SENSORY NEED

INTRODUCTION
To interact with our environment we rely on information coming in from our
senses.

This includes the five senses that the most of us are familiar with:
• sight( visual)
•Hearing(auditory)
•Smell(olfactory)
•Touch(tactile)
•Taste(gustatory)
 Components of sensory experience-
Reception, Perception and Reaction.

 The nervous system continuously receives information from sensory

nerve organs and relays the information through appropriate
neurological channels and integrates the information in to meaningful
response.
 Reception, Perception and Reaction are three components of any
sensory experience.
 RECEPTION:
It begins with stimulation of a nerve cell for sight, smell,
taste , sound, etc. In the case of special senses, the
receptors are located in specialized organs such as the
taste buds of the tongue or the retina of the eye.
The nerve impulse is created , it travels along the
pathway to the spinal cord or directly to the brain.
 PERCEPTION
The perception or awareness of unique sensations depends
on the receiving regions of the cerebral cortex , where
specialized neurons interpret the quality and nature of sensory
stimuli.
When a person receives the information, perception takes
place. Perception includes the integration and interpretation
of stimuli based on individual experiences.
 REACTION
It is not possible to react to all stimuli entering the nervous
system. A person usually reacts to the most meaningful
stimuli at a time.
After continued reception of the same stimulus, a person
stops responding, and the sensory experience goes
unnoticed.
For example, a person reading a favorite book is not aware of
background music.
 AROUSAL MECHANISM
Arousal is the physiological and psychological state of being
awaken or of sense organs stimulated to a point of perception.
It involves activation of the ascending reticular activating
system (ARAS) in the brain, which mediates wakefulness, the
autonomic nervous system, and the endocrine system, leading
to increased heart rate and blood pressure and a condition of
sensory alertness, desire , mobility, and readiness to respond.
 Arousal is mediated by several neural systems . Wakefulness is
regulated by the ARAS, which is composed of projections from
five major neurotransmitter systems that originate in the
brainstem and form connections extending throughout the
cortex; activity within the ARAS is regulated by neurons that
release the neurotransmitters acetylcholine, norepinephrine,
dopamine, histamine, and serotonin.
 Activation of these neurons produces an increase in cortical
activity and subsequently alertness.
 Activation of these neurons produces an increase in cortical
activity and subsequently alertness.
 Arousal is important in regulating consciousness, attention ,
alertness, and information processing. It is crucial for motivating
certain behaviours , such as mobility, the pursuit of nutrition, the
fight-or-flight response. It holds significance within emotion and
has been included in theories such as the James-Lange theory of
emotion.
 FACTORS AFFECTING THE SENSORY
FUNCTION
Many factors influence the capacity to receive or perceive the
stimuli.
AGE
PRESENCE OF MEANINGFUL STIMULI
AMOUNT OF STIMULI
SOCIAL INTERACTION
ENVIRONMENTAL FACTORS
CULTURAL FACTORS
 1. Age :
 Infants and children are at high risk for visual and
hearing impairment due to genetic, prenatal, and
postnatal conditions. Visual changes during
adulthood include presbyopia and astigmatism and
may require glass for reading.
(PRESBYOPIA : Long sightedness caused by loss of
elasticity of the lense of the eye.)
 Usually, hearing changes begin at the age of
thirty . Aging-related changes include decreased
hearing acuity and pitch discrimination. Low-pitched
sounds are easier to hear, but it is difficult to hear
conversations over background noise.
 There is a delay in reception and reaction to the
speech. Gustatory and olfactory changes begin
around age fifty and include a decrease in the
number of tastebuds and sensory cells in the nasal
lining.
 Reduce sensitivity to odours and decreased taste
discrimination are common during old age. After the
age of sixty proprioceptive changes are common
which include increased difficulty with balance and
coordination.
There are also tactile changes with aging, including
decreased sensitivity to temperature, pain, and
pressure secondary to peripheral vascular diseases
and neuropathies.
2. Presence of Meaningful Stimuli:

