DEPARTMENT OF NURSING

Nursing Care Plan

 

Student Name:

Course number:

Health care agency:

Date of Care:

Patient’s initials:

Patient’s room:

Age:

Developmental state:

Instructor:

 

Medical diagnosis:  EXPLAIN PATHOPHYSIOLOGY AND INCLUDE STRUCTURAL FUNCTIONAL CHANGES THAT THE DISEASE CAUSES:

 

 

 

 

 

 

Explain significance of operative procedure, lab data, and/or special diagnostic test or procedures:

 

 

 

 

 

 

 

 

Instructor’s comments:

 

 

 

ASSESSMENT

Universal Self

Care Requisites

NURSING DIAGNOSIS

Problem, Etiology, Symptoms

 

GOALS

 

PLANNING

INTERVENTIONS

 

SCIENTIFIC RATIONALES

 

EVALUATION

Self Care Agency (SCA):

 

 

 

 

 

 

 

 

Self Care Deficit (SCD)

SCD’s:

 

 

 

 

 

 

 

 

Nursing agency:

Wholly compensatory

Partially compensatory

Supportive-educative

 

 

P:

 

 

 

 

E:

 

 

 

 

 

S: