HOLY NAME UNIVERSITY

COLLEGE OF NURSING
City of Tagbilaran

NURSING CARE PLAN

Name of Patient: ________________________________________ Age: _______ Status: _____________ Sex: _______

Address: ___________________________________ Date of Admission: _______________________ Ward: ___________________ Bed No: ____________
Impression:__________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________

ASSESSMENT PLANNING INTERVENTION

PROBLEM CUES/NRSG. DX RATIONALE DESIRED GOAL BEHAVIORAL OBJECT NURSING ACTION RATIONALE EVALUATION

ASSESSMENT PLANNING INTERVENTION

PROBLEM CUES/NRSG. DX RATIONALE DESIRED GOAL BEHAVIORAL OBJECT NURSING ACTION RATIONALE EVALUATION
HOLY NAME UNIVERSITY
COLLEGE OF NURSING
City of Tagbilaran
 DRUG STUDY

Name of Patient: ________________________________________ Address: ___________________________________ Impression:_______________________

Date Admitted: ________________________ Ward: ___________________ Room: ____________ Status: ___________ Age: __________ Sex: ____________

Date Brand Generic DOSAGE Route & CLASSIFICATION: MECHANISM INDICATION CONTRA NURSING EVALUATION
Ordered Name Name Frequency OF ACTION INDICATIONS RESPONSIBILITIES

Date Brand Generic DOSAGE Route & CLASSIFICATION: MECHANISM INDICATION CONTRA NURSING EVALUATION
Ordered Name Name Frequency OF ACTION INDICATIONS RESPONSIBILITIES