K: Forms Nursing Forms Nursing Care Plan Form 2016

Patient's Initials: Age: Gender: Student Name: C.S. Mott Community College Date(s) Cared For (Month & Day only):_ Instructor's Name: Nursing Care Plan Form Course Number:_ Care Plan #:__

Nursing Diagnosis ***Clinical Reasoning *** Client Expected Outcomes Nursing Interventions Rationale Evaluation of (Actual- 3 parts; Risk For – Explain your rationale for choosing (short & long term) (with sources) Expected Outcomes 2 parts: Readiness for – 2 this nursing diagnosis. Include With Expected Outcome (Be clear: What/When or (include date/time) connections/relationships between How often/start with parts; include secondary to the parts of the n. dx. EX: how the Criteria as appropriate.) R/T caused the problem. Start with “Patient will” “Nursing will”)

Short Term:

Long Term:

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