9.7 Applying the Nursing Process to Anxiety Disorders
People with anxiety disorders rarely require hospitalization unless they are suicidal, although anxiety can occur with other mental disorders requiring hospitalization. As a nurse working with individuals with diagnosed anxiety disorders, be aware of your self-reaction. It is not uncommon to have feelings of frustration, especially if you feel as if the symptoms are a matter of choice or under the client’s control. The client often acknowledges the fear is unrealistic or exaggerated but continues to engage in avoidant behavior. Recall that avoidant behavior is a symptom, and behavioral changes are accomplished slowly with treatment.[1]
It is also important to be aware that hospitalized clients may develop anxiety in association with other medical conditions (i.e., chronic obstructive pulmonary disease [COPD], angina, or hyperthyroidism) or medical procedures. Anxiety is a nursing diagnosis, as well as a potential mental health disorder. While implementing interventions that address medical conditions, often the nurse must also implement interventions that address associated anxiety.
Assessment
Mental Status Examination
See Table 9.7a for common findings when assessing a client with an anxiety disorder. (See expected findings for these components of a mental status examination in the “Assessment” section in Chapter 4.) Critical findings that require immediate notification of the provider are bolded with an asterisk.
Table 9. 7aCommon Findings During Mental Status Examinations for Clients With Anxiety Disorders[2]
| Mental Status Examination Component | Common Findings in Anxiety Disorders
(*Indicates immediately notify provider) |
|---|---|
| Signs of Distress | Determine the client’s current level of anxiety (mild, moderate, severe, or panic) and assess for risk of suicide or self-harm. If a client is experiencing a panic attack, they may exhibit *shortness of breath, *chest pain or tightness, a choking sensation, dizziness, *palpitations, nausea, abdominal pain, diaphoresis, or a fear of dying or losing control.
Anxiety often coexists with depression and can lead to feelings of being overwhelmed and unable to cope, which can be a significant risk factor for suicidal ideation. *Note: Suicidal ideations indicate increased risk for self-injury, suicide, or injury to others and must be reported to provider. Do not leave clients alone if statements such as these are being made. |
| Level of Consciousness and Orientation | Typically alert and oriented to person, place, time, and situation. However, during acute panic episodes, transient confusion or disorientation may occur. |
| Appearance and General Behavior | May appear nervous and restless with fidgeting, wringing hands, foot tapping, facial tension, and tremors. Posture may be rigid or defensive. May avoid eye contact, appear guarded, or display frequent checking behaviors (e.g., looking around the environment for threats). May experience urinary frequency. May appear disheveled. May report altered sleep patterns. *Verbal and nonverbal threats of harm or *self-harming behaviors such as cutting, picking at skin, knocking head against the wall, tightening string or items on wrists, or stabbing self with anything fashioned into a weapon should be immediately reported to the provider. |
| Speech | Speech may be rapid, pressured, or hesitant; may include stammering, especially in social anxiety; often driven by urgency to express worries or fears. |
| Motor Activity | Psychomotor agitation is common (e.g., pacing, fidgeting, tapping fingers) with restless movements and muscle tension evident. May display shakiness or tremors. |
| Mood and Affect | Affect is often irritable. Mood is often reported as “worried,” “on edge,” “nervous,” or “panicked.” Mood and affect are generally congruent. |
| Thought and Perception | Thought content is dominated by worry, anticipatory fear, or intrusive thoughts (especially in clients with OCD). Thought process may be circumstantial with excessive unnecessary details, tangents, and related ideas included before addressing the core topic. Perceptions are generally intact with no hallucinations. |
| Attitude and Insight | Often cooperative but may be guarded or overly compliant. May recognize thoughts as excessive or irrational (especially in clients with GAD or OCD), but still struggles to control them. |
| Cognitive Abilities and Level of Judgment | Usually intact, although attention and concentration may be impaired by excessive worry. Working memory and decision-making may be affected with severe anxiety or panic. |
Psychosocial Assessment
It is helpful to begin the psychosocial assessment by obtaining the reason why the client is seeking health care in their own words and focus on what factors could be contributing to their anxiety. For example, the client may identify a problem such as a relationship issue, stressful job, or school challenges that could be addressed by counseling.[3]
A comprehensive psychosocial assessment includes the following components:
- Reason for seeking health care (i.e., “chief complaint”)
- Cultural assessment
- Spiritual assessment
- Family dynamics
- Thoughts of self-injury or suicide
- Current and past medical history
- Current medications
- History of previously diagnosed mental health disorders
- Previous hospitalizations
- Educational background
- Occupational background
- History of exposure to psychological trauma, violence, and domestic abuse
- Substance use (tobacco, alcohol, recreational drugs, misused prescription drugs)
- Family history of mental illness
- Coping mechanisms
- Functional ability/Activities of daily living
After identifying the reason the client is seeking health care, additional focused questions are used to obtain detailed information. The mnemonic PQRSTU can be used to ask questions in an organized fashion. See Table 9.7b for a sample PQRST assessment for anxiety.
