CHAPTER 13 DIAGNOSING 71
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing:father of their child. It seems that he lied
to some couples about using sperm from
anonymous donors and deceived others
into thinking the wives had become
pregnant when he had simply injected
them with hormones. Ted and Rosemary
have joined other couples in pressing
charges against this physician.
Rosemary tells the nurse in her pediatri-
cian’s office that she is concerned about
how all this is affecting her family. “Ted and
I both love Sarah and would do nothing to
hurt her, but I’m so angry about this whole
situation I’m afraid I may be taking it out
on her,” she says. Questioning reveals that
Rosemary has found herself yelling at Sarah
for minor disobedience and spanking her,
something she rarely did before. Both Ted
and Rosemary had commented before
about Sarah’s striking physical resemblance
to the fertility specialist but attributed this
to coincidence. Rosemary says, “Whenever
I see her now, I can’t help but see Dr.
Clowser, and everything inside me clenches
up and I want to scream.” Both Ted and
Rosemary express great remorse that Sarah,
who is innocent, is bearing the brunt of
something that is in no way her fault.
Nursing Diagnosis:APPLYING YOUR KNOWLEDGE
CRITICAL THINKING QUESTIONS
1.With a partner or several classmates, write
appropriate nursing diagnoses for the
following patient. Be sure to include actual,
potential, and possible diagnoses. Compare
your diagnoses with your partner’s and note
similarities and differences. Decide which
diagnoses best suit the patient’s situation.
A 35-year-old woman presents with chills,
fever, and severe vaginal bleeding. She tells
you she is 2 months pregnant and has had
two previous miscarriages. She is overwrought
and says she feels God is punishing her for an
abortion she had when she was in college. She
and her husband have been trying to have
children for years and were counting on this
pregnancy to come to term.2.Interview members of your family or several
close friends. Identify wellness diagnoses for
each person. What factors contributed to these
diagnoses?REFLECTIVE PRACTICE USING CRITICAL
THINKING SKILLS
Use the following expanded scenario from
Chapter 13 in your textbook to answer the
questions below.
Scenario:Martin Prescott, age 46, comes to
the clinic for a routine physical examination.
During the assessment, he says, “I’ve had
problems with constipation and I’ve seen
some blood when I wipe myself after a bowel
movement. It’s just hemorrhoids, right?
Nothing to worry about?” Upon further ques-
tioning, the nurse discovers that Mr. Prescott’s
father and an uncle both died in their early
50s from colon cancer.
1.What nursing diagnosis would be appropriate
for Mr. Prescott? How might the nurse advocate
for Mr. Prescott to ensure that he gets tested for
colon cancer?2.What would be a successful outcome for this
patient?3.What intellectual, technical, interpersonal,
and/or ethical/legal competencies are most
likely to bring about the desired outcome?4.What resources might be helpful for
Mr. Prescott?LWBK696-C13_p66-71.qxd 9/2/10 9:25 AM Page 71 Aptara Inc