PN Day2
PN Day2
PN Day2
Learner’s Code:
Patient Spouse Father Mother Sitter Others:
Methods of Education:
Oral Discussion Demonstration Written Video Translator Group
Barriers to Learning:
Communication Difficulties Physical Impairment Cognitive Impairment None
Sensory Impairment Cultural/Religious Others/Complex: Language Emotional
Materials Needed
1.
2.
3.
General Health Teachings Specific Health Teachings
Evaluation:
Date/Time Performed:
DISCHARGE PLAN
A. OBJECTIVES
At the end of an hour of health education the client will be able to:
1.
2.
3.
4.
5.
B. METHODS
1. Medications
Name of Drug Dosage Route Curative Side Instructions
(Generic and Preparation Effects Effects
Trade Name) Frequency
Duration
Restrictions:
Home Environmental Hazards:
3. Treatments/Therapies
4. Health Teaching/Education
Health Prevention/Promotion
5. OPD Visit
Clinic Appointment Schedule:
Follow-up Diagnostic or Laboratory Exam:
Referrals:
6. Diet
a. Prescribed Diet:
Lunch
Dinner
b. Diet Restrictions:
Sexual Needs
( ) Marriage Counseling
( ) Sex Therapy
( ) Sexual Violence
( ) Referral to Appropriate Agencies
C. DISCHARGE DETAILS
a. Date and Time of Discharge:
b. Accompanied by:
c. Mode of Transportation:
d. General Condition upon Discharge:
_____________________________
CLIENT/SIGNIFICANT OTHER
(Signature over Printed Name)
________________ ______________________
STUDENT NURSE CLINICAL INSTRUCTOR
(Signature over Printed Name) (Signature over Printed Name)
NURSING CARE PLAN
Assessment Nursing Diagnosis Planning Interventions Rationale Evaluation
ENDORSEMENT SHEET
Attending Physician/s
Diet
Ongoing IVF
IVF to follow
IV left
Clinical Instructor:
TIME BUDGET
LEARNING
OBJECTIVE(S) :_______________________________________________________________
_________________________________________________________________
DESCRIPTION OF EXPERIENCE(S)
1. Reflect on your feelings, attitudes and perceptions related to the clinical experiences. (AS
PRIMARY NURSE, MEDICINE NURSE, CHARGE NURSE, TEAM LEADER and
PRACTICING CI; ICU, ER, OR/DR NURSE, IN COMPLYING REQUIREMENTS &
INDIVIDUAL CONFERNCE).
3. Identify if any classroom theory /knowledge was helpful for this Clinical experience.
4. Analyze what you did well and what you could improve on.
5. Describe how this experience will affect how you handle a similar experience in the future.
Student Signature:
SCHOOL OF NURSING
Related Learning Experience (Clinical)
1st Semester, AY 2022 – 2023
_______________________________
Name and Signature of RLE Instructor