Table 9.7b Sample PQRSTU Questions for Assessing Anxiety
| PQRSTU | Sample Questions | Sample Client Response |
|---|---|---|
| Provocation/Palliation
|
“What makes your anxiety get worse?”
“What helps calm your anxiety?” |
“It usually gets worse when I have to speak in front of people or attend crowded events. Deep breathing and stepping outside help a bit.” |
| Quality | “Can you describe what it feels like when you have anxiety?” | “It feels like a heavy weight on my chest and my heart feels like it is skipping beats. My thoughts feel like they racing.” |
| Region | “Do you feel the anxiety in specific places in your body?” | “Mostly my chest and stomach feel tight. Sometimes I feel tingling in my hands or my legs feel shaky.” |
| Severity | “On a scale of 0 to 10, how bad is your anxiety right now?” | “Right now, it’s about a 3, but when I’m having a panic attack, it feels like a 10 and I feel like I’m going to die.” |
| Timing/Treatment
|
“When did the anxiety start? How long does it usually last? Is it constant or intermittent?”
|
“It started a few years ago in high school, but lately it’s gotten worse. I feel anxious every day. Panic attacks come on suddenly and last about 10–15 minutes.” |
| Understanding | “What do you think is causing your anxiety?” | “I think it started with stress from school and not wanting to fail.” |
Cultural Assessment
Cultural Formulation Interview (CFI) questions help nurses understand a client’s cultural background and how it influences their experience of mental health symptoms, including anxiety.[4] Sample CFI questions focused specifically on understanding anxiety within a cultural context include the following:
- Cultural Definition of the Problem
- “Can you tell me more about your experience of feeling anxious or nervous?”
- “What do you call these feelings or symptoms in your own words or language?”
- “What do people in your family or community think is going on when someone feels like this?”
- Cultural Perceptions of Cause, Context, and Support
- “Why do you think this anxiety started?”
- “Are there any stressors in your life or community that you believe contribute to these feelings?”
- “Do you believe your anxiety is related to physical health, spiritual issues, or emotional distress?”
- “What do others in your family or community (parents, elders, spiritual leaders) believe causes anxiety?”
- Cultural Factors Affecting Coping and Help-Seeking
- “How have you tried to deal with your anxiety so far?”
- “Are there any traditional practices, herbs, or dietary supplements you have tried to use to manage it?”
- “Have you sought help from community leaders, healers, or religious figures?”
- “What kinds of treatment or help do you think would be most useful or acceptable to you?”
- Cultural Features of the Nurse–Client Relationship
- “Are there any concerns you have about talking to a mental health professional?”
- “Would you feel more comfortable speaking with someone of a similar gender, cultural, or religious background?”
- “What would help you feel more supported or understood during treatment?”
Findings from the cultural formulation interview are used to individualize a client’s plan of care to their preferences, values, beliefs, and goals.
Cultural beliefs can affect an individual’s expression of their feelings of anxiety. An example of a culture-mediated response related to anxiety and panic disorder is ataque de nervios (ADN) or “attack of the nerves” that may be exhibited in Hispanic populations. Symptoms of ADNs can vary widely but are typically described as an experience of distress characterized by a general sense of being out of control. The most common symptoms include uncontrollable shouting, attacks of crying, trembling, and heat in the chest rising into the head. Suicidal gestures, seizures, or fainting episodes may be observed. These symptoms are reported to typically occur following a distressing event such as an interpersonal conflict or the death of a loved one.[5]
Spiritual Assessment
The FICA Spiritual History Tool is a widely used assessment model for evaluating a client’s spiritual beliefs and how they may influence health, illness, and coping. It’s especially helpful in understanding how patients with anxiety draw on spirituality or religion for support—or how spiritual distress may be contributing to feelings of anxiety. Spiritual distress is very common for clients experiencing serious illness, injury, or the dying process, and nurses assist clients to adopt healthy coping strategies to deal with these life events. Addressing a client’s spirituality and advocating spiritual care have been shown to improve clients’ health and quality of life, including how they experience pain, cope with stress and suffering associated with serious illness, and approach end of life.[6],[7]
The FICA Spiritual History Tool© is a common tool used to gather information about a client’s spiritual history and preferences. FICA© is a mnemonic for the domains of Faith, Importance, Community, and Address in Care.[8] Table 9.7v summarizes a sample FICA Spiritual Assessment for a client experiencing anxiety.
