Weekly Care Plan

CHILD HEALTH NURSING

St Name: St No: Week: Date: PW:

1. BASELINE DATA:
Patient’s Name: Patient’s ID No:
Age: DOB: DOA:
Medical Diagnosis:

2. BIRTH HISTORY:
Type of  Normal  LSCS  Forceps  Vacuum
Delivery:
Birth:  Term  Preterm  IUGR
Birth Birth length: Head Circumference:
weight:

Apgar Score: At birth (1 min): At 5 min:

Congenital
anomalies:

3. CHIEF COMPLAINTS:

4. PRESENT MEDICAL/SURGICAL HISTORY:

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 5. PAST MEDICAL/SURGICAL HISTORY( Any relevant past history/ family/ birth history
related to the child’s present condition )

6. NUTRITIONAL ASSESSMENT:

7. PLAY ASSESSMENT:
Critical Thinking question :
 What play therapy did you provide for the child? What is the reason for selecting
particular type of play?

8. MOTOR DEVELOPMENT:

Gross Motor Fine Motor

9. PSYCHOSOCIAL DEVELOPMENT:
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 Critical thinking questions:
 How did growth and development assessment help you in providing care to the child?

10. INVESTIGATIONS:

Interpretation of the
Investigation Purpose of Performing Findings
the Test Findings

What Specific Investigation(s) would confirm the diagnosis of the child? If it was performed, what
was the finding?
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11. HEALTH EDUCATION:
(attach evidence of the planned Health Education)

1.

2.

3.

4.

5.

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 T RR HR BP Apical Wt Expected Ht HC
pulse WT

12. PHYSICAL EXAMINATION

Vital Signs:

General Appearance:

Head & Neck:

Respiratory & Cardiac:

Abdomen:
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 Musculoskeletal (Back & Extremities):

Genitourinary:

Neurological examination:

13. HEALTH NEEDS IDENTIFIED:

Health Need Supporting Data

1.

2.

3.

4.

14. MEDICAL KNOWLEDGE:

1. Definition:
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 2. Etiology in Child compared to a Reference:

3. Pathophysiology:

4. Signs & symptoms in Child compared to a Reference:

5. Management in Child compared to what is expected in a Reference:

6. Complications:

7. Child’s Prognosis: 7
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 15. MEDICATION PRESCRIBED (Use additional papers if needed):
Drug Name
Why was it prescribed to the Nursing Responsibilities before/during &
Dose/
patient and will it help? after administration
Frequecny/Route:

1. Before:

During:

After:

2. Before:

During:

After:

3. Before:

During:

After:

4. Before:
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During:
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 After;

Before:
5.

During:

After:

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 16. NURSING CARE PLAN

Assessment Nursing Goals/Outcomes Planne Implemented Rationale Evaluation

# Diagnosis d NSG NSG
Interv Interventions
entions

1.

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 Evaluation Rationale Implemented NSG Planned Goals/Outcomes Nursing
Interventions NSG Diagnosis
Interventio
ns

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17. References:

1.