RASMUSSEN COLLEGE

School of Nursing

FORM #3

PATHOPHYSIOLOGY

Explanation of Medical Diagnosis

Diagnosis _______________________________________________________________

Pathophysiology __________________________________________________________________________________________________________________________________________________________________________________________________________________

Textbook Signs and Symptoms __________________________________________________________________________________________________________________________________________________________________________________________________________________

Client’s Signs and Symptoms __________________________________________________________________________________________________________________________________________________________________________________________________________________

Recommended Treatments __________________________________________________________________________________________________________________________________________________________________________________________________________________

Current Treatments __________________________________________________________________________________________________________________________________________________________________________________________________________________

Teaching __________________________________________________________________________________________________________________________________________________________________________________________________________________

Prevention __________________________________________________________________________________________________________________________________________________________________________________________________________________

RASMUSSEN COLLEGE

School of Nursing

FORM #3

PATHOPHYSIOLOGY

Explanation of Medical Diagnosis

Diagnosis _______________________________________________________________

Pathophysiology __________________________________________________________________________________________________________________________________________________________________________________________________________________

Textbook Signs and Symptoms __________________________________________________________________________________________________________________________________________________________________________________________________________________

Client’s Signs and Symptoms __________________________________________________________________________________________________________________________________________________________________________________________________________________

Recommended Treatments __________________________________________________________________________________________________________________________________________________________________________________________________________________

Current Treatments __________________________________________________________________________________________________________________________________________________________________________________________________________________

Teaching __________________________________________________________________________________________________________________________________________________________________________________________________________________

Prevention __________________________________________________________________________________________________________________________________________________________________________________________________________________

Medication Sheets

A.What is the medication used for?

B.Why would a patient being taking it?

C.What are the most common side effects?

D.What vital signs could be affected?

E.What labs could be affected?

Drug name	Answer to 5 questions
	A.
Vital signs:	B.
	C.
Labs:	D.
	E.
Drug name	Answer to 5 questions
	A.
Vital signs:	B.
	C.
Labs:	D.
	E.

NURSING DIAGNOSES

FORM #8

PRIORITY #	NURSING DIAGNOSIS	RELATED/TO (R/T)	AS EVIDENCED BY (AEB)	RATIONALE FOR PRIORITIZATION

Nursing Process Report Form

FORM #9

Nursing Diagnosis (R/T and AEB):
Assessment Data	Nursing Interventions	Scientific Rationale (including references)
Subjective Assessment Objective Assessment	Assessment Decrease Stressors and/or Strengthen Lines of Defense Teaching Counseling
Measurable and Realistic Outcomes Short Term Long Term

Short Term Outcome:_____ Met_____ Partially Met_____ Not

Describe:

Long Term Outcome:_____ Met_____ Partially Met_____Not MetDescribe:

References

RASMUSSEN COLLEGE

School of Nursing

FORM #3

PATHOPHYSIOLOGY

Explanation of Medical Diagnosis

Diagnosis _______________________________________________________________

Pathophysiology __________________________________________________________________________________________________________________________________________________________________________________________________________________

Textbook Signs and Symptoms __________________________________________________________________________________________________________________________________________________________________________________________________________________

Client’s Signs and Symptoms __________________________________________________________________________________________________________________________________________________________________________________________________________________

Recommended Treatments __________________________________________________________________________________________________________________________________________________________________________________________________________________

Current Treatments __________________________________________________________________________________________________________________________________________________________________________________________________________________

Teaching __________________________________________________________________________________________________________________________________________________________________________________________________________________

Prevention __________________________________________________________________________________________________________________________________________________________________________________________________________________

RASMUSSEN COLLEGE

School of Nursing

FORM #3

PATHOPHYSIOLOGY

Explanation of Medical Diagnosis

Diagnosis _______________________________________________________________

Pathophysiology __________________________________________________________________________________________________________________________________________________________________________________________________________________

Textbook Signs and Symptoms __________________________________________________________________________________________________________________________________________________________________________________________________________________

Client’s Signs and Symptoms __________________________________________________________________________________________________________________________________________________________________________________________________________________

Recommended Treatments __________________________________________________________________________________________________________________________________________________________________________________________________________________

Current Treatments __________________________________________________________________________________________________________________________________________________________________________________________________________________

Teaching __________________________________________________________________________________________________________________________________________________________________________________________________________________

Prevention __________________________________________________________________________________________________________________________________________________________________________________________________________________

Medication Sheets

A.What is the medication used for?

B.Why would a patient being taking it?

C.What are the most common side effects?

D.What vital signs could be affected?

E.What labs could be affected?

Drug name	Answer to 5 questions
	A.
Vital signs:	B.
	C.
Labs:	D.
	E.
Drug name	Answer to 5 questions
	A.
Vital signs:	B.
	C.
Labs:	D.
	E.

NURSING DIAGNOSES

FORM #8

PRIORITY #	NURSING DIAGNOSIS	RELATED/TO (R/T)	AS EVIDENCED BY (AEB)	RATIONALE FOR PRIORITIZATION

Nursing Process Report Form

FORM #9

Nursing Diagnosis (R/T and AEB):
Assessment Data	Nursing Interventions	Scientific Rationale (including references)
Subjective Assessment Objective Assessment	Assessment Decrease Stressors and/or Strengthen Lines of Defense Teaching Counseling
Measurable and Realistic Outcomes Short Term Long Term

Short Term Outcome:_____ Met_____ Partially Met_____ Not

Describe:

Long Term Outcome:_____ Met_____ Partially Met_____Not MetDescribe:

References

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