Wesleyan University – Philippines

College of Nursing and Allied Medical Sciences

Tel No. (044) 463-2162; Fax No 463-0596 local 126

N u r s i n g C a r e P l a n
NAME: __________________________________________________________________ GROUP NO: ______________ BLOCK: ______________ DATE: ______________

NAME OF PATIENT: ________________________________________________________ MEDICAL DIAGNOSIS: ____________________________________________________________

ASSESSMENT NURSING DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Independent Nursing Actions:
“ Nagmamanas ang Excess Fluid volume After of nursing
mukha ng anak ako” as related to failure of intervention the 1. Assess fluid status Assessment provides Goal met.
vervalized by the regulatory mechanism patient will a. Daily weight baseline and ongoing
patient’s mother (inflammation of demonstrate b. Monitor I & O database for monitoring
glomerular membrane compliance with c. Skin turgor and presence of edema changes and evaluating
Subjective: inhibiting filtration) dietary and fluid d. BP, PR,RR interventions
(+) facial edema evidenced by facial restrictions
BP:90/60 mmHg edema. 2. Limit fluid intake to prescribe Fluid restriction will be
Temp: 36.8 ℃ volume and explain to family the determined on basis of
Weight: 23.5 Kg rationale weight, urine output and
response to therapy.
Dependent Nursing Actions:

Give furosemide as prescribed by the Furosemide helps in

physician facilitating urine

Collaborative Nursing Actions:

NOTE: This NCP Form must be accomplished in handwriting.

Clinical Instructor: __________________________________________________ RLE Coordinator: ____________________________________________________