Posted: May 1st, 2025

RN Teaching Plan form (1) & RN Care Plan Form (2) (Scenario Based)

(Scenario Based)

Based on the severity of potential complications and impact on overall health, the priority for Mary’s diagnoses can be listed as follows:

Heart Failure

Chronic Atrial Fibrillation

Hypokalemia

Situation

1. Mary Richards is an 82-year-old woman being treated for digoxin toxicity and hypokalemia.
2. Background

Ms. Richards is an 82-year-old female who was brought to the emergency department by her son this evening when he found her confused and complaining of trouble with her vision. Ms. Richards has been ill for several days with complaints of nausea, dizziness, and weakness. Ms. Richards has a history of hypertension, diagnosed 40 years ago, and chronic atrial fibrillation and heart failure, diagnosed 30 years ago. Her current medications include furosemide, amlodipine, edoxaban, and digoxin.

Assessment

Upon initial assessment, the vital signs were RR 22, BP 96/54, temp 98.7°F (37.1°C), SpO2 96% on room air, and HR 58 with a rhythm of atrial fibrillation noted. Mary denied any pain and reported that she has been feeling ill for a few days now, but she was not sure why she was in the hospital. The patient complained of the light “hurting her eyes” and noted that her vision was becoming a bit yellow. Patient became more confused as the assessments were conducted and began to complain of feeling nauseated and dizzy. Patient was given 4 mg of ondansetron IV push for nausea. Patient hemoglobin was 16.8 g/dL, digoxin level was 2.1 ng/dL, and potassium level was 2.8 mEq/L. An infusion of 10 mEq potassium chloride in 100 mL 0.9% sodium chloride was started and infusing at 67 mL/hr. Vital signs were reassessed following interventions, with HR of 62 and BP of 100/60, and patient stated that her nausea improved following the ondansetron. Patient was educated on the relationship between digoxin toxicity and hypokalemia.

Recommendation

Continue to monitor the patient for signs of worsening digoxin toxicity and hypokalemia: Check potassium level 2 hours after the infusion of potassium chloride per provider’s orders. Educate patient on treatment and plan of care.  Patient Name: Mary Richards Admission Date: 4-16-2024 Date of Birth: 11-5-1941 Age: 82 Gender: Female Diagnosis: Chronic Atrial Fibrillation and Heart Failure

More Details/ Notes

Mary Richards, an 82-year-old woman, was brought to the emergency department by her son due to confusion and vision trouble. She’s been feeling sick for a few days with nausea, dizziness, and weakness. Mary has a history of high blood pressure, chronic atrial fibrillation, and heart failure. Her medications include furosemide, amlodipine, edoxaban, and digoxin. Initial assessment showed low blood pressure, low heart rate, and yellow vision. Mary became more confused and nauseated during assessments. She received ondansetron for nausea and started on a potassium chloride infusion for low potassium. After treatment, her nausea improved, and her vital signs stabilized. Her lab results showed high hemoglobin, elevated digoxin level, and low potassium. She needs close monitoring for digoxin toxicity and low potassium. It’s essential to educate Mary on her treatment plan and continue monitoring her closely.

Patient Name: Mary Richards Admission Date: 4-16-2024 Date of Birth: 11-5-1941 Age: 82 Gender: Female Diagnosis: Chronic Atrial Fibrillation and Heart Failure

