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NCP Format

This document is a nursing care plan template for a patient from Polytechnic College of Davao del Sur. It includes fields for the patient's name, age, sex, civil status, occupation, religion, address, ward, room number, bed number, date of admission, chief complaint, cues, needs, nursing diagnosis, scientific basis, goals, objectives, nursing intervention, rationale, and evaluation. It will be used to track a patient's care and progress while admitted.

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22 views3 pages

NCP Format

This document is a nursing care plan template for a patient from Polytechnic College of Davao del Sur. It includes fields for the patient's name, age, sex, civil status, occupation, religion, address, ward, room number, bed number, date of admission, chief complaint, cues, needs, nursing diagnosis, scientific basis, goals, objectives, nursing intervention, rationale, and evaluation. It will be used to track a patient's care and progress while admitted.

Uploaded by

shyavidah
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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POLYTECHNIC COLLEGE OF DAVAO DEL SUR

MacArthur Highway, Brgy. Kiagot, Digos City, Digos City, Philippines 8002
NURSING CARE PLAN
Name of Patients: ____________________ Attending Physician: .
Age: Sex: Civili Status: Diagnosis: .
Occupation: Religion: .
Address: Chief Complaint: .
Ward: Room No.: Bed No.: Date of Admission: .

Date & CUES NEEDS NURSING SCIENTIFIC BASIS GOALS OBJECTIVE NURSING RATIONALE EVALUATION
time DIAGNOSIS CRITERIA INTERVENTION

Student Name: Year & Sec: Group No.: Rating: .


Reference: .
Criteria: Promptness (5%) Objectives of Care (10%)
Format/Neatness (15%) Nursing Action (30%)
Assessment (15%) Evaluation (10%)
Nursing Diagnosis (15%) Clinical Instructor: .
POLYTECHNIC COLLEGE OF DAVAO DEL SUR
MacArthur Highway, Brgy. Kiagot, Digos City, Digos City, Philippines 8002
NURSING CARE PLAN
Name of Patients: ____________________ Attending Physician: .
Age: Sex: Civili Status: Diagnosis: .
Occupation: Religion: .
Address: Chief Complaint: .
Ward: Room No.: Bed No.: Date of Admission: .

Date & CUES NEEDS NURSING SCIENTIFIC BASIS GOALS OBJECTIVE NURSING RATIONALE EVALUATION
time DIAGNOSIS CRITERIA INTERVENTION

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