CLINICAL WORKSHEET: NURSING PROCESS CARE PLAN

STUDENT NAME ___________________________________________________________ DATE __________________________

Social Determinants of Health: This header

can be placed above occupation. It includes
occupation, health insurance, current work
status, etc.
Unit Psychiatry ward Room/Bed: 12 Religion: Catholic faith Support system; Husband

Age 32 Sex: Female Language: English

Weight: 69kg Height: 5’2” BMI: Marital status: Married

27.8(overweight)

Current medical diagnosis: Depression Occupation: Banker Siblings: no

Health insurance: Yes Name of significant other/primary caregiver:

Dr Cavin Brown
Current work status: Unemployed

Highest grade completed: yes Genogram: Use back of page

Alcohol/Smoking/ Drug use/Sexual and

Reproductive health:

Diagnostic Data and Results: Depression

Patient has no strength, unemployed, homeless, and husband is jobless with children, culture aspect of care, patient brother and

and mother are not supportive. Family therapy might be needed.

Surgical procedures (current and past):

Bilateral Tubal ligation in 2007.

Past Health History:

Hypertension, Diabetes

4/2019
 History of Present Illness:

Patient reports being irritable and having occasional crying spells. She has trouble remembering things and low energy level. Appetite has been
Very poor. She has obstructive sleep apnea. She denies any suicidal ideations or thoughts. Often gets panic during which she becomes
tachycardiac, has difficulty taking a breath, elevated blood pressure. This panic mode she communicates comes after periods of not able to pay
Her bills.

Health Assessment

 Physical Assessment:
HEENT: The patient states that she needs eyeglasses but cannot afford to buy them. Last eye exam was two years ago. She has blurred vision,

Eye pain and redness. She reports no problem with hearing. She has no nasal congestion. Has complete set of teeth. She denies neck stiffness or
neck pain.
NEURO: No history of seizures. She was having migraine and headache.

CV: No chest pain or palpitations.

RESP: She denies difficulty breathing, however, when she starts having a panic attack.

GI: She reports recurrent epigastric pain, relieved with Prevacid. Patient has no history of liver disease. No nausea and vomiting, no blood in stool
or black tarry stool.

GU: She reports stress incontinence. Patient last gynecological examination was in 2013.

MUSCULOSKELETAL: She reports having chronic back pain. The patient has also right knee pain usually relieved by taking Cymbalta.

4/2019
 INTEG: No rashes, color changes or abnormalities of hair and nails.

ENDOCRINE: Hyperthyroidism

HEMATOLOGIC: reports no known hematological disorders.

Pathophysiology (please write in your own words) – Cite References in APA Baseline and current vital signs/Frequency
format BP=132/88
The underlying pathophysiology of major depressive disorder has not been
Pulse:82_____________________________
clearly defined. ____Respiration: 18
 Current evidence points to a complex interaction between neurotransmitter
availability and receptor regulation and sensitivity underlying the affective ____________________________________
symptoms Allergies/Side effects
____________________________________
 Clinical trials suggest a disturbance in central nervous system serotonin No food and environmental allergies.
activity as an important factor. ____________________________________
 Other neurotransmitter implicated include norepinephrine, dopamine,
glutamate and brain derived neurotropic factor. ____________________________________
 The role of CNS serotonin activity in pathophysiology of major depressive ____________________________________
disorder is suggested by the therapeutic efficacy of selective serotonin Diet with rationale:
reuptake inhibitors ____________________________________
 An interrogative model of late-onset depression points that age-related Fruits, vegetables and legumes because they
brain changes and disease related physiologic changes. have healthy carbs and fiber and they are
linked with mood-boosting chemical,
 Neurotransmitter availability and receptor regulation and sensitivity serotonin.
underlying the affective symptoms. ____________________________________

4/2019
 Cite Reference: Beans, tuna and chicken because they have
______________________________________________________________________________ an amino acid called tryptophan, which may
help in making
_______1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental serotonin.____________________________
______
Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
____________________________________
2. Garside RF., Kay DW., Wilson IC., Deaton ID., Roth M. Depressive syndromes and
the classification of patients. Psychol Med. 1971;1:333–38. ____________________________________

