Name of patient: Student’s Name: Date:

Age: Gender: Clinical Instructor:

Medical Diagnosis: Clinical Area:
Physician: Rm #:

SUBJECTIVE OBJECTIVE NURSING SCIENTIFIC PLANNING INTERVENTIONS RATIONALE EXPECTED

CUES CUES DIAGNOSIS REFERENCE OUTCOME
.
 St. Paul University Dumaguete
Dumaguete City
College of Nursing
S.Y. 2010- 2011

In partial fulfilment
of the requirements in Related Learning Experiences

Nursing Care Plans

Submitted by:

Syra M. Tropezado
BSN- III B

Submitted to:

________________________
Clinical Instructor