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NCLEX & CGFNS Practice Questions
Impaired Verbal Communication
  • Actual
  • Risk for (Potential)

Related To: [Check those that apply]

  • Brain injury that adversely affects the transmission, reception or interpretation of language or other forms of communication
  • Structural problem such as cleft palate, laryngectomy, tracheostomy, intubation or wired jaws
  • Cultural difference (e.g., speaks different language)
  • Dyspnea
  • Fatigue
  • Patient has sensory challenge involving hearing or vision.

As evidenced by: [Check those that apply]

  • IInability to find, recognize, or understand words
  • Difficulty vocalizing words
  • Inability to recall familiar words, phrases, or names of known persons, objects, and places
  • Unable to speak dominant language
  • Problems in receiving the type of sensory input being sent or sending the type of input necessary for understanding

Patient’s Diagnosis: –
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Objective/Expected Outcome;The patient will:

  • use a form of communication to get needs met and to relate effectively with persons and his or her environment.
  • Others

Note: you need to indicate time frame/target as objective must be measurable.

Nursing Interventions Scientific Rationale
Assess conditions or situations that may hinder the patient's ability to use or understand language (e.g., tracheostomy, oral or nasal intubation). When air does not pass over vocal cords, sounds are not produced.
Assess for presence and history of dyspnea. Patients who are experiencing breathing problems may reduce or cease verbal communication that may complicate their respiratory efforts.
Assess energy level. Fatigue and/or shortness of breath can make communication difficult or impossible.
Assess knowledge of patient, family, or caregiver understanding of sign language, as appropriate. Individuals who have no formal training in sign language usually develop mechanisms for communication but since communication is such a critical aspect of everyone's life, consider formal training for patient and caregivers to enhance communication.
Assist the patient in seeking an evaluation of their home and work setting. To evaluate the need for assistive devices, talking computers, telephone typing device, interpreters, and others.
Anticipate patient needs and pay attention to nonverbal cues. The nurse should set aside enough time to attend to all of the details of patient care. Care measures may take longer to complete in the presence of a communication deficit.
Place important objects within reach. To maximize patient's sense of independence.
Never talk in front of patient as though he or she comprehends nothing. This increases the patient's sense of frustration and feelings of helplessness.
Keep distractions such as television and radio at a minimum when talking to patient. To keep patient focused, decrease stimuli going to the brain for interpretation, and enhance the nurse's ability to listen.
Do not speak loudly unless patient is hearing-impaired Loud talking does not improve the patient's ability to understand if the barriers are primary language, aphasia, or a sensory deficit.
Maintain eye contact with patient when speaking. Stand close, within patient's line of vision (generally midline). Patients may have defect in field of vision or they may need to see the nurses' face or lips to enhance their understanding of what is being communicated.
Give the patient ample time to respond. It may be difficult for patients to respond under pressure; they may need extra time to organize responses, find the correct word, or make necessary language translations.
Praise patient's accomplishments. Acknowledge his or her frustrations. The inability to communicate enhances a patient's sense of isolation and may promote a sense of helplessness.

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