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A care plan is a comprehensive overview of the risks a patient will encounter in their environment and a place to find out a patient's needs and wants. This helps to establish a connection between the caregiver and patient so they can work together more effectively and make everyone satisfied with the outcome. Care plans are most often for those of ages 60+, but can be for any age.

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Care plans, like most things directly involved in healthcare, aren't shared around much. Nearly all care plans are online and will be shared with the patient as well as the caretaker and the provider. For the patient to access their care plan they must simply ask for it. They are used to make communication between the caregivers and the patient more consistent and easy.

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typical rhetorical moves when writing a care plan

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typical rhetorical moves when writing a care plan

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Care plans have a structure to them that to be most effective should be followed. To create a good care plan should have these at least:
1. A health assessment that includes the patient's history. This is a very comprehensive assessment that would cover physical, spiritual, economic, and everything in between. This is searching for all the things that could affect your patient's health.
2. A nursing diagnosis of the patient's health issue or concern composed of the information retrieved from the health assessment.
3. The expected client outcomes which can be both long-term and short-term. These are the goals that are being aimed for with the plan.
4. The nursing intervention which is what specific actions can be done to achieve the goals set for the patient.
5. The rationales as to why the nurse used those interventions based on the evidence.
6. An evaluation which are the plans that can be done to get the goals wanted.

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Writing the best nursing care plan requires a step-by-step approach to complete the parts needed for a care plan correctly. This tutorial will walk you through developing a care plan. This guide has the ultimate database and list of nursing care plans (NCP) and NANDA nursing diagnosis samples for our student nurses and professional nurses to use-all for free! Care plan components, examples, objectives, and purposes are included with a detailed guide on writing an excellent nursing care plan or a template for your unit.

What is a Nursing Care Plan?

A nursing care plan (NCP) is a formal process that correctly identifies existing needs and recognizes a client's potential needs or risks. Care plans provide a way of communication among nurses, their patients, and other healthcare providers to achieve healthcare outcomes. Without the nursing care planning process, the quality and consistency of patient care would be lost.

Nursing care planning begins when the client is admitted to the agency and is continuously updated throughout in response to the client's changes in condition and evaluation of goal achievement. Planning and delivering individualized or patient-centered care is the basis for excellence in nursing practice.

Care plans can be informal or formal: An informal nursing care plan is a strategy of action that exists in the nurse's mind. A formal nursing care plan is a written or computerized guide that organizes the client's care information.

Formal care plans are further subdivided into standardized care plans and individualized care plans: Standardized care plans specify the nursing care for groups of clients with everyday needs. Individualized care plans are tailored to meet a specific client's unique needs or needs that are not addressed by the standardized care plan.

Standardized care plans are pre-developed guides by the nursing staff and health care agencies to ensure that patients with a particular condition receive consistent care. These care plans are used to ensure that minimally acceptable criteria are met and to promote the efficient use of the nurse's time by removing the need to develop common activities that are done repeatedly for many of the clients on a nursing unit.

Standardized care plans are not tailored to a patient's specific needs and goals and can provide a starting point for developing an individualized care plan.
Care plans listed in this guide are standard care plans which can serve as a framework or direction to develop an individualized care plan.
An individualized care plan care plan involves tailoring a standardized care plan to meet the specific needs and goals of the individual client and use approaches shown to be effective for a particular client. This approach allows more personalized and holistic care better suited to the client's unique needs, strengths, and goals.

Additionally, individualized care plans can improve patient satisfaction. When patients feel that their care is tailored to their specific needs, they are more likely to feel heard and valued, leading to increased satisfaction with their care. This is particularly important in today's healthcare environment, where patient satisfaction is increasingly used as a quality measure.
Tips on how to individualize a nursing care plan:

1. Perform a comprehensive assessment of the patient's health, history, health status, and desired goals.

2. Involve the patient in the care planning process by asking them about their health goals and preferences. By involving the client, nurses can ensure that the care plan is aligned with the patient's goals and preferences which can improve patient engagement and compliance with the care plan.

3. Perform an ongoing assessment and evaluation as the patient's health and goals can change. Adjust the care plan accordingly.

The following are the goals and objectives of writing a nursing care plan:

Promote evidence-based nursing care and render pleasant and familiar conditions in hospitals or health centers.

Support holistic care, which involves the whole person, including physical, psychological, social, and spiritual, with the management and prevention of the disease.