3. World Health Organization. The ICD-10 Classification of Mental and Behavioral ____________________________________

Disorders. Clinical Descriptions and Diagnostic Guidelines. Geneva, Switzerland: World Activity order
____________________________________
Health Organization; 1992.
____________________________________
_______________________________________________________________________
____________________________________
______________________________________________________________________________
____________________________________
______________________________________________________________________________ Limitations/prosthetic devices
____________________________________
______________________________________________________________________________ _____No_____________________________
__
______________________________________________________________________________
____________________________________
______________________________________________________________________________
____________________________________
______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________
Include all Pertinent Laboratory Include all Pertinent Laboratory Include all Pertinent Laboratory Include all Pertinent Laboratory
Data Results (normal and Data Results (normal and Data Results (normal and Data Results (normal and
abnormal) abnormal) abnormal) abnormal)
PERTINENT LABORATORY PERTINENT LABORATORY PERTINENT LABORATORY PERTINENT LABORATORY
DATA Lab Test #1 DATA Lab Test #2 DATA Lab Test #3 DATA Lab Test #4
____Glucose: 98mg/dl _____Cholesterol: ___________________________ ___________________________
_______________________ 168mg/dl____________________ Thyroid: Albumin: 4.5
__ Free T4(1.27mg/dl) ___________________________
___________________________ Triglycerides: 74mg/dl TSH (3.4mU/l)
Results within normal HDL: 55mg/dl ___________________________ Results: within normal

4/2019
 limit_________________
___________________________
___________________________
___________________________
___________________________
Rationale of abnormal results
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
INTRAVENOUS SOLUTION #1
Type ____________________________________________________
LDL: 110mg/dl
___________________________
Results: within normal
limit_____________________
___________________________
___________________________
___________________________
___________________________
Rationale of abnormal results
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
limit___________________
Results:
_____within normal ___________________________
limit________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________ Rationale of abnormal results
___________________________
___________________________
Rationale of abnormal results ___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
INTRAVENOUS SOLUTION #2
Type ____________________________________________________

ML/HR _________________________ gtts/min __________________ ML/HR _________________________ gtts/min __________________

Additives _________________________________________________ Additives _________________________________________________

Rationale for solution Rationale for solution

_________________________________________________________ _________________________________________________________

_________________________________________________________ _________________________________________________________

_________________________________________________________ _________________________________________________________

4/2019
 INTRAVENOUS SOLUTION #3 INTRAVENOUS SOLUTION #4
Type ____________________________________________________ Type ____________________________________________________

ML/HR _________________________ gtts/min __________________ ML/HR _________________________ gtts/min __________________

Additives _________________________________________________ Additives _________________________________________________

