Nurse's Pocket Guide

Anatomical deficit (e.g., cleft palate, alteration of the neurovascular
visual system, auditory system, or phonatory apparatus)
Difference related to developmental age
Physical barrier (tracheostomy, intubation)
Physiological conditions [e.g., dyspnea]; alteration of central
nervous system (CNS); weakening of the musculoskeletal
system
Psychological barriers (e.g., psychosis, lack of stimuli); emotional
conditions [depression, panic, anger]; stress
Environmental barriers
Cultural difference
Lack of information
Side effects of medication
Alteration in self-esteem or self-concept
Altered perceptions
Absence of SO(s)
Defining Characteristics
SUBJECTIVE
[Reports of difficulty expressing self]
OBJECTIVE
Inability to speak dominant language
Speaks/verbalizes with difficulty; stuttering; slurring
Does not/cannot speak; willful refusal to speak
Difficulty forming words/sentences (e.g., aphonia, dyslalia,
dysarthria)
Difficulty expressing thoughts verbally (e.g., aphasia, dysphasia,
apraxia, dyslexia)
Inappropriate verbalization [incessant, loose association of
ideas; flight of ideas]
Difficulty in comprehending/maintaining usual communication
pattern
Absence of eye contact/difficulty in selective attending; partial/
total visual deficit
Inability/difficulty in use of facial/body expressions
Dyspnea
Disorientation to person/space/time
[Inability to modulate speech]
[Message inappropriate to content]
[Use of nonverbal cues (e.g., pleading eyes, gestures, turning
away)]
[Frustration, anger, hostility]
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
Diagnostic Studies Pediatric/Geriatric/Lifespan Medications 167
impaired verbal COMMUNICATION