Free Family Nursing Care Plan Template
Family Nursing Care Plan
Family Profile
Family Name: Agustin Jerde's Family
Address: Fort Worth, TX 76101
Assessment Date: January 15, 2051
Nurse Assigned: Reyes Bayer, RN
Identified Problems and Priorities
|
Problem |
Cause/ Contributing Factors |
Impact on Family |
Priority Level |
Proposed Outcome |
|---|---|---|---|---|
|
Lack of Immunizations |
Parents unaware of vaccine schedule for children |
Risk of preventable diseases among children |
High |
All children vaccinated by March 15, 2051 |
|
Poor Diabetes Management |
Father’s inconsistent medication adherence |
Increased health risks and financial burden |
High |
Father to achieve stable blood sugar levels within 3 months |
|
Nutritional Deficiency |
Family’s reliance on fast food |
Obesity risk for children, fatigue for adults |
Medium |
Balanced family meal plan implemented by February 1, 2051 |
Care Plan
Goal #1: Improve Immunization Coverage for Children
|
Objective |
Activities |
Responsible Party |
Resources Needed |
Timeline |
|---|---|---|---|---|
|
Ensure all children are vaccinated by March 15, 2051 |
Schedule appointments, provide education on vaccine benefits, and address misconceptions |
Nurse Reyes Bayer |
Local health clinic, Vaccine Info Pamphlets |
February 1 - March 15, 2051 |
Goal #2: Stabilize Diabetes Management for the Father
|
Objective |
Activities |
Responsible Party |
Resources Needed |
Timeline |
|---|---|---|---|---|
|
Achieve stable blood sugar levels within 3 months |
Educate about medication adherence, provide glucometer training, create a tracking sheet |
Nurse Reyes Bayer |
Glucometer, Tracking Forms |
January 20 - April 20, 2051 |
Goal #3: Enhance Family Nutrition
|
Objective |
Activities |
Responsible Party |
Resources Needed |
Timeline |
|---|---|---|---|---|
|
Reduce reliance on fast food by 50% |
Conduct family cooking workshops, provide meal planning templates |
Nurse Reyes Bayer |
Nutritional Guide, Cooking Space |
February 1 - February 28, 2051 |
Evaluation Plan
|
Evaluation Date |
Objective |
Outcome |
Next Steps |
|---|---|---|---|
|
March 20, 2051 |
Improve Immunization Coverage |
90% of children vaccinated; Follow-up for remaining 10% |
Continue tracking compliance |
|
April 25, 2051 |
Stabilize Diabetes Management |
Father reports consistent adherence to medication |
Monitor progress quarterly |
|
March 1, 2051 |
Enhance Family Nutrition |
3 out of 5 family meals cooked at home weekly |
Expand meal variety |
Prepared By: [YOUR NAME]
Contact Email: [YOUR EMAIL]
