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NUR 200 -1- Nursing Care Plan

University of Maine at Fort Kent


Division of Nursing
Wholistic Nursing Care Plan Based on Gordon’s Functional Health Patterns

Students will develop a nursing care plan for Morrie Schwartz (Albom, 2002), using Gordon’s Functional Health Patterns. Your
completed care plan will demonstrate your use of the nursing process: assessment, diagnosis, planning, intervention, and evaluation. In
preparing this care plan, imagine yourself to be a visiting nurse involved in Morrie’s care. Because Morrie’s condition deteriorated as
the book progressed, we will consider today to be where Morrie is as of page 100. Your introduction of Morrie must identify this point
at which your care plan was developed in Morrie’s health and illness trajectory.

As part of your care plan preparation, you will be integrating current standards and best-practice guidelines to ensure that the care
outlined for Morrie is evidence-based. That means you will be using your text as a reference. I have also provided an article about
ALS to give you some background in the illness. The article gets a little technical, don’t let that bog you down.

The format for the care plan is listed below— be sure to use the table format for each of the components of the care plan. Each section
is compartmentalized for ease of constructing your care plan together. You do not need to have a diagnosis under each category. When
you are done you should have 6 diagnoses – 2 actual, 2 risk, 1 health promotion or wellness and either one syndrome or one possible
(your choice). Be sure to be concise, comprehensive, and thorough.
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Holistic Nursing Care Plan

Client: Morris Schwartz Albom, M. (2002). Tuesdays with Morrie. New York: Broadway Books.

Age: 78 Medical Diagnoses

Date Introduction and Context of Patient


Briefly describe the patient’s age, medical diagnosis, prognosis, family members, social history, and effect of illness on family system;
Morrie’s Health Goal/Priority and Nurses’ Health Goal/Priority

Date Assessment Data Nursing Expected Outcomes Nursing Interventions Rationale Evaluation Criteria
Diagnosis
Nutritional- Imbalanced  Patient maintains 1. Ascertain 1. Experts like
Metabolic Pattern nutrition: less weight or does healthy body a dietician
than body not continue to weight for age can
requirements lose weight. and height. determine
related to  Patient shows Refer to a nitrogen
decreasing no signs of dietitian for balance as a
muscle/neural malnutrition be complete measure of
functioning of specific. nutrition the
jaw and  Patient takes assessment and nutritional
swallowing adequate methods for status of the
mechanism as number of nutritional patient. A
evidenced by calories or support. negative
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reluctance to nutrients. What 2. nitrogen


chew solid food is adequate? Be balance may
specific, mean protein
measurable. malnutrition.
The dietician
can also
determine the
patient’s
daily
requirements
of specific
nutrients to
promote
sufficient
nutritional
intake.
2.
Pattern of Risk for
Elimination aspiration related
to depressed
cough/gag
reflexes and
impaired
swallowing
Pattern of Health Ineffective  Patient’s 1. Provide 1. Order
Perception and breathing pattern breathing respiratory medications
Health related to pattern is medications and oxygen
Maintenance impaired muscles maintained as and oxygen, needed to be
of breathing as evidenced by per doctor’s given on
evidenced by … eupnea, normal orders. time.
skin color, and 2. Monitor vital 2. Frequent
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regular signs, monitoring


respiratory respiratory of vital signs,
rate/pattern. status, and oxygen
 Patient pulse saturation,
indicates, either oximetry. and
verbally or 3. Check skin respiratory
through color for blue efforts can
behavior, color/cyanosis alert the
feeling 4. Listen to nurse and
comfortable breath sounds doctor to a
when breathing. q shift or change in
 Patient reports more often if condition.
feeling rested needed 3. Always
each day. immediately
report
cyanosis to
the inside of
the mouth,
this is a
medical
emergency.
Blue
discoloration
to the
extremities
may just
show
inadequate
perfusion
4. Listen to
breath
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sounds with
each
assessment
throughout
the day, or
with any
change of
condition
Pattern of Impaired Physical  Patient 1. Be careful when 1. The most
getting a mostly important
Activity & Mobility related demonstrates immobile client preventative
Exercise to decrease the use of up. Be sure to measure to
muscle control as adaptive lock the bed and reduce the risk
wheelchair and of injurious
evidenced devices to have sufficient falls for
by inability to increase personnel to nonambulator
control lower mobility protect client y residents
from falls. involves
extremities.  Patient 2. Identify clients increasing
evaluates pain likely to fall by safety
placing a "Fall measures
and quality of Precautions" while
management sign on the transferring,
 Patient uses doorway and by including
keying the careful locking
safety measures Kardex and of equipment
to minimize chart. Use a such as
potential for "high-risk fall" wheelchairs
arm band and and beds
injury room marker to before moves
alert staff for (Thapa et al,
increased 1996). These
vigilance and immobile
mobility clients
assistance. commonly
3. Routinely assist sustain the
client with most serious
toileting on his or injuries when
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her own they fall.


schedule. Always 2. These steps
take client to alert the
bathroom on nursing staff
awakening, of the
before bedtime, increased risk
and before of falls.
administering 3. The majority of
sedatives. Keep falls are
the path to the related to
bathroom clear, toileting. It is
label the more
bathroom, and acceptable to
leave the door fall than to
open. "wet yourself."
Studies have
indicated that
falls are often
linked to the
need to
eliminate in a
hurry
Cognitive- Risk for infection
Perceptual related to
Pattern prolonged
immobility

Pattern of Sleep
and Rest

Pattern of Self-
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Perception and
Self-Concept

Role- …
Relationship
Pattern

Sexuality-
Reproductive
Pattern

Pattern of Coping Readiness for


and Stress enhanced
Tolerance Coping
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Pattern of Values
and Beliefs

Summary and Conclusion