpan, keep wounds clean and covered,
provide good ventilation
o Take time to discuss the client’s problems and to correct misinterpretations
o Assist the client with stress-reducing techniques
Impaired Hearing:
o Clients who are unable to hear the alarms of IV pumps and cardiac monitors need to be
assessed frequently
o Can be taught to use their visual sense to identify kinks in the IV tubing or a loose ECG
lead
o Home clients need to obtain devices that amplify sound or respond with flashing lights
to sounds (doorbell, phone, smoke detector, crying baby)
o As a person ages it becomes difficult for them to understand speech
o Factors that influence this difficulty: environment, rate of speech, presence of accent
o Older adults ability to process verbal info is slower than younger adult
Sensory Aids for Impaired Hearing:
o Hearing aid in good order
o Lip reading
o Sign language
o Amplified telephones
, o Telecommunication device for the deaf (TDD)
o Amplified phone ringers and doorbells
o Flashing alarm clocks
o Flashing smoke detectors
Communicating with Clients that have Hearing Impairment:
o Before initiating conversation, convey your presence by moving to a position where you
can be seen or by gently touching the person
o Decrease background noises before speaking
o Talk at a moderate rate and in a normal tone of voice.
o Address the person directly. Do not turn away in the middle of a remark or story.
o Avoid talking when you have something in your mouth. Avoid covering your mouth with
your hand.
o Keep your voice at about the same volume throughout each sentence
o Always speak as clearly and accurately as possible
o Do not “overarticulate”; mouthing or overdoing articulation is as troublesome as
mumbling
o Use longer phrases which tend to be easier to understand
o Pronounce every name with care.
o Change to a new subject at a slower rate, making sure that the person follows the
change to the new subject
Impaired Olfactory Sense (smell):
o Clients with impaired smell need to be taught about the dangers of cleaning and
working with chemicals
o Ammonia used in confined spaces may affect the client before they are smelled
o Food poisoning is a concern because clients cannot smell spoiled meat or dairy
o Inspect food for freshness by color and texture and check expiration dates
Impaired Tactile Sense (touch):
o Clients may not be aware of hot temps.
o Clients should have temp adjusted on their hot water heater and test water temp with a
thermometer before bathing
o Must change position frequently
Impaired Vision:
o Orient the client to the arrangement of room furnishings
o Maintain uncluttered environment
o Keep pathways clear
o Do not rearrange furniture without orienting the client
o Organize self-care articles within the client’s reach
o Keep the call light within easy reach and place the bed in low position
o Assist with ambulation by standing at the client’s side, walking about 1 foot ahead, and
allowing them to grasp your arm
o Vision diseases affecting older adults: Macular degeneration, cataract, glaucoma,
diabetic retinopathy
Communicating with Clients that have Visual Impairment:
o Always announce your presence and identify yourself by name
o Stay in the client’s field of vision
o Speak in a warm and pleasant tone of voice
Sensory Deprivation: A decrease in or lack of meaningful stimuli
Clients at Risk for Sensory Deprivation:
o Confined in a non-stimulating or monotonous environment in the home or health care
agency
o Have impaired vision or hearing
o Have mobility restrictions (quadriplegia or paraplegia with bed rest, traction apparatus)
o Are unable to process stimuli (brain damage or taking meds that affect the CNS)
o Have emotional disorders (depression) and withdraw within themselves
o Have limited social contact with family and friends (clients from a different culture)
Clinical Manifestations of Sensory Deprivation:
o Excessive yawning, drowsiness, sleeping
o Decreased attention span, difficulty concentrating, decreased problem solving
o Impaired memory
o Periodic disorientation, general confusion, or nocturnal confusion
o Preoccupation with somatic complaints, such as palpitations
o Hallucinations or delusions
o Crying, annoyance over small matters, depression
o Apathy, emotional liability
Preventing Sensory Deprivation:
o Encourage the client to use eyeglasses and hearing aids
o Address the client by name and touch the client while speaking if this is not culturally
defensive
o Communicate frequently with the client and maintain meaningful interactions (discuss
current events)
o Provide a phone, radio, TV, clock, and calendar
o Provide murals, pictures, sculptures, and wall hangings
o Have family and friends bring fresh flowers and plants
o Consider having a resident pet such as a fish, cat, or a bird
o Include different textured objects to feel such as a sheepskin pillow, silk scarf, soft
blanket
o Increase tactile stimulation through physical care measures such as back massages, hair
care, and foot soaks
o Encourage social interaction through activity groups or visits by family and friends
o Encourage the use of crossword puzzles or games
o Encourage environment changes such as a walk through a mall, sitting near a window or
