Chapter 43: Sensory Functioning

A nurse who is assessing an older female patient in a long-term care facility notes that the patient is at risk for sensory deprivation related to severe rheumatoid arthritis limiting her activity. Which interventions would the nurse recommend based on this finding?

A nurse is assessing a 78 year old male patient for kinesthetic and visceral disturbances. Which techniques would the nurse use for this assessment?

A nurse asks a patient to close her eyes, state when she feels something, and describe the feeling. The nurse then brushes the patient's skin w/a cotton ball, and touches the patient's skin with both sides of a safety pin. Which sense is the nurse assessing?

A nurse observes that a patient who has cataracts is sitting closer to the television than usual. The nurse would interpert that the etiologic basis of the sensory problem is an alteration in

A patient is in the late stages of AIDS, which is now affecting his brain as well as other major organ systems. The patient confides to the nurse that he feels terribly alone because most of his friends are afraid to visit. The nurse determines that the least likely underlying etiology for his sensory problems would be

Which action would be most important for a nurse to include in the plan of care for a patient who is 85 years old and has presbycusis?

Which patient would a nurse assess as being at greatest risk for sensory deprivation?

A patient is in an intensive care burn unit for 1 week is in pain much of the time and has his face and both arms heavily bandaged. His wife visits every evening for 15 minutes at 6, 7, and 8pm. A heart monitor beeps for a patient on one side, and another patient moans frequently. Assessment would suggest that the patient is probably experiencing

A patient's spinal cord was severed, and he is paralyzed from the waist down. When obtaining data about this patient, which component of the sensory experience would be most important for the nurse to assess?

A nurse is diagnosing an 11 year old 6th grade student following a physical assessment. The nurse notes that the student's grades have dropped, she has difficulty completing her work on time, and she frequently rubs her eyes and squints. Her visual acuity on a Snellen's eye chart is 160/20. Which nursing diagnosis would be most appropriate?

A nurse is caring for a male patient with a severe hearing deficit who is able to read lips and use sign language. Which nursing intervention would be best to prevent sensory alterations for this patient?

A nurse formulates the following diagnosis for an older female patient in a long-term care facility. Disturbed Sensory Perception: Chronic Sensory Deprivation related to the effects of aging. The patient walked out the door unobserved and was lost for several hours. Which interventions would be most effective for this patient?

An older female patient has a severe visual deficit related to glaucoma. Which nursing action would be appropriate when providing care for this patient?

With decreased sensory input, the RAS is no longer able to project a normal level of activation to the brain. As a result, the person may hallucianate simply to maintain an optimal level of arousal.

For visually impaired patients, assist with ambulation by walking slightly ahead of the person, allowing the person to grasp your arm.