Establish programs such as care pathways and care bundles. Care pathways involve a team effort to reach a consensus regarding standards of care and expected outcomes. In contrast, care bundles are related to best practices concerning care for a specific disease.

Identify and distinguish goals and expected outcomes.

Review communication and documentation of the care plan.

Measure nursing care.

The following are the purposes and importance of writing a nursing care plan:

Defines nurse's role. Care plans help identify nurses' unique and independent role in attending to clients' overall health and well-being without relying entirely on a physician's orders or interventions.

Provides direction for individualized care of the client. It serves as a roadmap for the care that will be provided to the patient and allows the nurse to think critically in developing interventions directly tailored to the individual.

Continuity of care. Nurses from different shifts or departments can use the data to render the same quality and type of interventions to care for clients, therefore allowing clients to receive the most benefit from treatment.

Coordinate care. Ensures that all members of the healthcare team are aware of the patient's care needs and the actions that need to be taken to meet those needs preventing gaps in care.

Documentation. It should accurately outline which observations to make, what nursing actions to carry out, and what instructions the client or family members require. If nursing care is not documented correctly in the care plan, there is no evidence the care was provided.

Serves as a guide for assigning a specific staff to a specific client. There are instances when a client's care needs to be assigned to staff with particular and precise skills.

Monitor progress. To help track the patient's progress and make necessary adjustments to the care plan as the patient's health status and goals change.

Serves as a guide for reimbursement. The insurance companies use the medical record to determine what they will pay concerning the hospital care received by the client.

Defines client's goals. It benefits nurses and clients by involving them in their treatment and care.

A nursing care plan (NCP) usually includes nursing diagnoses, client problems, expected outcomes, nursing interventions, and rationales. These components are elaborated on below:

1. Client health assessment, medical results, and diagnostic reports are the first steps to developing a care plan. In particular, client assessment relates to the following areas and abilities: physical, emotional, sexual, psychosocial, cultural, spiritual/transpersonal, cognitive, functional, age-related, economic, and environmental. Information in this area can be subjective and objective.

2. Nursing diagnosis. A nursing diagnosis is a statement that describes the patient's health issue or concern. It is based on the information gathered about the patient's health status during the assessment.

3. Expected client outcomes. These are specific goals that will be achieved through nursing interventions. These may be long and short-term.

4. Nursing interventions. These are specific actions that will be taken to address the nursing diagnosis and achieve expected outcomes. They should be based on best practices and evidence-based guidelines.

5. Rationales. These are evidence-based explanations for the nursing interventions specified.

6. Evaluation. These includes plans for monitoring and evaluating a patient's progress and making necessary adjustments to the care plan as the patient's health status and goals change.

Nursing care plan formats are usually categorized or organized into four columns: (1) nursing diagnoses, (2) desired outcomes and goals, (3) nursing interventions, and (4) evaluation. Some agencies use a three-column plan where goals and evaluation are in the same column. Other agencies have a five-column plan that includes a column for assessment cues.

The three-column plan has a column for nursing diagnosis, outcomes and evaluation, and interventions.

This format includes columns for nursing diagnosis, goals and outcomes, interventions, and evaluation.

Below is a document containing sample templates for the different nursing care plan formats. Please feel free to edit, modify, and share the template.

Download: Printable Nursing Care Plan Templates and Formats

Student care plans are more lengthy and detailed than care plans used by working nurses because they serve as a learning activity for the student nurse.

Care plans by student nurses are usually required to be handwritten and have an additional column for "Rationale" or "Scientific Explanation" after the nursing interventions column. Rationales are scientific principles that explain the reasons for selecting a particular nursing intervention.

Writing a Nursing Care Plan

How do you write a nursing care plan (NCP)? Just follow the steps below to develop a care plan for your client.

The first step in writing a nursing care plan is to create a client database using assessment techniques and data collection methods (physical assessment, health history, interview, medical records review, and diagnostic studies). A client database includes all the health information gathered. In this step, the nurse can identify the related or risk factors and defining characteristics that can be used to formulate a nursing diagnosis. Some agencies or nursing schools have specific assessment formats you can use.

Now that you have information about the client's health, analyze, cluster, and organize the data to formulate your nursing diagnosis, priorities, and desired outcomes.

NANDA nursing diagnoses are a uniform way of identifying, focusing on and dealing with specific client needs and responses to actual and high-risk problems. Actual or potential health problems that can be prevented or resolved by independent nursing intervention are termed nursing diagnoses.

