NURSING CARE PLAN

STUDENT NAME: _______________________________________ INSTITUTION:______________________________________________ AREA: ______________________

TEACHER NAME: __________________________________

PATIENT IDENTIFICATION

ID NUMBER: ____________________ AGE: _______ GENDER:____ REGIME: _______

PRIMARY MEDICAL DIAGNOSTIC AND SECONDARY MEDICAL DIAGNOSTIC: _______________________________________________________________________________

__________________________________________________________________________________________________________________________________________________

DOMAIN: INDICATORS MEASURING SCALE EVALUATION:

DOMAIN: CLASS: NURSING DIAGNOSIS:
1. 1. Deeply committed .
2. Substantially committed .
CLASS: 3. Moderate committed
4. Slightly committed
5. Not committed

NOC RESULT:
Initial score:_________
2.
Final score:__________

3.

CLASSIFICATION OF NURSING INTERVENTIONS. NIC 1 CLASSIFICATION OF NURSING INTERVENTIONS. NIC 2

CAMP NIC 1: CLASS NIC 1: CAMP NIC 2: CLASS NIC 2:

INTERVENTION (NIC 1): SCIENTIFIC PRINCIPLE NIC 1: INTERVENTION (NIC 2): SCIENTIFIC PRINCIPLE NIC 2:

ACTIVITIES NIC 1 ACTIVITIES NIC 2