MS II Hematology

PATIENT CARE PLAN

STUDENT DATE

Patient Initials AGE SEX ADMITTING DX

OTHER MEDICAL DX

NURSING DIAGNOSIS

(in priority order)

PATIENT-CENTERED

GOALS

NURSING

INTERVENTION

RATIONALE

EVALUATION

___________________ ___________________ ___________________ __________________ related to ___________________ ___________________ ___________________ ___________________ __________________ As evidence by ___________________ ___________________ ___________________ ___________________

Short term goal 1. Long term goal 2.

Dependent intervention 1. Independent intervention

STG 1. LTG 2.

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