We've detailed the steps on how to formulate your nursing diagnoses in this guide: Nursing Diagnosis (NDx): Complete Guide and List.

Setting priorities involves establishing a preferential sequence for addressing nursing diagnoses and interventions. In this step, the nurse and the client begin planning which nursing diagnosis requires attention first. Diagnoses can be ranked and grouped as having a high, medium, or low priority. Life-threatening problems should be given high priority.

A nursing diagnosis encompasses Maslow's Hierarchy of Needs and helps to prioritize and plan care based on patient-centered outcomes. In 1943, Abraham Maslow developed a hierarchy based on basic fundamental needs innate to all individuals. Basic physiological needs/goals must be met before higher needs/goals can be achieved, such as self-esteem and self-actualization. Physiological and safety needs are the basis for implementing nursing care and interventions. Thus, they are at the base of Maslow's pyramid, laying the foundation for physical and emotional health.
Maslow's Hierarchy of Needs

Basic Physiological Needs: Nutrition (water and food), elimination (Toileting), airway (suction)-breathing (oxygen)-circulation (pulse, cardiac monitor, blood pressure) (ABCs), sleep, sex, shelter, and exercise.

Safety and Security: Injury prevention (side rails, call lights, hand hygiene, isolation, suicide precautions, fall precautions, car seats, helmets, seat belts), fostering a climate of trust and safety (therapeutic relationship), patient education (modifiable risk factors for stroke, heart disease).

Love and Belonging: Foster supportive relationships, methods to avoid social isolation (bullying), employ active listening techniques, therapeutic communication, and sexual intimacy.

Self-Esteem: Acceptance in the community, workforce, personal achievement, sense of control or empowerment, accepting one's physical appearance or body habitus.

Self-Actualization: Empowering environment, spiritual growth, ability to recognize the point of view of others, reaching one's maximum potential.

The client's health values and beliefs, priorities, resources available, and urgency are factors the nurse must consider when assigning priorities. Involve the client in the process to enhance cooperation.

After assigning priorities for your nursing diagnosis, the nurse and the client set goals for each determined priority. Goals or desired outcomes describe what the nurse hopes to achieve by implementing the nursing interventions derived from the client's nursing diagnoses. Goals provide direction for planning interventions, serve as criteria for evaluating client progress, enable the client and nurse to determine which problems have been resolved, and help motivate the client and nurse by providing a sense of achievement.

One overall goal is determined for each nursing diagnosis. The terms " goal outcomes" and "expected outcome s" are often used interchangeably.

According to Hamilton and Price (2013), goals should be SMART. SMART stands for specific, measurable, attainable, realistic, and time-oriented goals.

Specific. It should be clear, significant, and sensible for a goal to be effective.

Measurable or Meaningful. Making sure a goal is measurable makes it easier to monitor progress and know when it reaches the desired result.

Attainable or Action-Oriented. Goals should be flexible but remain possible.

Realistic or Results-Oriented. This is important to look forward to effective and successful outcomes by keeping in mind the available resources at hand.

Timely or Time-Oriented. Every goal needs a designated time parameter, a deadline to focus on, and something to work toward.

Hogston (2011) suggests using the REEPIG standards to ensure that care is of the highest standards. By this means, nursing care plans should be:

Realistic. Given available resources.

Explicitly stated. Be clear about precisely what must be done, so there is no room for misinterpretation of instructions.

Evidence-based. That there is research that supports what is being proposed.

Prioritized. The most urgent problems are being dealt with first.

Involve. Involve both the patient and other members of the multidisciplinary team who are going to be involved in implementing the care.

Goal-centered. That the care planned will meet and achieve the goal set.

Goals and expected outcomes must be measurable and client-centered. Goals are constructed by focusing on problem prevention, resolution, and rehabilitation. Goals can be short-term or long-term. Most goals are short-term in an acute care setting since much of the nurse's time is spent on the client's immediate needs. Long-term goals are often used for clients who have chronic health problems or live at home, in nursing homes, or in extended-care facilities.

Short-term goal. A statement distinguishing a shift in behavior that can be completed immediately, usually within a few hours or days.

Long-term goal. Indicates an objective to be completed over a longer period, usually weeks or months.

Discharge planning. Involves naming long-term goals, therefore promoting continued restorative care and problem resolution through home health, physical therapy, or various other referral sources.

Goals or desired outcome statements usually have four components: a subject, a verb, conditions or modifiers, and a criterion of desired performance.

