Med Surg Sensory Sample PDF

This free sample provided by CIMC
www.okcimc.com 800.654.4502
Practical Nursing Series:

Medical-Surgical Nursing II
Medical Surgical Nursing II, used in conjunction with Medical

Surgical Nursing I, replaces the 2002 version of Nursing
Focus. The curriculum adheres to the revised objectives
approved by the Oklahoma Board of Nursing.
This full-color text builds on the concepts and skills for

previous courses. It focuses on prevention of illness, health Practical Nursing:
management, and care of the individual. Treatments, patient Medical-Surgical Nursing II
2013
care, diet and pharmacological therapy are included in each Teacher Edition: HO1039
module. Medical Surgical Nursing II is designed to teach the Student Workbook: HO3039
nursing student focused nursing skills and the ability to apply
their knowledge to prepare for the NCLEX-PN. To order, call
800.654.4502
or visit
Modules include: www.okcimc.com
 Immune Nursing
 Sensory Nursing
 Neurology Nursing
 Digestive Nursing
 Endocrine Nursing
 Urinary Nursing
 Reproductive Nursing
 Oncology Nursing
We are offering “Sensory Nursing” as a free sample.
Copyright 2013 Oklahoma Department of Career and Technology Education

IM
Practical Nursing
Medical Surgical
Nursing II
CIMC
Teacher Edition
www.okcimc.com
800-654-4502
13-123456789 HO1039
MODULE 2
s e n s o r y Nu r s i n g
Free Sample Provided by CIMC

800-654-4502
okcimc.com
T
his module provides an understanding of interactions with their environment and other
the sensory organs and their functions, individuals. Impairments of these senses must be
disorders that affect these organs, and handled appropriately and carefully by the nurse.
treatments of these disorders. The most com- Completion of this module should provide an
mon senses which display impairments are vision, understanding and knowledge of how to provide
hearing, taste and smell. Additionally, the sense of appropriate nursing care to individuals with sen-
touch, position and movement may be impaired. sory disorders and impairments.
These senses are important for an individual’s
i
Review the Learning
Objectives with the LEarning ObjEctivEs
students. Look ahead
to the Learning Activities
1. Explain the function of the sensory system.
in this module and plan to
introduce them. 2. Distinguish among sensory disorders.
3. Relate diagnostic tests and surgical procedures to the nursing care of
patients with sensory disorders.
Teaching
SUggestions 4. Evaluate pharmacological effects of medications used to treat sensory
disorders.
• A
long with many helpful 5. Contribute to the plan of care for patients experiencing alterations in
websites, there are now sensory or perceptual function.
many “apps” available to 6. Distinguish among patient education needs related to self-care for sensory
help students and nurses disorders.
obtain needed informa-
tion from their smart
phones, tablet devices,
etc. Search iTunes or
other application data-
bases for the most up-to-
date “apps” available for
each content area. See the
following links for pos-
sible apps related to the
sensory system.
• B
e sure to advise the
students that these “apps”
may cost to download.
800-654-4502
■ S ensory apps okcimc.com
ttp://itunes.
h
apple.com/us/app/
hd-five-senses/
id373600865?mt=8
■ H
earing
ttp://itunes.
h
apple.com/us/app/
senses-what-u-hear/ 2 CIMC • MEDICAL SURGICAL NURSING II
id398460048?mt=8

http://itunes.apple.com/us/app/uhear/id309811822?mt=8
http://itunes.apple.com/us/app/soundamp-r/id318126109?mt=8 (amplifier)
http://itunes.apple.com/app/id450577890 — Continued on next page
module O v e r v i e w
This module provides concise information regarding sensory disorders including their symptoms and associ-
ated medications, diagnostic tests, and nursing care. Students should be encouraged to reacquaint themselves
with the sensory system information from their Anatomy and Physiology course.
2 CIMC • MEDICAL SURGICAL NURSING II

L E a r n i n g O b j E c t i v E Sense of Vision ■ V
ision
Obj ecti v e Explain the function of the sensory The actual mechanics of vision take place within the ttp://itunes.
h
system. retina, the optic nerve, and the brain. Photoreceptors, apple.com/us/app/
specialized cells that are sensitive to light and color,
The senses provide humans with the ability to inter- are the rods and cones of the retina. senses-what-u-see/
act with their environment through seeing, hearing, id411289776?mt=8
tasting, smelling, touching, and maintaining posi-
tion and movement. These senses enable humans to ttp://itunes.apple.
h
survive because of the appropriate responses. Should D i d You Know?
these responses not occur, or occur inappropriately, com/us/app/vision/
Color blindness is caused by an
patients may be injured or suffer disorders of the
absence of one or more cones. id295144131?mt=8
sensory system.
Cones are sensitive to the colors
red, green, and blue. ttp://itunes.
h
visiOn apple.com/us/
The function of the eyeball is transformation of light Normal aging causes the eye to lose elasticity of the app/vision-test/
to nerve signals which are interpreted into visual im- lens; this causes the muscles of the eye to be unable id380288414?mt=8
ages in the cerebral cortex of the brain. to accommodate (move the lens as needed) and
presbyopia (far sightedness due to aging) occurs.
The lens may also become slightly opaque, causing
ttp://itunes.
h
difficult vision when glare is present. Because the apple.com/us/
pupil becomes smaller with age, more light is needed app/eyes-vision/
to read.
id333809694?mt=8
Eye Glands ■ F
or iPad
Lachrimal gland ttp://itunes.
h
(Tear gland) apple.com/us/app/
eye-chart-pro/
id364802332?mt=8
Free Sample Provided by CIMC Tear ducts
(Eye chart)
800-654-4502 learning
okcimc.com w ww
link
Tear sac
Vision
www.webmd.com/eye-
health/picture-of-the-eyes
MODULE 2 • SENSoRy NURSING • stUDEnt EDitiOn 3
Teaching SUggestions
• Review the following information with the students.
■ S tructure of the eye
■ A ccessories of the eye
■ I ntraocular anatomy
■ P hysiology and function of the eye
M O D U L E 2 • S e n s o r y N u r s i n g • T E ACH E R E D I T I O N 3
HEaring
learning
w ww
link
The ear consists of three sections, which work to-
gether to provide the sense of hearing. The outer ear Important Fact
It’s easy for a throat infection to spread to the
receives the sound waves and propels them to the in-
terior portions of the ear. The middle ear is small and ears because it can travel up the Eustachian
contains air and three bones. The three bones are the tubes into the middle ear. These structures are all
malleus (hammer), the incus (anvil), and the stapes lined with continuous mucous membrane.
(stirrup). The inner ear contains fluid-filled cavities
and canals. It also contains the cochlea, semicircular
Hearing canals, and the vestibulocochlear nerve.
www.youtube.com/watch Semicircular
?v=PeTriGTENoc&featu canals
Incus
re=related (anvil)
Malleus
(hammer) Auditory nerve
To brain
Ear canal Cochlea

Oval window
Stapes
(stirrup)
Tympanic
membrane

Pinna
Eustachian Tube
800-654-4502
okcimc.com
D i d You Know?
Cerumen is earwax that protects
the ear by trapping foreign
particles and dust.

