Tonya discusses the concerns Mr. Jacobs has about his sexual relationship with his wife. She knows that a radical prostatectomy can cause nerve damage that impairs a man’s ability to have a normal erection. Tonya says, “You’ve told me that you’re worried about you and your wife. Can you tell me more?” Mr. Jacobs says, “I feel uncertain about my ability to have sex. The doctor said before the surgery that there is a risk of damaging a nerve that can affect my ability to perform sexually.” Tonya observes that Mr. Jacobs has poor eye contact as they talk and his voice quivers. Tonya asks, “How would you describe your relationship with Mrs. Jacobs?” The patient responds, “Oh, it’s been really good. We’ve had our ups and downs like anyone else, but she has been so good to me. I worry that I won’t be able to be the husband she wants anymore.” Tonya clarifies, “Has the doctor visited since surgery to discuss your concerns?” Mr. Jacobs replies, “No, he hasn’t been in yet.”
· Which of the following are defining characteristics from the assessment?
Ø Quiver in Mr. Jacobs’ voice
Ø Nurse’s statement, “You’ve told me that you’re worried.”
Ø Uncertainty about ability to have sex
Ø Poor eye contact
Ø Nurse’s question, “Can you tell me more?”
· Tonya clusters the defining characteristics to select the diagnostic label of anxiety. What would you identify as the related factor for this diagnosis?
· If Tonya identified the diagnosis as anxiety related to risk of nerve damage during surgery, would this be an accurate nursing diagnosis? Explain.
