Impaired Verbal Communication | NCP for Thyroidectomy

Nursing diagnosis: impaired verbal Communication related to Vocal cord injury, laryngeal nerve damage, Tissue edema; pain and discomfort

Possibly evidenced by
Impaired articulation, does not or cannot speak; use of nonverbal cues such as gestures

Desired Outcomes/Evaluation Criteria—Client Will
Communication
Establish method of communication in which needs can be understood.

Nursing intervention with rationale:
1. Assess speech periodically and encourage voice rest.
Rationale: Hoarseness and sore throat may occur secondary to tissue edema or surgical damage to recurrent laryngeal nerve and may last several days. Permanent nerve damage can occur (rare) that causes paralysis of vocal cords and or compression of the trachea.

2. Keep communication simple. Ask yes and no questions.
Rationale: Reduces demand for response; promotes voice rest.

3. Provide alternative methods of communication as appropriate—slate board, letter and picture board. Place intravenous (IV) line to minimize interference with written communication.
Rationale: Facilitates expression of needs.

4. Anticipate needs as much as possible. Visit client frequently.
Rationale: Reduces anxiety and client’s need to communicate.

5. Post notice of client’s voice limitations at central station and answer call light promptly.
Rationale: Prevents client from straining voice to make needs known and summon assistance.

6. Maintain quiet environment.
Rationale: Enhances ability to hear whispered communication and reduces necessity for client to raise and strain voice to be heard.