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Textbook For Nursing
Assistants
Chapter 29 - The Sensory System
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 1
Structure of the Sensory System
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 2
Structure of the Sensory System
The sensory system is part of the nervous
system
The sensory system consists of sensory
receptors
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 3
Sensory Receptors
Sensory receptors are specialized cells or
groups of cells associated with a sensory
nerve
Sensory receptors pick up information,
called a stimulus, and then translate it into
a nerve impulse
The nerve impulse is then sent to the brain
for interpretation, via the sensory nerve
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 4
Structure of the Sensory System
Sensory receptors are found throughout
the body. For example:
Some are found in the sense organs - the
eyes, the ears, the nose, and the taste buds
Other sensory receptors are found throughout
the skin, and even in the tissues of internal
organs
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 5
Structure of the Sensory System
The sensory system is sometimes divided
into two major parts:
General sense - receptors that are
responsible for general sense are found
throughout the body
Special sense - receptors that are
responsible for special sense are located in
the specific sense organs
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 6
General Sense
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 7
General Sense
General sense is responsible for our
sense of:
Touch
Position
Pain
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 8
General Sense - Touch
Our sense of touch allows us to feel
textures and the shapes of objects
Sense of touch is made
possible by tactile
receptors found in the
skin
Tactile is another word
for “touch”
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 9
General Sense - Touch
Tactile receptors
Tactile receptors are stimulated when
something comes in contact with the surface
of the body and presses on them, causing
them to change shape
Some areas of the skin have more tactile
receptors than others, and are therefore
considered more sensitive to touch
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 10
General Sense - Touch
Deep touch
Some tactile receptors in the skin allow us to
sense pressure, also known as deep touch
Intolerance to prolonged pressure makes us
shift our position when we have been sitting in
one position for a long time
A person who is unable to sense pressure (a
person who is paralyzed) does not become
uncomfortable from being in one position for a
long time
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Slide 11
General Sense - Position
Position sense provides us with muscle
tone and the ability to move our muscles in
a smooth, coordinated way
The sense of position is made possible by
position receptors found in the muscles,
tendons, and joints
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Slide 12
General Sense - Position
Position receptors:
Keep the brain informed about the position of
various body parts in relation to each other
Relay information to the brain about the
degree of muscle contraction, especially when
the muscle is contracting against resistance
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Slide 13
General Sense - Pain
Pain is the body’s distress signal
Pain tells us that:
We have been injured
We have overworked a muscle group
An organ is not working properly
We are ill
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 14
General Sense - Pain
Free nerve endings (dendrites) in the skin
and the tissues of our internal organs
allow us to detect pain
The brain pinpoints the cause of the pain
when the pain is on the surface of the
body
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Slide 15
General Sense - Pain
Referred Pain
Occurs when the brain cannot pinpoint the
exact location of pain coming from an internal
organ
Also known as radiating pain
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Slide 16
General Sense - Pain
Examples of referred
pain:
Gallbladder disease
may cause pain in the
back and shoulder on
the person’s right side
A back injury may
cause pain to radiate
down the leg, into a
person’s foot
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Slide 17
General Sense - Pain
Types of Pain
Acute pain
Chronic pain
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 18
General Sense - Pain
Acute pain:
Sharp, sudden pain, such as that which
occurs with an injury
Lasts a short period of time
Decreases as the body’s tissues repair
themselves and heal
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Slide 19
General Sense - Pain
Chronic pain:
Widespread, constant pain that continues
even after tissue healing has taken place
May be caused by conditions such as
arthritis or certain cancers
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Slide 20
General Sense - Pain
Factors that affect a person’s response to
pain include:
Culture and upbringing
The person’s age and past experience with
pain
The person’s sense of responsibility toward
others
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Slide 21
General Sense - Pain
Observation of pain:
As a nursing assistant, you may be the first to notice
that one of your patients or residents is in pain
The person may tell you about his discomfort, or your
observation skills will tip you off
Your observations can include:
Facial expressions
A red and swollen body part / area
Profuse sweating
Changes in the person’s vital signs
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 22
General Sense - Pain
If a person says that she is in pain, ask the
person the following questions, and report the
answers to the nurse:
Where is the pain?
How does the pain feel (for example, throbbing,
aching, sharp, dull)?
How long have you been feeling this pain?
Does anything make the pain feel better (or worse)?
How intense is the pain?