RN Name: ET

Care Plan Form
The following table provides information to utilize in developing your nursing care plan. Each column in the Care Plan Form should include the
appropriate information. You are expected to develop 3 Nursing Diagnoses with the supporting documentation as noted on the page below. The first
page of the Care Plan Form should be the priority nursing diagnosis. Before completing the Care Plan Form visit DocuCare and chart the patient
assessment.
(II) Stimuli
(I) Behaviors
Subjective
(Non- observable)
Subjective data
should be clear,
concise and
specific to the
Nursing
Diagnosis
Subjective Data:
What the patient
or family relates,
states, or reports.
(Non-observable)
Objective
(Observable)
(V) Nursing Interventions and
Scientific Rationales
Best Evidence with References
(VI) Evaluation of
Patient Goals/
Outcomes (Impact)
Focal, Contextual
and Residual
Focal Stimuli:
Objective data
should be clear,
concise and specific Individual needs, the
level of family
to the Nursing
adaptation, and
Diagnosis
changes in the family
Objective Data :
environment
What is observed or
measured. May
include the client’s
behavior, vital
signs, lung sounds,
urine output,
laboratory data,
diagnostic testing
(etc.) as related to
the specific nursing
diagnosis.
(Observable)
(III) Complete NANDA Nursing Diagnosis (Problem-Based
Nursing Diagnosis)
Contextual Stimuli:
Influence the
situation- Coping
mechanisms,
diagnosis, symptom
severity and comorbidities.
1.
2.
Choose a NANDA approved diagnosis.
The statement should list only one diagnosis and listed in the
following format, i.e., problem followed by “Related to
(R/T) the disease process
3. Manifested by: (signs and symptoms) is not part of
nursing diagnoses and should be written as a separate
line.
Example: Coping, ineffective family: R/T Temporary
family disorganization and role changes. Manifested by
significant other’s limited personal communication with
client.
4.
Each statement should be supported by a rationale
(IV) Goals/Outcomes (Long and Short term) Including
timelines/timeframes
1.
Residual Stimuli:
Beliefs, behaviors
and personal
experiences
Could have both short term and long term outcomes
throughout Nursing Care Plan (NCP), but each client should
have one long term goal as part of the NCP.
Definitions:
Short-term goals: Those goals that are usually met
before discharge or before transfer to a less acute level
of care.
Long-term goals: Those goals that may not be achieved
before discharge but require continued attention by client
and/or significant others as indicated.
2.
Each diagnosis, if appropriate, could have short-term goals
and long-term goals.
3.
Statements:
Specific – relates to nursing diagnosis.
Measurable – tells what to see, hear, or
smell. Achievable – realistic for patient.
Clear and Concise – don’t use “increase” or “decrease”
without giving baseline range of data.
4. Timelines (timeframes) for achievement of goals:
Should be realistic and specific.
Give a date or time at which the expected outcome and
nursing interventions are achieved and/or evaluated.
5.
hould specific as “by discharge date” or “on going.”
Nursing Interventions should be:
Evaluation should address:
1. Concise
2. Clear
3. Specific
4. Individualized
5. Accomplishable toclient and/or
1. If the expected revised,
family, significant other.
Scientific Rationales should address:
1. How interventions are going to
solve the problem and/or attain the
outcomes.
2. Be specific to the interventions, i.e.,
why giving morphine 10 mg IV,
why the client is being turned and
positioned in proper alignment
every 4 hours.
3. Can be summarized in own words
and/or quoted verbatim from
sources.
*For every nursing intervention, there
needs to be a rationale.
state how would revise
intervention.
2. What was the client’s
response to
interventions?
Care Plan Form
Student Name:
Patient Initials/ Code Status
Instructor:
Date
Indicate the Mode
__Physiologic Mode
__Self Concept Mode
__Role Function Mode
__Interdependence
Priority Nursing Diagnosis
(I) Behaviors
Non-Observable
Observable
(Subjective)
(Objective)
(III)Nursing Diagnoses
NANDA (ProblemFocal, Contextual, Residual
Based Nursing
Diagnosis)
(II) Stimuli
(V) Nursing Interventions
and Rationales
(3-Best Evidence-Based
Rationales with references)
(VI) Evaluation of
(Impact) Patient
Goals/Outcomes
(IV) Patient Care
Goals/Outcomes
Short and Long Term
(Including timeframes)
3
Subject to change as needed. Revised 2/1/2024.
Care Plan Form
Student Name:
Patient Initials/ Code Status
Instructor:
Date
Indicate the Mode
__Physiologic Mode
__Self Concept Mode
__Role Function Mode
__Interdependence
#2 Nursing Diagnosis
