Student Name:

Patient Initials:

Nursing Diagnosis:

Related to:

As evidenced by:

NRSE 4570 – Diversity

Nursing Care Plan

Assessment

(Subjective & Objective Data Supporting Nursing Dx)

Planning Goal

Desired Outcome (2)

(Specific/Measurable/time-limited)

Implementation

(Interventions performed to meet goals)

Minimum 3 per outcome

(Independent, Dependent, Collaborative)

Rationale

(Reason for Interventions & citation of source)

Evaluation of Goal

(Goal met or unmet) Support statement with assessment data

Pertinent Data:

Patient Will:

Nurse Will:

Why:

What Happened: