Nursing Dx

Taxonomy II: Perception/Cognition—Class 5 Communication (00051)
[Diagnostic Division: Social Interaction]
Submitted 1983; Revised 1998 (by small group work 1996)
Definition: Decreased, delayed, or absent ability to receive, process, transmit, and use a system of symbols

Related Factors
Decrease in circulation to brain, brain tumor
Anatomic 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 of self-esteem or self-concept
Altered perceptions
Absence of SO(s)

Defining Characteristics
SUBJECTIVE
[Reports of difficulty expressing self]
OBJECTIVE
Unable to speak dominant language
Speaks or verbalizes with difficulty
Does not or cannot speak
Disorientation in the three spheres of time, space, person
Stuttering; slurring
Dyspnea
Difficulty forming words or 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 and maintaining the usual communicating pattern
Absence of eye contact or difficulty in selective attending; partial or total visual deficit
Inability or difficulty in use of facial or body expressions
Willful refusal to speak
[Inability to modulate speech]
[Message inappropriate to content]
[Use of nonverbal cues (e.g., pleading eyes, gestures, turning away)]
[Frustration, anger, hostility]