(III)Nursing Diagnoses
(I) Behaviors
(II) Stimuli
NANDA (ProblemNon-Observable
Observable Focal, Contextual, Residual
(Subjective)
(Objective)
Based Nursing
Diagnosis)
(V) Nursing Interventions
and Rationales
(3 Best Evidence-Based
Rationales with references)
(VI) Evaluation of
(Impact) Patient
Goals/Outcomes
(IV) Patient Care
Goals/Outcomes
Short and Long Term
(Including timeframes)
3
Subject to change as needed. Revised 2/1/2024.
Care Plan Form
Student Name:
Patient Initials/ Code Status
Instructor:
Date
Indicate the Mode
__Physiologic Mode
__Self Concept Mode
__Role Function Mode
__Interdependence
#3 Nursing Diagnosis
(I) Behaviors
Non-Observable
Observable
(Subjective)
(Objective)
(III)Nursing Diagnoses
NANDA (ProblemFocal, Contextual, Residual
Based Nursing
Diagnosis)
(II) Stimuli
(V) Nursing Interventions
and Rationales
(3 Best Evidence-Based
Rationales with references)
(VI) Evaluation of
(Impact) Patient
Goals/Outcomes
(IV) Patient Care
Goals/Outcomes
Short and Long Term
(Including timeframes)
3
Subject to change as needed. Revised 2/1/2024.
Teaching & Learning Plan
The following table provides information to utilize in developing your Teaching & Learning Plan. Each column in the teaching and learning plan form should include the
appropriate information related to the individual client needs identified in the Nursing Care Plan. You are expected to develop 3 Teaching Objectives with the supporting
documentation as noted on the page below. Any questions that you have concerning Teaching & Learning Plan should be directed to your instructor.
Teaching Objective(s)
After identifying the teaching
needs during the assessment, the
objective should be created.
The objectives are the main
ideas that you want your
learner(s) to understand and
apply after the teaching
experience. Two or three
objectives should be identified
for the teaching experience.
Each objective should start with
the stem below:
The learner (client) will …
Content
(Evidence-based with references)
Once the objectives for the teaching plan have
been created, content must be selected.
Depending on what is being taught, a reference to
where the content was found should be identified.
Content should be applicable to the audience.
Considerations on the use of terminology and
complexity should be incorporated into the
selection of the content.
The teacher will discuss …
Teaching & Learning
Method(s)
(How are you going to teach)
Time Frame
When determining how to share
the content during the teaching
experience, be sure to think about
the various learning styles.
Learning styles may include
auditory, visual and cognitive.
The following are some examples
of presentation formats:
The amount of time
for the teaching
experience will
depend on the
individual and the
amount of content
presented.
Consider timing of
when the teaching
experience will take
place. If during
discharge, allow
10-15 minutes
depending on the
amount and
complexity of the
content.
•
•
•
•
•
•
•
Diagrams
Charts
Videos
Handouts
Brochures
Hands on Simulation
Demonstration of skills
The material will be presented by
…
Evaluation of
Learning
(How long)
This teaching
experience will take
…
Evaluation of learning
occurs after the
content has bene
presented. Evaluation
can be a verbal
acknowledgement,
return demonstration
or the completion of a
brief survey. The
type of evaluation is
dependent upon the
type of teaching and
the type of content
presented.
The teaching
experience will be
successful if the
learner is able to …
Student Name:
Instructor: ________________________________
Client Code:
Nursing Diagnosis Priority #
Date:
Grade:
Teaching & Learning Plan
Assessment of Client’s
Readiness to Learn
Physical
Complexity of task
Environmental effects
Health status
Gender
Emotional
Anxiety level
Support system
Motivation
Frame of mind
Developmental stage
Experiential
Level of aspiration
Past coping mechanisms
Cultural background
Description of Findings:
Description of Findings:
Description of Findings:
Conclusion of Findings of the
Readiness to Learn
Knowledge
Description of Findings:
Present knowledge base
Cognitive ability
Learning disabilities
Learning styles (Visual, Auditory,
Reading)
Move forward with teaching
Hold teaching plan- describe rationale and discuss strategies to prepare the client for teaching.
Cultural Considerations
Description of findings and how to incorporate into the teaching plan.
Teaching Objective(s)
Content
(Evidence-based with references)
Teaching & Learning
Method(s)
(How are you going to teach)
Time Frame
Evaluation of
Learning
(How long)
(How is success of the
teaching measured)
(1) The learner will
(2) The learner will
(3) The learner will