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Objective: -difficulty expressing thoughts verbally -difficulty comprehending communication pattern -Paralysis on left part of the body
Impaired verbal communication related to impaired cerebral circulation as evidenced by the objectives.
After series of nursing intervention the client will be able to participate in therapeutic communication. -maintain good environment -enhance participation and communication plan
1. Assess type/ degree of dysfunction .
1. Helps determine area and degree of brain involvement and difficulty patient has with any or all steps of the communicatio n process.
After series of nursing intervention the client was able to participate in therapeutic communication. -maintain good environment -enhance participation and communication plan
2. Use simple communica tion speaks in a wellmodulated voice, smile, and shown concern for the client.
2. Good communicatio n involves many familiar concepts, including sore eye contact.
Establish rapport 3. listening carefully and attending to clients verbal and non-verbal expressions.To build trusting relationship 4. 6. 5. Provide sufficient time for client respond. . To maintain good communication skills with the patient. 4. Establish good relationship. 6. To have baseline data.3.Monitor and records vital sign 5. To give right manner when communication.
Assessment Diagnosis Planning Intervention Rationale Evaluation .
Observe the client for cause of impaired mobility. Prevents external hip rotation. 3. Reduce risk of tissue ischemia / injury. After series of nursing intervention the client was able to verbalized feeling of increased strength and ability to move 3.Subjective: Impaired physical mobility related to neuromuscular impairment Objective: -Slowed movement -difficulty of turning After series of nursing intervention the client will be able to verbalize feeling of increased strength and ability to move 1. Change positions at least every 2 hours and possibly more often if placed on affected side. 2. Affected side has poorer circulation and reduced sensation and is more predisposed to skin breakdown / decubitus. 1. . Maintain leg in neutral position with a trochanter roll. Some clients choose not to move because of physiologica l factors such as an inability to cope or depression. 2.
Circulatory stimulation and padding help pre vents skin breakdown decubitus. enhancing propriocepti on and motor response. particularly over bony prominence. 6. Aids in retraining neuronal pathways. Gently massage any reddened areas and provide aids such as sheepskin pads as necessary. 5. Promotes sense of expectation of progress. 4. 5. . improvemen t and provides some sense of control. Assist to develop sitting balance. Set goals with patient significant others for participation in activities exercise and 6. Inspect skin regularly.4. Pressure points over bony prominence are most at risk for decreased perfusion.
position changes. Encourage patient to assist with movement and exercises using unaffected extremity to Support. 7. May respond as if affected side is no longer part of body and needs encouragem ent and active training to “reincorpora te” it as a part of own body. independen ce 7. . move weaker side.