Subject. The subject is the client, any part of the client, or some attribute of the client (i.e., pulse, temperature, urinary output). That subject is often omitted in writing goals because it is assumed that the subject is the client unless indicated otherwise (family, significant other).

Verb. The verb specifies an action the client is to perform, for example, what the client is to do, learn, or experience.

Conditions or modifiers. These are the "what, when, where, or how" that are added to the verb to explain the circumstances under which the behavior is to be performed.

Criterion of desired performance. The criterion indicates the standard by which a performance is evaluated or the level at which the client will perform the specified behavior. These are optional.

When writing goals and desired outcomes, the nurse should follow these tips:

1. Write goals and outcomes in terms of client responses and not as activities of the nurse. Begin each goal with "Client will [...]" help focus the goal on client behavior and responses.

2. Avoid writing goals on what the nurse hopes to accomplish, and focus on what the client will do.

3. Use observable, measurable terms for outcomes. Avoid using vague words that require interpretation or judgment of the observer.

4. Desired outcomes should be realistic for the client's resources, capabilities, limitations, and on the designated time span of care.

5. Ensure that goals are compatible with the therapies of other professionals.

6. Ensure that each goal is derived from only one nursing diagnosis. Keeping it this way facilitates evaluation of care by ensuring that planned nursing interventions are clearly related to the diagnosis set.

7. Lastly, make sure that the client considers the goals important and values them to ensure cooperation.

Nursing interventions are activities or actions that a nurse performs to achieve client goals. Interventions chosen should focus on eliminating or reducing the etiology of the nursing diagnosis. As for risk nursing diagnoses, interventions should focus on reducing the client's risk factors. In this step, nursing interventions are identified and written during the planning step of the nursing process; however, they are actually performed during the implementation step.

Nursing interventions can be independent, dependent, or collaborative:

Independent nursing interventions are activities that nurses are licensed to initiate based on their sound judgement and skills. Includes: ongoing assessment, emotional support, providing comfort, teaching, physical care, and making referrals to other health care professionals.

Dependent nursing interventions are activities carried out under the physician's orders or supervision. Includes orders to direct the nurse to provide medications, intravenous therapy, diagnostic tests, treatments, diet, and activity or rest. Assessment and providing explanation while administering medical orders are also part of the dependent nursing interventions.

Collaborative interventions are actions that the nurse carries out in collaboration with other health team members, such as physicians, social workers, dietitians, and therapists. These actions are developed in consultation with other health care professionals to gain their professional viewpoint.

Nursing interventions should be:

Safe and appropriate for the client's age, health, and condition.

Achievable with the resources and time available.

Inline with the client's values, culture, and beliefs.

Inline with other therapies.

Based on nursing knowledge and experience or knowledge from relevant sciences.

When writing nursing interventions, follow these tips:

1. Write the date and sign the plan. The date the plan is written is essential for evaluation, review, and future planning. The nurse's signature demonstrates accountability.

2. Nursing interventions should be specific and clearly stated, beginning with an action verb indicating what the nurse is expected to do. Action verb starts the intervention and must be precise. Qualifiers of how, when, where, time, frequency, and amount provide the content of the planned activity. For example: "Educate parents on how to take temperature and notify of any changes," or "Assess urine for color, amount, odor, and turbidity."

3. Use only abbreviations accepted by the institution.

Rationales, also known as scientific explanations, explain why the nursing intervention was chosen for the NCP.

Rationales do not appear in regular care plans. They are included to assist nursing students in associating the pathophysiological and psychological principles with the selected nursing intervention.

Evaluation is a planned, ongoing, purposeful activity in which the client's progress towards achieving goals or desired outcomes is assessed, and the effectiveness of the nursing care plan (NCP). Evaluation is an essential aspect of the nursing process because the conclusions drawn from this step determine whether the nursing intervention should be terminated, continued, or changed.

The client's care plan is documented according to hospital policy and becomes part of the client's permanent medical record, which may be reviewed by the oncoming nurse. Different nursing programs have different care plan formats. Most are designed so that the student systematically proceeds through the interrelated steps of the nursing process, and many use a five-column format.

Nursing Care Plan List

This section lists the sample nursing care plans (NCP) and NANDA nursing diagnoses for various diseases and health conditions. They are segmented into categories:

For the full list of nursing diagnosis care plans, please visit: Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing

Miscellaneous nursing care plans examples that don't fit other categories:

Care plans that involve surgical intervention.