Table 9.7C Sample FICA Spiritual Assessment Questions For Clients With Anxiety
| Domain | Sample Assessment Question | Sample Client Response |
| Faith | “Do you consider yourself spiritual or religious? What gives your life meaning?” | “Yes, I believe in God. My faith gives me strength when I feel overwhelmed.” |
| Importance | “What importance does your faith or belief have in your life? Has it influenced how you cope with stress or your anxiety?” | “I believe that everything happens for a reason. I try to trust in God when I feel anxious, but sometimes I wonder if I’m being punished for something I have done.” |
| Community | “Are you part of a spiritual or religious community? Does participation in this community provide support when you’re feeling anxious or stressed?” | “Sometimes I go to church on Sundays. Being with others who have similar beliefs helps me feel less alone.” |
| Address in Care | “How would you like me (or the health care team) to address spiritual issues during your care? Would you like to speak with a chaplain?” | “Yes I would be interested in speaking to a chaplain.” |
Screening Tools
The Severity Measure for Generalized Anxiety Disorder in Adults is a common tool for measuring anxiety. High scores may indicate generalized anxiety disorder or panic disorder, although it can also be associated with major depressive disorder.
View the Severity Measure for Generalized Anxiety Disorder—Adult PDF screening tool.
Diagnostic and Lab Work
When assessing for anxiety disorders, the provider will typically order lab work to rule out common medical causes of anxiety, such as hyperthyroidism, hypoglycemia, hypercalcemia, hyperkalemia, hyponatremia, or hypoxia. Toxicology screen to identify potential substance abuse. Review and/or monitor the results of these tests as part of the nursing assessment.
Lifespan Considerations
Children and Adolescents
All children experience some anxiety, and anxiety is expected at specific times of a child’s development. For example, from approximately age eight months through the preschool years, healthy children may show anxiety when separated from their parents or caregivers, called separation anxiety. Young children also commonly have fears, such as fear of the dark, storms, animals, or strangers. Anxiety is considered normal when situational. Consider the fear of dangerous situations such as approaching a rattlesnake or standing on a steep cliff; at crucial times such as these, anxiety is important because it provides safety. Anxiety can also be also motivational if it drives clients to accomplish goals.
When a child is overly worried or anxious, a nurse’s initial assessment should determine if conditions in the child’s environment are causing this feeling. For example, is the anxiety resulting from being bullied or from adverse childhood experiences (ACEs)? If so, protective interventions should be put into place. If no realistic threat exists and the anxiety causes significant life dysfunction, then the child should be referred to a mental health provider to determine if an anxiety disorder exists.
Children with anxiety disorders are overly tense or fearful and their worries interfere with daily activities. Some children may require significant amounts of reassurance. Because anxious children may also be quiet, compliant, and eager to please, their feelings of anxiety can be easily missed. When a child does not outgrow the typical fears and anxieties in childhood or when there are so many fears and worries they interfere with school, home, or play activities, the child may be diagnosed with an anxiety disorder.
Anxiety can also make children irritable and angry and can include physical symptoms like fatigue, headaches, stomachaches, or trouble sleeping. Early treatment of anxiety disorders in children and adolescents can enhance friendships, social and academic potential, and self-esteem.