Sense of Hearing Sources of damage to hair cells in the organ of Corti,
learning
w ww
causing permanent hearing loss, include:
• The eardrum, or tympanic membrane, separates
the outer ear from the middle ear. • Jet engines link
• The eustachian tubes connect the middle ear • Factory equipment
with the nasopharynx. They function to equal-
• Race car engines
ize pressure on either side of the eardrum. This
is why yawning or swallowing, which opens the • Loud amplifiers (music or drums)
tube and allows air to enter the middle ear, helps
• Wearing earphones with electronic equipment
“pop” the ears when at high altitudes.
turned to high volumes Taste
• Sound waves travel through the middle ear from
the vibrating tympanic membrane causing the www.wisc-online.com/
malleus to vibrate. s E n s E s O f ta s t E a n D objects/ViewObject.
sMELL
• The malleus movement triggers the incus to aspx?ID=AP14104
move and transfer the sound waves to the stapes. Smell and taste are two very closely related senses.
The movement of the stapes transfers the sound These senses protect us from eating food that is Smell
wave to the oval window, which transfers the spoiled or poisonous. Many of the toxins in poison-
sound waves into the inner ear. ous plants have a bitter taste. Our tongues are most www.entnet.org/HealthIn-
sensitive to bitter tastes, and our brain interprets
• The ossicles of the middle ear are the small bones
them as something to reject, thereby protecting the
formation/smellTaste.cfm
that carry the sound waves; they are the malleus,
body from possible harm.
incus, and stapes.
www.nidcd.nih.gov/
• The endolymph and perilymph conduct sound Taste and Smell health/smelltaste/smell.
waves from the middle ear through the inner ear.
The location of the taste receptors are: html
• The organ of Corti transmits sound waves to
the brain through the hair cells. The inside of • Sweet receptors—tip of the tongue
the organ contains many, many hair cells that • Sour receptors—sides of the tongue
stimulate the cochlear nerve (part of the vestibu-
lar cochlear nerve, the eighth cranial nerve) in • Salty receptors—tip of the tongue
response to sound waves. • Bitter receptors—back of the tongue
• The cochlear nerve then transmits the sound to

Normal aging affects smell and taste by causing a
the brain for interpretation.
decrease in the nerve receptors for smell and taste.
• The semicircular canals contain hair cells also. Sweet and salty taste receptors are the most affected.
800-654-4502
The movement of endolymph within the semi-
circular canals stimulates these hair cells. The
message is sent to the brain, which interprets it to
okcimc.com
maintain balance and equilibrium.
Normal aging affects hearing by causing a decrease in

the ability to distinguish high frequencies of sound.
This is thought to be due to declining function of the
nerve fibers in the cochlear nerve and the cells of the
organ of Corti. The ability to distinguish consonant
sounds in hearing also decreases for the same reasons
Sour
Bitter
Sour
Sweet
Salty
The glossopharyngeal nerve transmits the messages sEnsE Of tOUcH

of taste to the brain. The olfactory receptors are
located in the upper section of the nasal cavity. This Sensory receptors cover the skin and epithelia, skel-
is why people breathe deeply when smelling a flower. etal muscles, bones and joints, internal organs, and
the cardiovascular system. The sense of touch reacts
The olfactory nerve transmits the messages of smell to diverse stimuli using different receptors:
to the brain.
• Thermoreceptors (temperature)
• Certain odors stimulate memories because the • Nocireceptors (pain)
brain stores the odor and the events associated

with it in long-term memory. • Mechanoreceptors (pressure)
• When olfactory cells are damaged, the person’s • Chemoreceptors (chemical)
800-654-4502
sense of smell will be lost since the body cannot
regenerate olfactory cells.
• Food does not taste good when you have a cold
okcimc.com
because the sense of smell is impaired by nasal
congestion. When we cannot smell what we eat,
some of the taste is lost. The senses of smell and
taste work together in our brain.

L E a r n i n g O b j E c t i v E
learning
Obj ecti v e Distinguish among sensory
disorders.
D i d You Know?
• Severe visual impairment is defined
w ww
link
as the inability to read newspapers
visUaL DisOrDErs with the use of corrective lenses.
Many eye conditions can affect a patient’s vision and • Total blindness is absence of light
understanding a patient’s vision impairment will perception and usable vision.
allow the nurse to provide care that will meet the • Functional blindness occurs when Eye Health Slide Show
patient’s needs. Refractory errors prevent light rays
from converging into focus on the retina.
there is some light perception but — visual examples of eye
no usable vision. disorders
www.webmd.com/eye-
Refractory Errors health/slideshow-eye-
Disorder Structure Affected Physical Findings
Treatment/Nursing conditions-overview
Care
Hyperopia Causes light rays to focus Blurred vision • LASIK (laser-assisted Lasik Eye Procedures
• Farsightedness behind the retina in-situ keratomileusis)
Myopia Causes light rays to be fo- • PRK (photorefractive www.tlcvision.com/lasik-
• Nearsightedness cused in front of the retina keratectomy)
• ICR’s (intra-corneal laser-vision-expectations/
Presbyopia • The lens becomes less
• Farsightedness elastic
ring segments) lasik/
• Refractive IOL (in-
due to aging • Decreases accommoda-
traocular lens) implan- Hyperopia
tive ability of the eye
tation
Astigmatism • Irregularity of curve of
cornea
• Phakic IOL’s www.aoa.org/x4696.xml
▶ Administer medica-
• Causes light rays to tions as directed by
bend unequally physician www.nlm.nih.gov/
▶ Teach patient signs medlineplus/ency/ar-
Free Sample Provided by CIMC and symptoms of
infection
▶ Patient will return
ticle/001020.htm
800-654-4502 Myopia
www.aoa.org/x4688.xml
for follow-up care as
directed
• Corrective lenses
okcimc.com www.nlm.nih.gov/
• Contact lens
medlineplus/ency/ar-
ticle/001023.htm
Presbyopia
www.nlm.nih.gov/
7
MODULE 2 • SENSoRy NURSING • stUDEnt EDitiOn
ticle/001026.htm
Astigmatism
www.aoa.org/Astigmatism.
xml
www.nlm.nih.gov/
ticle/001015.htm
EyE injUriEs
learning
wwwlink
Eye injuries can result in permanent visual impair-
ment. Causes of eye injury include trauma, through
auto accidents and sports injuries, or chemical expo-
to the eye occurs, first aid measures include having
the victim lie down to prevent fluid from escap-
ing from the eye. The penetrating object should be
sure. The patient may experience pain, photophobia, stabilized (a Styrofoam cup works well to cover the
redness, edema, tearing, blood present in chamber, eye and the object), and the victim transported to an
abnormality in vision, abnormal intraocular pres- emergency department as soon as possible. Only a
sure, or deficits in peripheral vision. physician should remove the penetrating object.
Penetrating Eye Injury Penetrating wounds to the eye can result in complete To provide care for an eye injury, the nurse should
loss of vision and loss of the eye itself. It is important cover the eye with a dry sterile patch and a protec-
www.insidermedicine. for the nurse to assess the size of the object that is tive shield, stabilize any foreign objects, elevate head
com/insidermedicine-if- penetrating the eye and whether fluid is leaking from of bed 45 degrees, avoid pressure on the eye, and
the eye. When vitreous humor, the jelly-like fluid instruct patient not to blow their nose. In the case
i-had.aspx?Category=349 that gives the eyeball its shape, escapes from the eye, of chemical exposure, the eye should be irrigated as
vision is usually lost. When a penetrating wound soon as possible with sterile saline or water.
Hordeolum Infections and Inflammation of the Eye
http://health-pictures. Disorder Structure Affected Physical Findings
Treatment/Nursing
Care
com/hordeolum.htm
Hordeolum Sebaceous glands in the • Red • Treatment consists of
• Stye eyelid • Swollen application of warm,
www.ncbi.nlm.nih. • Tender area moist compresses four
gov/pubmedhealth/ times daily until healed
• Antibiotic ointment or
PMH0002004/ drops
Chalazion Sebaceous glands in the • Swelling • Warm, moist com-
Chalazion upper lid • Tender presses
• Red • If this treatment is
www.mayoclinic.com/ not effective, then an
health/medical/IM03093 ophthalmologist may
remove it surgically or
inject it with corticos-

