Scenario: Nurse MB begins to discuss Mr.

and Mrs Don-Ramon questions about caring for a wound at

home. The patient lives in his own home. Mrs. Ramon has no restrictions to her activity and believes
that she can help the patient with any physical limits. As they talk, Mr. Don-Ramon shares with Nurse
MB, "I'm worried about being able to work on time". When instructing the patient an hour ago, Nurse
MB noticed that the he was having trouble concentrating on what she had to say. He seemed more
concerned about how his incision felt. Mrs Ramon tells Nurse MB, "His office has been laying off
workers; that's why he's concerned".
1. Consider Mr. Don-Ramon behaviors and statements in this case study and identify three pieces of
assessment data that cluster together to form defining characteristics.
Nurse MB noticed that the he was having trouble concentrating on what she had to say.
The patient lives in his own home. Mrs. Ramon has no restrictions to her activity and believes
that she can help the patient with any physical limits.
He seemed more concerned about how his incision felt.
2. Nurse MB clusters the defining characteristics to select the diagnostic label of Anxiety. What would
you identify as the relayed factor for this diagnostic?
3. If Nurse MB identified the patient's diagnosis as Anxiety related to need to perform wound care,
would this be an accurate nursing diagnosis? Explain