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CNA-NIC F25 CH4.4
Identify Communication Guidelines for Speech Impairment
| Question | Answer |
|---|---|
| What are certain problems that interfere with the ability to speak | difficulty breathing (dyspnea), physical problems with the mouth or lips, or an artificial airway |
| DYSPNEA | difficulty breathing |
| Physical problems of the lips, mouth, and tongue include the following: | Lip/Mouth/Tongue sores, Missing teeth/Mouth pain/Recent Dental Work, poorly fitting dentures (Artificial Teeth), Birth defects like cleft palate (an opening or split in the roof of the mouth), Paralysis of one side of the mouth due to stroke |
| AIRWAY | is the passageway for air to move into and out of the lungs |
| ARTIFICAL AIRWAY | is any tube inserted into the respiratory tract for the purpose of maintaining an airway and facilitating ventilation |
| VENTILATION | the exchange of air between the lungs and the environment |
| when is an artificial airway needed | when the airway is obstructed due to illness, injury, secretions, or inhaling fluid into the lungs |
| when may an artificial airway be necessary | when a person has surgery or is unconscious |
| TRACHEOSTOMY | is a common type of artificial airway seen in long term care facilities |
| how is a tracheostomy used | an opening is made in the neck, either surgically or percutaneously (through the skin - usually in an emergency) into the trachea (windpipe) so that air can reach a persons lungs |
| describe the length of time a tracheostomy is used | this procedure can be temporary or permanent |
| when may a tracheostomy be used | while a person is recovering from acute illness |
| some types of head and neck cancers require | a tracheostomy |
| a tracheostomy may be necessary in what situation | when a person needs a ventilator |
| while a tracheostomy is in place the person | may be unable to speak |
| Speech Impairment Guidelines #1 | Give the resident plenty of time to speak. Allow pauses between words and sentences. Be patient |
| Speech Impairment Guidelines #2 | Ask the resident to write down anything you do not understand |
| Speech Impairment Guidelines #3 | Allow for rest periods if the resident becomes tired |
| Speech Impairment Guideline #4 | Do not remove a resident's oxygen for any reason. Only nurses remove oxygen |
| Speech Impairment Guideline #5 | Report mouth sores, poorly fitting dentures or complaints of mouth pain to the nurse |
| Speech Impairment Guideline #6 | Use other methods of communication if the resident cannot speak. Try writing notes, drawing pictures, and using communication boards. Watch for hand and eye signals. (Use one blink for yes and two blinks for no) |
| Speech Impairment Guideline #7 | Be reassuring and calm. Be empathetic. It can be frightening and uncomfortable to have an artificial airway. Some residents may choke or gag. Imagine how it might feel to have a tube in your nose, mouth or throat |
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