MCN Form 016

Lyceum of the Philippines University

College of Nursing

NURSING CARE PLAN

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION
Subjective Data: -Insomnia related to Patient will Identify poor sleep The use of electronics After 1 day of nursing
“nahihirapan ako sa pag ihi” as Poor sleep hygiene identify factors hygiene behaviors. before bed, napping interventions, the patient
verbalized by the patient as evidenced by contributing to during the day, irregular will be able to:
Restless sleep. poor sleep bedtimes, caffeine intake Report averaging
Objective Data: patterns. too late in the day, and 7-9 hours of
-Observed tiredness, mood sedentary lifestyles restful sleep per
changes, lack of energy Patient will contribute to inadequate night.
report averaging sleep.
7-9 hours of Report feeling
restful sleep per Assess when the patient rested and
night. normally goes to bed, energized upon
what time they wake up, waking.
Patient will how long it takes them to
report feeling fall asleep, and how many
rested and times they wake up during
energized upon the night to provide
waking. Assess sleep patterns. baseline data.

Chronic pain
And incontinence can
interrupt sleep patterns.
Acute and chronic
diseases and conditions
should first be identified as
these cannot always be
adjusted.
 MCN Form 016

Lyceum of the Philippines University

College of Nursing

Identify health
conditions contributing
to insomnia.