Nursing diagnosis – READINESS FOR ENHANCED COMMUNICATION

READINESS  FOR  ENHANCED

COMMUNICATION

DEFINITION

A pattern of exchanging information and ideas with others that is suf-

ficient for meeting one’s needs and life’s goals, and can be strengthened

DEFINING CHARACTERISTICS

• Expresses willingness to enhance communication ability

• Can speak or write language clearly

• Forms words, phrases, and language with articulation

• Uses and interprets nonverbal cues appropriately

• Expresses satisfaction with ability to share information and ideas

with others

• Expresses needs in an assertive way

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Communication

• Roles and relationships

• Coping

• Values and beliefs

EXPECTED OUTCOMES

The patient will

• Maintain pulse within predetermined limit.

• Maintain blood pressure within predetermined limits.

• Have no arrhythmias.

• Exhibit skin that is warm and dry.

• Have no pedal edema.

• Maintain acceptable cardiac output.

• Verbalize understanding of reportable signs and symptoms.

• Understand diet, medication regiment, and prescribed activity level.

SUGGESTED NOC OUTCOMES

Cardiac Pump Effectiveness; Circulation Status; Tissue Perfusion:

Peripheral; Vital Signs

INTERVENTIONS AND RATIONALES

Determine: Monitor patient at least every 4 hr for irregularities in

heart rate, rhythm, dyspnea, fatigue, crackles in lungs, jugular venous

distension, or chest pain. Any or all of these may indicate impending

cardiac failure or other complications. Report changes immediately.

Perform: Provide an environment that diminishes space between the

patient and the nurse to eliminate barriers to communication such

as noise and lack of privacy.

Incorporate questions that are open-ended and start with such

words as “what,” “how,” and “could,” rather than “why.” Open-

minded, nonthreatening questioning encourages patient to discuss

issues of concern and improve communication skills.

Schedule frequent interdisciplinary treatment team meetings

regarding communication skill development with patient. Team

meetings with the patient can ensure continuity of care.

Inform: Educate patient and family members about the aging

process. Educating the patient and family will help them anticipate

processes that will naturally occur again.

Teach theory of assertive behavior and role-play assertive commu-

nication approaches. Assertive training can decrease passive or

aggressive communication patterns.

Include role-playing as a teaching strategy to model methods of

enhanced verbal and nonverbal communication skills. Role-playing in

a nonthreatening safe environment can enhance communication skills.

Attend: Encourage patient verbally and nonverbally to explore

strategies to enhance self-advocacy communication skills with health

care providers. Self-advocacy communication can guide a patient

toward autonomy, confidence, and independence.

Provide support through active listening, appropriate periods of

silence, reflection on feelings, and paraphrasing and summarizing

comments. Active listening techniques encourage patient

participation in communication.

Provide patient with clear explanations for everything that will

happen to him. Ask for feedback to ensure that the patient under-

stands. Anxiety may impair patient’s cognitive abilities.

Manage: Identify appropriate social agencies and support groups for

the patient and provide referrals to ensure ongoing opportunities for

the patient to increase social interaction.

SUGGESTED NIC INTERVENTIONS

Active Listening; Anticipatory Guidance; Assertiveness Training;

Behavior Modification; Social Skills; Relationship-Building Enhance-

ment; Simple Guided Imagery; Support Group

Reference

Whyte, R. E., et al. (2006, September). Nurses’ opportunistic interventions

with patients in relation to smoking. Journal of Advanced Nursing, 55(5),
568–577.

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