www.webmd.com/
teroids
eye-health/tc/styes-and- Blepharitis Infection of follicles of the • Itching • Warm compresses
800-654-4502
chalazia-topic-overview eyelash along the rim of • Burning • Antibiotic eyedrops
the eyelid • Crusting mucus
Blepharitis Conjunctivitis Inflammation of the • Redness of the eye • Antibiotic eyedrops
www.southcoasteyecare- okcimc.com(pink eye) conjunctiva caused by a

bacterial infection
• Pain
• Tearing
• Itching
inc.com/pages/blepharitis.
Keratitis Inflammation of the • Pain and discomfort • Antibacterial, antifun-
html cornea • Photophobia gal, and antiviral drugs
• Blurred vision • Response to trauma
www.nei.nih.gov/health/ • Response to immune-
mediated reactions
blepharitis/blepharitis.asp • Replacement of vita-
min A due to deficiency
www.medicinenet.com/
blepharitis/article.htm
Conjunctivitis
www.webmd.com/eye-health/slideshow-pinkeye
www.webmd.com/eye-health/eye-health-conjunctivitis
Keratitis
www.lyme.org/gallery/keratitis.html
www.medicinenet.com/keratitis/article.htm
www.nlm.nih.gov/medlineplus/ency/article/001609.htm

Important Fact
learning
Pink eye (conjunctivitis) is highly contagious
and can easily be spread to others. Reinfection
w ww
link
within a house or school can occur if preventative
measures aren’t followed.
These include:
• Hand washing
• Not sharing eye makeup
• Not sharing towels and handkerchiefs Cataracts
• Changing pillowcases frequently
www.nei.nih.govw.nei.nih.
gov/health/cataract/cata-
Conditions Affecting Vision ract_facts.asp
Treatment/Nursing
Care www.geteyesmart.org/eyes-
Cataract Opacity of the lens, caus-
• Blurred vision/ photo- Surgical removal of cata-
ing cloudiness phobia ract
mart/diseases/cataracts.cfm
• Double vision
• Decreased night vision Teach patient it is ex- Cataract Simulation
• Increased nearsighted- tremely critical to follow
ness their physician’s instruc- www.cataracteye.com/
• Need for increased light tions following cataract simulation.html
with detailed work or surgery for optimal
reading healing
• The lens becomes Open-Angle Glaucoma
cloudy in appearance (Chronic)
Open-angle Increased intraocular pres- • Decrease in peripheral • Photocoagulation is
Glaucoma (chronic) sure, causing damage to vision used to seal the leaking www.visionrx.com/library/
the optic disc • Occurs more gradually of serous fluid and blood enc/enc_oaglaucoma.asp
and has mild symptoms vessels in the region
• Medication
www.glaucoma.org/glauco-
ma/types-of-glaucoma.php
• Surgery
800-654-4502
Postop care includes:
• Notify physician if
worsening pain is expe-
okcimc.com
rienced
• Avoid strenuous activity
• Do not strain with
stool or bend over
• Take a stool softener
Conditions Affecting Vision Continued
learning
w ww
link
Disorder
Narrow-angle
Structure Affected Physical Findings
Iris is too close to the canal • Severe eye pain with

Treatment/Nursing
Care
• Treatment is aimed at
Glaucoma (acute) that drains aqueous humor colored haloes decreasing the intraoc-
and blocks it • Blurry vision ular pressure
• Nausea • A laser is used to create
• Comprises a medical openings that allow the
emergency excess fluid to escape
Narrow-Angle Glau- • Teach patient proper
coma (Acute) after-surgery care and
medication usage
www.youtube.com/ Retinal detachment Separation of retinal layers • Flashes of light with • Laser surgery is often
from the choroid floaters used to repair the reti-
watch?v=gDfM3s7jxqM • Possible complete loss nal tear
of vision • Scleral buckling
www.webmd.com/eye- • More invasive repair
health/glaucoma-eyes • Reinforce instructions
regarding the need to
wear eye patches and/
Retinal Detachment or eye shields after
surgery
www.ncbi.nlm.nih. • Explain that light sen-
gov/pubmedhealth/ sitivity is common for
PMH0002022/ several weeks post-op
Retinopathy Rupture of aneurysms on • Symptoms occur later • The best treatment
retinal blood vessels and include blurred is prevention, which
www.maculacenter.com/ vision involves management
EyeConditions/retinal- • Missing areas in vision of diabetes and/or
Detachment.htm • Abnormal spots or lines hypertension
in vision • Photocoagulation
Macular Photoreceptors, bleeding • Inability to see colors or • Laser therapy is effec-
Scleral Buckling
www.webmd.com/eye-
degeneration of abnormal vessels near
macula
details
• Blurry vision
•
tive if initiated early in
progression of disorder
P hotocoagulation
800-654-4502
health/scleral-buckling-sur- • Straight lines appearing
wavy
gery-for-retinal-detachment • Loss of central vision
www.youtube.com/ okcimc.com with intact peripheral

