Ch. 49 Cognition and Sensation

The nurse is providing care to a patient who is color blind. Which statement by the nurse is accurate when teaching the patient about this condition? "The rods located in the retina are responsible for color vision." Though rods are photoreceptors, they are not responsible for color vision. Rods are sensitive to light and provide vision in dim light. "The cones located in the retina are responsible for color vision." Cones are the photoreceptors that detect sharp, color images. "The labyrinths in the retina are responsible for color vision." Labyrinths are located in the ear and play a role in hearing, not vision. "The ossicles in the retina are responsible for color vision." Ossicles are located in the ear and play a role in hearing, not vision.

"The cones located in the retina are responsible for color vision." Cones are the photoreceptors that detect sharp, color images.

Hydrogen peroxide is used for irrigation during cerumen removal. What is the concentration of hydrogen peroxide used for irrigation? Record your answer using a whole number.

3%

In which conditions is the use of hearing aids contraindicated? Inability to hear properly A chronic feeling of dizziness Visible cerumen accumulation Traumatic deformity of the ear Decreased pitch discrimination

A chronic feeling of dizziness Visible cerumen accumulation Traumatic deformity of the ear

Dementia

A permanent and progressive decline in mental function. Characteristics It is characterized by decline in: Judgment (wandering or individuals finding themselves in unsafe situations) Language (verbal outbursts or repetitive asking of questions) Reasoning (inability to follow directions) Memory (unable to recognize family members, remember the purpose of an item, or the last time they ate or took medication) Causes Dementia is not a specific disease. It has a variety of causes.

Delirium

A temporary state of confusion, is reversible. Characteristics: Fluctuations in awareness (confusion) Memory impairment (loss of orientation to person, place, or time) Disorganized speech (slurred speech or aphasia) Hallucinations Disturbances of sleep-wake cycles Causes: Other medical conditions Low oxygen saturation levels Medication side effects Alcohol or substance abuse Fluid and electrolyte imbalances Hypoglycemia Pain Infections Sensory overload also causes delirium in hospitalized patients. For example, a patient in the intensive care unit is at a high risk for developing delirium from sensory overload.

Cerebrovascular accident (CVA)

Also knowns as a stroke, deprives blood flow to an area of the brain. The risk factors for CVA include: Hypertension Atrial fibrillation Vascular disease

The nurse recognizes the presence of which sensory alteration when an 82-year-old complains of inability to smell anything for years? Meniere's disease Presbycusis Myopia Anosmia

Anosmia

Which assessment finding should cause the nurse to suspect an older patient has presbycusis? Asking to have questions repeated Verbally communicating with difficulty Failing to see nearby objects Lacking the ability to smell food

Asking to have questions repeated

During an annual checkup, the parent of a 5-year-old boy expresses that the child does not react to noxious odors. What nursing interventions should the nurse perform? Convince the parent that odor is a subjective perception. Inform the parent that the child has a decreased sensitivity to odor. Assess the ability of the child to identify several noxious odors. Assess the ability of the child to identify several nonirritating odors. Inform the parent that it is difficult to assess children younger than 7 years old.

Assess the ability of the child to identify several nonirritating odors. Inform the parent that it is difficult to assess children younger than 7 years old. Assessment of the ability to differentiate smell is done using nonirritating odors such as coffee or vanilla. It is difficult to assess smell in children younger than 7 years of age. Even though appreciating smell is a subjective feeling, the failure to react to noxious odors should be assessed. If the child is not reacting to noxious odors, he or she might have a decreased sensitivity to odor. It is a medical diagnosis and should be performed by a specialist.

A patient has reduced taste sensation and is finding food less appealing. What does the nurse instruct the patient? Avoid smelling baked bread. Avoid smelling cooked garlic. Avoid blending or mixing foods. Avoid eating food of different textures.

Avoid blending or mixing foods. The patient should avoid blending or mixing foods because doing that makes it difficult for the patient to identify tastes. Smelling baked bread, smelling cooked garlic, and eating foods of different textures heightens taste sensation. There is no need to avoid such activities.