at a place on the nursing unit where the client can watch local traffic
o Encourage the use of self-stimulation techniques such as singing, humming, whistling, or
reciting
Sensory Overload: Occurs when a person is unable to process or manage the amount or
intensity of sensory stimuli
3 factors that contribute to sensory overload:
o Increased quantity or quality of internal stimuli (pain, dyspnea, anxiety)
o Increased quantity or quality of external stimuli (noisy health care setting, intrusive
diagnostic studies, contacts with many strangers)
, o Inability to disregard stimuli selectively, perhaps as a nervous system disturbances or
meds that stimulate the arousal mechanism
Patients at Risk for Sensory Overload:
o Have pain or discomfort
o Are acutely ill and have been admitted to an acute care facility
o Are being closely monitored in an ICU and have intrusive tubes such as IVs, catheters, or
nasogastric or endotracheal tubes
o Have decreased cognitive ability (head injury)
Clinical Manifestations of Sensory Overload:
o Complaints of fatigue, sleeplessness
o Irritability, anxiety, restlessness
o Periodic or general disorientation
o Reduced problem-solving ability and task performance
o Increased muscle tension
o Scattered attention and racing thoughts
Preventing Sensory Overload:
o Minimize unnecessary light, noise, and distraction. Provide dark glasses and earplugs
o Control pain
o Introduce yourself by name and address the client by name
o Provide clocks, calendars, equipment, and furniture
o Provide a private room
o Limit visitors
o Plan care to allow for uninterrupted periods of rest or sleep
o Schedule a routine of care so the client knows when and what to expect
o Speak in a low tone of voice
o Provide new info gradually to enable the client to process the meaning
o Describe any tests and procedures to the client beforehand
o Reduce noxious odors. Empty a commode or bedpan, keep wounds clean and covered,
provide good ventilation
o Take time to discuss the client’s problems and to correct misinterpretations
o Assist the client with stress-reducing techniques
Impaired Hearing:
o Clients who are unable to hear the alarms of IV pumps and cardiac monitors need to be
assessed frequently
o Can be taught to use their visual sense to identify kinks in the IV tubing or a loose ECG
lead
o Home clients need to obtain devices that amplify sound or respond with flashing lights
to sounds (doorbell, phone, smoke detector, crying baby)
o As a person ages it becomes difficult for them to understand speech
o Factors that influence this difficulty: environment, rate of speech, presence of accent
o Older adults ability to process verbal info is slower than younger adult
Sensory Aids for Impaired Hearing:
o Hearing aid in good order
o Lip reading
o Sign language
o Amplified telephones
, o Telecommunication device for the deaf (TDD)
o Amplified phone ringers and doorbells
o Flashing alarm clocks
o Flashing smoke detectors
Communicating with Clients that have Hearing Impairment:
o Before initiating conversation, convey your presence by moving to a position where you
can be seen or by gently touching the person
o Decrease background noises before speaking
o Talk at a moderate rate and in a normal tone of voice.
o Address the person directly. Do not turn away in the middle of a remark or story.
o Avoid talking when you have something in your mouth. Avoid covering your mouth with
your hand.
o Keep your voice at about the same volume throughout each sentence
o Always speak as clearly and accurately as possible
o Do not “overarticulate”; mouthing or overdoing articulation is as troublesome as
mumbling
o Use longer phrases which tend to be easier to understand
o Pronounce every name with care.
o Change to a new subject at a slower rate, making sure that the person follows the
change to the new subject
Impaired Olfactory Sense (smell):
o Clients with impaired smell need to be taught about the dangers of cleaning and
working with chemicals
o Ammonia used in confined spaces may affect the client before they are smelled
o Food poisoning is a concern because clients cannot smell spoiled meat or dairy
o Inspect food for freshness by color and texture and check expiration dates
Impaired Tactile Sense (touch):
o Clients may not be aware of hot temps.
o Clients should have temp adjusted on their hot water heater and test water temp with a
thermometer before bathing
o Must change position frequently
Impaired Vision:
o Orient the client to the arrangement of room furnishings
o Maintain uncluttered environment
o Keep pathways clear
o Do not rearrange furniture without orienting the client
o Organize self-care articles within the client’s reach
o Keep the call light within easy reach and place the bed in low position
o Assist with ambulation by standing at the client’s side, walking about 1 foot ahead, and
allowing them to grasp your arm
o Vision diseases affecting older adults: Macular degeneration, cataract, glaucoma,
diabetic retinopathy
Communicating with Clients that have Visual Impairment:
o Always announce your presence and identify yourself by name
o Stay in the client’s field of vision
o Speak in a warm and pleasant tone of voice