Older Adults
Anxiety disorders in older adults may be impacted by age-related physical, psychological, and social factors. Older adults may not use the word “anxiety”, but may instead describe feeling “worried,” “nervous,” “or “tense.” Some older adults may view anxiety or expression of their emotions as a personal weakness due to generational beliefs. Nurses can normalize mental health conversations and reduce stigma by framing care in terms of well-being, quality of life, and stress reduction. Hearing or memory issues may affect how an older adult responds to questions, so nurses should allow more time for responses. Death of a spouse, family members, or friends can lead to increased feelings of loss and isolation. It is often beneficial to include social engagement and reminiscence therapy in treatment of anxiety in older adults. Chronic illnesses like chronic obstructive pulmonary disease (COPD), cardiovascular disease, or diabetes mellitus can increase levels of anxiety due to medical concerns and may be compounded by issues like fear of falling, losing autonomy, or being placed in a long-term care setting. Symptoms of anxiety may be mistaken for signs of early dementia, such as restlessness and difficulty concentrating. Side effects from certain medications can also cause or worsen feelings of anxiety, such corticosteroids, bronchodilators, or stimulants. Benzodiazepines are not recommended for use by older adults to treat anxiety due to side effects of oversedation, confusion, and increased fall risk.
Diagnoses
Anxiety is a NANDA-I nursing diagnosis and described as “vague, uneasy feeling of discomfort or dread accompanied by an autonomic response; a feeling of apprehension caused by anticipation of danger. It is an alerting sign that warns of impending danger and enables the individual to take measures to deal with the threat.”[9] Review signs and symptoms of anxiety in the preceding “Assessment” subsection or consult an evidence-based nursing care plan resource for defining characteristics of this nursing diagnosis.
Outcomes Identification
The overall goal for clients experiencing anxiety is to reduce the frequency and intensity of the anxiety symptoms. SMART outcomes are individualized to the client’s specific diagnosed conditions, situational factors, and current status. Planning outcomes in small, attainable steps can help a client gain a sense of control over their anxiety.[10]
Examples of SMART outcomes include:
- The client’s vital signs will return to baseline within one hour.
- The client will identify and verbalize symptoms of anxiety by the end of the shift.
- The client will verbalize three preferred stress management and coping strategies for controlling their anxiety by the end of Week 1.
Planning Interventions
The client should be encouraged to participate in planning outcomes and interventions tailored to their situation and needs. This will increase the likelihood that the interventions will be successful. Keep in mind that clients with severe anxiety or panic may not be able to participate in planning and rely on the nurse to take a directive role.[11]
Safety
Immediately planning and implementing interventions to maintain client safety receive priority. Review interventions for clients with a risk for suicide in the “Application of the Nursing Process in Mental Health Care” chapter.
If a client’s anxiety continues to escalate and they become agitated, measures must be taken to keep them and others safe. The nurse may find that administering prescribed medications, initiating time in a quiet room, seclusion, or restraints is required. Review crisis intervention in the “Stress, Coping, and Crisis Intervention” chapter. Review information regarding the use of seclusion and restraints in the “Psychosis and Schizophrenia” chapter.
Mild to Moderate Anxiety
The nurse can reduce a client’s anxiety level and prevent escalation by providing a calm presence in a quiet environment, acknowledging their feelings of distress, and actively listening. Using therapeutic techniques like open-ended questions, distraction, exploring, and seeking clarification can be used to relieve the client’s feelings of tension and focus on previously successful coping strategies.[12] Review therapeutic communication techniques in the “Therapeutic Communication and the Nurse-Client Relationship” chapter.
It may be helpful to encourage the client to participate in physical activities that may provide relief from tension and increase endorphin levels. For example, the nurse can encourage the mildly anxious client to walk or play ping-pong.[13]
Severe Anxiety to Panic
A person experiencing severe anxiety to panic is often unable to solve problems or grasp what is going on in the environment. The nurse should also remain with a client experiencing acute, severe, or panic levels of anxiety. Therapeutic communication should focus on helping the client feel safe. Firm, short, simple statements using a slow, low-pitched voice are helpful.[14]
In addition to keeping the client and others safe, priority nursing interventions for a client experiencing severe anxiety focus on the client’s physical needs, such as fluids to prevent dehydration, blankets for warmth, and rest to prevent exhaustion. If a person continues to constantly move or pace despite interventions, high-calorie finger foods may be offered to maintain their nutrition.[15] Read additional interventions related to crisis intervention in the “Stress, Coping, and Crisis Intervention” chapter.