The nurse understands that peripheral neuropathy occurs from damage to sensory fibers at which location? Close to the body's midline Lower part of the spinal cord Away from the body's center Near the base of the brain

Away from the body's center

A nurse has been assigned to an accident patient whose temporal lobe area is suspected to be injured. The nurse is required to monitor this patient for alterations. For effective monitoring, which cognitive functions should the nurse observe? Select all that apply. Behavior Personality Memory Speech Intelligence

Behavior Memory Speech

Function of temporal lobe

Behavior Memory Speech

Hemorrhagic stroke

Bleeding from a rupture occurs when there is bleeding in the brain from a traumatic brain injury.

A patient is admitted to the hospital for a scheduled cataract surgery. The patient has no major health history and the vital signs are stable. While assessing the patient, the nurse realizes that the patient has a progressive hearing disorder. The nurse understands that the patient is also visually impaired. What could be the possible effects of this sensory deprivation on the patient? Stroke Boredom Disorientation Malnourishment Poor task performance

Boredom Disorientation Poor task performance Sensory deprivation can have many ill effects on an individual. This patient is vision and hearing impaired. This can cause boredom, because the person is not able to read, see, or hear well enough to enjoy normal forms of entertainment. This alteration can also cause disorientation, because the person cannot fully understand or perceive his or her surroundings. Hearing and vision alteration can hamper a person's task performance. A stroke is a medical condition; it is not caused by hearing or vision impairment. Hearing or visual alteration are not causes of malnutrition.

Following an assessment, the nurse finds that a patient has reduced tactile sensation. How does the nurse improve the patient's tactile sensation? By avoiding rubbing the back of the patient By providing touch therapy to the patient By avoiding turning and repositioning By recommending special wrist splints

By providing touch therapy to the patient Touch therapy is used to improve tactile sensation. It stimulates the existing function of the tactile receptors. A back rub is a way of increasing tactile contact. Turning and repositioning also improve the quality of tactile sensation. Special wrist splints are helpful in relieving nerve pressure. They are used for the patient who has numbness and tingling or pain in the hands. They are not useful for the patient with reduced tactile sensation.

The nursing student is presenting information related to cognition. Which cognitive skills should the student include in the presentation? Calculation Calculation is a cognitive skill. It should be included in the presentation. Memory Memory is a cognitive skill. It should be included in the presentation. Vision Vision is a sense. It should not be included in the presentation. Language Language is a cognitive skill. It should be included in the presentation. Equilibrium Equilibrium is a sense. It should not be included in the presentation.

Calculation Calculation is a cognitive skill. It should be included in the presentation. Correct Memory Memory is a cognitive skill. It should be included in the presentation Language Language is a cognitive skill. It should be included in the presentation.

In which condition does alteration of tactile sensation occur due to the pressure on the median nerve? Aphasia Presbyopia Hyperesthesia Carpal tunnel syndrome

Carpal tunnel syndrome In carpal tunnel syndrome, alteration of tactile sensation occurs due to the pressure on the median nerve. It is a use-related injury. In aphasia, the patient has an inability to speak, interpret, or understand language. In presbyopia, the patient has an inability to see close objects. In hyperesthesia, the patient is overly sensitive to tactile stimuli.

Which cognitive and sensory impairments are exhibited by cocaine users? Select all that apply. Macular degeneration Hearing loss Change in smell Myopia Dizziness

Change in smell Dizziness

Diabetic retinopathy

Characteristics Diabetic retinopathy is a condition in which the blood vessels of the retina are damaged. It is caused by complications related to diabetes mellitus. Cause Prolonged hyperglycemia, leads to destruction of the small vessels in the retina that contain the photoreceptors. When these cells are destroyed, loss of vision occurs.

Glaucoma

Characteristics Glaucoma is a serious medical condition of the eye. It causes increased intraocular pressure, which puts pressure on the optic nerve. Causes There are no early symptoms, but risk is higher with: Aging Having a family history of glaucoma Having medical conditions such as diabetes, heart disease, and high blood pressure

Cataract

Characteristics In cataract, the lens of the eye becomes cloudy. Cause It occurs with aging.

Myopia

Characteristics In myopia, vision is clear at close distance. It is also known as nearsightedness. Causes The image is focused in front of the retina instead of directly on it. The eye becomes elongated; it is not known why this happens.

Presbyopia

Characteristics In presbyopia, distance vision is clear. Age-related change in vision occurs usually after the age of 40. Change occurs gradually. Cause The cause is unknown, but the lens of the eye appears to become less flexible and loses its ability to change shape in order to focus.

