DISTRICT
SAMPLE DIABETES Individual Health Care Plan (IHP) Page _____ of _____
For health needs that may result in an emergency and/or need management or monitoring.
Student Name:___________________________________ Medical Diagnosis: Part of IEP: Yes No
School: Date Initiated:
Grade: _____________________________ Health Care Provider: By:
Date Reviewed:
By:
Underline areas of concern: Medical management, dental management, safety, vital functions, elimination, mobility, rest, comfort.
NURSING ASSESSMENT NURSING DIAGNOSIS NURSING INTERVENTIONS EVALUATION
The school nurse will: Student Outcomes- The student will:
|The student is very knowledgeable regarding their |High Risk for Physiological Injury due to development of |Hypoglycemic Management (NIC 2G –2130) |1. ____will recognize and treat early signs of |
|diabetes management. They most often can recognize |acute complications related to hypoglycemia (low blood |Activities: |hypoglycemia appropriately and know how to |
|hypoglycemic states. Their primary symptom of low |sugar) or ketoacidosis (high blood sugar) (NANDA 1.6.1) |School nurse will develop– emergency action plan - and |recognize and respond to early signs of |
|glucose levels is being belligerent. They have a | |instruct staff in how to respond to low blood sugar |ketoacidosis. |
|very supportive family. They manage their blood | |levels |2. ____ will manage or have assistance managing |
|sugar with and insulin pump and continuous glucose | |School nurse will observe _____- check his blood sugar |hypoglycemic reactions. |
|monitor. | |levels bi-weekly. |3. ___ will have minimal low blood sugar |
| | | |reactions in school. |
| | |Hyperglycemia Management (NIC 2G – 2120) | |
| | |Activities: | |
| | |School nurse will train staff and supervise student in | |
| | |administration of insulin. | |
| | |School nurse will observe ____ self-administer insulin | |
| | |bi-weekly. | |
Page _____ of ____
OUTCOME: Risk Control (NOC IV-T-1902)
|Indicators |Never Demonstrated 1 |Rarely Demonstrated 2 |Sometimes Demonstrated 3 |Often Demonstrated 4 |Consistently Demonstrated 5 |
|____ recognizes own low blood sugar| | | | | |
|reactions | | | | | |
|Staff follows emergency care plan | | | | | |
|_____ monitors own blood glucose | | | | | |
|levels | | | | | |
| | | | | | |
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- us district court western district of texas
- us district court middle district florida
- us district court eastern district of wi
- us district court southern district of ny
- united states district court southern district ny
- district court southern district florida
- federal district court southern district of florida
- southern district of florida district court
- us district court southern district of florida
- us district court middle district florida tampa
- middle district of florida us district court
- us district court eastern district california