Table 1.

1
Problem:
Criteria Standard Score Weight Actual Justification
Score
Nature of the Health Deficit 3 1
Problem
Health Threat 2 1 2/3

Foreseeable Crisis/ Stress Point 1 1/3

COMPUTE

Modifiability of Removable 2 1
the Problem
Partially Modifiable 1 2 1/2

Not Modifiable 0 0
COMPUTE

Preventive High 3 1
Potential Moderate 2
Low 1 1 2/3

1/3
COMPUTE

Salience of the Needs Immediate Attention 2 1 1

Problem
Does not Need Immediate Attention 1 ½

Not a Problem 0 0
COMPUTE

TOTAL SCORE:

Copy and paste this circle to the number you will encircle. Example for computation: 2/3 x 1= 0.66
Table 1.2
Cues Health Problem Family Nursing Goals Objectives Intervention/ Rationale Resources Evaluation
Problem Methods/ Required
Family Contact
Subjective: (If there are more - - - - -
- than one due to, - - - - -
- use “-“ as a - - - - -
- bullet.)
Objective:
-
-
-