Meaningful stimuli reduce the incidence of sensory

deprivation. Meaningful stimuli at home include
pets, television , music, a clock, pictures of family
members , etc.
 The same stimuli need to be present in the
hospital. The presence of family members offers
positive stimulation. The presence of meaningful
stimuli influences alertness and the ability to
participate in care.
3. Amount of Stimuli:
 Excessive stimuli in an environment causes sensory
overload. The frequency of procedures performed in
the health care setting is often stressful to patients. If
a patient’s movement is restricted by cast or
traction , over stimulation is a problem. A hospital
room that is near to loud noises (eg. Nurses' station,
Lift, etc) contributes to sensory overload.
4. Social Interaction:
The quality and amount of social contact with
supportive family members and significant others
influence sensory function, The absence of visitors
during hospitalization influence the degree of
isolation a patient feels. Visitors are often restricted
in hospital intensive care units.
The ability to discuss concerns with loved ones is
an important coping mechanism for most patients .
Therefore the absence of meaningful conversation
results in a feeling of isolation, anxiety, and
depression in patients.
5. Environmental Factors:

 A person's occupation may influence visual,

auditory, and peripheral nerve alterations.
 Persons with occupations involving exposure to
high noise levels are at risk of noise induced hearing
loss.
 Individuals who have an Occupation involving the
risk of exposure to chemicals are at risk for eye
injuries and need to screened for vision.

Patients who are immobilized by bed rest or who

have a chronic disability unable to experience the
normal sensations of movement and unable to enjoy
normal interactions with visitors.
 ASSESSMENT OF SENSORY
ALTRATIONS:

Assess the nature and characteristics of sensory

alterations and include them in nursing history.
When taking the history, consider the cultural
background of the patient because certain
alterations are higher in some cultural groups.
A nursing history also reveals any recent
changes in a patient's behavior.
 Assessment of mental status is valuable when
you suspect sensory deprivation or overload.
 Observation of a patient during history
taking, during the physical examination, and
while providing nursing care offers valuable data
about a patient's behaviors and mental status.
Observe the patient’s physical appearance and
behavior, measure cognitive ability, and assess his or
her emotional status.

The Mini-Mental State Examination (MMSE) is a

tool you can use to measure disorientation, change
in problem-solving abilities and altered
conceptualization and abstract thinking.
 TYPES OF SENSORY ALTERATIONS
The most common types of sensory alterations are
sensory deficits, sensory deprivation, and sensory
over load. Sensory deficit A deficit in the normal
function of sensory reception and perception is a
sensory deficit. When a person loses hearing or
visual acuity, he withdraws from others to cope with
the sensory loss.
Sensory deficit :

A deficit in the normal function of sensory reception

and perception is a sensory deficit. When a person
loses hearing or visual acuity, he withdraws from
others to cope with the sensory loss.
It becomes difficult for the person to interact with
the environment safely until he learns new skills.
Sensory deprivation:
 Individuals can receive stimuli even while sleeping
deeply because the reticular activating system in the
brainstem mediates all sensory stimuli to the cerebral
cortex. Sensory stimulation must be of sufficient quality
and quantity to maintain a person's awareness.
The restrictive environment is due to limited
movement. eg. bedrest. There are cognitive,
affective, and perceptual effects of sensory
deprivation. The person may experience
disorientation, confusion , restlessness, increased
anxiety, changes in visual and motor coordination.
Sensory Overload:

A person experiences sensory overload when he

receives multiple sensory stimuli and cannot
perceptually selectively ignore them. Excessive
sensory stimulation prevents the brain from
responding appropriately. Sensory overload prevents
meaningful responses by the brain. The individual's
attention scatters in many directions, anxiety and
restlessness occur.
Sensory Poverty

Sensory poverty is learning about the world with out

experiencing it up close, right here, right now, in all
its messy, majestic, riotous detail.
At some medical schools, it's even possible for future
doctors to attend virtual anatomy classes, in which
they can dissect a body by computer - minus that
whole smelly , fleshy, disturbing human element.