Macular degeneration

Characteristics The macula is the area of the retina that provides central vision. Macular degeneration is the leading cause of visual defects in the United States. Causes Diabetes, genetics, smoking, and hypertension The risk of developing this condition is higher after the age of 50.

Gustation

Chemoreceptors are located in the taste buds on the tongue, the roof of the mouth, and the throat. They are stimulated when they come into contact with food. The right and left seventh cranial nerves, (facial) and the right and left ninth cranial nerves (glossopharyngeal), transfer the taste information to the brain. The input is analyzed in the insula.

Olfaction

Chemoreceptors, which react to chemicals, are located in the upper nasal passages and are stimulated by odor. The nerve impulse passes through the right and left first cranial nerves (olfactory) to the brain. The input is interpreted in the temporal lobe of the cerebrum.

Which medicine may cause irritation of the optic nerve? Gentamicin Tobramycin Streptomycin Chloramphenicol

Chloramphenicol Chloramphenicol sometime causes irritation of the optic nerve. Gentamicin, tobramycin, and streptomycin are ototoxic drugs. These drugs may cause permanent damage to the auditory nerve. Study Tip: Here is a mnemonic to help you recall the medications that are oto toxic: Think of having mice in your ears = drugs that end in -mycin or -micin such as gentamicin, tobramycin, and streptomycin. Such a disturbing idea can help you remember!

Ischemic stroke

Clot or plaque blocks or narrows a blood vessel in the brain. occurs when a clot or plaque embolus narrows or blocks a blood vessel in the brain, diminishing or preventing blood flow to that region of the brain.

Types of hearing loss

Conductive hearing loss: Occurs in the portion of the ear that conducts sound waves Causes include a buildup of wax (cerumen) and otitis media Sensorineural hearing loss: Damage occurs to the nerves or nerve pathway Causes include: Loud noises Infection Adverse reaction to medication Head injury or trauma

Which term is used to describe sensory impulses that cross over to the other side of the body before reaching the brain? Stimulus Perception Adaptation Decussate

Decussate

Which cognitive alteration does the nurse suspect when a 70-year-old receiving pain medication following a hip replacement stays awake all night and is confused? Dementia Delirium Depression Sensory deprivation

Delirium is a temporary state of cognitive impairment that can cause the patient to experience memory loss or disorientation.

The nurse will be alert for which cognitive alterations when caring for a 40-year-old patient admitted to the emergency department with a high blood alcohol level? Select all that apply. Delirium Slurred speech Expressive aphasia Ringing in the ears Exogenous depression

Delirium Slurred speech Exogenous depression

Alzheimer's disease

Dementia has a subtle onset and progresses in severity over time. The most common example of dementia is Alzheimer's disease. In this disease, the brain shows marked cerebral atrophy, or a decrease in size. The progressive loss of brain tissue affects the communication between nerve cells, causing the person to lose cognitive function and, eventually, even basic functions such as breathing.

The nurse is aware that a patient kept in strict isolation after a bone marrow transplant is at increased risk of developing which cognitive alteration? Dementia Sundowning Depression Delirium

Depression

The nurse recognizes which sensory alteration in a 79-year-old patient who has lost interest in eating and has lost five pounds over the past month? Depression Lack of appetite and weight loss can be indicative of depression. Correct Anosmia Loss of the sense of smell can decrease appetite and result in weight loss. Presbycusis Impairments in hearing do not lead to changes in eating habits. Incorrect Presbyopia Impairments in vision do not lead to changes in eating habits. Correct Sensory deprivation Sensory deprivation can lead to loss of appetite and result in weight loss.

Depression Lack of appetite and weight loss can be indicative of depression. Correct Anosmia Loss of the sense of smell can decrease appetite and result in weight loss. Sensory deprivation Sensory deprivation can lead to loss of appetite and result in weight loss.

Where are tactile receptors located? Select all that apply. Dermis Eyes Nose Mouth Subcutaneous tissue

Dermis Subcutaneous tissue

Which cognitive or sensory factors should a nursing student consider when caring for a patient who is blind? Select all that apply. Eating assistance Safety needs Pain management Activities of daily living (ADLs) Verbal communication

Eating assistance Safety needs Activities of daily living (ADLs)

The nurse is attending to patients with hearing impairments. What precautions should the nurse take while communicating with these patients? Speak loudly when talking. When not understood, repeat the conversation. Ensure that the patients keep their eyeglasses clean. Use written information to enhance or supplement spoken communication. Keep the patient's hands free to allow communication through hand gestures.