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 23
General Sense - Pain
It is important for the nurse to know if a
patient or resident is in pain because:
If the pain is new, then the nurse will need to
take steps to find out what is causing the pain
If the pain is familiar and the cause of it is
known, there may still be something the nurse
can do to help make the person more
comfortable
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 24
General Sense - Pain
Ways of relieving and controlling pain
include:
Heat and cold applications
Pain-relieving drugs
Narcotics
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Slide 25
General Sense - Pain
Pain-relieving drugs include:
Aspirin
Acetaminophen (Tylenol)
Ibuprofen (Advil)
These drugs are very effective for relieving
mild to moderate pain
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Slide 26
General Sense - Pain
Narcotics
Severe pain may only be controlled by the
use of narcotics, such as morphine or
Demerol
People who need narcotics to control their
pain should be encouraged to ask for
medication before the pain becomes too
intense
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 27
General Sense - Pain
Narcotics
Giving a small dose of a narcotic early on can
help to stop the pain before it gets too bad
If untreated, the pain will get worse, and a
higher dose of the medication will be needed
to relieve it
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 28
General Sense - Pain
Giving heat and cold applications may be
beyond a nursing assistant’s scope of
practice
Most nursing assistants are not permitted
to give medications to patients and
residents…HOWEVER
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 29
General Sense - Pain
There are many things you can do to help
a person who is experiencing pain and
discomfort:
Report any observations of pain or discomfort
Help the person to relax
Distract the person from the pain
Remember that each person’s response to
pain, and the methods he is most
comfortable using to address it, will vary
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 30
Taste and Smell
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Slide 31
Taste and Smell
The sense organs of taste and smell are
the taste buds and the roof of the nasal
cavity, respectively
The senses of taste and smell are made
possible by special cells in these areas,
called chemoreceptors
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Slide 32
Taste and Smell - Chemoreceptors
Chemoreceptors detect chemicals in the
food we eat, the beverages we drink, and
the air we breathe
The chemical signal is changed to an
electric one and carried by sensory
neurons to the brain, which tells us what
we are tasting or smelling
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Slide 33
Taste - Taste Buds
Thousands of taste buds cover the surface of
the tongue
Each taste bud consists of about 100
chemoreceptors, plus some supporting cells
The taste buds are bathed in fluid (either saliva
or the liquids that we drink)
The fluid contains dissolved chemicals, which
stimulate the taste buds
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Slide 34
Taste - Taste Buds
There are four basic tastes:
Sweet
Salty
Sour
Bitter
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Slide 35
Taste - Taste Buds
The taste buds that detect these four basic
tastes are arranged in a particular pattern on the
tongue:
The “sweets” are found on the tip of the tongue
The “salties” are found on each side of the tongue,
toward the front
The “sours” are located on each side of the tongue,
toward the back
The “bitters” are located across the back of the
tongue
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Slide 36
Smell
The receptors that allow us to smell are located
on the roof of the nasal cavity
These receptors are stimulated by chemicals
that have been dissolved in fluid, which is the
moist mucous membrane lining of the nasal
cavity
The sense of smell is easily fatigued, or worn
out. This explains why an odor that is very
strong at first becomes less noticeable over time
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 37
Taste and Smell
Together, taste and smell have a very powerful
effect on the appetite
Under normal circumstances, a person will not
eat something that tastes or smells bad, even if
he is hungry, but may overeat because it tastes
or smells good
Similarly, when you have a cold and a stuffy
nose, food seems to lose appeal. This happens
in part because you can’t smell the food!
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Slide 38
Taste and Smell - Effects of Aging
As we get older, the number of chemoreceptors
on the tongue and on the roof of the nasal cavity
decrease
In addition, we produce less saliva, which makes
it harder to dissolve the chemicals that stimulate
the taste buds
As a result of these changes, the senses of taste
and smell become less intense, leading to an
overall decrease in appetite
To make up for a diminished sense of taste and
smell, older people often season their food more
heavily than younger people
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Slide 39
Risks Due to Diminished Ability to Taste or Smell
There are many dangers associated
with a diminished ability to taste or
smell
For example:
An older person may not be able to tell
that food has spoiled, and become ill
from eating it
An older person may not be able to
detect the smell of smoke or a gas leak
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Assistants.
