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Online Companion:
Fundamentals of Nursing Standards and Practice 2E
Frequently Asked
Questions
Compare sensation, perception and cognition and discuss how their interaction
affects neurological integrity.
The interaction of sensation, perception and cognition leads to the development
of neurological integrity. Sensation, perception and cognition are neurological
functions of the central nervous system (CNS) and peripheral nervous system (PNS).
Sensation refers to the ability to receive and process stimuli through sensory
organs. Perception refers to the ability to experience, recognize, organize and
interpret sensory stimuli. Cognition refers to the ability to intellectually think.
It includes memory, judgment and orientation. The combined action of these neurological
functions in the presence of an intact nervous system leads to a client being
able to fully experience and interact with one’s environment.
Discuss the effects of the normal aging process with regard to cognitive
function.
As one ages, cognitive development shows no decline in intellectual function.
However, memory loss is often a concern for the elderly client. This can be due
in part to loss of activities that stimulate mental function as well as pathophysiological
processes. Crystallized intelligence (acquired knowledge) usually increases with
age and fluid intelligence (ability to learn new concepts) decreases with age.
It is important to encourage activities that promote cognitive development in
older clients such as reading, studying a new topic, solving word problems and
doing puzzles.
Discuss how both sensory deprivation and sensory overload can affect
a client’s neurological function. Give examples of each type of alteration.
Sensory deprivation refers to a reduced state of sensory input from the internal
or external environment that causes alterations in sensory perception. This
can be due to a disease process, medication, trauma or isolation. The effect
of deprivation can lead to poor mental function with a reduced ability to concentrate
and a change in mental status and behavior. Sensory deprivation can exist in
both acute and chronic phases and lead to clinical depression if not corrected.
An example of sensory deprivation is a client who is left alone for long periods
of time with no directed activity, no ability to look out the window or watch
television or read. Sensory overload refers to a state of excessive multisensory
stimulation is applied to an individual that causes a change in behavior and
perceptual distortion. The client is unable to effectively process all the incoming
information that can lead to behavioral changes and impaired problem-solving
ability. An example of sensory overload is a client who is in a critical care
unit being monitored by multiple machines where there is a high noise level.
Why is it so important to perform the Glasgow Coma Scale on a client
who presents with altered level of consciousness (LOC)?
The Glasgow Coma Scale represents a standardized tool that assesses LOC objectively
in the clinical setting. By using this scale, the nurse and physician will be
able to objectively document the client’s mental baseline and trend results
during the course of therapy. This tool is meant to be used in conjunction with
a complete neurological examination but does provide pertinent information related
to whether the client is experiencing LOC changes. The Glasgow Coma Scale examines
three areas; eye opening, verbal and motor response and points are given according
to the client’s response. The higher the score reflects that the client
is oriented (15). As the score decreases, the probability of the client progressing
to a coma state is increased. A score of 7 or > is considered to be a state
of coma. A score of 3 is the lowest possible score and is associated with a
state of deep coma. The nurse must be aware of what activity is graded and how
the total score is interpreted in order to provide accurately documented assessments
and communicate these findings to the physician.
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