Lennox Gastaut seizure disorder Care plan

[RN2BMU2009]

I need a push in the right direction. I have a 19 year old pt. with a rare but aggressive seizure disorder called lennox gastaut disorder. Ontop of that she is autistic, nonverbal, incontinent. She has a vagal nerve stimulator and the seizures are managed with medication therapy. Her seizures are bad and they are very tempremental. Just about anything will set them off. Constipation, fatigue, menses and they can range from tonic clonic to a silent one. In addition to medication therapy she is on natural sleep wake cycles; she is allowed to sleep and wake up on her own, she is on oral contraceptives to limit menses to 3-4 times a year, her bowels are monitored to prevent constipation. Before she was placed in the group home she was having as many as 5-10 seizures a day but they were successful in finding out what triggers them and they are pretty much under control but she will still have them occasionally. I have a nursing diagnoses as activity intolerance r/t seizure disorder. My outcome criteria is foggy. I would like for her to maintain activity within her limits of capability. Can anyone give me any ideas?

[Daytonite, BSN, RN]

i don't know that activity intolerance is the correct diagnosis. the reason is because the definition of this diagnosis is insufficient physiological or psychological energy to endure or complete required or desired daily activities and it usually specifically pertains to hypoxia and oxygen deprivation of the tissues during activity. lack of energy is not this patient's problem. it is the fact that activity sets off seizures, right? being nonverbal (impaired verbal communication) and incontinent (total urinary incontinence) are other nursing diagnoses. i would suggest that you make a list of all the symptoms this patient has and look to different nursing diagnoses to handle each problem.

[RN2BMU2009]

Impaired verbal communication was the very first diagnoses that I had initially decided but then I changed my mind. I guess you should always go with your first instinct! I always want to make a good impression and end up making more work for myself. She will never be able to have control of her bowels so impaired verbal communication would be the next best dx. Thank you

[Daytonite, BSN, RN]

I'm not being mean here, but instinct has nothing to do with diagnosing. Diagnosing is a logical and rational process. It involvesw doing an assessment of the patient and then analyzing the information. Abnormal findings are grouped into known patterns that form the defining characteristics of specific nursing diagnoses. The NANDA taxonomy should be used to help clarify that diagnostic choices are being made correctly.