University of San Carlos

College of Nursing
Nursing Care Plan

Name of Patient:_________________________________________________ Patients Health Profile: ___________________________________________

Age: _________________________ Sex:______________________________
Occupation:_____________________________________________________
Status:____________________ Religion:_____________________________
Date of Admission:_______________________________________________
Initial Complaints:_______________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Diagnosis:_______________________________________________________
________________________________________________________________

Needs/ Nursing Scientific Analysis Objective Nursing Problem/ Rationale Evaluation

Diagnosis/ Cues Interventions

Imbalance Nutrient: less Proper Nutrition is After 4-6 days of

than body requirement
related to inability to
digest food and absorb
nutrients secondary to
carbohydrate intolerance.
Cues:
S: “After breastfeeding,
the baby had diarrhea” as
verbalized by the mother.
O: On the examination
the patient was in the 10th
percentile for weight and
length.
The mucus membrane
was mildly dry.
essential for optimal monitoring the patient
growth and development, with the care plan design
especially in the first few with him. The patient
months of life, because will be able to manifest:
brain growth procedes at
such a rapid rate during • Well-balance
this time. Normally, the nutrition
enzyme lactase Hydro-
lyzes dietary lactose in • Maintain age- a. weigh daily and - to monitor effectiveness
the jejunum and appropriate document results of dietary plan.
proximal ileus. This weight b. give health -
hydrolysis splits lactose teaching to the
into glucose carriers and mother about
eventually pass into proper treatment
portal vein. However if of diarrhea
the if the lactase
insufficient to split the
lactose, a chain of effects
triggered. Available
lactase insufficient to
hydrolyze dietary
lactose. Unsplit lactose
remains as unabsorbed
glucose in the small
intestine. Unabsorbed
glucose glucose acts
osmotically to draw in
the retain intraluminal
fluid, leading to diarrhea.