Running head: (GAGTAN, ANDREI RAPHAEL, L.

Sensory and Perceptual Alterations

Gagtan,Andrei Raphael L.

Union Christian College

(GAGTAN, ANDREI RAPHAEL, L.) 2

Introduction

Sensory-perceptual alteration can be defined as when there is a change in the pattern of sensory

stimuli followed by an abnormal response to such stimuli. Such perceptions could be increased,

decreased, or distorted with the patient's hearing, vision, touch sensation, smell, or kinesthetic

responses to stimuli. Such changes in the pattern of responses to stimuli lead to changes in a

patient’s behavior, sensory acuity, decision-making process, and problem-solving abilities. This

can lead to irritability, restlessness, poor concentration, fluctuating mental status, changes in

communication due to inattention, and lack of focus. Furthermore, sensory deprivation in

isolated patients can lead to anxiety, depression, aggression, hallucinations, and psychotic

reactions.

Any alteration in a patient's normal environment can result in stress especially if such alteration

is involuntary. Sensory overload occurs when an individual experiences a stimulus that they are

unable to manage and process. Usually, the second stimulus is filtered out by selective

perception or coping behavior. However, in certain environmental conditions such as the

emergency department, or due to specific underlying illnesses such as dementia, sensory

overload can occur due to inadequate filtering of stimuli.

Sensory deprivation occurs when an individual receives a stimulus that is reduced or below the

threshold of normal. Risk factors to such alterations can be broadly due to acute illnesses, patient

factors related to chronic medical conditions, aging, or due to environmental or iatrogenic

causes. This typically occurs when the patient is placed in isolation, such as changes in the

environment due to hospital admission or admission to isolated wards. While in isolation, there

can be a reduction in the quantity and quality of stimuli and restriction of social interaction.

Other risk factors that can lead to increased or decreased alteration in the processing of stimuli
(GAGTAN, ANDREI RAPHAEL, L.) 3

can be due to hearing impairment, loss of vision, loss of smell or taste, aging, trauma, electrolyte

imbalance, seizure disorder, mental health problems, and genetic causes.

Summary

The history will be relevant to the underlying risk factor responsible for sensory-perceptual

alteration. Signs and symptoms can occur at a specific time and place when the patient is

exposed to a certain environment or trigger, or it can happen instantaneously without any

triggers. Furthermore, the signs and symptoms of sensory and perceptual alteration can occur

when the patient is exposed to certain stimuli or environmental factors. Such sensory and

perceptual disorders would be magnified in an unfamiliar environment, especially when patients

are hospitalized in unfamiliar hospital rooms.

Vital signs can be abnormal or normal, depending upon the etiology of the sensory and visual

alterations. Patients may not be oriented to time, place, or person. They can be confused,

irritable, exhibit a lack of focus and concentration, unable to solve problems or communicate.

They may also be suffering from hallucinations (visual, auditory, or tactile). Depending on the

altered perception, cranial nerve and sensory examination may be abnormal. The remaining

systems examinations can be expected to be normal or variable according to the patient's

condition.

Implications

Nursing Student

Sensory-perceptual alteration can be defined as when there is a change in the pattern of sensory

stimuli, followed by an abnormal response to such stimuli. Such perceptions could be increased,

decreased, or distorted with the patient's hearing, vision, touch sensation, smell, or kinesthetic

responses to stimuli. During the assessment process, thoroughly assess each patient and critically
(GAGTAN, ANDREI RAPHAEL, L.) 4

analyze findings to ensure that you make patient-centered clinical decisions required for safe

nursing care.

Nursing Profession

Apply the nursing process and use a critical thinking approach in your care of patients. The

nursing process provides a clinical decision-making approach for you to develop and implement

an individualized plan of care for your patients.

Nursing Education

To mitigate the psychosocial effects of isolation, it is necessary for patients to understand the

importance of contact isolation. Educating and emotionally preparing the patient for such a need

will reduce anxiety, distress, and help them cope better. One way to prevent delirium in patients

in the ICU is to engage family members in their care. Open communication should be established

between family members and healthcare professionals. Family members are encouraged to bring

personal items (i.e. pillows, frames, eyeglasses, hearing aids) belonging to patients. This would

ease communication and orientation, therefore assisting in cognitive stimulation. Family

members should also be educated on the signs and symptoms of delirium for early recognition

and management. Patients who are visually impaired can be provided with corrective lenses and

reading material in large print or braille. Conversations should be carried out at the patient's eye

level and within their field of vision. The surrounding environment should be organized, and

they should be aware of where their items are placed. Patients with hearing deficits should be

provided with their hearing devices. To ensure effective communication, the environment should

be noise-free. The written form of communication or sign language may be facilitated to aid in

communication
(GAGTAN, ANDREI RAPHAEL, L.) 5

Nursing Research

Nurses Research that delirium in the ICU is underdiagnosed, despite its high occurrence. For

early detection and treatment, it is imperative to understand delirium, and it's clinical subtypes.