vision
watch?v=YftCbXIw11k
Nursing Care for

Patient Having Eye Important Fact
The most common cause of loss of vision from
Surgery aging is macular degeneration.
http://wps.prenhall.
com/wps/media/ob-
jects/737/755395/
eye_surgery.pdf
Retinopathy Amsler Grid to Check for Macular Degeneration

www.bmj.com/content/328/7440/625.full www.allaboutvision.com/conditions/amsler-grid.pdf
Diabetic Retinopathy
www.nei.nih.gov/health/diabetic/retinopathy.asp
Macular Degeneration
www.nei.nih.gov/health/maculardegen/armd_facts.asp
www.allaboutvision.com/conditions/amd.htm
www.macular.org/1_blindness.html

strabisMUs aUDitOry DisOrDErs
learning
Strabismus (crossed eyes) occurs when the eye
muscles are weak in one or both eyes. This muscle
There are two different types of hearing loss attributed
to problems with the ear. Sensorineural hearing loss is w ww
link
weakness may occur because of muscle imbalance, due to dysfunction of the auditory nerve. When the
muscle paralysis, or a congenital condition. Often hearing loss is caused by problems with sound trans-
the good eye is patched for six to eight weeks mission through the ear it is conductive hearing loss.
to strengthen the muscles of the affected eye.
Sometimes glasses may be prescribed as well as Causes of Hearing Loss
eye exercises. In some cases, surgery is indicated to
straighten the deviated eye. Conductive: Strabismus
• Obstruction by cerumen (earwax) www.pedseye.com/strabis-
• Scarring of tympanic membrane (repeated otitis mus_adult_strabismus.htm
D i d You Know? media)
Intraocular pressure is the • Congenital disorder www.aapos.org/terms/con-
pressure within the eye and Sensorineural: ditions/11
is determined by the amount • Ototoxic drugs
of aqueous humor present.
www.nlm.nih.gov/
• Repeated exposure to loud noise
• History of mumps, measles, meningitis, or
Meniere’s disease
ticle/001004.htm
Q: How would you communicate differently with a
• Acoustic neuroma Deaf Communication
patient with severely impaired vision?
Technologies
Q: How would you communicate with a patient
with severe hearing loss? www.assistech.com/deaf-
communication.htm
Causes of Hearing Loss
Treatment/Nursing Ototoxicity
Care
Ototoxicity
from certain drugs
www.hearinglosshelp.com/
Damage to the inner ear
or vestibulocochlear nerve
• Problems with hearing • Determine cause such
and/or balance
articles/ototoxicupheaval.
• Permanent or temporary
as the use of ototoxic
drugs
800-654-4502 htm (Part 1)

• Ototoxicity- ringing in • Instruct patients to
the ears and a decrease report hearing loss,
www.hearinglosshelp.com/
in hearing ability problems with balance
okcimc.com • Low urine output

articles/ototoxicaudiology.
htm (Part 2)
Drugs causing condition
• Warn patients about the
use of aspirin and other
medications, which can
include: cause condition
• Antibiotics • Monitor urine output
• Antineoplastics
• Loop diuretics
• Non-steroidal anti-
inflammatory drugs
CRI TICA L T HIN K ING q ue s ti on a ns wers

Q: How would you communicate differently with a patient with severely impaired vision?
Answer: How a nurse communicates with a person with severe vision impairment may depend on whether
there are other concurrent health issues. See the links below for information on this topic. Vision impaired:
www.afb.org/Section.asp?SectionID=36&TopicID=163&DocumentID=194
Q: How would you communicate with a patient with severe hearing loss?
Answer: Several tips for communicating with people who have severe hearing loss can be found at: www.mich-
dhh.org/hearing/comm_tips.html
Causes of Hearing Loss Continued
learning
w ww
link
Disorder
Meniere’s disease
Structure Affected
Increased fluid in the

Physical Findings
• Hearing loss
Treatment/Nursing
Care
• Treatment includes
labyrinth spaces, causing • Vertigo drugs such as:
swelling of the membranes • Loss of balance ▶ Atropine
of the cochlea • Dizziness ▶ Epinephrine
• Nausea ▶ Valium
Increased pressure in the ▶ Antihistamines
Meniere’s Disease inner ear, causing damage ▶ Antiemetics
to structures ▶ Anticholinergics
www.nidcd.nih.gov/health/ ▶ Vasodilators
balance/meniere.html ▶ Diuretics
• Surgical removal of the
endolymph sac
www.medicinenet.com/ • Assess and document
meniere_disease/article.htm symptoms and frequency
• Instruct patient on
Otitis Media safety precautions dur-
ing acute attacks
www.nidcd.nih.gov/health/ • Assist patient to de-
termine if they experi-
hearing/earinfections ence an aura and what
actions to take should
www.umm.edu/altmed/ar- it occur
• Instruct patient to rest
ticles/otitis-media-000121. in dark, quiet room
htm • Tell patient to avoid:
▶ Caffeine
Image of Tympanic ▶ Decongestants
▶ Stimuli that cause at-
Membrane with and tacks such as bright
without OM lights or noisy places
www.pedisurg.com/pt-Free Sample Provided by CIMC ▶ Bending over with

head down
800-654-4502
• A low-sodium diet
educent/otitis_media.htm and diuretics may help
reduce excess fluid
okcimc.com
Otitis media Infection of the middle ear • Occurs after a respira- • Antibiotics, antihista-
from bacteria or viruses tory infection and causes mines, and/or decon-
fluid to build up gestants
• Pain in infected ear, • Incision may be made
fever into the eardrum and a
• Feeling of fullness in tube inserted to drain
the ear the fluid and equalize
• Impairment in hearing pressure
• Redness and bulging of • Administer pain meds
the tympanic membrane as needed
Teaching SUggestions
• R
emind students that when a patient experiences hearing loss while on a medication known to cause oto-
toxicity, it isn’t necessarily ototoxicity. The nurse should always assess if the patient has had prior hearing
loss or if the hearing loss they are experiencing is different from what they normally experience.