Slide 40
Sight
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Slide 41
Sight
Our sense of sight allows us to detect:
Light
Color
Shape
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Slide 42
Sight - Structure of the Eye
The sense organ of sight
is the eye
The bones of the skull
form a protective cavity
around the eye
Only the very front of the
eyeball lacks the bony
protection of the skull
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Slide 43
Sight - Structure of the Eye
To protect the front of the eye, we have
eyelids that close and eyelashes and
eyebrows that serve as “dust catchers”
Lacrimal glands, located above the eye in
the orbit, form tears that help to keep the
eye moist and free of dust and bacteria
Skeletal muscles located around the
eyeball allow us to move our eyes
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Slide 44
Sight - Structure of the Eye
The eyeball itself is made up of three
layers of tissue
Sclera
Choroid
Retina
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Slide 45
Structure of the Eye - Sclera
The sclera is the tough outer layer
The sclera is made of connective tissue
Although most of the sclera is white
(hence the term, “white of the eye”), the
front of the sclera, which is called the
cornea, is clear
Light passes through the cornea to the
inside of the eye
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Slide 46
Structure of the Eye - Choroid
The choroid is the middle layer
This layer contains the blood vessels that supply the
retina and other parts of the eye
At the front of the eye, the choroid also forms the ciliary
body and the iris
The ciliary body is a muscular structure that attaches to the lens,
a flexible, transparent, curved structure that adjusts to focus light
rays onto the retina. The ciliary body changes the shape of the
lens, allowing the eye to focus.
The iris is the colored part of the eye. The iris is actually a round
muscle with an opening in the center (the pupil). The iris controls
the amount of light that enters the eye through the pupil.
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Slide 47
Structure of the Eye - Retina
The retina is the innermost layer
The retina contains receptors, called rods
and cones, which turn light into nerve
impulses
The nerve impulses travel through the
optic nerve to the brain for interpretation
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Slide 48
Structure of the Eye - Chambers
The eyeball also has two fluid-filled
chambers
The anterior chamber is
located between the
cornea and the lens
The posterior chamber is
located between the lens
and the retina
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Slide 49
Sight - Function of the Eye
The human eye works much like a camera
The retina is the “film”
The iris and pupil
control the amount of
light that enters the eye
The cornea and lens
work to focus light rays
onto the retina, resulting
in a clear image
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Slide 50
Sight - Defects
Many people need some help to achieve
perfect vision
Vision defects include:
Myopia (nearsightedness)
Hyperopia (farsightedness)
Astigmatism
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Slide 51
Defects - Myopia
In myopia, the eyeball may be a little more oval than
normal, causing the distance between the lens and the
retina to be greater than usual
People who are nearsighted have trouble seeing images
that are far away
This is because the distance between the person’s lens
and retina is longer than usual, which means that the
image actually comes into focus before it hits the retina
This is a very common problem - 20% of the people in
the United States have some degree of nearsightedness
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Slide 52
Defects - Hyperopia
In people who are farsighted, the eyeball
is rounder than normal, causing the
distance between the lens and the retina
to be shorter than usual
Therefore, when the image hits the retina,
it is not yet in focus
People who are farsighted are able to see
objects in the distance fairly well, but they
have trouble seeing objects that are close
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Slide 53
Defects - Astigmatism
In astigmatism, the cornea is not perfectly
curved
The irregular curve of the cornea bends
the light rays in funny ways, which results
in a blurred, distorted image
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Slide 54
Sight - Defects
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Slide 55
Sight - Effects of Aging on the Eye
As we age, many changes occur in the eye that
can affect vision:
The number of receptors in the retina decreases, and
the lens becomes opaque (cloudy)
The iris becomes more rigid, which means that it
takes longer for an older person’s eyes to adjust when
she moves from a bright area to a dim one, or vice
versa
The lens becomes less flexible, which affects the
older person’s ability to focus on objects that are
close, a condition known as presbyopia
There is a decrease in tear production, which leads to
dryness and irritation of the eyes
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Slide 56
Sight - Disorders of the Eye
Conjunctivitis
Cataracts
Glaucoma
Diabetic retinopathy
Macular degeneration
Blindness
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Slide 57
Disorders of the Eye - Conjunctivitis
Conjunctivitis is infection and inflammation
of the conjunctiva, a clear membrane that
lines the inside of the eyelids and covers
most of the surface of the eye
The eye may itch or burn, and it tears
excessively
There may be a sticky white or yellow
discharge
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Slide 58
Disorders of the Eye - Conjunctivitis
Conjunctivitis is highly contagious. Rubbing the
eyes and then touching something transfers the
microbes to that surface, where they can easily
be picked up by someone else
Conjunctivitis is usually treated with eye drops or
an eye ointment prescribed by a doctor
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Slide 59
Disorders of the Eye - Cataracts
A cataract is the gradual yellowing and hardening of the
lens of the eye. The lens becomes opaque and
eventually prevents light from passing though to the
retina.