Ensure that the patients keep their eyeglasses clean. Use written information to enhance or supplement spoken communication. Keep the patient's hands free to allow communication through hand gestures. The nurse should keep the patients' eyeglasses clean so that they are able to see the gestures and face of the speaker. If possible, information can be written down and shared with hearing-impaired patients. Patients with hearing impairment should be allowed to use their hands freely so that they can communicate with hand gestures or sign language. Loud sounds are usually higher-pitched and often impede hearing by accentuating vowel sounds and concealing consonants. If you need to raise your voice, speak in lower tones. When you are not understood, rephrase rather than repeat the conversation.

The nurse recognizes which cognitive impairment in a patient with a recent CVA who can follow commands but has difficulty responding verbally? Expressive aphasia Hypoglycemia Delirium Receptive aphasia

Expressive aphasia In expressive aphasia, the patient can understand what they hear but cannot express words appropriately when communicating.

The nurse observes that the patient cannot make decisions without the spouse present, is unable to focus on a topic being discussed, does not retain information given and repeats the same stories with each encounter. Which area of the cerebrum is most likely affected? Parietal lobe Occipital lobe Frontal lobe Temporal lobe

Frontal lobe The frontal lobe is involved in communication, concentration, decision making and memory.

The nurse is providing care to a patient who is having difficulty with voluntary motor function. Which lobe of the cerebrum is likely damaged and causing this clinical manifestation to occur? Frontal lobe Parietal lobe Temporal lobe Insula

Frontal lobe The frontal lobe is responsible for voluntary motor function.

The nurse is providing care to a patient who is experiencing personality changes after having a stroke. Which lobe of the cerebrum is affected based on this data? Frontal lobe Parietal lobe Temporal lobe Insula

Frontal lobe The frontal lobe of the cerebrum is responsible for personality. The nurse can expect this lobe to be affected if the patient is experiencing personality changes.

A patient who has vision and hearing problems has a history of striking out at caregivers. What is the most appropriate nursing intervention? Consult the health care provider regarding the use of restraints. Perform tasks quickly to reduce risks to caregivers. Explain to the patient that this is unacceptable behavior. Get the patient's consent before starting care.

Get the patient's consent before starting care. Individuals with limited sensory ability may strike out because of fear or confusion. Taking time to make contact with the individual before starting care should reduce problems. Restraints are not appropriate in this situation because the patient would become more violent. Performing tasks quickly will further confuse the patient and not promote understanding. Explaining appropriate behavior will not be effective, because the patient has sensory impairment.

The nurse can expect which sensory alterations in a patient with Meniere's disease? Select all that apply. Hearing loss Vertigo Light sensitization Noise confusion Cognitive deprivation

Hearing loss Vertigo

Which proprioceptive change is observed in older adults? Increased difficulty with balance Increased sensitivity to pain Increased sensitivity to pressure Increased sensitivity to temperature

Increased difficulty with balance Older adults may experience increased difficulty with balance; it is a sign of proprioceptive changes. Older adults also experience tactile changes, including decreased sensitivity to pain, pressure, and temperature. Study Tip: Remember that proprioception relates to "position sense" (spatial awareness). It refers to the body's ability to tell where it is in space, and includes the sense of position for each movable joint. Position sense can be improved with practice, such as balance exercises or tai chi; but first, patient safety must be ensured.

Function of parietal lobe

Intelligence Language Reading

A nurse is assessing a patient who is unable to balance properly. Which sense organ structure should the nurse know is responsible for this alteration? Cones Ossicles Labyrinths Rods

Labyrinths A second set of labyrinths in the inner ear, known as the semicircular canal, has receptor cells that interpret the head's position and maintain a state of balance.