Nursing care plans about the different diseases of the cardiovascular system:

Nursing care plans (NCP) related to the endocrine system and metabolism:

Care plans (NCP) covering the disorders of the gastrointestinal and digestive system:

Care plans related to the reproductive and urinary system disorders:

Care plans related to the hematologic and lymphatic system:

NCPs for communicable and infectious diseases:

All about disorders and conditions affecting the integumentary system:

Nursing care plans about the care of the pregnant mother and her infant. See care plans for maternity and obstetric nursing:

Care plans for mental health and psychiatric nursing:

Care plans related to the musculoskeletal system:

Nursing care plans (NCP) for related to nervous system disorders:

Care plans relating to eye disorders:

Nursing care plans (NCP) for pediatric conditions and diseases:

Care plans for respiratory system disorders:

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.

References and Sources

Recommended reading materials and sources for this NCP guide:

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M., & Zanotti, M. (2019). Nursing diagnosis handbook e-book: an evidence-based guide to planning care. Elsevier Health Sciences.

Björvell, C., Thorell-Ekstrand, I., & Wredling, R. (2000). Development of an audit instrument for nursing care plans in the patient record. BMJ Quality & Safety, 9(1), 6-13. [Link]

Carpenito-Moyet, L. J. (2009). Nursing care plans & documentation: nursing diagnoses and collaborative problems. Lippincott Williams & Wilkins.

DeLaune, S. C., & Ladner, P. K. (2011). Fundamentals of nursing: Standards and practice. Cengage learning.

Freitas, F. A., & Leonard, L. J. (2011). Maslow's hierarchy of needs and student academic success. Teaching and learning in Nursing, 6(1), 9-13.

Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. [Link]

Hamilton, P., & Price, T. (2007). The nursing process, holistic. Foundations of Nursing Practice E-Book: Fundamentals of Holistic Care, 349.

Lee, T. T. (2004). Evaluation of computerized nursing care plan: instrument development. Journal of Professional Nursing, 20(4), 230-238.

Lee, T. T. (2006). Nurses' perceptions of their documentation experiences in a computerized nursing care planning system. Journal of Clinical Nursing, 15(11), 1376-1382.

Rn, B. O. C., Rn, H. M., Rn, D. T., & Rn, F. E. (2000). Documenting and communicating patient care: Are nursing care plans redundant?. International Journal of Nursing Practice, 6(5), 276-280.

Stonehouse, D. (2017). Understanding the nursing process. British Journal of Healthcare Assistants, 11(8), 388-391.

Yildirim, B., & Ozkahraman, S. (2011). Critical thinking in nursing process and education. International journal of humanities and social science, 1(13), 257-262.

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1,000+ Nursing Care Plans: The Ultimate Guide and List for Free (Updated for 2023)

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Writing the best nursing care plan requires a step-by-step approach to complete the parts needed for a care plan correctly. This tutorial will walk you through developing a care plan. This guide has the ultimate database and list of nursing care plans (NCP) and NANDA nursing diagnosis samples for our student nurses and professional nurses to use-all for free!

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Each step of a care plan are there to to create clarity and promote communication. a good care plan is succinct, comprehensive, a shows good reasoning and a well thought out plan to deal with the problem. It must show that there was a thorough look into the patient and the thing ailing them.

The health assessment also serves to introduce and give a brief on the patient. This is key in making the patient feel like they are being paid attention to and valued as well as instilling trust in their caregiver.

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This nursing care plan for Constipation includes a diagnosis and care plan for nurses with nursing interventions and outcomes for the following conditions: Hemorrhoids or pain on defecation Patients who experience hemorrhoids may delay having bowel movements to avoid pain associated with it.

What are hemorrhoids? Hemorrhoids are vascular structures in the anus canal that helps with controlling stool. These structures can become inflamed from some type of trauma. The pain experience with hemorrhoids can very painful, making a patient to prolong defecation.

When defecation is prolonged the stool stays in the rectum where water in reabsorbed causing the stool to be hard. When the stool becomes hard it makes it difficult to pass.

Below is a case scenario that may be encountered as a nursing student or nurse in a hospital setting.

What are nursing care plans? How do you develop a nursing care plan? What nursing care plan book do you recommend helping you develop a nursing care plan?

This care plan is listed to give an example of how a Nurse (LPN or RN) may plan to treat a patient with those conditions.
Important Disclosure: Please keep in mind that these care plans are listed for Example/Educational purposes only, and some of these treatments may change over time. Do not treat a patient based on this care plan.
Care Plans are often developed in different formats. The formatting isn't always important, and care plan formatting may vary among different nursing schools or medical jobs. Some hospitals may have the information displayed in digital format, or use pre-made templates. The most important part of the care plan is the content, as that is the foundation on which you will base your care.

