Do a one-two page paper of a community experience at a site related to the maternal newborn area.

COMMUNITY EXPERIENCE RUBRIC

NURS_316L-A – COMMUNITY

Chief Complaint

Contractions, rupture of membrane or bleeding.

Admitting Diagnosis

NSVD, or C-Section

Medical Conditions

Patient Information

(1)

Name:

Age:

Height/Weight:

Allergies:

Gestational Age:

Admitting Dx (Cite References) Medical, Surgical, Social History and OB History

Medical History

Surgical History

Social History

Obstetric History

GTPAL

Cultural considerations, ethnicity, occupation, religion, family support, insurance. (1) (14)

Medical Management/ Orders/ Medications & Allergies (2)

Name

Dose

RT

Freq.

MOA

RN Considerations

Onset/Peak/Duration

(Insulin)

Erickson’s Developmental Stage Related to pt. & Cite References (1)

Patient Education (In Pt.) & Discharge Planning (home needs )

Diagnostic Test/ Lab Results with dates and Normal Ranges (3)

Test

Norms

Date

Current Value

Concept Map

Student Name:

Instructor:

PC Outcomes/Goal

Priority nursing diagnosis #2

Respiratory (7)

Vital Signs (4)

Integumentary (12)

Interventions # 2

Assessment/ Evaluation #1

Assessment/ Evaluation #2

PC Evaluation Plan

Potential Complications/ at risk for

PC Interventions

Psychosocial (14)

Cardiovascular (6)

Endocrine (13)

Misc. (Ht/Wt)

GU (10)

GI (9)

Nutrition/Hydration

(8)

Rest/ Exercise (11)

Neurological (5)

Outcome/Goal #1

Priority nursing diagnosis #1

Outcome/Goal #2

Interventions #1