Nursing Care Plan Examples: NANDA Diagnoses, ADPIE, and SMART Goals

By Rachel M, Registered Nurse, Master of Science in Nursing, with Lisa P, Registered Dietitian, Certified Specialist in Renal Nutrition. Clinically reviewed by Dr. Helen B, Doctor of Nursing Practice, Board Certified Medical-Surgical Registered Nurse. Last reviewed 23 April 2026. This guide on nursing care plan examples walks through the rules, examples, and decisions that come up in real student work.

Why the care plan drives nursing accountability

The nursing care plan is not a homework exercise invented for students. The American Nurses Association defines the nursing care plan as a standard of professional practice that every Registered Nurse must follow to coordinate individualized patient care (American Nurses Association Scope and Standards of Practice, 2021). That single sentence carries legal weight. Documentation that fails to state the diagnosis, goals, interventions, and outcomes in a structured form weakens the nurse's defensibility in both board review and civil litigation.

Accreditors reinforce the same standard. Joint Commission accreditation surveys sample patient records specifically for evidence that the interdisciplinary team assessed the patient, identified problems, planned interventions, and evaluated outcomes in writing. The Centers for Medicare and Medicaid Services conditions of participation require individualized written care plans for long-term care, home health, and hospice reimbursement. A missing or generic care plan becomes a billing denial, a survey citation, and, in the worst case, an adverse event that reaches a courtroom.

Evidence-based nursing interventions reduce preventable hospital readmissions when paired with structured discharge care plans (Agency for Healthcare Research and Quality, 2018). The Agency for Healthcare Research and Quality's Re-Engineered Discharge program demonstrated a 30 percent reduction in 30-day readmission risk in adult medical inpatients when the discharge plan followed a structured, patient-specific format rather than boilerplate instructions. That is the practical payoff of writing the plan correctly: fewer bounce-backs, better outcomes, cleaner audits.

The ADPIE nursing process

ADPIE structures the nursing process into five ordered steps of Assessment, Diagnosis, Planning, Implementation, and Evaluation (Yura and Walsh, 1967). Nursing educators Helen Yura and Mary Walsh formalised the sequence in their 1967 textbook, and every United States nursing program has taught it since. The steps are iterative, not strictly linear. Evaluation often loops back to Assessment as the patient's condition changes, and strong ADPIE nursing process documentation makes that loop visible.

Assessment: subjective plus objective data

Assessment begins with what the patient reports and what the nurse measures. Subjective data includes the chief complaint, pain description using OPQRST, sleep, appetite, medication adherence, functional status, psychosocial concerns, and any direct patient quotation that carries clinical weight. Objective data includes vital signs, head-to-toe physical examination findings, laboratory values, imaging, intake and output, validated screening scores, and bedside monitoring trends. Cluster the data by Gordon's functional health patterns or by Maslow's hierarchy so defining characteristics for a nursing diagnosis become visible.

Diagnosis: NANDA International 2024 to 2026

NANDA International 2024 to 2026 classifies nursing diagnoses across 13 domains (NANDA International, 2024). A nursing diagnosis is not a medical diagnosis. Where a physician writes "Type 2 diabetes mellitus," a nurse writes a human-response diagnosis such as Risk for Unstable Blood Glucose Level or Deficient Knowledge regarding insulin self-administration. The current taxonomy uses three-part statements for actual diagnoses, Problem related to Etiology as evidenced by Signs and Symptoms, and two-part statements for risk diagnoses where no symptoms yet exist.

Planning: SMART goals and interventions

Planning translates the diagnosis into measurable expected outcomes and prioritized interventions. The SMART framework, meaning Specific, Measurable, Achievable, Relevant, and Time-bound, improves the measurability of care-plan goals (Doran, 1981). George Doran coined the acronym for management in the journal Management Review, and nursing education adopted it because it forces concrete, auditable targets. "Patient will ambulate" is not a goal. "Patient will ambulate 50 feet with rolling walker and contact-guard assist within 48 hours post-op" is.

Implementation: executing evidence-based interventions

Implementation is the execution phase and the phase that actually touches the patient. Nursing Interventions Classification, known as NIC, codifies more than 550 standardized interventions used in care plans (Butcher, Bulechek, Dochterman, and Wagner, 2018). Each NIC intervention carries a label, a definition, and a list of activities the nurse performs. Using standardized labels such as Fluid Management (4120) or Pain Management: Acute (1410) makes the care plan interoperable across electronic health records, reportable for quality improvement, and defensible in chart audits.

Evaluation: outcome measurement with Nursing Outcomes Classification

Evaluation closes the loop. Nursing Outcomes Classification, known as NOC, provides standardized outcome indicators for evaluation (Moorhead, Swanson, Johnson, and Maas, 2018). Each NOC outcome uses a 5-point Likert scale so the nurse can score baseline, document change, and decide whether to continue, modify, or resolve the nursing diagnosis. Evaluation without an NOC-style indicator is just charting. Evaluation with a scored indicator is the evidence trail that survives audit.

NANDA International diagnoses decoded

NANDA International is the global body that curates nursing diagnoses. Originally founded in 1982 as the North American Nursing Diagnosis Association, the organisation now publishes a revised taxonomy every two years after a rigorous Diagnosis Development Committee review. Using the current edition matters. Old diagnoses are retired, new ones added, and defining characteristics refined as evidence accumulates.

