Nursing Care Plan Help

  1. Hey all,

    this is my first time posting on the site I am formulating a nursing care plan at the moment for a patient with Alzheimer's disease. I have come up with the following Nursing Diagnosis: Impaired verbal communication related to aphasia. I am wondering what sort of nursing interventions would be recommended as well as what sort of outcomes i should expect.

    As a background, the pt is presenting with some confusion and has trouble speaking and slurred speech, the pt can do some ADL independently too.

    Thanks for any advice !
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    About Tampanian

    Joined: May '09; Posts: 8

    2 Comments

  3. by   Daytonite
    you've got a problem with your diagnostic statement: impaired verbal communication related to aphasia. aphasia is the inability to speak which is what impaired verbal communication is. (definition of impaired verbal communication: decreased, delayed, or absent ability to receive, process, transmit, and/or use a system of symbols). aphasia is also a medical diagnosis and cannot be used in a nursing diagnostic statement. the related factor (related to part) of the diagnostic statement is the etiology and explains why the problem exists. aphasia occurs in alzheimer's patients because they have problems controlling the working of their tongue, they have memory regression, with a disease like alzheimer's they forget how to do things such as the action of talking because their memory is failing them. so, i would re-write this diagnostic statement as impaired verbal communication related to impaired cognitive functioning as evidenced by slurred speech and difficulty speaking. part of your work in writing a care plan is to investigate and learn about alzheimer's disease in order to understand it's pathophysiology and the signs and symptoms. that information is crucial to the development of some of the etiologies of your nursing diagnostic statements. if you couldn't find that information in your textbooks, you will find it on this website: merck manual of diagnosis and therapy http://www.merck.com/mrkshared/mmanual/sections.jsp

    i am wondering what sort of nursing interventions would be recommended as well as what sort of outcomes i should expect.
    outcomes and interventions are based upon the evidence you have that supports the existence of the problem.
    problem (nursing diagnosis): impaired verbal communication
    etiology (cause of the problem): impaired cognitive functioning
    symptoms (evidence of the problem): slurred speech, difficulty speaking
    outcomes are what you predict will occur as a result of the nursing interventions you are going to order for the slurred speech and difficulty speaking. what do you imagine you would order the nursing staff to do for the slurred speech or difficulty speaking?
    • face the patient when communicating with them, listen and watch them closely
    • pay attention to their voice inflection and body cues
    • encourage patient to speak slowly
    • always speak to the patient in a calm even voice
    • allow the patient time to complete what they are saying
    • provide encouragement and reassurance to the patient at all times when they are attempting to communicate with you
    • work toward teaching the patient hand symbols or motions to represent simple and commonly asked requests for things such as a drink, go to toilet, lie down, etc.
    • refer to speech therapy for assistance in understanding patient's speech patterns
    outcomes might be:
    • the patient will speak with others calmly and slowly while conveying their needs in an organized way
    • hand symbols to represent where patient wants to go will be used by the patient.
    the pt is presenting with some confusion and can do some adl independently too.
    these are other nursing problems that require other nursing diagnostic labels, symptoms to identify them, outcomes and nursing interventions.
    there is more information on the construction of a care plan on this thread. you can see a number of examples of how diagnosing is done on the thread: https://allnurses.com/general-nursin...ns-286986.html - help with care plans
  4. by   Tampanian
    That was Extremely helpful ! It allowed me to see the actual thought process of how you formulated this. Thanks a ton

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