DX for Glioblastoma Multiforme- FHP Paper Due in 2 days!

[z123]

Hi, I am a 2nd semester nursing student and I am required to write a functional health status paper (FHP) following GORDON'S 11 FHPs on a 50 yr. old patient with stage 4 glioblastoma multiforme. (diagnosed in 2009)

I am having trouble with one thing - coming up with a nursing dx for the cognition/perception portion. here is the data -

Patient was alert and oriented X 1 - he would at times open his eyes and respond to his name when the nurse spoke to him in a loud voice. The nurse also asked him to blink his eyes if he was not in pain, and he did. However, we were unsure if this action was voluntary or involuntary, because the patient would resume his usual sleep pattern. I also placed the pen light across both eyes and noted that both pupils were equal and reactive to light. I compared these results with the Glasgow Coma Scale, and I obtained a score of (5) for Mr. Z - "best eye response (3): eye opening to verbal command, best verbal and motor response (1-1): N/A for both" (Weber, 2008, p. 435).

The patient would only open his eyes and he did not respond to painful stimuli or any stimuli. at times he would move his legs on his own, but other than that - he would only open his eyes at times.

Any suggestions for 1. nursing dx 2. expected outcomes 3. interventions??

PLEASE HELP ASAP - I WOULD TRULY APPRECIATE A THOROUGH REPLY. THANK YOU

[Daytonite, BSN, RN]

Impaired Verbal Communication.

[z123]

hi, thank you for the reply. I actually used this nursing Dx under the roles/relationships FHP because that is where I found it in my diagnoses book. If I was to use impaired verbal communication in the cognition section of my FHP, do you have any suggestions on what to put in the roles/relationships portion then?? As I stated before, this patient is Alert and oriented X 1 - at times responds to name by opening eyes . other than that, he is unable to do anything. his family is devastated and they are the ones who make the decisions for him. It is kind of hard to write a paper on such a patient, but it is very interesting.

Any suggestions please??

In addition to my question above, I also wanted to know how is it possible to write expected outcomes for a patient who is not alert or oriented? most of the expected outcomes and interventions require verbal/non-verbal communcation (which is NOT APPLICABLE TO MY PATIENT) so how can I come up with expected outcomes/interventions specifically for this patient? ((((Now I am not just referring to the cognitive and role/relationship FHP, I am speaking of all 11 Gordon FHP which I am expected to do for this patient)))) any ideas?

The reason I am asking this question is because I am also expected to take 2 priority nursing Dx's and make plans of care for each.