sex, drugs and rock
sometimes i like to do drugs, as do many rock stars. Nursing Care Plan Course: NUR 1210L Instructor: Dates of Care: 12, 13, 19 & 20 Sept 96 Date Submitted: 11/15/96 Student Names: Anthony Bernardi, SN/SPJC HOLISTIC NURSING CARE PLAN STUDENT Anthony Bernardi GRADE DATE November 15, 1996 Client’s Clinical Picture (5) (Initial Cephacaudal assessment) Textbook Description of Diagnosis (5) Summary of Client’s Progress (5) Completion of Holistic NCP Tool (30) NURSING DIAGNOSIS (15) GOALS (10) INTERVENTIONS (10) RATIONALES (5) EVALUATIONS (10) REFERENCES (5) TABLE OF CONTENTS SUBJECT PAGE # · Cover Page 1 · Grading Point Scale 2 · Table of Contents 3 · Summary Page 4 · Client’s Clinical Picture (Cephacaudal Assessment) 5 · Medical Diagnosis 6 · Textbook Description of Disease 6-12 · Treatments and Procedures 13 · Summary of Caregiver Progress Notes 14 · Diagnostic Values Out Of Normal Range Clinical Implications 16 · Radiology 17 · Medications 18-52 · Holistic Nursing Care Plan Form 53-62 · List of Nursing Diagnosis 65 · Five Nursing Diagnoses 66-70 · References 71 CLIENT CLINICAL PICTURE: Please see attached Cephacaudal Assessment (Pages 5) MEDICAL DIAGNOSIS: Current diagnosis:Necrotizing pneumonia, cachexia secondary to malnutrition / infection, hypothroidism, NIDDM, empyema RUI, Aspergilloma, RUI, and depression. HX: HTN, atrial fibrillation, COPD, asthma TEXTBOOK DESCRIPTION OF DIAGNOSIS: See attached Disease Process Description (pages 6-12-) SUMMARY OF CAREGIVER PROGRESS NOTES: See attached Caregiver Progress Notes (page 14-15) CLIENT CLINICAL PICTURE Mr. GB is a 78 year old white male admitted to Bay Pines VAMC on 6/18/96. for “ atypical chest pain and hemoptysis”. V/S BP 114/51, P 84, R 24, T 97.4.