Implementation
Nursing Interventions for Anxiety Based on Categories of the APNA Implementation Standard
Nursing interventions for anxiety disorders can be categorized based on the American Psychiatric Nurses Association (APNA) standard for Implementation that includes the Coordination of Care; Health Teaching and Health Promotion; Pharmacological, Biological, and Integrative Therapies; Milieu Therapy; and Therapeutic Relationship and Counseling. Read more about these subcategories in the “Application of the Nursing Process in Mental Health Care” chapter. See examples of interventions for each of these categories for clients with anxiety disorders in Table 9.7d.
Table 9.7d Examples of Nursing Interventions for Anxiety by APNA Subcategories[16],[17]
| Subcategory of the APNA Standard of Implementation | The nurse will … | Rationale |
|---|---|---|
| Coordination of Care | – Collaborate with interdisciplinary team members to develop a comprehensive anxiety management plan. – Ensure continuity of care during transitions. – Facilitate referrals to specialists or community programs. |
Anxiety is often multifactorial, requiring input from various disciplines. Coordinated care ensures consistent, holistic support across settings and improves outcomes. |
| Health Teaching and Health Promotion | – Teach about the physiological signs of anxiety. – Teach stress management techniques (eating a healthy diet, avoiding caffeine and other stimulants, participating in regular physical activity, obtaining adequate sleep, using mindfulness activities).-Teach positive coping strategies (mediation, prayer, deep breathing exercises, grounding, yoga, journaling, mindfulness activities). |
Increasing the client’s understanding of the symptoms of anxiety helps empowers self-management. Lifestyle changes and coping strategies reduce physiological arousal and improve resilience. |
| Pharmacological, Biological, and Integrative Therapies | – Monitor effectiveness prescribed medications and for side effects. – Educate client and family members on medication purpose and adherence. – Support safe use of integrative therapies (e.g., mindfulness, aromatherapy). – Monitor for misuse of benzodiazepines. |
Pharmacologic treatment can reduce symptom severity. Patient education improves adherence and safety. Integrative therapies can enhance relaxation and overall well-being. Monitoring reduces the risk of adverse effects or dependence. |
| Milieu Therapy | – Maintain a calm and structured unit with minimal overstimulation. – Provide quiet, safe spaces for de-escalation. – Encourage participation in group therapy or activities. – Use environmental cues to reduce uncertainty. |
A structured, low-stimulation environment reduces external stressors and promotes emotional stability. Group participation fosters connection, reduces isolation, and models healthy coping behaviors. |
| Therapeutic Relationship and Counseling | – Establish trust and rapport using active listening and empathy. – Use therapeutic communication techniques. – Encourage expression of thoughts and fears. – Support realistic goal-setting and problem-solving. |
A strong nurse–client relationship and therapeutic communication provides emotional safety, fosters insight, and motivates engagement in treatment. |
Nursing Interventions for Physiological Signs of Anxiety
Nursing interventions also target common physiological signs of anxiety and associated self-care deficits. See common interventions for these conditions in Table 9.7e.
Table 9.7e Nursing Interventions Targeting Physiological Signs of Anxiety and Self-Care Deficit[18]
| Problem/Intervention | Rationale |
|---|---|
Nutrition
|
Anxiety may reduce appetite or lead to emotional eating. Caffeinated and high-sugar foods can exacerbate physiological arousal (e.g., palpitations, restlessness). Balanced nutrition supports energy, mood, and overall functioning. |
Sleep
|
Anxiety can cause difficulty falling asleep or staying asleep. Sleep deprivation worsens anxiety and impairs coping. Non-pharmacologic approaches promote better rest without dependence. |
Elimination
|
Autonomic arousal due to feelings of anxiety can disrupt gastrointestinal and urinary patterns. Supporting elimination helps reduce physical discomfort and increased levels of anxiety. Some medications (e.g., SSRIs) can affect bowel/bladder function. |
Self-Care Deficits
|
Anxiety can cause fatigue, low motivation, or avoidance, leading to neglected hygiene and self-care. Structured support helps maintain dignity, routine, and functioning. |
Communication Tips for Clients With Anxiety
Communicating effectively with someone experiencing severe anxiety must foster feelings of trust, safety, and therapeutic alliance. People in states of heightened anxiety may struggle to process information, express themselves clearly, or feel emotionally overwhelmed. Table 9.7f provides communication tips when speaking with clients with severe anxiety.