Nursing Care Plan for: Constipation for patients with Hemorrhoids

If you want to view a video tutorial on how to construct a care plan in nursing school, please view the video below. Otherwise, scroll down to view this completed care plan.

A 26 year old female is in day 3 of postpartum care from delivering a healthy baby girl via c-section. She reports to you she is experiencing constipation and has been unable to have a bowel movement for 5 days. She says she has been "straining" and she is having difficulty passing stool and when she does it is a very hard small "ball". In addition, she say she feels " a lot of pressure" in her rectum and she is having pain from hemorrhoids she developed in the last trimester of her pregnancy. She says she is afraid to have a bowel movement because of the pain caused by the hemorrhoids The patient received many narcotics during and after the delivery.

-Constipation related to pain on defecation secondary to hemorrhoids as evidence by the patient reporting she has not had a bowel movement for 5 days, hard stool, rectum pressure, and painful hemorrhoids.

-The patient states she is experiencing constipation and has been unable to have a bowel movement for 5 days. She says she has been "straining" and she is having difficulty passing stool and when she does it is a very hard small "ball". In addition, she say she feels " a lot of pressure" in her rectum and she is having pain from hemorrhoids she developed in the last trimester of her pregnancy. She says she is afraid to have a bowel movement because of the pain caused by the hemorrhoids.

A 26 year old female is in day 3 of postpartum care from delivering a healthy baby girl via c-section. The patient received many narcotics during and after the delivery.

-The patient will have a bowel movement before discharge.-The patient will report decreased pain in rectum from hemorrhoids.

-The patient will verbalize 3 techniques on how to keep bowel movements regular.

-The patient will verbalize how to take prescribed medication regime to prevent constipation.

Nursing Interventions:

-The nurse administer per MD orders Miralax and Colace as prescribed to help assist patient with bowel movement.-The nurse assess and document when patient has had a bowel movement daily.

-The nurse will provide the patient with a sitz bath and hemorrhoid cream as prescribed to help with hemorrhoid pain.

-The nurse will educate the patient on 3 techniques on how to keep bowl movements regular by discharge.

-The nurse will educate the patient how to take prescribed medications to prevent constipation by discharge.

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Nursing Care Plan & Diagnosis for Constipation due to Hemorrhoids | Interventions & Goals

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This nursing care plan for Constipation includes a diagnosis and care plan for nurses with nursing interventions and outcomes for the following conditions: Hemorrhoids or pain on defecation Patients who experience hemorrhoids may delay having bowel movements to avoid pain associated with it.

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There isn't really any part of a care plan that is optional. Every part of a care plan there exists to help a patient, and if there is something missing then it must be fixed by someone who sees it. The font must be readable and at a size that can be read without difficulty. This may be adjusted if the patient has bad eyesight and needs the font bigger.

There are two main formats to care plans, a diagonal format with three to four sections, and a vertical format also with three to four sections.

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This nursing care plan for is for patients who have received a Permanent Pacemaker Placement. This care plan includes a diagnosis with interventions and goals for nurses with thefollowing conditions: Impaired Physical Mobility & Disturbed Self-Concept. The purpose of a pacemaker to is maintain a normal, adequate heart rate for a patient. Patients who have received a permanent pacemaker have had problems with the heart's natural pacemaker, known as the AV node (atrioventricular node). These patients have been diagnosed with sick sinus syndrome, complete heart block (third-degree heart block) etc. A permanent pacemaker is usually placed under the left subclavicular area. However, due to small chest size a patient may have a permanent pacemaker placed under the right subclavicular area.

Patients who have received a permanent pacemaker can experience impaired physical mobility due to the activity restrictions required. In addition, the patient can have a disturbed self-concept because they feel they must now depend on the pacemaker to live, which makes the patient feel like they have lost their health.

Below is a case scenario that may be encountered as a nursing student or nurse in a hospital setting.

What are nursing care plans? How do you develop a nursing care plan? What nursing care plan book do you recommend helping you develop a nursing care plan?