Rationale for solution Rationale for solution

_________________________________________________________ _________________________________________________________

_________________________________________________________ _________________________________________________________

_________________________________________________________ _________________________________________________________

4/2019
 MEDICATION DOSE / TIMES RATIONALE FOR THERAPEUTI NURSING CITATIONS
NAME ROUTE ADMINISTERE ADMINISTERING C RANGE FOR IMPLICATIONS
BRAND/GENERIC ORDERE D AGE/WEIGHT Required Patient
CLASSIFICATION D If Applicable Education
Wellbutrin 200mg/ Twice a day Depression  DO NOT take 2 doses at oroko FE, Maxwell RA. The
(bupropion) oral  bupropion acts via dual once. Avoid drinking pharmacologic basis for
alcohol or using illegal therapeutic interest in
inhibition of norepinephrine bupropion. J Clin Psychiatry.
drugs while you are
and dopamine reuptake, which taking bupropion 1983 44(sec 2). 67–73.
constitutes a novel mechanism because the beneficial
of antidepressant action effects of the medication
may be decreased and
the risk of seizures may
be increased.
Cymbalta 30mg/ oral Once a day Depression The  Do not drive, use Bailey RK, Mallinckrodt
(duloxetine) Duloxetine inhibits the recommended machinery, or do anything
CYMBALTA that needs alertness until
CH, Wohlreich MM, et al.
reuptake of serotonin and dosage is 60 mg you can do it safely. Duloxetine in the
norepinephrine (NE) in the once daily in Avoid alcoholic beverages treatment of major
central nervous adults with . depressive disorder:
system. Duloxetine increase fibromyalgia.
comparisons of safety
s dopamine (DA) specifically
and efficacy. J Nat Med
in the prefrontal cortex, where
Assoc. 2006;98:437–47. 
there are few DA reuptake
pumps, via the inhibition of
NE reuptake pumps (NET),
which is believed to mediate
reuptake of DA and NE.
Zestril (lisinopril) 20mg/ PO Once a day Hypertension Do not drive, use Warner NJ, Rush JE.
Lisinopril inhibits machinery, or do anything
that needs alertness until
Safety profiles of the
angiotensin-converting you can do it safely. angiotensin-converting
enzyme (ACE) in human Avoid alcoholic beverages enzyme
subjects and animals. ACE is . inhibitors. Drugs. 1988;3
a peptidyl dipeptidase that
5 Suppl 5:89-97.
catalyzes the conversion of
angiotensin I to the
vasoconstrictor substance,
angiotensin II. Angiotensin II
also stimulates aldosterone
secretion by the adrenal
cortex.
Hydrochlorothiazid 25mg/PO Once a day Hypertension Do not drive, use Sica DA, Carter B,
e Hydrochlorothiazide inhibits machinery, or do anything
Cushman W, Hamm L.
4/2019
 sodium chloride transport in
the distal convoluted tubule.
More sodium is then excreted
in the kidney with
accompanying fluid.
Metformin 800mg/PO Twice a day Diabetes
Metformin decreases hepatic
glucose production,
decreases intestinal
absorption of glucose, and
improves insulin sensitivity by
increasing peripheral glucose
uptake and utilization.
Zocor (Simvastatin) 20mg/PO Twice a day Cholesterol
Simvastatin is in a class of
medications called HMG-CoA
reductase inhibitors (statins).
It works by slowing the
production of cholesterol in
the body to decrease the
amount of cholesterol that
may build up on the walls of
the arteries and block blood
flow to the heart, brain, and
other parts of the body.
Ultram (tramadol) 75mg/PO Once a day GERD
Tramadol is a centrally
acting analgesic with a
multimode of action. It acts
on serotonergic and
noradrenergic nociception,
while its metabolite O-
desmethyltramadol acts on
the µ-opioid receptor. Its
analgesic potency is claimed
to be about one tenth that of
morphine.
Prevacid 15mg/PO Once a day GERD
(lansoprazole) Mechanism of Action
PREVACID (lansoprazole)
4/2019
that needs alertness until
you can do it safely.
Avoid alcoholic beverages
. Hypertens
Do not drive, use
machinery, or do anything
that needs alertness until
you can do it safely.
Avoid alcoholic beverages
. risk patients with type 2
The Limit alcoholic beverages.
recommended Daily use of alcohol may
dose for adult increase your risk for liver
patients with problems, especially when
severe hepatic combined with simvastatin
impairment is 50
mg every 12
hours.
Thiazide and loop
diuretics. J Clin
(Greenwich). 2011
Sep;13(9):639-43.
. Scheen AJ, Paquot N.
Metformin revisited: A
critical review of the
benefit-risk balance in at-
diabetes. Diabetes
Metab. 2013;39:179–90.
Kannel WB, Castelli WP,
Gordon T, McNamara PM:
Serum cholesterol,
lipoproteins, and the risk of
coronary heart disease. The
Framingham study. Ann
Intern Med. 1971
Jan;74(1):1-12. doi:
10.7326/0003-4819-74-1-1. 
Ultracet(TM), Tramadol/
paracetamol. Ortho-McNeil
Pharmaceutical, Raritan,
NJ,200
Kim KA, Kim MJ, Park
JY, Shon JH, Yoon YR,
Lee SS, Liu KH, Chun
 belongs to a class of JH, Hyun MH, Shin JG:
antisecretory compounds, the Stereoselective
substituted benzimidazoles, metabolism of
that suppress gastric acid lansoprazole by human
liver cytochrome P450
secretion by specific inhibition
enzymes. Drug Metab
of the (H+,K+)-ATPase Dispos. 2003
enzyme system at the Oct;31(10):1227-34. doi:
secretory surface of the 10.1124/dmd.31.10.1227.
gastric parietal cell.

MEDICATION DOSE / TIMES RATIONALE FOR THERAPEUTIC NURSING IMPLICATIONS CITATIONS

NAME ROUTE ADMINISTERED ADMINISTERING RANGE FOR Required Patient Education
BRAND/GENERI ORDERED AGE/WEIGHT If
C Applicable
CLASSIFICATION

4/2019
 NURSING THEORIST CITE REFERENCES
The Theory of Goal Attainment was developed by Imogene King in the early
1960s. It describes a dynamic, interpersonal relationship in which a patient
 Butts, J.B., & Rich, K.L. (2018). Philosophies and Theories for
grows and develops to attain certain life goals. The theory explains that Advanced Nursing Practice (3rd ed.). Burlington, MA: Jones &
factors which can affect the attainment of goals are roles, stress, space, and
time.
Bartlett Learning.
The model has three interacting systems: personal, interpersonal, and social.
Each of these systems has its own set of concepts. The concepts for the
personal system are perception, self, growth and development, body image,
space, and time. The concepts for the interpersonal system are interaction,
communication, transaction, role, and stress. The concepts for the social
system are organization, authority, power, status, and decision-making.

