Name:_____________________________________________MRN_________________ Age: __________

Gender M F DOA: _____/______/_____ Nationality: ______________ Dept: ________________

General Nursing Care Plan-NICU

□ Keep NPO □ Baby will have adequate □ Provide prescribed feeding on time □ baby hydrated well
□ Feeding nutrition with no nausea and □ Record amount of feed consumed. □ No nausea or vomiting
vomiting
□ Others

Oxygenation

□ O2 Hood □ Baby will have normal O2 □ Provide well ventilated □ O2 saturation within normal
□ Nasal canula saturation. environment. range
□ Nebulizer □ Check O2 saturation.
□ Ventilators □ Refer any O2 saturation
abnormalities refer to attending
□ Other physician.
Fluid and
electrolytes
□ Baby will have balanced fluid □ Encourage fluid intake unless □ Well hydrated
□ IV and electrolytes balance restricted
□ IV canula is patent and intact
□ Oral /Tube □ Check IV sites and access if there is
Feed any complication
□ Others
Date & Patient specific Measurable goal Nursing interventions Evaluations Name and
time nursing needs ID No.
Elimination Date and time
□ Baby will have normal □ Encourage fluid intake □ Voided freely
□ NGT elimination pattern □ Maintain I/O record if needed □ No constipation
□ Bowel □ Report any abnormalities to the □ Balance I/O record
Movement attending doctor
□ Urination □ Maintain voiding
□ Others
Hygiene □ Baby will stay clean and well □ Daily bathing □ good hygiene noted
□ Baby Bath groomed □ change patient’s gown daily
□ Sponge Bath

Safety □ Patient will not have life □ check the identity with ID band □ Patient safety secured
□ check ID threating situations before any interaction with the
band patient
□ allergy □ raise side rails
□ side rails □ keep bed locked and low at all time
□ others
Observation □ Baby will have normal range □ monitor vital signs regularly □ stable vital signs
□ vital signs of vital signs □ monitor vital signs on ordered time
□ blood sugar □ access physically for any
□ others abnormality
□ inform doctor if there is any
abnormality

Date & Patient specific Measurable goal Nursing interventions Evaluations Name and
time nursing needs signature
Psychological Date and time
□ Parent will be able to □ encourage verbalization of feelings □ reactive positively
/spiritual control his/her feelings □ Provide empathy and reassurance
□ support toward Baby’s Illness
□ others
___________
Health □ Patient will repeat □ access the patient/ family □ Patient understood the
education knowledge gained and educational needs needy education.
□ Family practiced it properly. □ Provide proper education
□ others

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Special □ to manage on time □ double check ordered medication □ medication on time
interventions
□ administer medication on time □ no side effects
□ medication
□ observe medication reaction
□ wound care
□ report any untoward medication
□ isolation reaction
□ others
_________