This care plan is listed to give an example of how a Nurse (LPN or RN) may plan to treat a patient with those conditions.
Important Disclosure: Please keep in mind that these care plans are listed for Example/Educational purposes only, and some of these treatments may change over time. Do not treat a patient based on this care plan.
Care Plans are often developed in different formats. The formatting isn't always important, and care plan formatting may vary among different nursing schools or medical jobs. Some hospitals may have the information displayed in digital format, or use pre-made templates. The most important part of the care plan is the content, as that is the foundation on which you will base your care.

Nursing Care Plan for: Impaired Physical Mobility & Disturbed Self-Concept for patients with Permanent Pacemaker Placement

If you want to view a video tutorial on how to construct a care plan in nursing school, please view the video below. Otherwise, scroll down to view this completed care plan.

A 72-year-old male presented to the ER "not feeling well". The EKG showed he was in sick sinus syndrome. Immediately, the patient was rushed to the cath lab for placement of a permanent pacemaker. The patient was then transferred to your unit for 23 hours observation. When you arrive to the patient's room, he is wearing the arm immobilizer and has a clean, dry dressing over his pacemaker site. You assist the patient to the bathroom and he comments, "It is hard moving around normally with this sling on but I hear you can displace those lead wires if you're not careful". You note the patient does have limitations in his physical activity. When the patient is back in bed, you complete your assessment and note his vital signs are within normal limits. The bedside cardiac monitor shows the patient's heart is being paced at 65 beats per minute (bpm). The patient seems like he has "a lot on his mind" and you ask him how he is doing. The patient tells you he is thankful for the pacemaker but feels he has lost control over his health and must depend on "a piece of electronics" to keep him alive. He states it is weird and he feels like a bionic man.

Disturbed Self-Concept related to perceived loss of health and dependence on pacemaker as evidence by patient states he feels he has lost control over his health and must depend on a "piece of electronics" to keep him alive.

Impaired Physical Mobility related to activity restrictions and fear of lead displacement as evidence by patient exhibiting limitations in his physical mobility.

"It is hard moving around normally with this sling on but I hear you can displace those lead wires if you're not careful". The patient seems like he has "a lot on his mind" and you ask him how he is doing. The patient tells you he is thankful for the pacemaker but feels he has lost control over his health and must depend on "a piece of electronics" to keep him alive. He states it is weird and he feels like a bionic man.

-A 72-year-old male presented to the ER "not feeling well". The EKG showed he was in sick sinus syndrome. Immediately, the patient was rushed to the cath lab for placement of a permanent pacemaker. The patient was then transferred to your unit for 23 hours observation. When you arrive to the patient's room, he is wearing the arm immobilizer and has a clean, dry dressing over his pacemaker site. The bedside cardiac monitor shows the patient's heart is being paced at 65 beats per minute (bpm).

-The patient will demonstrate understanding and coping skills about the importance of the pacemaker placement by discharge.-The patient will verbalize increased positive feelings regarding the pacemaker placement by discharge.

-The patient will verbalize an increase control over his health by discharge.

-The patient will remain feel from any falls during his hospitalization due to limited mobility.

-The patient will describe three ways to prevent injury to self and pacemaker by utilizing 4 alternative methods for activity until healing period is complete by discharge.

Nursing Interventions:

-The nurse will encourage and educate the patient about the importance of the pacemaker daily.-The nurse will help the patient develop an understanding that he is in control of his health not the pacemaker daily.
-The nurse will build up the patient emotionally by complimenting on his health status and hard work daily.-The nurse will assess the patient's self-image daily.-The nurse will assess and remove any clutter in the patien'ts room upon entering the room every time.

-The nurse will ensure call light is in accessible area for patient usage upon arrival to room every time.

-The nurse will teach the patient three ways to prevent injury to self and pacemaker with 4 alternative methods for activity by discharge.

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Nursing Care Plan & Diagnosis for Pacemaker Placement Sick Sinus Syndrome & Heart Block

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This nursing care plan for is for patients who have received a Permanent Pacemaker Placement . This care plan includes a diagnosis with interventions and goals for nurses with thefollowing conditions: Impaired Physical Mobility & Disturbed Self-Concept. The purpose of a pacemaker to is maintain a normal, adequate heart rate for a patient.

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Common language features changed depending on what section they were in. These are some of the more specific areas that differ.

In the first section which is always the health assessment the language is Descriptive, has technical lingo mixed in, and is kind of informal, like an interview.

In the second section is the Nursing diagnosis which uses technical lingo, formal speech, and gets the point across quickly and efficiently.

In the third section is usually nursing interventions combined with expected patient outcomes. This is the part that is sometimes split into two parts and other times kept as one part. The language used here is like much of the rest and uses technical lingo, and is mostly formal with a bit of informal speech spread throughout.

