A client is becoming frustrated because of an inability to communicate with a tracheostomy. Which intervention by the nurse most effectively enhances communication?
a. Explain to the client that speech will be clear and distinct with a fenestrated tube.
b. Reassure the client that in time he or she will get used to the speech difficulties.
c. Place a sign above the client's bed indicating that the client cannot speak.
d. Provide the client with a communication board and call light within easy reach.
D
A communication board and the call light will reassure the client that needs will be communicated and met. It is doubtful that the client with a tracheostomy will ever speak clearly and distinctly, no matter what type of tube he or she uses. Reassuring the client that he or she will get used to the speech difficulties does nothing to alleviate the discomfort and fear associated with impaired communication. Placing a sign above the client's bed indicating that he cannot speak will not enhance his ability to communicate, although it may help staff remember that the client has impaired communication.
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