Causes of Hearing Loss Continued
learning
Disorder
Otosclerosis
Structure Affected
Affects the bones of the

Physical Findings
Treatment/Nursing
Care
• Difficulty hearing exter- • Hearing aid
w ww
link
middle ear, causing the sta- nal sounds • Surgical procedure
pes to become fixed so it • The sound of patient’s called a stapedectomy,
cannot vibrate or produce own voice becomes or a tympanoplasty
sound waves louder • Provide post-operative
treatment
Otosclerosis
OtHEr sEnsOry www.entnet.org/HealthIn-
i M pa i r M E n t s formation/otosclerosis.cfm
Other sensory impairments can be problematic to
the patient. If a patient is unable to smell or taste Otosclerosis and
food, they may become malnourished. The sense of Stapedectomy
smell and taste work together to make the dining
experience more appealing. www.audiologynet.com/
Other Sensory Impairments otosclerosis-stapedectomy.
Treatment/Nursing html
Care
Dysgeusia Taste buds • Foul, salty, rancid, or • Determine cause such Loss of Taste Sensation
metallic taste sensa- as smoking, flu, medi- — Dysgeusia
tion will persist in the cations
mouth • Prepare foods with a www.medicinenet.com/
• Burning mouth syn- variety of colors and
drome, a condition in textures loss_of_taste_sensation/
which a person experi- • Use spices symptoms.htm
ences a painful burning • Add foods that have
sensation in the mouth butter, olive oil and

other forms of fat
• Avoid dishes that have
a combination of ingre-
800-654-4502
dients
Hyposomia Diminished sense of smell • Total or partial loss of • Assess to determine if
smell condition is related to ag-
Presbyosomia – loss
of smell due to aging okcimc.com • Think they smell bad
odors
• Headaches, dizziness,
ing or other conditions
• Determine if medica-
tions could be possible
shortness of breath, or cause
anxiety • Support treatment of
underlying cause such
as flu, cold, infection,
nasal swelling
• Recommend patient stop
smoking if applicable
• Tell patient to check for
spoilage of foods
Other Sensory Impairments Continued
learning
w ww
link
Disorder Structure Affected
Sensory integration Inability to integrate cer-

Physical Findings
• Over-sensitivity to
Treatment/Nursing
Care
• Therapeutic body
disorder or dysfunc- tain information received touch, movement, brushing to override
tion (SID) from the body’s basic sights, or sounds stimulation
sensory systems • Under-reactivity to • TENS units
touch, movement, • Music therapy
sights, or sounds • Biofeedback
Sensory Integration • Easily distracted
Disorder (SID) • Activity level that is un-
usually high or unusu-
www.sinetwork.org/ ally low
• Physical clumsiness or
apparent carelessness
www.youtube.com/ • Impulsivity or lack of
watch?v=6O6Cm0WxEZA self-control
• Difficulty in making
Benign Paroxysmal transitions from one
situation to another
Positional Vertigo • Inability to unwind or
calm self
www.mayoclinic.com/ Benign paroxysmal Inner ear • Dizziness • Teach exercises
health/vertigo/DS00534 positional vertigo • Unsteady gait/balance • Assess to determine
• Frequent falls cause and remove caus-
Movement Disorders • Labyrinth becomes ative agent
infected or swollen • Administer antibiotics
www.movementdisor- • Small calcium stones in as ordered
the inner ear become • Assist ambulation as
ders.org/education/ displaced needed
• Fluid in the inner ear
www.nlm.nih.gov/med- Movement disorders Disruption of any portion • Dystonia • Assist with physical

lineplus/movementdisor- of nervous system can • Tremor therapy as directed
cause a person to produce • Tics • Teach medication use
ders.html undesirable movement • Akathisia – restless leg • Provide perioperative
www.wemove.org/ 800-654-4502 syndrome (a desire to

move to relieve uncom-
fortable sensations)
care
okcimc.com • Rigidity
• Postural instability

L E a r n i n g O b j E c t i v E
learning
Obj ecti v e Relate diagnostic tests and surgical
procedures to the nursing care of w ww
link
patients with sensory disorders.
Various external devices are used for assessment of

the eye. They are:
• Slit lamp — diagnosing cataracts- allows better

visualization of the opacity of the lens. Snellen Eye Chart
• Tonometer — measurement of intraocular pres- www.i-see.org/eyecharts.
sure
html
• Ophthalmoscope — retinal detachment by
direct visualization Online Eye Tests
Sensory Disorder Tests and Surgical Procedures www.websightmd.com/
Test/ Procedure Purpose Procedure Nursing Care id23.html
Snellen eye chart Test visual acuity - ability Chart is placed twenty feet Teach patient about the
to see images at a distance away and the individual results of testing
reads downward as letters • The results include a
E-Activity Showing
decrease in size on each line fraction, comparing the Different Eye Disorders
individual’s vision with
normal vision www.richmondeye.com/
(e.g. the results are eyemotil.asp
20/30 means the
individual sees letters
at 20 feet as others see
at 30 feet)
Rosenbaum’s vision Tests near vision Holding the chart 14 inches Explain purpose and
screener away while patient reads the results of test
smallest print possible
Cover-uncover test
Used to assess extraocular
muscle function
The individual focuses on an
object far away and covers
800-654-4502
one eye
The uncovered eye is ob-
okcimc.com
served for movement
The test is performed on

both eyes
Classroom Activity
• M
any of these eye/vision tests are easy to do on each other. Have the students pair up and complete the
tests on their partner.
Sensory Disorder Tests and Surgical Procedures Continued
learning
w ww Nursing Care
Test/ Procedure Purpose Procedure
link Cardinal gaze test Determines eye muscle

strength and function of
The individual is asked
to focus on an object 12
Explain purpose, proce-
dure and results of test
cranial nerves inches away and the exam-
iner moves the object in six
different positions while
watching the individual’s eye
movements
Cardinal Gaze Test
Movement should be
www.websightmd.com/ smooth in all directions
id57.html Ophthalmoscopy Examination of the inte- Physician uses ophthalmo-
rior portion of the eye scope to provide illumina-
tion of the eye, allowing for
Ophthalmoscopy visualization of the inner
structures of the eye
www.youtube.com/
Tonometry Intraocular pressure A tonometer is applied
watch?v=leMexvs9HVU directly on the surface of the
eye which flattens the surface
Tonometry
Another method includes
www.youtube.com/ the use of a noncontact
watch?v=TTnLVw6yzB8 tonometer, which blows a
puff of air onto the eye
Amsler grid Problems with the macula Grid of identical sized
Amsler Grid exist squares with a central point
www.amd.org/living- is used, and the individual is
asked to stare at the central
with-amd/resources-and- point and notice if squares
tools/31-amsler-grid.html are uniform and straight.
Vascularity Observation of the eye Use of retinal angiography

www.opt.indiana.edu/
riley/HomePage/Amsler_
vessels
Dye is injected through a
vein and special photographs
Grid/4TEXTamsler_grid.
html
800-654-4502 are taken of the dye perfusing
through the eye vessels
Retinal Angiography okcimc.com

