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West Visayas State University

COLLEGE OF NURSING
Luna St., La Paz, Iloilo City 5000
Iloilo, Philippines
* Trunkline: (063) (033) 320-0870 to 78 loc. 1313 * Telefax No.: (033) 320-0879
* Website: www.wvsu.edu.ph * Email Address: con@wvsu.edu.ph

NURSING CARE PLAN


Name of Patient:_________________ Attending Physician:________________
Age:____________ Ward/Bed Number:________________ Impression/ Diagnosis:______________

Clustered Cues Nursing Diagnosis Rationale Outcome Criteria Nursing Rationale Evaluation
Interventions

Date and Time:

Students Name:_____________________________________________
Clinical Instructor:_____________________________________________

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