NURSING CARE PLAN (NCP)

DATE AND TIME

August 31, 2020

NURSING DIAGNOSIS
Impaired Verbal Communication presence of
artificial airway

SHORT – TERM AND LONG – TERM OUTCOMES

After 3 hours of nursing intervention, patient uses a After 3 days of nursing intervention, Patient spends two
form of communication to get needs met and to to three 5-minute sessions with nurse sharing
relate effectively with people and his or her observations in the environment within 3 days.
environment.

IMPLEMENTATION
NURSING ORDERS / APPROACHES
Dx:
- Establish rapport to the patient
- Assess the client’s communication ability.
- Assess for frustration and anxiety related to not
being able to communicate needs.
- Assess the effectiveness of nonverbal
communication methods.
Tx:
- Provide emotional support to the client and
significant others.
- Provide alternative methods for communicating:
 Hand gestures
RATIONALE
To gain trust and cooperation of the patient
Standard tracheostomy tubes allow the vocal cords to move, but no airflow
passes over them if the cuff is inflated; therefore vocalization is not possible.
The inability to communicate enhances a client’s sense of isolation and may
promote a sense of helplessness.
The client may use hand signals, facial expressions, and changes in
body posture to communicate with others. However, others may have difficulty
in interpreting these nonverbal techniques. Each new method needs to be
assessed for effectiveness and altered as necessary.
Difficulties communicating are a source of frustration for all involved.
Providing a variety of communication aids allows the client more channels
through which information can be communicated.

 Word-and-phrase cards

 Picture board for clients who are unable to write

 Writing pad

- Allow the client time to communicate his or her
needs.
- Place important objects within reach.
- Provide concrete directions that the patient is
physically capable of doing (e.g., “point to
the pain,” “open your mouth,” “turn your head”).
Edx:
- Create a list of words that the patient can say; add
new words to it as needed. Share this with family
members, significant others, and other care
providers.
- Involve family and significant others in plan of
care as much as possible.
- Allow significant others the opportunity to ask
questions about the patient’s communication
problem.
ASSESSMENT PARAMETERS
The nurse should set aside enough time to attend to all of the details of client
care. Care measures may take a longer time to complete in the presence of a
communication deficit.
To maximize patient’s sense of independence.
Simple, one-action directions enhance comprehension for the patient with
language impairment.
Sharing information with others broadens the group of people with whom the
patient can communicate.
Enhances participation and commitment to plan.
It is vital for the family to know that there are many ways to send information
to someone and that time may be needed to understand the special needs of
the patient.
SUBJECTIVE:
N/a

OBJECTIVE:
-Speaks with difficulty
- Difficulty in constructing sentence
- Difficulty in expressing thoughts
- Use of non-verbal cues
- Frustration
- Disorientation to person, space and time