Student Name:
NURSING CARE PLAN FORM
Patient Idenfier:
Patient Medical Diagnoses:
Nursing
Diagnoses: Excess
fluid volume
related to
decreased urine
output, dietary
excesses, and
retention of
sodium and water
Assessment Data
(include five
subjective and or
objective pieces of
data that lead to
the Nursing
diagnosis)
Date:
Subjective Data
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

Objective Data
Hypertension




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
Goals & Outcomes
(Two statement are require
for each nursing diagnosis.
Must patient and or family
focus; measurable, time
spacific and reasonable)
Nursing
Intervention
(List at least
three nursing
with
collaborative
interventions
with rational
for each
goals and
outcomes)
Rational
(Provide reason
why interventions
is necessary and
provide referances
as well)
Outcomes
evaluation
and
Planning