- Chronic Low Self-Esteem related to fear of rejection and Ineffective as evidenced by excessive seeking of reassurance and Self-negating verbalizations
- Deficient Knowledge Related to Inadequate information about hearing loss as evidenced by inaccurate follow-through of instructions and Nonadherence with hearing devices
- Impaired Verbal Communication related to Inability to hear audibly, and Inner ear abnormality as evidenced by Withdrawal from conversations and difficulty expressing thoughts
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: Verbalizes fear of Rejection from Society Objective data: -Excessive seeking of reassurance -Expresses loneliness -Hopelessness -Reduced eye contact -Self-negating verbalizations -Underestimates their ability to deal with the situation -Isolates self | Chronic Low Self-Esteem related to fear of rejection and Ineffective as evidenced by excessive seeking of reassurance and Self-negating verbalizations | Patient will show an improved ability to interact with other people. Patient will demonstrate self-acceptance and attempt to communicate with others. | 1. Use therapeutic communication. Therapeutic communication techniques such as maintaining eye contact, listening, offering time, and validating the patient’s experiences promote trust and ongoing communication. 2. Help the patient recognize their strengths. Acknowledging positive strengths and coping abilities to manage hearing loss can help boost the patient’s self-esteem. 3. Refer the patient to group therapies and support groups. Support and community groups for hearing impairments provide the patient with emotional and social support enabling acceptance and promoting confidence. 4. Encourage socialization. Once the patient becomes comfortable, encourage activities that promote ongoing socialization where talking isn’t the primary goal, such as quiet craft events or outdoor activities. | Patient shown improved ability to interact with other people. Patient demonstrated self-acceptance and attempt to communicate with others. |
| Subjective data: Verbalizes poor understanding Seeks additional information Objective data: -Inaccurate statements about hearing loss -Lack of motivation to change -Development of poor social or language skills in children -Nonadherence with hearing devices | Deficient Knowledge Related to Inadequate information about hearing loss as evidenced by Inaccurate follow-through of instructions and Nonadherence with hearing devices | Patient will actively participate in the care plan to manage hearing loss. Patient will utilize devices and tools to increase hearing ability | 1. Educate on tips to improve hearing abilities: Remove background noise Remind people not to yell but to speak clearly Be upfront about your hearing loss and explain how you hear best In a loud setting, such as a restaurant, ask to be seated in a quieter area Ask a friend to relay important information Focus on one person at a time instead of a group Turn on closed captioning on the television 2. Refer the patient to a speech therapist or audiologist. A speech therapist can help children develop their speech and language around hearing loss. An audiologist is integral in assessing hearing loss and recommending devices such as hearing aids or cochlear implants. 3. Teach the patient alternative communication techniques. Children can be taught sign language at a young age. Amplifiers can increase sound volume while eliminating background noise. Text telephones can allow typing of messages instead of voice calls. 4. Recommend organizations and resources. Schools for the deaf, the Hearing Loss Association of America, and community resources help adults and children learn about hearing loss and available technologies. | Patient actively participated in the care plan to manage hearing loss. Patient utilized devices and tools to increase hearing ability |
| Subjective data: Reported unable to Verbalize properly Objective data: -Difficulty establishing social interaction -Difficulty maintaining communication -Difficulty using facial expressions -Inappropriate verbalization -Withdrawal from conversations -Absence of eye contact -Difficulty expressing thoughts -Frustration | Impaired Verbal Communication related to Inability to hear audibly and Inner ear abnormality as evidenced by Withdrawal from conversations and Difficulty expressing thoughts | Patient will demonstrate the use of effective communication techniques. Patient will communicate verbally and nonverbally congruently. | 1. Make sure you have the patient’s attention. Before speaking or asking the patient questions, ensure you have their attention and make eye contact to prevent misunderstandings. 2. Place signage in the room. It is reasonable to place a sign in the patient’s room to alert other healthcare providers to the patient’s hearing loss and how they best communicate. 3. Use simple and easy-to-understand instructions. Simple and easy-to-understand instructions allow the patient time to process information correctly or follow instructions. Speak clearly, face the patient, and enunciate your words. 4. Encourage the use of alternative communication techniques. Using gestures, writing, and sign language are effective strategies for communicating with patients with hearing loss. 5. Help utilize hearing aids. Hearing aids are a common device used to overcome hearing loss. The nurse can assist the patient in charging, cleaning, and inserting hearing aids. | Patient demonstrated the use of effective communication techniques. Patient communicated verbally and nonverbally congruently. |