CAPITOL UNIVERSITY

COLLEGE OF NURSING
Name of Student: ______________________________________________
Name of Patient: _______________________________________________

Date of Assignment: ___________________________
Ward: ____________________ Bed No. ___________

NURSING CARE PLAN
ASSESSMENT DATA
(Subjective & Objective
Cues)

Issue: 05 April 2006

NURSING DIAGNOSIS
(Problem and Etiology)

GOALS AND OBJECTIVES

NURSING INTERVENTIONS AND
RATIONALE

EVALUATION

Revision Code : 003
CU-ARXE-NURSING-0018