Preoperative care for an eye surgery includes admin- Postoperative care for an eye surgery includes pre-
istration of stool softeners to prevent straining with vention of anything that may cause straining, such
www.webmd.com/eye- stool after surgery, administration of eyedrops if as constipation, vomiting, bending over, etc. Eye
ordered, and patient education. patches are often used on affected eye after surgery
health/eye-angiogram for protection. Patient education on medications
prescribed and follow-up care is very important.
www.nlm.nih.gov/
ticle/003846.htm
Preoperative Care for 16 CIMC • MEDICAL SURGICAL NURSING II
Eye Surgery
http://eyerepublic.com/cataract-surgery-manila-phil- NOTE
ippines/preop-instructions.html
One of the primary nursing interventions for the
Postoperative Care for Eye Surgery postoperative care of the patient having had eye
surgery is to take measures to prevent increased
http://nursing411.org/Courses/MD0919_Nursing_
intraocular pressure (IOP). Assist the students with
care_sensory_neurologic/1-22_Nursing_Care_sen-
identifying common actions to avoid that may increase
sory_neuro.html
IOP (i.e. bending over to tie shoes, picking up small
http://eyerepublic.com/cataract-surgery-manila-phil- children, coughing and sneezing).
ippines/postop-instructions.html

Ear ExaMs Preoperative care of the patient undergoing ear
learning
w ww
surgery may involve administration of ear drops and
Instruments used for ear exams are: cleaning of the surgical site.
• An otoscope is an instrument used to inspect the link
tympanic membrane and the external acoustic Postoperative care for the patient undergoing ear sur-
canal. The normal tympanic membrane should gery may involve specific positioning in bed, depend-
appear pearly gray and transmit light. The nor- ing on type of surgery and ear affected. The nurse
mal canal should be smooth. should monitor for signs of damage to the facial
nerve, which includes inability to shut eyes, pucker
• A tuning fork is used to perform the Rinne and lips, or wrinkle forehead. There may be a dressing in
Weber tests. place over the ear. Safety is an important factor as Otoscope — Examina-
▶ I n the Rinne test, the tuning fork is struck to
balance may be impaired. tion of the Ear
produce vibration and placed on the mastoid
process until the individual can no longer
For administration of eye ointments, the steps are www.youtube.com/watch?
the same except for actual administration, where you
hear the vibration.
squeeze a thin line of ointment along the length of
v=KfHW3ES0IA4&featur
▶ The tuning fork is moved at once to a posi- the conjunctival sac. e=related
tion lateral to the ear until patient can no
longer hear the vibration. Air conduction Taste and smell disorders are identified by both www.youtube.com/
should be twice as long as bone conduction. subjective and objective data. The physician will use
a variety of tools, such as the ones listed below, to watch?v=iIbaq15t1L0
▶ T
he Weber test is done by striking the tun- confirm a diagnosis of a taste or smell disorder:
ing fork to produce vibration and placing it
midline along the individual’s skull.
Rinne and Weber Test
• Skull X-ray
▶ Sound should be heard equally in both ears. • MRI www.youtube.com/watch?
If the sound lateralizes to one ear, hearing
• CT scan
v=4WzGmDD0Zq8&feat
loss may be indicated.
ure=related
• Olfactory nerve testing
• Nasal cytology www.webster.edu/~davittdc/
Diagnostic Tests for Ear Disorders ear/rinne/rinne.htm
Test Purpose Procedure Nursing Care
www.webster.edu/~davittdc/
Romberg test
Checks for balance The individual is asked
to stand with their arms
extended to their sides,
• Explain purpose, proce-
dure and results of test
• Prevent patient from
ear/weber/weber.htm
800-654-4502 their feet together, and

Romberg Test
their eyes closed
falling during exam
www.neuroexam.com/neu-
okcimc.com There should not be sway-
roexam/content.php?p=37
ing or loss of balance
Audiometry Measure hearing acuity Headset is worn and vari- Explain purpose, proce-
ous intensities of sound dure and results of test Audiometry
are produced through the
headset one ear at a time www.ncbi.nlm.nih.gov/
books/NBK239/ http://
The results are based on
when the individual is first
able to hear sound
www.nlm.nih.gov/
ticle/003341.htm
http://itunes.apple.com/
Class Discussion us/app/audiometry/
id298494364?mt=8
• A
t this point, consider asking your students about which nursing diagnoses
they think are appropriate for the patient having undergone ear surgery.
Then discuss interventions and rationales for each diagnosis.
Class Discussion Touch, position and movement conditions are diag- L E a r n i n g O b j E c t i v E
nosed using:
Obje c ti v e Evaluate pharmacological effects of
• Th
is portion of the • Brain imaging studies medications used to treat sensory
course provides a good • CT scan disorders.
opportunity to review • PET scan
the administration of
• MRI
ophthalmic medica-
• Blood and urine studies, positron emission
tions and the applica-
• Lumbar puncture
tion of eye patches/
dressings. Medications for Sensory Disorders
Category and
Uses Actions Side Effects Nursing Care
Examples
Antibiotics Used to treat Interferes • Confusion • Assess for possible
• Gentamicin or prevent with protein • Seizures allergic reaction to drug
sulfate bacterial infec- synthesis of the• Hypo/hypertension • Observe for signs and
• Neomycin sulfate tions of the eye bacterial cell • Oliguria symptoms of infection
• Polymyxin B • Hematuria • Get culture and sensi-
sulfate • Renal damage tivity before giving first
• Ciprofloxacin • Rash dose of medication
• Monitor changes in
vital signs
Mydriatic & Dilate pupils Used for surgi- • Restlessness • Assess for eye pain
cycloplegic and paralyze cal procedures • Dry mouth • Monitor intake and
• Atropine muscles of ac- of the eyes • Abdominal output
• Scopolamine commodation distress • Assess for abdominal
• Homatropine Enhances abil- • Blurred vision complications such as
ity to examine • Rash constipation
inside of eye • Assess mental status
and prevents Alteration in vital
Free Sample Provided by CIMC moving of lens signs:

• Rapid pulse
800-654-4502
• Palpitations,
hypotension
Topical anesthetics Anesthetize Block nerve • Pain in the eye • Assess for possible
okcimc.com
• Alcaine the eye conduction • Redness allergic reaction to drug
• Pontocaine causing anes- • Eye irritation • Observe for signs and
thetic effect • Allergic reaction symptoms of infection
Additional Learning Activity

Using 3x5 note cards have your students write the name of a medication/classification on one side of a card.
Next write down the uses, actions, side effects and nursing considerations each on their own card. Do this
for each of the medications/classifications listed. Have the students mix all of the cards then match them
appropriately using the chart to grade their progress. This can be done as a team or individually. If using
teams, have each side see who can match the correct cards the fastest.

Medications for Sensory Disorders Continued
Category and
Uses Actions Side Effects Nursing Care
Examples
Miotics Treatment of Constrict the • Difference in taste • Assess for possible
• Cholinergics- glaucoma pupil, which • Ocular burning allergic reaction to drug
pilocarpine increases flow and stinging • Observe for signs and
hydrochloride of aqueous • Blurred vision symptoms of infection
• Cholinesterase humor and • Abdominal pain • Treat symptoms as pre-
inhibitors-echo- decreases • Back pain scribed by physician
thiophate iodide intraocular • Cough
• Beta-adrenergic pressure • Dizziness
blockers-timolol • Headache
maleate • Hypertension
• Urinary tract
infection
Sympathomimetics Decrease Aids in outflow • Tachycardia • Assess for possible
• Epinephrine intraocular of aqueous • Arrhythmias allergic reaction to drug
• Dipivefrin pressure fluid and • Hypertension • Observe for signs and
decreases the • Blurred vision symptoms of infection
body’s produc- • Headache • Treat symptoms as pre-
tion of aqueous • Eye pain scribed by physician
fluid • Conjunctivitis
Carbonic anhydrase Decrease Decrease • Dry eye • Assess for possible
inhibitors intraocular formation of • Headache allergic reaction to drug
• Azopt pressure aqueous humor • Ocular discharge • Observe for signs and
by decreasing • Ocular pain symptoms of infection
production of • Chest pain • Treat symptoms as pre-
carbonic acid • Eye fatigue scribed by physician
• Urticaria
• Dry mouth
• Dizziness
• Eye pain

• Conjunctivitis
800-654-4502
okcimc.com
L E a r n i n g O b j E c t i v E L E a r n i n g O b j E c t i v E
Object i v e Contribute to the plan of care for Obje c ti v e Distinguish among patient
patients experiencing alterations in education needs related to self-care
sensory or perceptual function. for sensory disorders.
LPNs will be assigned the task of direct patient The patient should receive teaching that is appropri-
care and will be responsible for contributing to the ate for self-care of disorders of the senses. Examples
patient’s plan of care. The following is a partial list of patient teaching follow.
of nursing diagnoses that may be associated with
patients experiencing sensory impairments. Patient teaching for glaucoma:
• Always wear ID tab stating “glaucoma”
• Disturbed sensory perception related to (hear-
ing, visual, taste) deficit • Take medications as prescribed
• Risk of injury related to (hearing, visual, taste) • Do not take over-the-counter medications with-
impairment and inability to (hear, see, taste) out consulting physician
potential dangers
• Signs of increased intraocular pressure to report
• Self-care deficits related to sensory (hearing, include eye pain, blurry vision, and presence of
visual, taste) deficit halos
• Fear of inability to sense potential danger or • Prevention of increased intraocular pressure
accurately interpret environment includes low sodium diet, prevention of consti-
pation
• Grieving related to loss of function
Patient teaching after ear surgery:
Goals for the patient with a sensory impairment
include: • Avoid sneezing, coughing, or blowing nose
• Successfully adjusting to the impairment • Avoid heavy lifting or bending over for 3 weeks
• Verbalizing feelings related to the loss • Avoid flying until physician permits
• Using appropriate coping strategies • Do not drink from a straw or from plastic bottle
for 3 weeks
• Maintaining safety during daily life

• Avoid people with illness and loud noises
• Performing activities of daily living as indepen-
dently as possible
800-654-4502
okcimc.com

LEarning activity 1 Lea rni ng
Acti v i ty
Ans wers
naME
Answers will vary.
Introduction
LPNs will be involved in identifying interventions promoting desired patient outcomes.
Activity
List two different nursing interventions for each of the nursing diagnoses listed below. Include rationale, or
reasoning, for the intervention.
• Glaucoma
• Ear surgery
Compare and contrast identified interventions with a peer.
Application
Present list to the facilitator.

800-654-4502
okcimc.com
Le a r ni ng LEarning activity 2
Ac t i v i t y
A nsw e r s
naME
Answers will vary.
Introduction
It is important for the nurse to be able to answer questions and provide instructions to the patient as their
questions arise. Patients with sensory impairment often need reassurance and directions.
Activity
Work individually or in groups of three as assigned by the facilitator. Review the following scenario and
discuss nursing care and appropriate patient instructions to be given to the patient.
During a routine health physical, a patient reports changes in his vision. He states these changes have become
increasingly prevalent during the past 2 to 3 years. The patient is currently 78 years old. He asks questions
about what other changes can be anticipated in his visual abilities related to aging. What information should
be provided the patient? What recommendations concerning preventive behaviors can be made to the patient
at this time?
Application
Check the answers with the facilitator.

800-654-4502
okcimc.com
Le a r ni ng Act i v i t y Rel ated Content

Normal Age-Related Vision Loss and Related Services for the Elderly, by Donia E. Nolan
www.laurenscharff.com/research/donia/aging_visual_changes.htm

LEarning activity 3 Lea rni ng
Acti v i ty
Ans wers
naME
Answers will vary.
Introduction
Patient teaching is important for the patient with sensory impairment.
Activity
A 78-year-old Native American patient with hearing loss who has had retinal reattachment surgery is as-
signed. The physician has explained surgical options to the patient, but the patient is still unsure of the differ-
ence between the various procedures.
Using the teaching plan developed by the RN and the information provided by the physician, determine
specific modifications to the teaching plan for the patient.
Application
Perform the patient teaching with a student or facilitator.

800-654-4502
okcimc.com
Le a r ni ng LEarning activity 4
Ac t i v i t y
A nsw e r s
naME
Answers will vary.
Introduction
Patient teaching and safety are important for the patient with sensory impairment.
Activity
Prepare a list of safety instructions for a patient who has recently experienced severely impaired touch, taste,
and smell.
Application
Perform patient teaching to a student or the facilitator.

800-654-4502
okcimc.com
Te ac hi ng Su g g e s t i o n
• H
ave students search for online resources related to this patient’s condition/situation. Guide students in
developing a teaching plan. Have the students blindfold themselves, wear ear plugs and role-play how they
would present the information to a patient with similar impairments. Discuss the challenges of this activity
and whether options exist to address them.

KEy sUMMary
• The senses provide individuals with interactions with their environment, interactions with
other individuals, and contribute to their safety within their environment.
• Treatment for sensory disorders may include corrective lenses, medications, and/or surgery.
There are numerous disorders which may affect an individual’s hearing. Some of these
include otitis media, otosclerosis, and Meniere’s disease.
• There are two different types of hearing loss attributed to problems with the ear.
Sensorineural hearing loss is due to dysfunction of the auditory nerve. When the hearing
loss is caused by problems with sound transmission through the ear it is conductive hearing
loss.
• The sense of touch, position and movement assist in ambulation and mobility. If the patient
is unable to move or moves uncontrollably, optimum wellness may not be possible.
• Taste and smell disorders are identified by both subjective and objective data.
• Disorders that affect the senses provide unique challenges because they have significant
impact on the patient’s ability to interact with others and their ability to maintain safety.

