Brenda Patton care plan vsim
Today’s Assessment .1OLUTION #INTRAVENOUS SINTRAVENOUS SOLUTION #2Typen IV)Lactate Ringers’ (maiType)ml NS (piggyback500cc/hr125gtts/mincc/hrgtts/minmilliunits/minute via pump2AdditivesAdditivesU Oxytocin30Rationale for solutionRationale for solution.
| New Professions Technical Institute | |||||||
| ASSOCIATE SCIENCE IN NURSING | |||||||
| CLINICAL WORKSHEET: MATERNITY NURSING PROCESS CARE PLAN | |||||||
| STUDENT NAME | DATE | ||||||
| Client Initials | Culture/Ethnicity | Support System | |||||
| Unit | Room/Bed | Religion | |||||
| Age | Sex | Language | |||||
| Pre-preg Wt | Pre-preg Ht | Marital Status | Children & Ages | ||||
| Current Wt | Current Ht | Occupation | |||||
| G | T | P | A | L | Health Insurance | ||
| Current Work Status | |||||||
| Current Medical Diagnosis | Name of Significant Other/Primary Caregiver | ||||||
| Highest Grade Completed | |||||||
| Pain
Rating, Quality & Location |
|||||||
| Infant Feeding | |||||||
| Date/Time of Delivery | Delivery Type (Vaginal, Cesarean**, Forceps, Vacuum) | ||||||
| **Reason for Cesarean | |||||||
| Diagnostic procedures | |||||||
| Surgical procedures | |||||||
| Pathophysiology/Psychopathology (List Reference) | |||||||
| Reference | |||||||
| M | Admissions Vital Signs | ||||||
| A | T | Frequency | |||||
| B | P | ||||||
| U | R | ||||||
| BB | B/P | ||||||
| L | Allergies/Side Effects | ||||||
| E | |||||||
| H | |||||||
| Brief Health History | Diet with Rationale | ||||||
| Time | Flowsheet Notes | Activity Order | |||||
| Limitations/Prosthetic Device | |||||||
| PERTINENT LABORATORY DATA | |||||||
| Lab T | est # 1 | Lab Test # 2 | Lab Test # 3 | Lab Test # 4 | |||
| Hgb/Hct #1 | |||||||
| Hgb/Hct #2 | Results | Results | Results | ||||
| Hgb/Hct #3 | |||||||
| . | |||||||
| Rationale for ab | normal results | Rationale for abnormal results | Rationale for abnormal results | Rationale for abnormal results | |||
| Medication Name Generic/Trade | Classification | Major Actions (why taking meds) | Dose/ Route Safe Range | Adverse Effects | Nursing Implications | ||
| Assessment Data Subjective/Objective | Nursing Diagnosis | Plan
Outcome Criteria (Client Centered) |
Interventions (Nurse Centered) | Rationale for Interventions
(REFERENCED) |
Evaluation | ||
| Assessment Data Subjective/Objective | Nursing Diagnosis | Plan
Outcome Criteria (Client Centered) |
Interventions (Nurse Centered) | Rationale for Interventions
(REFERENCED) |
Evaluation | ||
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