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II.

Health Condition and Problem Sheet

DATE
HEALTH CONDITIONS AND
NURSING PROBLEMS SUPPORTING DATA/CUES
PROBLEMS IDENTIFIED RESOLVED

III. Nursing Care Plan

HEALTH CONDITION/S OR EVALUATION PLAN


OBJECTIVES OF NURSING
PROBLEM/S AND FAMILY PLAN OF INTERVENTION OUTCOME
CARE METHODS/TOOLS
NURSING PROBLEMS CRITERIA/INDICATORS
IV. Service and Progress Notes
NURSING OBSERVATIONS,
ACTION/S TAKEN, RESPONSES AND
HEALTH CONDITIONS / NURSING
DATE EVALUATION OF SIGNATURE
PROBLEMS
PROGRESS/OUTCOMES

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