instructions attached Pertinent Medical diagnoses/Reason for hospitalization: Student name: ______________________ Date:

instructions attached

Pertinent Medical diagnoses/Reason for hospitalization:

Student name: ______________________

Date: ______________________

Client initials:__________ Age: ________________

Male/Female/Nonbinary

High priority NANDA diagnosis

NANDA diagnosis

Psychosocial NANDA diagnosis

Short term (ST) goal:

Long term (LT) goal:

Short term(ST) goal:

Long term (LT) goal:

Short term (ST) goal:

Long term (LT) goal:

ST interventions

1.

2.

3.

LT interventions

1.

2.

3.

ST interventions

1.

2.

3.

LT interventions

1.

2.

3.

ST interventions

1.

2.

3.

LT interventions

1.

2.

3.

Evaluation

Evaluation

Evaluation

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