4/2019
 NURSING DIAGNOSES – NANDA
LIST IN PRIORITY ORDER (BEGINNING WITH #1 IN PRIORITY)
Self-care deficit related to severe anxiety as evidenced
by Awakening earlier or later than desired
Impaired Social Interaction related to Altered thought
processes as evidence by Dysfunctional interaction with
family, peers, and/or others
Chronic Low Self-Esteem related to Feelings of shame
and guilt as evidence by Negative view of self and abilities
Disturbed thought process related to Disturbed thought process
related to as evidence by Decreased problem-solving
abilities.
Hopelessness may be related to Losses, stressors, and
the burdensome symptoms of depression as evidence
4/2019
DESCRIBE RATIONALE FOR PRIORITY ORDER
UTILIZE THEORY (NEEDS THEORY/NURSING THEORY) FOR RATIONALE
The Health Promotion Model was designed by Nola J. Pender to be a
“complementary counterpart to models of health protection.” It defines health
as a positive dynamic state rather than simply the absence of disease.
Health promotion is directed at increasing a patient’s level of well-being. The
health promotion model describes the multidimensional nature of persons as
they interact within their environment to pursue health.
Betty Neuman’s Systems Model provides a comprehensive holistic and
system-based approach to nursing that contains an element of flexibility. The
theory focuses on the response of the patient system to actual or potential
environmental stressors and the use of primary, secondary, and tertiary
nursing prevention intervention for retention, attainment, and maintenance of
patient system wellness.
 The nurse makes a diagnosis by interpreting the data collected. The data
includes health-seeking behaviors, activity intolerance, ineffective coping,
and ineffective thermoregulation.
The Theory of Goal Attainment was developed by Imogene King in the early 1960s. It
describes a dynamic, interpersonal relationship in which a patient grows and develops
to attain certain life goals. The theory explains that factors which can affect the
attainment of goals are roles, stress, space, and time. The nursing diagnosis is
developed using the data collected in the assessment. In the process of attaining goals,
the nurse identifies problems, concerns, and disturbances about which the patient is
seeking help.
The Health Promotion Model was designed by Nola J. Pender to be a
“complementary counterpart to models of health protection.” It defines health
 by Impaired decision making as a positive dynamic state rather than simply the absence of disease.
Health promotion is directed at increasing a patient’s level of well-being. The
health promotion model describes the multidimensional nature of persons as
they interact within their environment to pursue health.

SAMPLE DIRECTION PAGE: Do not leave in when turning care plan into Faculty

ASSESSMENT DATA NURSING DIAGNOSIS PLAN INTERVENTIONS RATIONALE FOR EVALUATION

SUBJECTIVE/ NANDA OUTCOME CRITERIA (NURSE CENTERED) INTERVENTIONS
OBJECTIVE/ (CLIENT CENTERED) Cite References
CONTRIBUTING Must flow from Diagnosis
FACTORS and be individualized
Use a NANDA State the overall plan as Make the State the principle or Look at the outcome criteria.
diagnosis which has client centered, e.g.,: interventions nurse scientific rationale for
three (3) parts: centered. the nursing State whether the client
•"The client will..." intervention(s). achieved the outcome criteria,
•Part I: NANDA Indicate what the e.g.,
statement of nursing Relate the plan to the nurse will do to assist Include the reference
problem nursing diagnosis: the client in achieving for the rationale. "The client gained 2 lbs within
"Alternation in the outcome criteria, the past 7 days..."
nutrition: Less than e.g.,
body requirements" •."have adequate NOTE:
nutritional intake" •The nurse will..." If the outcome criteria was not
achieved or only partially
•Part 2: relating to a Indicate a measurable State frequency/time achieved, the nurse needs to go
nursing etiology: outcome criteria by /amount so any nurse back to the beginning, e.g., the
"relating to including time can carry out the "assessment" and make
inadequate nutritional frame/amount/range: plan: revisions or changes as
4/2019
 intake" necessary.
1) Document all food
•"as evidenced by..." intake for 3 days.
•Part 3: manifested by
the assessed signs 1) the ability to create a 2) Determine and
and symptoms: balanced meal plan by make available
"manifested by low day (7). client's favorite foods
body weight and by day 2.
emaciation." 2) gaining 1-2 lbs/wk
until FDA recommended 3) etc.
weight is achieved.

