Author Question: A middle-age patient was admitted to the trauma intensive care unit after a motor vehicle accident. ... (Read 101 times)

mmm · **on:** Jul 22, 2018

A middle-age patient was admitted to the trauma intensive care unit after a motor vehicle accident. The nurse notes that the patient becomes increasingly agitated when visitors stay for an extended period or after nursing interventions.

The nurse identifies this as sensory overload. Which of the following would most likely help the patient? (Select all that apply.) a. Reducing the number of visitors to her room
b. Performing dressing changes with the bath
c. Providing a dedicated period of rest time each afternoon
d. Requesting that health care providers do rounds when the family is available
e. Coordination with other departments for tests and examinations

Question 2

A home care nurse is conducting a home assessment. The nurse is looking for the presence of sensory alterations. Factors to assess include if any changes have occurred in which of the following? (Select all that apply.)

a. Activities of ADLs
b. Health promotion
c. Has person had visitors
d. Is person wearing hearing aids and glasses
e. Ability to follow a conversation

sailorcrescent · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

A, B, C, E
Reduce sensory overload by organizing the patient's care to control for excessive stimuli. Combining activities such as dressing changes, bathing, and vital sign assessment in one visit prevents the patient from becoming overly fatigued. Coordination with other departments will reduce the time needed for tests and examinations. The patient needs time for rest and quiet. Although it is important for health care professionals to communicate to family members, it will not likely reduce sensory overload for the patient.

Answer to Question 2

A, B, C, D, E
When assessing for sensory alterations, home care nurses need to assess sensory status, self-care management, and health promotion activities, as well as lifestyle and socialization.