Care Plan for (insert condition)

Student Name: Patient: Admission Diagnosis/History: Age: Sex: Current Date: Dates Care Given:

Nursing Diagnosis:

ASSESSMENT Objective Data Potential Complications: Subjective Data

Expected Outcome

GOALS Outcome Criteria

TD

DA

TD: Target Date

DA: Date Achieved

NURSING INTERVENTIONS Interventions Rationale

Evaluation:

Signature:

_____________________________________

Date:

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