NANDA Dx: Impaired Verbal Communication r/t alteration of central nervous system, differences related to the developmental age and side effects of medication aeb absence of eye contact, expressive aphasia, and disorientation. Goal: Client will use alternate methods of communication effectively. Goal not met, patient still unable to communicate effectively. Outcome: Client will be orientated to his name, where he is, and his birth date by 1100. Outcome not met, patient was only orientated to his name and where he was. Intervention #1 Use simple communication; speak in a well-modulated voice, smile, and show concern for the client. “Affective questions and tentative speech, together with continuers, facilitated active participation by clients receiving health counseling.” Intervention #2 Use touch as appropriate. “The use of touch by the nurse conveys caring to the client.” Intervention #3 Be persistent in deciphering what the client is saying, and do not pretend to understand ‘when the message is not clear. “When clients are truly understood, they experience greater satisfaction with nursing care.” Intervention #4 ‘Supplement the work of a speech pathologist “Speech pathologists consider interventional optimizing communication and collaboration with a speech pathologist may provide the best approach to improving communication in clients with aphasia. Nursing Diagnosis Handbook an Evidence-Based Guide to Planning Care. By: Ackley, Betty J., Gail B. Ladwig, Elsevier 2008,