sensory.ppt
- 1. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Impact of Sensory Impairment on the Child and Family NUR 106
- 2. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Hearing Impairment • Ranges from mild to profound • Deaf: a person whose hearing disability precludes processing linguistic information with or without hearing aid • Hard of hearing: Generally able to hear with hearing aid
- 3. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Etiology of Hearing Impairments • Anatomic malformation • LBW • Ototoxic drugs • Chronic ear infections • Perinatal asphyxia • Perinatal infections • Cerebral palsy
- 4. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Pathology of Hearing Impairments • Conductive hearing loss—middle ear • Sensorineural hearing loss—nerve deafness • Mixed conductive-sensorineural loss— may follow recurrent OM with complications • Central auditory interception – Organic – Functional
- 5. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Symptom Severity • Measured in decibels (dB) • Hearing threshold • Effect on speech
- 6. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Therapeutic Management • Medical or surgical interventions • Hearing aid • Cochlear implants
- 7. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Manifestations of Hearing Impairment Infancy • Lack of startle reflex • Absence of babbling by age 7 months • General indifference to sound • Lack of response to spoken word Childhood • Profound deafness likely to be diagnosed in infancy • Entry into school • Concerns with speech development
- 8. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Promoting Communication • Lip reading – face to face & eye level • Cued speech • Sign language • Speech language therapy • Socialization • Additional aids
- 9. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Care for Hearing Impaired Child During Hospitalization • Reassess understanding of instructions given • Supplement with visual and tactile media • Communication devices – Picture board – Common words and needs (food, water, toilet)
- 10. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Prevention of Hearing Loss • Treatment and management of recurrent otitis media • Prenatal preventive measures • Avoid exposure to noise pollution
- 11. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Visual Impairment Classification • Visual Impairment General term that refers to visual loss that cannot be corrected with regular prescription lenses • Partially sighted – Acuity of 20/70-20/200 – Education usually in public school system • Legal blindness – Acuity of 20/200 or less – Legal as well as medical term
- 12. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Etiology of Visual Impairments • Perinatal or postnatal infections – Gonorrhea, Chlamydia, rubella, syphilis, toxoplasmosis • Retinopathy of prematurity • Perinatal or postnatal trauma • Other disorders • Unknown causes
- 13. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Refractive Errors • Refraction: bending of light rays through the lens of the eye • Myopia • Hyperopia • Strabismus (may or may not be refractive)
- 14. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Other Visual Impairments • Astigmatism • Amblyopia • Strabismus • Cataracts • Glaucoma
- 15. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Infections • Conjunctivitis – Ophthalmic antibiotics – Systemic antibiotics in some cases – Caution with use of steroids—may exacerbate viral infections – Infection control concerns
- 16. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Nursing Assessment • Infancy – Response to visual stimuli – Parental observations and concerns – Expect binocularity by age 6 months • Childhood – Visual acuity testing
- 17. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Promoting Child’s Optimum Development • Play and socialization • Development of independence • Education – Braille – Audio books and learning materials
- 18. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Hospitalization of the Visually Impaired Child • Safe environment • Reassurance • Encourage familiar objects from home • Orient child to surroundings • Encourage independence • Consistency of team members
- 19. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Measures to Prevent Visual Impairment • Prenatal care/prevention of prematurity • Rubella immunizations for all children • Safety counseling for preventing eye injuries • Periodic Recommended Screening Prenatal Newborns through preschoolers Children of all ages
- 20. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Emergency Treatment for Eye Injuries • Foreign body • Chemicals • UV burns • Hematoma • Penetrating injuries
- 21. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Deaf – Blind Children • Profound effects on development • Motor milestones usually achieved • Other development often delayed • “Finger spelling” • Developing future goals for the child
- 22. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Retinoblastoma: A congenital malignant tumor Arises from retina & may be hereditary *Present @ birth or arises in 1st 2 yrs *Cat’s eye reflex – most common finding Whitish appearance of lens w/ light *Strabismus *Red, painful eye *Blindness (late) *Secondary tumors • Treatment: Depends on stage, Chemo? Irradiation for early stage Enucleation for late stage
- 23. Mosby items and derived items © 2005, 2001 by Mosby Inc. Mosby items and derived items © 2005, 2001 by Mosby Inc. Retinoblastoma