Which skills are associated with cognition? Select all that apply. Language Smell Attention Memory Vision

Language Attention Memory

The nurse notes the presence of which alterations when admitting a 30-year-old patient with suspected meningitis? Hypoglycemia Light sensitivity Aphasia Motor deficits

Light sensitivity

Vision

Light stimuli enter the eye through the cornea and pass through the lens. Two types of photo receptors, rods and cones, present in the retina (the innermost layer of the eye), detect visual images by perceiving light waves. Rods are more sensitive to light and so can provide vision in dim light. Cones detect sharp, color images. Visual impulses travel through the right and left optic nerves (second cranial nerves) to the brain. The visual data is interpreted in the occipital lobe of the cerebrum.

Which sensory alteration presents a safety hazard when assisting an older patient with ambulation? Glaucoma Ansomia Loss of equilibrium Presbycusis

Loss of equilibrium

The nurse is performing a physical assessment of an older adult. Which age-related hearing changes is the nurse likely to find? Low-pitched vowels are easily heard. Hearing acuity is decreased. Reaction to speech is not delayed. Discrimination of consonants becomes difficult. High-pitched sounds are easier to hear than low-pitched sounds.

Low-pitched vowels are easily heard. Hearing acuity is decreased. Discrimination of consonants becomes difficult. Aging can affect hearing. Low-pitched vowels are easily heard. The hearing acuity is decreased and the discrimination of consonants becomes difficult. These signs indicate age-related changes in the auditory system. Reaction to speech is usually delayed, and low-pitched sounds are easier to hear than high-pitched sounds.

On assessment, the nurse finds that the patient has blurred vision, loss of central vision, and distortion of vertical lines. Which visual deficit is likely to be found in the patient? Cataracts Glaucoma Presbyopia Macular degeneration

Macular degeneration Blurred vision, loss of central vision, and distortion of vertical lines are symptoms of macular degeneration. It is a condition in which the macula loses its ability to function efficiently. Development of cloudy or opaque areas in part of the lens, glare, blurred vision, redness, and tearing in the eye are the symptoms of a cataract. Peripheral visual loss, decreased visual acuity with difficulty in adapting to darkness, and a halo effect around lights are symptoms of glaucoma. The inability to see close objects is called presbyopia.

Function of Insula lobe

Memory

The nurse is planning to conduct a hearing acuity test on a patient. What are the different activities through which the nurse may assess this sensory function? Ask the patient to read the newspaper. Observe the patient's behavior in a group. Use the tuning fork test. Use the spoken word test. Ask the patient to identify colors.

Observe the patient's behavior in a group. Use the tuning fork test. Use the spoken word test. The nurse can detect sensory alteration in the patient by closely observing the patient. Patients with a hearing impairment may seem inattentive to others. They believe that people are talking about them and respond with inappropriate anger when spoken to. They answer questions inappropriately and have trouble following clear directions. They also have a monotonous voice quality and speak unusually loud or soft. The hearing can be further tested using the tuning fork and conducting the Weber's test and the Rinne's test. Test the patient's hearing by asking the patient to repeat spoken words. Test the patient's vision by asking the patient to read the newspaper and identify colors.

When communicating with a patient who has expressive aphasia, what is the highest priority for the nurse? Asking open-ended questions Understanding that the patient will be uncooperative Coaching the patient to respond Offering pictures or a communication board so the patient can point

Offering pictures or a communication board so the patient can point Patients who have expressive aphasia understand questions but have difficulty expressing an answer. To promote interaction with the patient, offer pictures or a communication board so the patient can point to key words or images. Listen to the patient and wait for him or her to communicate. Use simple, short questions and facial gestures to give additional cues.

The nurse knows that a patient with long-term diabetes mellitus is at high risk for which alteration? Peripheral neuropathy A diabetic patient is at a higher risk for this alteration because of damage to peripheral nerve fibers. Presbyopia Presbyopia refers to age-related visual changes and is not specific for diabetes mellitus. Meniere's disease Meniere's disease refers to a disease involving dizziness and tinnitus and is not specific for diabetes mellitus. Depression Depression can occur with any disease and is not specific for diabetics. Retinopathy Diabetic retinopathy is a complication related to diabetes mellitus.

Peripheral neuropathy A diabetic patient is at a higher risk for this alteration because of damage to peripheral nerve fibers. Retinopathy Diabetic retinopathy is a complication related to diabetes mellitus.