Table 9.7f Communication Tips for Clients With Severe Anxiety[19]
| Tip | Explanation |
| Use a Calm, Reassuring Tone | Speak slowly and in a steady, gentle voice. A calm tone can reduce the client’s arousal level and model a sense of control. |
| Keep Language Simple and Clear | Avoid complex instructions and medical jargon. Use short sentences and one idea at a time. Anxiety impairs concentration and memory, so information must be simplified. |
| Validate Feelings Without Dismissing Them | For example, validate feelings by saying things like “I can see this is really overwhelming for you,” or “It’s okay to feel scared.” Avoid saying “Calm down” or “You’re overreacting,” which can feel invalidating to the client. |
| Avoid Rapid-Fire Questions | Ask one question at a time and give the person time to respond. Allow silence for processing. Over-questioning can escalate anxiety and create cognitive overload. |
| Offer Grounding Techniques | Gently guide the person to the present: “Can you tell me 3 things you see in the room?” or “Let’s take a slow breath together.” This helps redirect their focus away from anxious thoughts. |
| Be Patient and Nonjudgmental | Avoid correcting or challenging irrational fears if a person is experiencing severe anxiety or panic. Focus on providing support and safety rather than using logic to try to dispel fear. Use therapeutic presence. |
| Respect Personal Space | Stay at a comfortable distance to avoid making the person feel trapped. Maintain non-threatening body language with a relaxed posture and uncrossed arms. |
| Provide Structure and Predictability |
Explain what you’re doing step by step: “I’m going to put this cuff on your arm to take your blood pressure now.” Uncertainty increases anxiety. |
| Encourage Autonomy and Choices |
Offer choices when possible (e.g., “Would you prefer to sit here or over by the window?”). Choices restore a sense of control that is often lost during severe anxiety. |
Evaluation
Nurses refer to the individualized SMART outcomes established for each client when evaluating the effectiveness of interventions in the care plan. In general, evaluation of goals for clients with anxiety disorders includes the following questions[20]:
- Is the client experiencing a reduced level of anxiety?
- Does the client recognize their symptoms are related to anxiety?
- Is the client successfully implementing adaptive coping strategies to manage their anxiety?
- Is the client adequately performing self-care activities (e.g., hygiene, eating, and elimination)?
- Is the client able to maintain satisfying interpersonal relationships?
- Is the client able to successfully function socially, occupationally, or in other important areas of functioning?
If the client outcomes or goals are not met or only partially met, the nursing care plan should be revised and reimplemented.
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
- DeSilva, R., Aggarwall, N. K., & Lewis-Fernandez, R. (2015). The DSM-5 cultural formulation interview and the evolution of cultural assessment in psychiatry. Psychiatric Times, 32(6). https://www.psychiatrictimes.com/view/dsm-5-cultural-formulation-interview-and-evolution-cultural-assessment-psychiatry ↵
- Keough, M. E., Timpano, K. R., & Schmidt, N. B. (2009). Ataques de nervios: Culturally bound and distinct from panic attacks? Depression & Anxiety, 26(1), 16-21. https://onlinelibrary.wiley.com/doi/10.1002/da.20498 ↵
- Pilger, C., Molzahn, A. E., de Oliveira, M. P., & Kusumota, L. (2016). The relationship of the spiritual and religious dimensions with quality of life and health of patients with chronic kidney disease: An integrative literature review. Nephrology Nursing Journal: Journal of the American Nephrology Nurses’ Association, 43(5), 411–426. https://pubmed.ncbi.nlm.nih.gov/30550069/ ↵
- Puchalski, C., Jafari, N., Buller, H., Haythorn, T., Jacobs, C., & Ferrell, B. (2020). Interprofessional spiritual care education curriculum: A milestone toward the provision of spiritual care. Journal of Palliative Medicine, 23(6), 777–784. https://doi.org/10.1089/jpm.2019.0375 ↵
- GW School of Medicine & Health Sciences. (n.d.). Clinical FICA tool. https://smhs.gwu.edu/spirituality-health/program/transforming-practice-health-settings/clinical-fica-tool ↵
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
- Ackley, B., Ladwig, G., Makic, M. B., Martinez-Kratz, M., & Zanotti, M. (2020). Nursing diagnosis handbook: An evidence-based guide to planning care (12th ed.). Elsevier. ↵
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
- Halter, M. (2022). Varcarolis’ foundations of psychiatric-mental health nursing (9th ed.). Saunders. ↵