(3) etc.

ASSESSMENT DATA NURSING PLAN INTERVENTIONS RATIONALE FOR

SUBJECTIVE/ DIAGNOSIS OUTCOME CRITERIA (CLIENT (NURSE CENTERED) INTERVENTIONS
OBJECTIVE/ NANDA (North CENTERED) Cite References EVALUATION
CONTRIBUTING American Nursing Must flow from Diagnosis and be
FACTORS Diagnosis individualized
Asciation)
1.
 Use simple, concrete
Patient will process: words. Slow thinking and Patient is able to
Subjective data: Nursing Diagnose: difficulty concentrating process
Patient reports that “I have impair comprehension. information and
been feeling depressed, Disturbed Thought information and makes  Allow the client to have make appropriate
anxious, and under stress. Process appropriate decisions. plenty of time to think Slowed thinking decisions.
and frame responses. necessitates time to
Objective data: May be related to: May be related to:  Allow more time than formulate a response.
usual for the client to
BP: 138/88 Severe anxiety or Negative thoughts, anxiety and finish usual activities of
Resp: 18 depressed mood depressed mood. daily living. Usual task might take Patient is
Pulse: 88 long time; client’s hurry exhibiting
Temp: 98.8 F Possibly Evidenced  Help the client identify only increase anxiety. organized
Weight: 68kg by: Evidenced by: negative thought process.
Height: 5’3” thinking/thoughts.
Impaired ability to Patient will exhibit organized Teach the client to Interventions in helping Patient is now
Lack of eye contact grasp ideas or orders thought process. reframe and/or refute the clients in thoughts able to recall
Guarding behavior thoughts. negative thoughts. disturbance process recent and
Rejects negative  Help client and family provides healthier and remote
Patient will show improved mood
Stooped gait, slightly more useful outlook of life. information.
structure an
unkempt hair and nails Short Term goal: environment that can
Some agitations help re-establish set
observed because of After 4 to 8 hours of effective schedules and A fairly and non-
frequent wringing of nursing intervention patient would predictable routines demanding repetitive
4/2019
 hands during severe routine is easier to both
identify ways to compensate for depressions. follow and remember.
cognitive impairment.  Help the client to
Making rational major life
postpone important
decision requires optimal
Long term goal: major life decision psychophysiological
making. functioning.
After 2 to 3 days of effective
nursing intervention patient will be
able to exhibit organized thought
process.

ASSESSMENT DATA NURSING PLAN INTERVENTIONS RATIONALE FOR EVALUATION

SUBJECTIVE/ DIAGNOSIS OUTCOME CRITERIA (CLIENT (NURSE CENTERED) INTERVENTIONS
OBJECTIVE/ NANDA (North CENTERED) Cite References (APA)
CONTRIBUTING American Nursing Must flow from Diagnosis and be
FACTORS Diagnosis individualized
Association)
2. Nursing Diagnosis Short term goals:
Allow the patient to perform Paying attention to
Subjective data: Within 8 hours of duty the patient personal care activities. grooming serves ad a first Short term:
Patient reports that “I have Chronic Low Self- will gradually lessen her stress step towards achieving
been feeling depressed, Esteem related to feeling of shame. positive self-image. Patient showed
anxious, and under stress. less stress
Short term goals: Give positive feedback after a task Positive reinforcement related to her
Objective data: May be related to:. is achieved. has a big part in building current situation
Patient shows negative After 3 days of duty the patient will self-esteem. before.
forms of coping like show adaptation and verbalize
arguing Feelings of shame and acceptance of self in situation. Allow the patient to engage in Long term:
Inability to meet basic guilt. simple recreational activities. Patient may feel
needs including no time overwhelmed when Patient able to
for self-hygiene. participating in such adapted and
Possibly evidenced activities.
BP: 138/88 show accepted
by:
Resp: 18 herself and have
Rejection of positive To promote a healthier
Pulse: 88 Teach visualization techniques positive self-
feedback and more realistic self-
Temp: 98.8 F that can help the client replace esteem.
Weight: 68kg negative self-images with more image by helping the
Height: 5’3” positive images and thought client choose more

4/2019
 positive thoughts and
actions.

