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.
For more samples of nursing care plan you are free to check it out in our NCP LIST page.
From time to time, the hearing loss is so severe that the most effective hearing aids can not enhance the noise
ReplyDeleteenough. Studies have shown that a childs intellectual and personal
development is closely connected to hearing. An audiologist has specialized training in identifying and quantifying the kind and level
of hearing loss and advocating treatment choices.