ASSESSMENT

DIAGNOSIS

Subjective: dili maklaro ang iyang inistoryahan! as verbalized by the SO Objective: Difficulty pronouncing words Left sided paralysis Slurring of speech Facial tension

Impaired verbal communication related to left sided paralysis secondary to cardiovascular accident

SCIENTIFIC ANALYSIS

PLANNING

CVA is a broad term used to describe a condition in which blood flow to the brain is interrupted as a result there is temporary or permanent dysfunction of a patient motor, sensory, perceptual, emotional or cognitive abilities.

Short term: After 6-8 hours of Nurse Patient interaction the patient will be able to: Indicate an understanding of the communication difficulty and cooperates in planning for ways of handling. Patient will communicate needs without excessive frustration.

Footnote: Medical Surgical of Nursing 2nd edition by Frances Donovan Monahan page 654

PLANNING

Long term: After 3 days of Nurse Patient interactions the patient will be able to: Improve communication skills to extent possible. Demonstrate congruent verbal and Non verbal communication

Continue to attend session with speech therapist

INTERVENTION INDEPENDENT: 1. face the patient, maintained eye contact, speak slowly and enunciate clearly when initiating communication. 2. Take steps to enhance communication while providing care; > Communicate one idea at a time > Use yes and no questions > Avoid abstract thoughts and controversial topics Avoid abstract thoughts and controversial topics Use plain, everyday vocabulary Allow longer response time Guess at the meaning of incorrect words Reduce distractions

RATIONALE

To make it easier for the patient to receive and process your message.

Facilitating communication efforts will help decrease the patients frustration

INTERVENTION

RATIONALE

Eliminate unnecessary noise Encourage the patient to use gestures or other alternative means of communication. 3. If the patient doesnt follow your conversation, rephrase ideas using simpler words.

To overcome differences in language or culture that may block communication.

4. Dont rush the patient when hes struggling to express his thoughts. Demonstrate tact and willingness to listen. Even if you cant understand the patient, let him know you accept his efforts to communicate and you empathize with his frustrations. COLLABORATE: 5. Obtain referral to a speech therapist.

A patient with impaired verbal communication experiences isolation, despair, and frustration. Demonstrating compassion and fostering a therapeutic relationship is the important step in improving communication.
> To ensure continuity of care.

EVALUATION Short term: After 6-8 hours of Nurse Patient interaction the patient was able to: Indicate an understanding about difficulty of communication and cooperates in planning for ways of handling.

Patient will communicate needs without excessive frustration.

Long term: After 3 days of Nurse Patient interactions the patient was able to: Improved communication skills to extent as possible. Demonstrated congruent verbal and Non verbal communication Continued to attend session with speech therapist