IMPAIRED VERBAL COMMUNICATION Nursing Care Plan

Mrs. Vivaane, 46 years old, a dog lover and a call-center agent. One day after lunch break, Mrs. Vivaane started to unable to speak, confuse and agitated. Below is a nursing care plan of impaired verbal communication of Mrs. Vivaane. If nursing interventions focus on reducing hallucinations, fear, or anxiety, Confusion, Fear, or Anxiety would be more appropriate.

 

Assessment:

Objectives:

- Absence of speech

- Impaired ability to speak
- Incongruence between verbal and nonverbal messages
- Stuttering
- Slurring of speech
- Word-finding problems
- Absence of voice
- Dysarthria, a condition in which muscles you use for speech are weak and you have difficulty of controlling them
- Aphasia, impairment of language

 

Diagnosis:

Impaired verbal communication related to impaired motor function of muscles of speech secondary to cerebrovascular accident or brain attack.

 

Planning:

After 4 hours of nursing interventions, the patient will report improved satisfaction with ability to communicate. The patient will demonstrate increased ability to understand. The patient will demonstrate improved ability to express self. The patient will be able to use alternative methods of communication, as indicated.

 

Interventions:

- Identify a method to communicate basic needs. Assess Mrs. Vivaane's ability to comprehend, speak, read, and write. Provide her alternative methods of communication. Use a computer, pad and pencil, hand signals, eye blinks, head nods, and bell signals. Make flash cards with pictures or words depicting frequently used phrases like “Wet my lips,” “Move my foot,” “I need a glass of water,” or “I need a bedpan”. Encourage Mrs. Vivaane to point, use gestures, and pantomime. Using alternative forms of communication can help decrease anxiety, isolation, and alienation; promote a sense of control; and enhance safety.

- Identify factors that promote communication, create atmosphere of acceptance and privacy. Provide a non-rushed environment. Use techniques to increase understanding. Face Mrs. Vivaane and establish eye contact with her if possible. Use uncomplicated one-step commands and directives. Have only one person talk following a conversation among multiple parties can be difficult. Encourage Mrs. Vivaane the use of gestures and pantomime. Match words with her actions; use pictures. Terminate the conversation on a note of success. Validate that Mrs. Vivaane understands the message. Give information in writing to reinforce.

- Initiate health teaching and referrals. Seek consultation with a speech or audiology specialist.

 

- If Mrs. Vivaane can hear with a hearing aid, make sure that it is on and functioning. If Mrs. Vivaane can hear with one ear, speak slowly and clearly into the good ear. If Mrs. Vivaane can read and write, provide pad and pencil at all times. If Mrs. Vivaane can understand only sign language, have an interpreter with her as much as possible. Write and speak all important messages. Validate Mrs. Vivaane’s understanding by asking questions that require more than “yes” or “no” answers. Avoid asking, “Do you understand?” Assess if cerumen impaction is impairing hearing.

 

Evaluation:

After 4 hours of nursing interventions, the patient was reported improved satisfaction with ability to communicate. The patient was demonstrated increased ability to understand. The patient was demonstrated improved ability to express self. The patient was able to use alternative methods of communication, as indicated.

 

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