Which assessment will the nurse make on a patient with long-standing diabetes mellitus? Peripheral sensation Taste detection Pupillary reaction Facial movement

Peripheral sensation

The nurse is performing an assessment on a patient admitted to the emergency department with eye trauma. What do the nurse's priority interventions include? Conducting a home safety assessment and identifying hazards in the patient's living environment Reinforcing eye safety at work and in activities that place the patient at risk for eye injury Placing necessary objects such as the call light and water in front of the patient to prevent falls due to reaching Orienting the patient to the environment to reduce anxiety and prevent further injury to the eye Assessing the patient for signs of abuse

Placing necessary objects such as the call light and water in front of the patient to prevent falls due to reaching Orienting the patient to the environment to reduce anxiety and prevent further injury to the eye

When assessing a 45-year-old patient's sensory status, which assessment findings does the nurse consider a normal part of aging? Presbyopia and the need for glasses for reading Reduced sensitivity to odors Impaired balance and coordination Reduced taste discrimination

Presbyopia and the need for glasses for reading Visual changes during adulthood from ages 40 to 50 include presbyopia and the need for glasses for reading. Gustatory and olfactory changes begin around age 50 and include reduced taste discrimination and reduced sensitivity to odors. Proprioceptive changes common after age 60 include increased difficulty with balance, spatial orientation, and coordination.

Location of brain damage

Right side of the brain: Motor and sensation deficits are possible on the left side of the body. Visual problems may be present. Left side of the brain: Motor and sensation deficits are possible on the right side of the body. Speech difficulties, or aphasia, may be present.

A patient with Meniere's disease reported which symptoms to the nurse? Select all that apply. Ringing or other abnormal sounds in the ears Progressive hearing loss Visual-spatial problems Distorted vision Heart rate above normal

Ringing or other abnormal sounds in the ears Progressive hearing loss

Peripheral neuropathy

Sensation to the nerves in the distal extremities decreases. Most commonly affected are the feet and hands from where the symptoms move to the legs and arms. Causes Vascular disease Diabetes mellitus Renal disease Nerve compression in the back Patients are at a high-risk for injury due to the loss of sensation. They may not be able to discern hot and cold items, sharp objects, or feel if they have an injury or wound.

What senses are associated with the temporal lobe?

Sense of hearing Sense of smell

What sense is associated with the occipital lobe?

Sense of light

What sense is associated with the insula?

Sense of taste

What sense is associated with the parietal lobe?

Sense of touch

A 28-year-old patient who suffered a head injury is alert and oriented but does not respond to questions in a timely manner. The nurse suspects which hearing alteration? Meniere's disease Meniere's is a progressive disease with dizziness and ringing in the ears. This patient does not display those symptoms. Incorrect Conductive hearing loss Conductive hearing loss refers to blockages that prevent sound conduction. This patient does not display conductive hearing loss. Sensorineural hearing loss The symptoms are indicative of sensorineural hearing loss which is caused by trauma or loud noises. Presbycusis Presbycusis refers to age-related hearing loss. This patient is 28 years old and does not display age-related hearing changes.

Sensorineural hearing loss The symptoms are indicative of sensorineural hearing loss which is caused by trauma or loud noises.

The nurse is aware that a patient kept in strict isolation after a bone marrow transplant is at increased risk of developing which cognitive alteration? Dementia Dementia is a permanent decline in mental function. Strict isolation is not a risk factor for dementia. Sundowning Sundowning is associated with dementia. Strict isolation is not a risk factor for dementia. Sensory deprivation Patients in strict isolation are at increased risk for sensory deprivation because of enforced social isolation. Delirium Delirium is a reversible state of acute confusion. It is associated with sensory overload and other medical conditions.

Sensory deprivation Patients in strict isolation are at increased risk for sensory deprivation because of enforced social isolation.

On a home visit, the nurse finds that a patient has sensory impairment. Which environmental factors can increase the risk of falls for the patient? A bathroom with a shower Water faucets with red and blue rings indicating hot and cold water Stairways without lamps Lack of handrails Phone cords in the main route of walking

Stairways without lamps Lack of handrails Phone cords in the main route of walking

The nurse suspects which condition when finding an older patient confused, disoriented, and wandering the halls at night? Sundowning Sensory deprivation Anosmia Sensory overload

Sundowning

The nurse is performing a routine checkup of pregnant women. What nursing interventions are helpful in preventing hearing impairment in the fetus? Testing for syphilis in the women Screening for rubella in the women Avoiding the use of ototoxic drugs Avoiding erythromycin Avoiding citrus fruits during pregnancy