The person’s vision becomes cloudy as the cataract
worsens.
Total blindness can result as the cataract becomes more
opaque.
Many people with cataracts have surgery to remove the
opaque lens and replace it with an artificial one.
Cataract surgery enables people with cataracts to once
again enjoy activities such as needlework and reading
that would have been nearly impossible before.
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Slide 60
Disorders of the Eye - Glaucoma
Glaucoma is a disorder of the eye that occurs when the
pressure within the eye is increased to dangerous levels.
This occurs when the aqueous humor in the anterior
chamber is not reabsorbed into the bloodstream.
As more and more aqueous humor is formed, it creates
pressure, which builds up in the eye.
The pressure squeezes the nerves and the blood
vessels in the retina.
Eventually, the nerves are destroyed and vision is lost.
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Slide 61
Disorders of the Eye - Glaucoma
People who are older than 40 years and have a
family history of glaucoma are at high risk for
developing glaucoma themselves.
Glaucoma also seems to be more common in
people with dark irises (brown eyes), as
opposed to light ones (blue or green eyes).
The most common type of glaucoma occurs
gradually.
Early detection and treatment of glaucoma can
help to save the person’s vision.
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Slide 62
Disorders of the Eye - Diabetic Retinopathy
Diabetic retinopathy is a complication of diabetes that
can lead to blindness.
In the early stages, the tiny blood vessels that supply the
retina burst, leading to hemorrhages and damaging the
retina.
As the retina tries to heal, new blood vessels start to
grow along the retina and in the vitreous humor.
These new vessels are very fragile and they often burst
as well, damaging the retina even more.
Early detection during an eye examination is essential
for preserving the person’s vision.
Laser treatment is often necessary to help seal off
hemorrhages in the retina.
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Slide 63
Disorders of the Eye - Macular Degeneration
The macula is the small area in the middle of the retina
where images are sharpest.
In macular degeneration, deposits build up in the
macula.
The receptors in the area become damaged, and the
person’s ability to see is impaired.
Factors that can increase a person’s risk of developing
macular degeneration are:
Smoking
Excessive exposure to sunlight
A diet high in cholesterol
An inherited tendency for the disorder
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Slide 64
Disorders of the Eye - Blindness
Blindness takes many different forms:
Many people are considered blind but have partial sight.
Some people see nothing but darkness.
Others can see light, movement, shapes, and even colors, just
not clearly enough to distinguish between them.
Some people who are blind have been blind since birth and have
never seen anything, while others may have lost their sight later
in life.
With time, most people who are blind adapt well and are
independent.
People who have recently lost their sight may be very
frightened, especially of walking or moving around on
their own.
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Slide 65
Blindness - Rehabilitation
Rehabilitation for a person who has recently lost
his sight focuses on safety and the person’s
return to independence.
Ambulation and navigation skills are taught so
that the blind person can be independent again.
During rehabilitation, a blind person may learn to
work with a companion animal that has been
specially trained to guide the person as she
walks.
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Slide 66
Blindness - Rehabilitation
The person may learn Braille, a system that
uses letters made from combinations of
raised dots.
The person runs her fingers over words
written in braille to read them.
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Slide 67
Rehabilitation - Role of a Nursing Assistant
When assisting a person who is blind:
Treat the person with respect
Allow the person to be as independent as
possible
Learn the techniques that the patient or
resident is being taught and reinforce them by
helping the person to practice them
continuously
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Slide 68
Caring for Eyeglasses, Contact Lenses, and Artificial Eyes
Many of your patients or residents will use:
Glasses
Contact lenses
A prosthetic (artificial) eye
Most people are able to care for their own
vision accessories, but others may need
your help
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Slide 69
Eyeglasses
Eyeglasses are commonly used to correct vision
Always make sure that your patients or residents
who need glasses wear them, especially if the
person is confused or disoriented
Being unable to see clearly can make confusion
and disorientation worse and adversely affect
the person’s quality of life
Eyeglasses are very expensive to replace if
broken or lost
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Slide 70
Caring for Eyeglasses
Clean
eyeglasses
with cloths
or a special
solution
made
specifically
for that
purpose, or
with warm
water
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Slide 71
Caring for Eyeglasses
If water or a special cleaning solution is
used to clean the lenses, finish by drying
them with a soft cloth or tissue
Paper towels or napkins may scratch the
lenses and should not be used
When not in use, store the person’s
eyeglasses in their case within easy reach
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Slide 72
Contact Lenses
Contact lenses are also commonly worn to
help make vision sharp
Contact lenses are made of molded plastic
and fit directly on the eyeball
Contacts may be soft or hard
Some lenses are removed and cleaned
daily, while others can be left in for several
days at a time
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 73
Caring for Contact Lenses
Contact lenses must be
cared for carefully to
prevent infection and
irritation of the eyes
Special cleaning and
soaking solutions are
used to clean and store
the lenses
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 74
Caring for Contact Lenses
The types of solutions that are used vary
according to the type of lens
Each lens is kept in its own case (“left” and
“right”)
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Assistants.
