NURSING CARE PLAN

NAME OF PATIENT: _______________________________ AGE: ______ CIVIL STATUS: _________________

ADDRESS: _______________________________ ATTENDING PHYSICIAN: _____________________
CHIEF COMPLAINT: _______________________________

CUES RATIONALE OF
NURSING GOALS/OBJECTIVES NURSING THE NURSING EVALUATION
SUBJECTIVE OBJECTIVE DIAGNOSIS INTERVENTIONS INTERVENTION
 DRUG STUDY

NAME OF PATIENT: _______________________________ AGE: ______ CIVIL STATUS: _________________

ADDRESS: _______________________________ ATTENDING PHYSICIAN: _____________________
CHIEF COMPLAINT: _______________________________

DATE SIDE
ORDERED GENERIC NAME CLASSIFICATION DOSAGE MECHANISM OF INDICATIONS CONTRA- EFFECTS/ NURSING
(mm/dd/yy) (BRAND NAME) ACTION INDICATIONS ADVERSE IMPLICATIONS
EFFECTS RESPONSIBILITIES