To prevent adverse outcomes, healthcare professionals can help in recognizing predisposing risk

factors and eliminating precipitating risk factors for delirium. To improve the sleep of patients

admitted to the ICU, sleep protocols should be implemented, and a change in ICU culture is

required. ICU clinicians, nurses, and other staff should be educated about the importance of sleep

in preventing delirium. Performance can be routinely measured along as well as compliance of

protocol.Training caregivers responsible for patients with dementia has a positive impact on the

care and management of these patients. Family caregivers' skills, knowledge, competencies, and

communication significantly improved after training intervention. However, for this intervention

to be effective, it is necessary to apply this training and practice. Training intervention for

professional caregivers also improved knowledge and communication. Because of this

communication, training should be included as a strategy in dementia training. A standardized

approach to care for patients suffering from dementia was found to have an adverse effect. To

improve the quality of care for these patients, consistent patient-centered nursing care should be

adapted.
(GAGTAN, ANDREI RAPHAEL, L.) 6

Conclusion and Recommendation

This article is provided the informations and guidelines that specialized in our training because

it provide mental healthcare to children with sensory processing disorder are able to assist

families in carrying out and it recommended sensory interventions and home programs. That

they also play a key role in promoting communication between all the healthcare professionals

that working with children diagnosed with  sensory perceptional disorder.

References

1.Leach J. Psychological factors in exceptional, extreme and torturous environments. Extrem

Physiol Med. 2016;5:7. [PMC free article] [PubMed]

2.Scheydt S, Müller Staub M, Frauenfelder F, Nielsen GH, Behrens J, Needham I. Sensory

overload: A concept analysis. Int J Ment Health Nurs. 2017 Apr;26(2):110-120. [PubMed]

3.Bannon L, McGaughey J, Clarke M, McAuley DF, Blackwood B. Impact of non-

pharmacological interventions on prevention and treatment of delirium in critically ill patients:

protocol for a systematic review of quantitative and qualitative research. Syst Rev. 2016 May

04;5:75. [PMC free article] [PubMed]

4.Robertson CE, Baron-Cohen S. Sensory perception in autism. Nat Rev Neurosci. 2017

Nov;18(11):671-684. [PubMed]

5.Holstein DH, Vollenweider FX, Geyer MA, Csomor PA, Belser N, Eich D. Sensory and

sensorimotor gating in adult attention-deficit/hyperactivity disorder (ADHD). Psychiatry Res.

2013 Jan 30;205(1-2):117-26. [PubMed]

(GAGTAN, ANDREI RAPHAEL, L.) 7

6.Weilnhammer V, Röd L, Eckert AL, Stuke H, Heinz A, Sterzer P. Psychotic Experiences in

Schizophrenia and Sensitivity to Sensory Evidence. Schizophr Bull. 2020 Jul 08;46(4):927-936.

[PMC free article] [PubMed]

7.Brenner CA, Krishnan GP, Vohs JL, Ahn WY, Hetrick WP, Morzorati SL, O'Donnell BF.

Steady state responses: electrophysiological assessment of sensory function in schizophrenia.

Schizophr Bull. 2009 Nov;35(6):1065-77. [PMC free article] [PubMed]

8.Voss P, Thomas ME, Guercio GD, de Villers-Sidani E. Dysregulation of auditory

neuroplasticity in schizophrenia. Schizophr Res. 2019 May;207:3-11. [PubMed]

9.Martínez A, Tobe R, Dias EC, Ardekani BA, Veenstra-VanderWeele J, Patel G, Breland M,

Lieval A, Silipo G, Javitt DC. Differential Patterns of Visual Sensory Alteration Underlying Face

Emotion Recognition Impairment and Motion Perception Deficits in Schizophrenia and Autism

Spectrum Disorder. Biol Psychiatry. 2019 Oct 01;86(7):557-567. [PMC free article] [PubMed]

10.Lang M, du Plessis E. Sensory processing disorder: Perceptions on the clinical role of

advanced psychiatric nurses. Health SA. 2019;24:1197. [PMC free article] [PubMed]

11.Watson PL, Ceriana P, Fanfulla F. Delirium: is sleep important? Best Pract Res Clin

Anaesthesiol. 2012 Sep;26(3):355-66. [PMC free article] [PubMed]

12.Locihová H, Axmann K, Padyšáková H, Fejfar J. Effect of the use of earplugs and eye mask

on the quality of sleep in intensive care patients: a systematic review. J Sleep Res. 2018

Jun;27(3):e12607. [PubMed]
(GAGTAN, ANDREI RAPHAEL, L.) 8

13.Hu RF, Jiang XY, Chen J, Zeng Z, Chen XY, Li Y, Huining X, Evans DJ. Non-

pharmacological interventions for sleep promotion in the intensive care unit. Cochrane Database

Syst Rev. 2015 Oct 06;(10):CD008808. [PMC free article] [PubMed]

14.Pisani MA, Friese RS, Gehlbach BK, Schwab RJ, Weinhouse GL, Jones SF. Sleep in the

intensive care unit. Am J Respir Crit Care Med. 2015 Apr 01;191(7):731-8. [PMC free article]

[PubMed]

15.Abad C, Fearday A, Safdar N. Adverse effects of isolation in hospitalised patients: a

systematic review. J Hosp Infect. 2010 Oct;76(2):97-102. [PMC free article] [PubMed]