NURS 240 Nursing Care Plan Assignment with Multiple NANDA Diagnoses

Assignment 2: Nursing Care Plan

Course Details

Course Code: NURS 240

Course Title: Medical-Surgical Nursing

Semester: Spring 2026

Level: Undergraduate (Year 2)

Assessment Weighting: 25%

Due Date: Week 8

Word Count: 1,000–1,500 words

Context

This assignment develops skills in applying the nursing process to create a comprehensive care plan for patients with multiple health issues. It aligns with standards from the American Association of Colleges of Nursing (AACN) and emphasizes evidence-based practice in medical-surgical settings. Students will use data from a provided case study to identify priorities, drawing on concepts from lectures on pathophysiology, pharmacology, and patient safety. This prepares you for clinical rotations where care plans guide multidisciplinary teams in hospitals or community care.

Task Description

Develop a nursing care plan for the assigned patient scenario, incorporating at least three NANDA-approved nursing diagnoses (two actual, one risk). Include full assessment data, prioritized diagnoses with related factors and defining characteristics, SMART outcomes, evidence-based interventions with rationales, and an evaluation strategy. Use the ADPIE framework to structure your plan.

Requirements

• Select a case study from the provided options (e.g., elderly patient with COPD, diabetes, and risk for falls).
• Include a patient profile summary with de-identified demographics, medical history, and current condition.
• Use NANDA-I 2024-2026 diagnoses; support with at least four peer-reviewed sources.
• Format interventions and rationales in a table for clarity.
• Adhere to APA 7th edition for citations and references.
• Submit via the learning management system as a Word document, including a title page and reference list.

Marking Criteria/Rubric

1. Patient Assessment and Profile (15%): Comprehensive summary of subjective/objective data, relevant history, and priorities. Data is organized and linked to diagnoses.
2. Nursing Diagnoses (25%): At least three accurate NANDA diagnoses (with related factors and evidence). Prioritized logically, e.g., using Maslow’s hierarchy.
3. Outcomes and Planning (20%): SMART goals for each diagnosis. Outcomes are measurable and patient-centered.
4. Interventions and Rationales (25%): Evidence-based interventions (at least 3-4 per diagnosis) with clear rationales. Includes independent, collaborative, and teaching elements.
5. Evaluation and Academic Standards (15%): Plan for evaluating outcomes. Writing is clear, within word limit, with proper APA formatting.

Patient exhibited shortness of breath on exertion and bilateral crackles in lower lung fields during assessment. Vital signs showed elevated respiratory rate of 24 breaths per minute and oxygen saturation of 92% on room air. History revealed chronic obstructive pulmonary disease with recent exacerbation due to infection. Impaired gas exchange related to alveolar-capillary membrane changes as evidenced by dyspnea and hypoxemia became the priority diagnosis. Interventions included administering supplemental oxygen at 2 liters per minute via nasal cannula and encouraging pursed-lip breathing to improve ventilation. Evaluation after 4 hours noted improved saturation to 96% and reduced respiratory rate. As outlined in Herdman et al. (2024), precise NANDA diagnoses enhance targeted care, leading to better patient outcomes. Continued monitoring of lung sounds and activity tolerance supported adjustment of the plan.

• References

1. Herdman, T. H., Kamitsuru, S. and Lopes, C. T. (eds.) (2024) NANDA-I international nursing diagnoses: definitions and classification, 2024-2026. 13th edn. New York: Thieme. Available at: https://doi.org/10.1055/b000000928.
2. Ackley, B. J., Ladwig, G. B., Makic, M. B. F., Martinez-Kratz, M. and Zanotti, M. (2020) Nursing diagnosis handbook: an evidence-based guide to planning care. 12th edn. St. Louis: Elsevier. Available at: https://www.elsevier.com/books/nursing-diagnosis-handbook/ackley/978-0-323-55212-7.
3. Carpenito, L. J. (2019) Nursing care plans: transitional patient & family centered care. 7th edn. Philadelphia: Wolters Kluwer. Available at: https://shop.lww.com/Nursing-Care-Plans/p/9781496349262.
4. Doenges, M. E., Moorhouse, M. F. and Murr, A. C. (2022) Nurse’s pocket guide: diagnoses, prioritized interventions, and rationales. 16th edn. Philadelphia: F.A. Davis. Available at: https://www.fadavis.com/product/nursing-diagnoses-nurses-pocket-guide-doenges-moorhouse-murr-16.

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