Evaluate client’s need for Low self-esteem

assertiveness training tools to
pursue things he or she wants or
needs in life. Arrange for training
through community-based
programs, personal counseling,
literature etc.
individuals often have
feelings of unworthiness
and have difficulty
determining their needs
and wants.

3.
Nursing Diagnosis
Subjective data: Short term goals: Depressed people lack
Patient reports that “I have After 30 minutes of nursing concentration and
been feeling depressed, Impaired Social intervention the client will be able Initially, provide activities that The patient will
require minimal concentration memory. Activities that
anxious, and under stress. Interaction to verbalizing feeling that lead to have no “right or wrong” be able to
poor social interaction. (e.g., drawing, playing simple verbalizing
board games). or “winner or loser”
minimizes opportunities feeling that lead
Objective data: for the client to put to poor social
May be related to: interaction
himself/herself down.
BP: 138/88
Resp: 18
Pulse: 88 Altered thought
Patient will
Temp: 98.8 F processes. Maximizes the potential participate in
Weight: 68kg for interactions while certain
Height: 5’3” Long term goals: When the client is at the most
Possibly evidenced
by: After 5 days of nursing intervention depressed state, Involve the client minimizing anxiety levels. community social
in one-to-one activity. activities (eg
Discomfort in social the client will voluntarily spend leisure activity,
situation time with other clients and nurse or Socialization minimizes church member).
Verbalized discomfort therapist in group activities Involve the client in gross motor
activities that call for very little feelings of isolation and
Do not ask question in social situations increase feelings of self-
concentration. Patient will
worth.
Observed lack of attention participate in one
during social activities. activity by the
Eventually maximize the client’s Contact with others
end of the day.
contacts with others (first one distracts the client from
other, then two others, etc.). self-preoccupation.

4/2019
 The client and family can Patient
gain tremendous support
Refer the client and family to self-
and insight from sharing will discuss two-
help groups in the community.
their experiences. three alternative
ways to take
when feeling the
need to
withdraw.

Discharge Plan / Patient Teaching

The patient will return in two weeks to the clinic for follow up visit.  The patient will continue taking medications as prescribed to help manage her
anxiety and depression. Patient has been given the emergency access phone number to the local crisis center and encouraged to call 911 if
symptoms become severe. The patient will continue with treatment at this clinic.

4/2019
Reference of FIRST Nursing diagnose:

  American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric
Association; 1994.
  Garside RF., Kay DW., Wilson IC., Deaton ID., Roth M. Depressive syndromes and the classification of patients. Psychol Med. 1971;1:333–
38.
 World Health Organization. The ICD-10 Classification of Mental and Behavioral Disorders. Clinical Descriptions and Diagnostic Guidelines.
Geneva,
 Boyd, M. A. (Ed.). (2008). Psychiatric nursing: Contemporary practice. lippincott Williams & wilkins.
 Keltner, N. L. (2013). Psychiatric nursing. Elsevier Health Sciences.
 Videbeck, S. L. (2010). Psychiatric-mental health nursing. Lippincott Williams & Wilkins.
 Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse’s pocket guide: Diagnoses, prioritized interventions, and rationales. FA
Davis.
 Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences.

Reference of second nursing diagnose:

 Boyd, M. A. (Ed.). (2008). Psychiatric nursing: Contemporary practice. lippincott Williams & wilkins.
 Keltner, N. L. (2013). Psychiatric nursing. Elsevier Health Sciences.
 Videbeck, S. L. (2010). Psychiatric-mental health nursing. Lippincott Williams & Wilkins.
 Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse’s pocket guide: Diagnoses, prioritized interventions, and rationales. FA
Davis.
 Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. 

Reference of third nursing diagnosis:

 Boyd, M. A. (Ed.). (2008). Psychiatric nursing: Contemporary practice. lippincott Williams & wilkins.

 Keltner, N. L. (2013). Psychiatric nursing. Elsevier Health Sciences.

 Videbeck, S. L. (2010). Psychiatric-mental health  nursing. Lippincott Williams & Wilkins.

4/2019
  Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse’s pocket  guide: Diagnoses, prioritized interventions, and rationales. FA
Davis.

 Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. 

4/2019