Testing for syphilis in the women Screening for rubella in the women Avoiding the use of ototoxic drugs Special precautions should be taken by pregnant women to prevent hearing impairment in the fetus. Testing for syphilis, screening for rubella, and avoiding the use of ototoxic drugs are helpful in preventing hearing impairment of the fetus. Syphilis and rubella may increases the risk of a hearing impairment in the fetus. Consumption of ototoxic drugs during pregnancy causes hearing impairment in the fetus. Erythromycin does not cause hearing impairment in the fetus. It is helpful for the infant as an eye prophylaxis. Consumption of citrus fruits during pregnancy does not cause hearing impairment of the fetus.

Hearing

The auricle (outer ear) collects sound waves, causing the eardrum (membrane dividing the outer and middle ears) to vibrate. These vibrations cause the three ossicles (small bones) in the middle ear to vibrate. The vibration is transmitted to the fluid-filled inner ear via the oval window (a membrane-covered opening). The inner ear is comprised of a complicated set of labyrinths (intricate communicating passageways). Here, receptor cells pick up the sound waves and send the impulse to the brain via the right and left eighth cranial (vestibulocochlear) nerves. The input is analyzed in the temporal lobe of the cerebrum.

What part of the brain is associated with both cognition and the ability to process and integrate information from sensory input?

The cerebrum.

Equilibrium

The receptor cells in the second set of labyrinths in the inner ear, the semicircular canal, provide sensory input to interpret the head's position and maintain equilibrium, or balance. Different receptors detect when the head is still and when it is in motion. This information is sent to the brain via the vestibulocochlear nerves.

The nurse is caring for a visually impaired patient. Which nursing intervention is helpful for enhancing the vision of the patient and for promoting functional ability? The use of telescopic lens eyeglasses The use of pocket magnifier The use of sunglasses while outside The use of warm, incandescent lighting

The use of warm, incandescent lighting The amount of light entering the eye is reduced due to aging, causing a reduction in vision, contrast, and color. In the case of a visual impairment, the use of warm, incandescent lighting is helpful for enhancing the patient's vision. Incandescent lighting provides less glare and is brighter and helps patients to see paths clearly, which prevents accidents. The use of telescopic lens eyeglasses and pocket magnifiers is helpful in cases of reduced visual acuity. Wearing sunglasses while outside helps to minimize glare.

Tactile receptors

Those detectable by touch, are located in the dermis and subcutaneous tissue. These nerve fibers supply the brain with information regarding touch and pressure by way of the sensory pathways.

The nurse finds that a patient is very sensitive to visual glare. Which appropriate nursing interventions are helpful for the patient? Use blinds on the windows. Use a telescopic lens. Use a pocket magnifier. Wear sunglasses outside. Use yellow or amber lenses.

Use blinds on the windows. Wear sunglasses outside. Use yellow or amber lenses.

The home care nurse is teaching the nursing assistant about interventions to facilitate the location of items for a patient with vision impairment. Which strategies will enhance the patient's ability to see? Use of fluorescent lighting Use of warm incandescent lighting Use of colors with sharp contrast and intensity Use of yellow or amber lenses to decrease glare

Use of warm incandescent lighting Use of colors with sharp contrast and intensity Use of yellow or amber lenses to decrease glare Interventions to enhance vision include the use of sharply contrasting colors, warm incandescent lighting, and yellow or amber lenses to decrease glare. Fluorescent lighting can contribute to indirect and direct glare. Study Tip: Come to the test prep with a positive attitude about yourself, your nursing knowledge, and your test-taking abilities. A positive attitude is achieved through self-confidence gained by effective study. This means (1) answering questions (assessment), (2) organizing study time (planning), (3) reading and further study (implementation), and (4) answering questions (evaluation).

The nurse is caring for a patient with reduced olfaction. What should be included in teaching to promote safety? Use smoke detectors. Use color codes for water faucets. Check food package dates. Keep leftovers in labeled containers. Use low-pile carpeting.

Use smoke detectors. Check food package dates. Keep leftovers in labeled containers. Using smoke detectors will help patients with olfactory impairment to detect smoke. The patient may not be able to smell stale food. Therefore, it is important for the patient to check the food package dates and to keep leftovers in labeled containers. Using color codes for water faucets and low-pile carpeting is not necessary for patients with olfaction impairment.

