NURSING CARE PLAN Problem: Unable to communicate verbally Nursing Diagnosis: Impaired verbal communication r/t decreased tongue

mobility secondary to right sided hemiparesis Cause Analysis: Due to impaired cerebral circulation there is dysfunction in the cranial nerve X which is responsible for speech (vocal quality), gagging & swallowing. ( RN, Cranial Nerve Assessment pp.63) CUES Subjective: The patient is unable to speak or to communicate verbally OBJECTIVES Short term objective: Within 8 hours of giving nursing intervention and health teaching, the patient will be able to express desire for social interaction. NURSING INTERVENTIONS Independent: 1. Establish an alternative method of communication such as writing or pointing to letters, words phrases or picture cards. 2. Anticipate clients needs until effective communicate is possible. 3.Use simple communication, speak in a well-modulated voice; smile and show concern\for the client 4. Maintain eye contact at clients level; read clients lips as able 5. Use touch as appropriate 6. Spend time with client; allow time for responses; make call light readily available to client. 7. Note carefully, and validate nonverbal expression of patient. RATIONALE EVALUATION

1. Alternative methods of communication are necessary when the client is unable to use verbal communication. 2. Anticipation of clients needs increases client satisfaction. 3. Such technique have been described by clients as demonstrating caring 4. Standing while the client is lying or makes the nurse appear rushed and hinders communication 5. Physical touch reduces client anxiety. 6. Clients consider good care to include listening, helping, and being there. 7. Client satisfaction studies have repeatedly shown that what clients want must from their nurses is common courtesy-someone who really listens to \their fears and concerns and treats them like a real person, not a disease. .

After 8 hours of
giving nursing intervention and health teaching, the patient is able to express desire for social interaction.

Objective: Right side hemiparesis Slurred speech Decreased tongue mobility

Long term objective: Within 2 days of giving health teaching nursing intervention, the patient will be able to know effective communication techniques in the way of expression of feelings through non-verbal expressions.

After 2 days of
giving health teaching nursing intervention, the patient is able to know effective communication techniques in the way of expression of feelings through non-verbal expressions.

Reference: Nursing care Plan: Guidelines for individualizing patient car.ed6; M. Doenges, M.F Moorhouse, A. Geissler-Murr.pp.138-139.