Slide 75
Artificial Eyes
A person who has had an eye removed may choose to
wear a patch to cover the missing eye, or he may wear a
prosthetic (artificial) eye
Prosthetic eyes are made of ceramic or plastic and are
close in appearance to the person’s own eye
When the natural eye is removed, a supporting structure
is often inserted into the empty socket
Many times, the muscles that move the eyeball are
attached to the supporting structure
This allows the prosthetic eye, if the person chooses to
wear one, to move with the other eye
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Slide 76
Caring for Artificial Eyes
A prosthetic eye is usually a curved disc (not a ball) that
fits underneath the person’s eyelids
If the patient’s or resident’s prosthetic eye is removable,
a nursing assistant may need to help him with cleaning
and storing it
Like eyeglasses, a prosthetic eye is very expensive to
replace and should be cared for carefully
Improper handling can cause scratches or nicks on the
prosthetic eye that can injure or irritate the person’s
eyelids
Handling the prosthetic eye with dirty hands or not
cleaning it properly can result in an infection
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Assistants.
Slide 77
Hearing and Balance
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Assistants.
Slide 78
Hearing and Balance
The sense organ of hearing and balance is
the ear
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 79
Hearing and Balance - Structure of the Ear
The ear has three main sections:
Outer ear
Middle ear
Inner ear
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Slide 80
Structure of the Ear - Outer Ear
The outer ear consists of the:
Pinna or the auricle
The part of the ear that you can see
The shape of the pinna allows it to collect sound
waves and direct them down the external auditory
canal
External auditory canal
A short canal with small hairs and special glands
that secrete cerumen, which helps to protect the
ear canal by trapping dirt and other particles
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Slide 81
Structure of the Ear - Middle Ear
The middle ear is an air space that
contains:
Three very small bones (called ossicles)
These bones form a tiny bridge between the
tympanic membrane and the inner ear
The opening of the eustachian tube
The eustachian tube connects the middle ear to
the pharynx (throat) and serves to equalize the
pressure in the middle ear
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Slide 82
Structure of the Ear - Inner Ear
The most complex part of the ear is the
inner ear, which contains:
Receptors that make hearing and balance
possible
Two sac-like structures, called the vestibule
Three semicircular canals
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Slide 83
Functions of the Ear - Hearing
Sound waves are captured by the pinna and sent down the
external auditory canal
Sound waves traveling down the external auditory canal come
in contact with the tympanic membrane, causing it to vibrate
The tympanic membrane vibrations are then passed to the
first bone of the inner ear, which sends the vibrations to the
second bone, and then to the last bone
The stapes (last bone) vibrates, causing the oval window to
vibrate, sending the vibrations through the fluid inside the
cochlea
The moving fluid stimulates the receptors inside the cochlea,
which then send nerve impulses via the cochlear nerve to the
brain
The brain interprets these nerve impulses as sound
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 84
Functions of the Ear - Balance
When body position changes, receptors in
the vestibular apparatus are stimulated
These receptors then send nerve impulses
via the vestibular nerve to the brain
These nerve impulses tell the brain what
the body’s position is, relative to the
ground
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 85
Hearing and Balance - Effects of Aging on the Ear
Like other organs, the ear is prone to agerelated changes
The tympanic membrane and ossicles become
stiffer, and the number of sensory receptors
decreases
As a result, many older people gradually lose
the ability to hear high-pitched sounds
This type of hearing loss is called presbycusis
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Slide 86
Effects of Aging on the Ear - Presbycusis
A person with presbycusis has trouble telling the
difference between similar-sounding high-pitched sounds
like ‘th’ and ‘s’
Conversations can be difficult to follow, especially when
many people are talking at once or there is a lot of
background noise
An older person with presbycusis may start to avoid
social situations, because she cannot hear well and is
embarrassed to have to keep asking others to repeat
themselves
Many older people with presbycusis are mistakenly
labeled “confused” or “disoriented”
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Slide 87
Hearing and Balance - Disorders of the Ear
Ear infections
Otitis media
Otitis externa
Ménière’s disease
Deafness
Conductive hearing loss
Sensorineural hearing loss
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Slide 88
Ear Infections - Otitis Media
Otitis media
An infection of the middle ear that is common in
young children
Occurs when fluid builds up in the middle ear