The nurse is caring for a patient who suffers from hearing impairment. What measures should the nurse adopt to improve communication with this patient? Talk loudly. Sit beside the patient when talking. Use written information. Speak slowly and articulate clearly. Talk toward the patient's best ear.

Use written information. Speak slowly and articulate clearly. Talk toward the patient's best ear. Written information is used to enhance spoken words and improve communication. The communication should be slow and well articulated, because the patient may need time to process the information. If the patient has one ear functioning well, then the nurse should talk towards that ear. Talking loudly may accentuate vowel sounds and conceal consonants, which could hamper hearing. The nurse should sit opposite the patient to allow the patient to see the nurse's face when talking and to observe nonverbal cues.

Depression

Usually has a rapid onset, and the affected person's mood, typically, is constant. Causes Social isolation, or sensory deprivation (decreased stimulation from the environment) from lack of contact with others, can lead to depression A patient in strict isolation is prone to sensory deprivation. Chemical changes in the brain termed as major, or endogenous, depression Life situations, such as receiving a terminal diagnosis or grieving the loss of a spouse termed as situational, or exogenous, depression Medication side effects mimicking depression-like symptoms Genetic predisposition

Which sensory deficit poses the greatest danger to the safety of an 80-year-old patient with Alzheimer's disease? Anosomia Loss of taste Isolation Vertigo

Vertigo

A nurse is attending to a patient who is experiencing problems in hearing. Which cranial nerve should the nurse assess in this patient? Vestibulocochlear Cranial nerve VIII, the vestibulocochlear nerve, plays a role in hearing; therefore, the nurse should assess this nerve for a patient who is experiencing problems related to hearing. Glossopharyngeal Cranial nerve IX, the glossopharyngeal nerve, plays a role in taste, not in hearing. Optic Cranial nerve II, the optic nerve, plays a role in sight, not hearing. Olfactory The olfactory nerve plays a role in smell, not hearing.

Vestibulocochlear Cranial nerve VIII, the vestibulocochlear nerve, plays a role in hearing; therefore, the nurse should assess this nerve for a patient who is experiencing problems related to hearing.

The medical record of an older adult reveals a stroke affecting the right hemisphere of the brain. Which of these assessment findings should the nurse expect to find? Visual spatial alterations such as loss of half of a visual field Loss of sensation and motor function on the right side of the body Inattention and neglect, especially to the left side Cloudy or opaque areas in part of the lens or the entire lens Difficulty with speech

Visual spatial alterations such as loss of half of a visual field Inattention and neglect, especially to the left side Difficulty with speech A stroke in the right hemisphere produces symptoms on the left side, which includes visual spatial alterations such as loss of half of a visual field or inattention and neglect, especially to the left side. A stroke affecting the right hemisphere of the brain may result in symptoms such as loss of sensation and motor function on the left side of the body and difficulty with speech. Cloudy or opaque areas in part of the lens or the entire lens indicate cataracts.

Function of front lobe

Voluntary motor function Behavior Intelligence Memory Concentration Communication Decision making Personality

Sundowning

Worsening of agitation and confusion in the evening

Decrease to or damage of the gustatory cells leads to

a diminished ability to taste. Causes Use of dentures (Dentures cover the roof of the mouth where some taste receptors are located.) Injury or surgical interventions to the tongue, cheeks, or roof of mouth Smoking Aging While the loss of the senses of smell and taste are not life-threatening disorders, they can cause alterations in nutrition and patients may perceive a decrease in the quality of life.

presbycusis

hearing loss associated with aging.

Meningitis

is an infection of the lining of the brain caused by a virus or bacteria. The membranes that surround the brain and spine become inflamed, resulting in many, if not all, of the symptoms of meningitis which include severe headaches and fever as well as sensitivity to light. Cause It is acquired, just as other bacterial and viral infections are, through contact with someone who has the illness. After it enters the body, it migrates to the meninges of the brain and causes alterations in cognitive and sensory functions. It can be life-threatening if not diagnosed and treated quickly.

Anosmia

is the complete loss of the sense of smell. Causes Polyps Sinus infection Aging Certain medications Cocaine use The nurse may have little or no objective data to determine any decrease in the sense of smell. Most data will be subjective.