Rationales and evaluation are used throughout the whole care plan, it doesn't have it's own section most of the time.

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This nursing care plan for Constipation includes a diagnosis and care plan for nurses with nursing interventions and outcomes for the following conditions: Hemorrhoids or pain on defecation Patients who experience hemorrhoids may delay having bowel movements to avoid pain associated with it.

What are hemorrhoids? Hemorrhoids are vascular structures in the anus canal that helps with controlling stool. These structures can become inflamed from some type of trauma. The pain experience with hemorrhoids can very painful, making a patient to prolong defecation.

When defecation is prolonged the stool stays in the rectum where water in reabsorbed causing the stool to be hard. When the stool becomes hard it makes it difficult to pass.

Below is a case scenario that may be encountered as a nursing student or nurse in a hospital setting.

What are nursing care plans? How do you develop a nursing care plan? What nursing care plan book do you recommend helping you develop a nursing care plan?

This care plan is listed to give an example of how a Nurse (LPN or RN) may plan to treat a patient with those conditions.
Important Disclosure: Please keep in mind that these care plans are listed for Example/Educational purposes only, and some of these treatments may change over time. Do not treat a patient based on this care plan.
Care Plans are often developed in different formats. The formatting isn't always important, and care plan formatting may vary among different nursing schools or medical jobs. Some hospitals may have the information displayed in digital format, or use pre-made templates. The most important part of the care plan is the content, as that is the foundation on which you will base your care.

Nursing Care Plan for: Constipation for patients with Hemorrhoids

If you want to view a video tutorial on how to construct a care plan in nursing school, please view the video below. Otherwise, scroll down to view this completed care plan.

A 26 year old female is in day 3 of postpartum care from delivering a healthy baby girl via c-section. She reports to you she is experiencing constipation and has been unable to have a bowel movement for 5 days. She says she has been "straining" and she is having difficulty passing stool and when she does it is a very hard small "ball". In addition, she say she feels " a lot of pressure" in her rectum and she is having pain from hemorrhoids she developed in the last trimester of her pregnancy. She says she is afraid to have a bowel movement because of the pain caused by the hemorrhoids The patient received many narcotics during and after the delivery.

-Constipation related to pain on defecation secondary to hemorrhoids as evidence by the patient reporting she has not had a bowel movement for 5 days, hard stool, rectum pressure, and painful hemorrhoids.

-The patient states she is experiencing constipation and has been unable to have a bowel movement for 5 days. She says she has been "straining" and she is having difficulty passing stool and when she does it is a very hard small "ball". In addition, she say she feels " a lot of pressure" in her rectum and she is having pain from hemorrhoids she developed in the last trimester of her pregnancy. She says she is afraid to have a bowel movement because of the pain caused by the hemorrhoids.

A 26 year old female is in day 3 of postpartum care from delivering a healthy baby girl via c-section. The patient received many narcotics during and after the delivery.

-The patient will have a bowel movement before discharge.-The patient will report decreased pain in rectum from hemorrhoids.

-The patient will verbalize 3 techniques on how to keep bowel movements regular.

-The patient will verbalize how to take prescribed medication regime to prevent constipation.

Nursing Interventions:

-The nurse administer per MD orders Miralax and Colace as prescribed to help assist patient with bowel movement.-The nurse assess and document when patient has had a bowel movement daily.

-The nurse will provide the patient with a sitz bath and hemorrhoid cream as prescribed to help with hemorrhoid pain.

-The nurse will educate the patient on 3 techniques on how to keep bowl movements regular by discharge.

-The nurse will educate the patient how to take prescribed medications to prevent constipation by discharge.

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Nursing Care Plan & Diagnosis for Constipation due to Hemorrhoids | Interventions & Goals

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This nursing care plan for Constipation includes a diagnosis and care plan for nurses with nursing interventions and outcomes for the following conditions: Hemorrhoids or pain on defecation Patients who experience hemorrhoids may delay having bowel movements to avoid pain associated with it.

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Strengths: - Helps everyone stay on the same page and up to date on what would be best for the patient.
- doesn't overcomplicate the care instructions allowing the patient to also understand what they need to do.
- gives structure to a patient's recovery that may help them to feel that they are helping in the process, improving their mental health.

weaknesses: - This is a very specific genre that sets out to accomplish a few tasks such as a health assessment and creating a plan for the patient so I believe that it accomplishes its goal.