Usually accompanied by ear pain, fever, and difficulty
hearing
If untreated, otitis media can cause scarring of
the tympanic membrane and a permanent loss
of hearing
If the infection is bacterial, antibiotics are usually
given to treat it
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 89
Ear Infections - Otitis Externa
Otitis externa
Common in people who swim frequently or get the
insides of their ears wet during showering or bathing
Commonly referred to as “swimmer’s ear”
An infection of the lining of the external auditory canal
The ear becomes very painful to the touch
Antibiotic ear drops are usually needed to treat
the infection
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 90
Disorders of the Ear - Ménière’s Disease
Ménière’s disease, named after the French doctor who
first described it, is a disease of the inner ear
It causes:
Dizziness (vertigo)
Ringing in the ear (tinnitus)
Temporary hearing loss
A feeling of pressure or fullness in the ear
There is usually no cure for this disorder
A person with Ménière’s disease may need to take more
time when getting up from a sitting or lying position, to
prevent an attack from occurring
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Slide 91
Disorders of the Ear - Deafness
Deafness has many different causes and takes
many different forms
The two main types of deafness are:
Conductive hearing loss
Occurs when something prevents sound waves from
reaching the receptors in the cochlea
Sensorineural hearing loss
Occurs when the receptors are unable to receive stimuli or
transmit nerve impulses
There are many other causes of sensorineural hearing loss
that are not necessarily the result of aging
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 92
Deafness - Rehabilitation
A person with hearing loss may work with a
speech therapist to learn how to speak more
clearly
Many adaptive devices are available to help a
person with hearing loss maintain his
independence
For example
Telephone devices for the deaf (TDD) systems
Television shows with “closed captioning”
Doorbell, alarm clock, alarms may flash instead of ring
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 93
Communicating with a Person who is Hearing-impaired
Face the person when
you are speaking to
him or her
Avoid chewing gum or
speaking unusually
fast, as this can hinder
the person’s ability to
lip-read
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 94
Communicating with a Person who is Hearing-impaired
Use a notepad to write down important questions or
directions so that the person can read them. If the
person cannot read or reads in a language that is
unfamiliar to you, a picture board may be quite helpful.
Make sure that the person fully understands what you
said. Make sure that the person has indeed gotten the
message you were trying to send.
Let the person know if you cannot understand what he is
saying to you. Please do not pretend that you did to
spare the person’s feelings. The person may be trying to
tell you something that is vitally important to his care or
health.
Consider learning sign language.
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 95
Hearing and Balance - Hearing Aid
Many people who are hearing-impaired use a
hearing aid.
A hearing aid is a battery-powered device that
amplifies sound (makes it louder) before it
enters the external auditory canal.
There are many different styles of hearing aids.
Some styles fit entirely within the external
auditory canal, others attach behind the ear or to
the person’s eyeglasses. Others take the form of
a small box that the person carries in his pocket.
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 96
Hearing and Balance - Hearing Aid
Not all people with hearing loss can
benefit from the use of a hearing aid. It
depends on the type of hearing loss the
person has.
An otologist (ear specialist) evaluates the
person’s hearing deficit to determine
whether or not a hearing aid will be useful,
and to determine what type of hearing aid
should be used.
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 97
Hearing and Balance - Hearing Aid
Hearing aids amplify all sounds, not just
the voice of the person who is speaking.
Noises from the environment, such as
traffic noise or background music in a
restaurant, are also amplified.
This can be very distracting to a person
wearing a hearing aid, and as a result, the
person may choose to keep his hearing
aid turned off most of the time.
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Slide 98
Hearing and Balance - Hearing Aid
Hearing aids are expensive and must be cared for
carefully.
If one of your patients or residents uses a hearing aid,
make sure that you know how to care for it and operate
it.
If a person who uses a hearing aid seems unable to hear
you, make sure:
The hearing aid is turned on
The volume is turned up high enough
If the hearing aid still does not seem to be working:
Check the batteries to see if they need to be replaced
Make sure the sound passageway is not blocked with cerumen
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Slide 99
End of Presentation
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Assistants.
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