JOSE RIZAL UNIVERSITY
College of Nursing and Health Sciences
Oral Revalida Evaluation Checklist
Disease Process
Name of Student: Date:
Year/Section/Group No. Grade:
I. CLINICAL IMPRESSION/DISORDER & DEFINITION
1.
2.
3.
II. DEVELOPMENTAL THEORIES
PSYCHOSEXUAL PHYCOSOCIAL COGNITIVE
THEORICIAN Sigmund Freud Erik Erikson Jean Piaget
STAGE OF
DEVELOPMENT
DEVELOPMENTAL TASK
CHARACTERISTICS
III. GORDON’S FUNCTIONAL HEALTH PATTERNS
PHYSIOLOGIC-
ELIMINATION-
REST AND SLEEP-
SEXUALITY-
OXYGENATION-
NUTRITION-
IV. ANATOMY
V. PHYSIOLOGY
VI. PATHOPHYSIOLOGY
VII. NURSING CARE PLAN
PRIORITIZED NURSING DIAGNOSIS
1.
2.
3.
NURSING DIAGNOSIS 1.
CUES GOALS NURSING INTERVENTION RATIONALE EVALUATION
SUBJECTIVE
Dependent:
1. 1.
2. 2.
OBJECTIVE
Independent:
3. 3.
4. 4.
Collaborative:
5. 5.
NURSING DIAGNOSIS 2.
CUES GOALS NURSING INTERVENTION RATIONALE EVALUATION
SUBJECTIVE
Dependent:
1. 1.
2. 2.
OBJECTIVE
Independent:
3. 3.
4. 4.
Collaborative:
5. 5.
NURSING DIAGNOSIS 3.
CUES GOALS NURSING INTERVENTION RATIONALE EVALUATION
SUBJECTIVE
Dependent:
1. 1.
2. 2.
OBJECTIVE
Independent:
3. 3.
4. 4.
Collaborative:
5. 5.
VIII. DIAGNOSTIC PROCEDURES:
LABORATORY/DIAGNOSTIC LABORATORY/DIAGNOSTIC
EXAMINATION #1 EXAMINATION #2
DEFINITION
NORMAL VALUES/FINDINGS
SIGNIFICANCE
NURSING RESPONSIBILITIES
IX. DRUG STUDY
DRUG #1 DRUG #2
GENERIC NAME:
TRADE NAME:
DRUG CLASSIFICATION
MECHANISM OF ACTION
SIDE EFFECTS
NURSING RESPONSIBILITIES