Individualized Healthcare Plan
Medical Diagnosis:
Heart Condition
Brownsville ISD: Health Services
Student Name:
DOB:
School Nurse:
Date of IHP:
NURSING DIAGNOSIS
1. Risk for Activity intolerance related to
cardiac insufficiency secondary to
2. Risk for decreased cardiac output
related to altered cardiac function
secondary to
STUDENT GOALS
1. Student will maintain optimal activity
level in the school setting.
.
Home Campus:
PLAN OF ACTION
BY WHOM/WHEN
EXPECTED OUTCOMES
1. Request physician direction for activity
level : encouraged activities and activity
restriction.
School Nurse – as needed
Student will identify three signs that
he/she is exceeding his/her exercise
tolerance.
2. Collaborate with physician, parents and
teachers to establish exercise activities
that meet encouraged and restricted
activities.
School Nurse, Classroom teacher - as
needed.
Student will participate in physical
education, with modified activities.
3. Assist teachers to modify activities, as
needed.
School nurse
Student will tell his/her teacher if he/she is
having shortness of breath. Student will
identify and describe his/her symptoms.
4. Assist teachers to assess for signs and
symptoms of increasing shortness of
breath and fatigue.
School Nurse
5. Discuss with student:
 The signs and symptoms of
increasing fatigue and shortness of
breath.
 What the symptoms mean
 The need to stop activity if the
symptoms occur.
 Student will participate in activities,
with peers, at school.
School Nurse, classroom teacher – ongoing
1. Student will notify his/her teacher or the
school nurse when he/she feels his/her
heart pounding or racing.
1. Develop an emergency care plan in
collaboration with student, his parents and
healthcare providers.
School Nurse, family – ongoing
2. Student will have in place an emergency
care plan.
2. Teach student:
 Signs and symptoms to report
 What these symptoms mean
 How to report his/her signs and
symptoms to parents, teachers,
and school health staff.
School Nurse
Classroom teacher as needed.
3. Provide special health needs form to all
teachers who work with student including:
 Signs and symptoms of cardiac
dysfunction
 Emergency care plan
Student reports an episode of racing or
pounding heart to parent, teacher, or
school health staff immediately.
Cardiovascular Disorder Health Care Plan
NURSING DIAGNOSIS
3. Knowledge deficit pertaining to specific
diagnosis, treatment plan and medical
regimen.
STUDENT GOALS
1. Student will increase knowledge about
his/her cardiovascular problem and
medical regimen plan.
2. Student will follow his prescribed diet,
restrictions and treatment plan during the
school day.
PLAN OF ACTION
BY WHOM/WHEN
1. Assist student and his parents to utilize
resources for information, discussion, and
support regarding cardiovascular disease
and medications.
School Nurse/Counselor – ongoing
2. Assist student and his parents in finding
resources for nutritional discussion to
further promote heart health.
School Nurse/Counselor – ongoing
EXPECTED OUTCOMES
Student will adhere to his/her medication
regimen plan.
Student will maintain weight within normal
limits for his/her age.