NURSING CARE PLAN

Name of Patient ________________________________________________

Age __________ Sex ___________ Civil Status ______________________

Nationality_________________________

Occupation _________________________

Date of Admission _____________________________Chief Complaint / Diagnosis _________________________________________________________________

Brief History

CUES

Nursing Diagnosis

Scientific
Explanation

Nursing Objective

Nursing Intervention

Scientific
Explanation

Evaluation

Name of Student ____________________________________________

Rating _________________________________

Year / Section _________________________

________________________________________
Clinical Instructor
667 F.T. Dalupan Sr. St., Sampaloc, Manila Philippines
www.marychilescollge.edu.ph / marychilescollege@gmail.com
Tel. 711 - 4233, 735-5341 to 45

Print Name & Signature

667 F.T. Dalupan Sr. St., Sampaloc, Manila Philippines

www.marychilescollge.edu.ph / marychilescollege@gmail.com
Tel. 711 - 4233, 735-5341 to 45