Lesson 1, Topic 1
In Progress


May 1, 2021

The nursing diagnosis of impaired verbal communication is used to describe “decreased, delayed, or absent ability to receive, process, transmit, and use a system of symbols” (Ackley and Ladwig, 2011).

Any of the factors that affect communication discussed previously in this chapter is potentially related to impaired verbal communication. Defining characteristics that indicate impaired verbal communication include absence of eye contact; inability to speak; willful refusal to speak; difficulty in comprehending or maintaining usual communication pattern; difficulty expressing thoughts verbally; difficulty forming words or sentences; difficulty in selective attending; difficulty or inability in use of body or facial expressions; disorientation to person, space, or time; inability to speak language of caregiver; difficult or inappropriate verbalization; and slurring or stuttering (Ackley and Ladwig, 9e, 2011).

 Nursing Diagnosis

If one or more of the defining characteristics are present, the nursing diagnosis of impaired verbal communication may be indicated. For example, Mr. W. has an endotracheal tube in place to relieve respiratory distress that occurred after a traumatic chest injury. The presence of the endotracheal tube renders him unable to speak. The loss of speech hampers his abilities to express his needs and provides support for the nursing diagnosis of impaired verbal communication.

 Expected Outcomes and Planning

The goal for any patient experiencing impaired verbal communication is that the patient will be able to communicate effectively with others in the environment by sending and receiving clear, concise, and understandable messages. The desired outcomes established with the patient have to be specific and realistic for the patient and address the patient’s needs and concerns. In general, the desired outcomes state that the patient will:

•Use effective communication techniques.
•Use alternative methods of communication effectively.
•Demonstrate congruency of verbal and nonverbal behavior.
•Demonstrate an understanding of communication exchanges even if not able to speak.
•Express desire for social interactions (Ackley, 2011).


Nursing interventions appropriate to the patient with impaired verbal communication depend on the type of communication problem that exists, and the factors contributing to the problem. Thus, nursing interventions may vary greatly from one patient to the next. See Box 4-6 for examples of helpful nursing interventions related to specific types of impaired commu­nication.

The nurse evaluates the effectiveness of communication based on the patient’s ability to meet the established goals and outcomes. A good way to accomplish this is by observing the patient’s response to an interaction and considering what kind of message is received from the patient’s verbal and nonverbal