800-654-4502
okcimc.com
HOSA Spotlight
Health Education Competitive Event www.hosa.org/natorg/sectb/cat-iv/he.pdf
• A
teamwork event for 2-4 members. One of the sensory disorders/diseases could be selected. A lesson is
prepared on the topic, instruction presented to a class of students, and results evaluated. This event includes
the use of multimedia presentation tools.
gLOssary
Blepharitis: An inflammation of the lid margins of the eye.
Cataract: Opacity of the lens of the eye.
Conjunctivitis: An inflammation of conjunctiva.
Endolymph sac: A pouch in the inner ear which contains endolymph.
Hordeolum: An infection causing inflammation of an oil gland located on margin of

eyelid (also referred to as a stye).
Intraocular pressure: The amount of pressure in the eye, determined by amount of

aqueous humor present.
Keratitis: An inflammation of the cornea.
Macular degeneration: A condition in which macula is damaged or destroyed.
Narrow angle glaucoma: Also known as angle-closure glaucoma, this occurs due to a
narrow angle present where iris and cornea meet, causing susceptibility to angle
closure; requires immediate treatment.
Open angle glaucoma: This occurs when methods of drainage of aqueous humor are
blocked and intraocular pressure increases. It occurs gradually.
Photophobia: Sensitivity to light.

Retinal angiography: A procedure in which dye is injected into a peripheral vein and a
camera records the blood flow through the retinal vessels.
800-654-4502
Retinal detachment: A condition in which the sensory layer and the pigmented layer of
the retina become separated.
okcimc.com
Retinopathy: A condition in which vessels of the retina are destroyed.
Sensorineural hearing loss: Hearing loss caused by nerve damage.
Stapedectomy: A procedure in which the stapes or portion of the stapes is removed

surgically and replaced with prosthesis for improvement of hearing.
Tympanoplasty: A procedure in which the tympanic membrane is repaired following

perforation.

rEsOUrcE bibLiOgrapHy
Publications
Burke, L. (2007). Medical-Surgical Nursing Care (2nd ed.). Pearson, Prentice Hall.
DeWitt, Susan (2009). Medical Surgical Nursing Concepts and Practice. Portland; Saunders.
Hogan, M. A. (2008). Medical Surgical Nursing (2nd ed.). Pearson Education.
Nursing Focus. Stillwater, OK: Oklahoma Department of Career and Technology Education,
Curriculum and Instructional Materials Center, 2002.
Timby, B., Smith, N. (2007). Introductory Medical Surgical Nursing (9th ed.).
Lippincott, Williams &Williams.
White L. (2005). Foundations of Nursing (2nd ed.). United States; Thompson Delmar.

800-654-4502
okcimc.com
nOtEs

800-654-4502
okcimc.com

Med Surg Sensory Sample PDF

Hochgeladen von

Dokumentinformationen

Originaltitel

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

Med Surg Sensory Sample PDF

Hochgeladen von

Copyright:

Verfügbare Formate

This free sample provided by CIMC

Practical Nursing Series:

Medical Surgical Nursing II, used in conjunction with Medical

This full-color text builds on the concepts and skills for

We are offering “Sensory Nursing” as a free sample.

Copyright 2013 Oklahoma Department of Career and Technology Education

Free Sample Provided by CIMC

http://itunes.apple.com/app/id450577890 — Continued on next page

2 CIMC • MEDICAL SURGICAL NURSING II

Ear canal Cochlea

Free Sample Provided by CIMC

4 CIMC • MEDICAL SURGICAL NURSING II

4 CIMC • MEDICAL SURGICAL NURSING II

Free Sample Provided by CIMC

Normal aging affects hearing by causing a decrease in

MODULE 2 • SENSoRy NURSING • stUDEnt EDitiOn 5

The glossopharyngeal nerve transmits the messages sEnsE Of tOUcH

Free Sample Provided by CIMC

• When olfactory cells are damaged, the person’s • Chemoreceptors (chemical)

6 CIMC • MEDICAL SURGICAL NURSING II

6 CIMC • MEDICAL SURGICAL NURSING II

Free Sample Provided by CIMC

www.southcoasteyecare- okcimc.com(pink eye) conjunctiva caused by a

8 CIMC • MEDICAL SURGICAL NURSING II

MODULE 2 • SENSoRy NURSING • stUDEnt EDitiOn 9

Iris is too close to the canal • Severe eye pain with

www.youtube.com/ okcimc.com with intact peripheral

Nursing Care for

Retinopathy Amsler Grid to Check for Macular Degeneration

10 CIMC • MEDICAL SURGICAL NURSING II

800-654-4502 htm (Part 1)

okcimc.com • Low urine output

MODULE 2 • SENSoRy NURSING • stUDEnt EDitiOn 11

CRI TICA L T HIN K ING q ue s ti on a ns wers

Increased fluid in the

www.pedisurg.com/pt-Free Sample Provided by CIMC ▶ Bending over with

12 CIMC • MEDICAL SURGICAL NURSING II

12 CIMC • MEDICAL SURGICAL NURSING II

Affects the bones of the

Free Sample Provided by CIMC

MODULE 2 • SENSoRy NURSING • stUDEnt EDitiOn 13

Sensory integration Inability to integrate cer-

Free Sample Provided by CIMC

www.wemove.org/ 800-654-4502 syndrome (a desire to

14 CIMC • MEDICAL SURGICAL NURSING II

14 CIMC • MEDICAL SURGICAL NURSING II

Various external devices are used for assessment of

• Slit lamp — diagnosing cataracts- allows better

The uncovered eye is ob-

The test is performed on

MODULE 2 • SENSoRy NURSING • stUDEnt EDitiOn 15

link Cardinal gaze test Determines eye muscle

Free Sample Provided by CIMC

Retinal Angiography okcimc.com

Preoperative Care for 16 CIMC • MEDICAL SURGICAL NURSING II

16 CIMC • MEDICAL SURGICAL NURSING II

800-654-4502 their feet together, and

Free Sample Provided by CIMC moving of lens signs:

18 CIMC • MEDICAL SURGICAL NURSING II

Additional Learning Activity

18 CIMC • MEDICAL SURGICAL NURSING II

Free Sample Provided by CIMC

MODULE 2 • SENSoRy NURSING • stUDEnt EDitiOn 19

http://itunes.apple.com/app/id450577890 — Continued on next page