The 13 domains of the current taxonomy

The 2024 to 2026 taxonomy organises every diagnosis under one of 13 domains: Health Promotion, Nutrition, Elimination and Exchange, Activity and Rest, Perception and Cognition, Self-Perception, Role Relationship, Sexuality, Coping and Stress Tolerance, Life Principles, Safety and Protection, Comfort, and Growth and Development. Each domain breaks into classes and then into individual diagnoses with a unique code. Using the domain structure during assessment keeps the nurse from missing whole categories of patient response, such as Coping and Stress Tolerance on a post-diagnosis oncology unit.

Actual, risk, and wellness diagnoses compared

NANDA International recognises three diagnosis types. An actual diagnosis describes a present problem with observable signs and symptoms, written as Problem related to Etiology as evidenced by defining characteristics. A risk diagnosis describes a vulnerability to a future problem and is written as Risk for Problem related to risk factors, with no "as evidenced by" clause because symptoms have not yet emerged. A health promotion or wellness diagnosis captures the patient's motivation to improve a current healthy state, for example Readiness for Enhanced Knowledge.

Choosing the priority diagnosis

Students often list six diagnoses and call the plan finished. Real practice prioritises. Use Maslow's hierarchy and the ABCs, meaning Airway, Breathing, and Circulation, to rank the diagnosis list. A patient with Impaired Gas Exchange, Anxiety, and Deficient Knowledge gets Impaired Gas Exchange first. Life-threatening before health-threatening, acute before chronic, actual before risk when clinical severity is equal. Time-limited rotations cannot address every diagnosis, so explicit prioritisation proves clinical judgment.

Top 20 most-used NANDA diagnoses in table form

How to write a nursing care plan in five steps

Turning patient data into a defensible nursing care plan example takes five disciplined steps. Skipping any one step weakens the whole plan and usually costs points in academic grading or citations in clinical audit.

Step 1: Complete a head-to-toe assessment

Gather subjective data through open questioning, then objective data through inspection, palpation, percussion, and auscultation. Pull vital signs, intake and output, laboratory values, imaging, medications, and relevant history from the electronic record. Cluster the data by NANDA domain or by Gordon's functional health patterns so defining characteristics group naturally under candidate diagnoses.

Step 2: Identify priority NANDA diagnoses

Match the clustered data to NANDA International 2024 to 2026 definitions and defining characteristics. Draft a three-part Problem, Etiology, Signs and Symptoms statement for each actual diagnosis, and a two-part Problem plus Risk Factors statement for each risk diagnosis. Rank using the ABCs and Maslow. Pick the top three for an academic plan, top one or two for a shift plan.

Step 3: Set SMART goals linked to Nursing Outcomes Classification

Write one short-term and one long-term goal per priority diagnosis using the SMART framework. Tie each goal to a Nursing Outcomes Classification label and indicator, for example Pain Control (1605) with indicator "recognises pain onset." Define the scoring scale and the target score. State a realistic time frame, for example "by end of shift" or "within 72 hours."

Step 4: Plan interventions from Nursing Interventions Classification with rationales

Pick three to five Nursing Interventions Classification interventions per goal. For each, add a brief evidence-based rationale with a citation. Rationales are non-negotiable in academic care plans. They are what proves the nurse chose the intervention because of evidence, not because a preceptor said so. Order interventions independent, collaborative, and dependent so the scope of practice is clear.

Step 5: Schedule evaluation metrics and re-planning points

Schedule the evaluation. State when the goal will be reviewed, which Nursing Outcomes Classification score will count as "met," and what the fall-back is if the patient does not progress. If the goal is not met, loop back to Assessment and revise. That loop is the reason the nursing process is depicted as a cycle, not a line.

Nursing care plan examples by condition

The following annotated examples show the full ADPIE structure for common medical-surgical, cardiac, respiratory, infectious, neurological, perinatal, and psychiatric conditions. Each links to its full programmatic child page with a downloadable template and expanded pathophysiology notes. See the complete set under Nursing care plans by condition for 50+ diagnoses.

Care plan for Type 2 diabetes

A Type 2 diabetes nursing care plan typically anchors on Risk for Unstable Blood Glucose Level and Deficient Knowledge. Full worked example:

Full example and template at Care plan for Type 2 diabetes.

Care plan for heart failure

A heart failure nursing care plan commonly centres on Excess Fluid Volume, Decreased Cardiac Output, and Activity Intolerance. Typical SMART goal: "Patient will exhibit weight loss of 1 to 2 kilograms within 48 hours, clear lung fields on auscultation, and urine output of 0.5 to 1 millilitre per kilogram per hour, scoring 4 on Nursing Outcomes Classification Fluid Balance (0601)." Core interventions include daily weights at the same time on the same scale, fluid and sodium restriction per physician order, and medication education on loop diuretics and beta blockers. See Care plan for heart failure for the full document.

Care plan for chronic obstructive pulmonary disease exacerbation

The chronic obstructive pulmonary disease care plan prioritises Impaired Gas Exchange and Ineffective Airway Clearance. SMART goal: "Patient will demonstrate oxygen saturation above 92 percent on prescribed oxygen within 4 hours, use pursed-lip breathing during dyspnea episodes, and clear airways with huff cough technique." Interventions span airway management, oxygen therapy titration, respiratory monitoring, and smoking cessation counselling guided by the five As framework.

Care plan for sepsis

A sepsis care plan opens with Risk for Shock and Ineffective Tissue Perfusion. The Surviving Sepsis Campaign Hour-1 bundle drives interventions: measure lactate, obtain blood cultures before antibiotics, administer broad-spectrum antibiotics within the first hour, begin 30 millilitres per kilogram crystalloid for hypotension or lactate greater than 4, and initiate vasopressors to maintain mean arterial pressure above 65. Document reassessment every hour. Full worked plan at Care plan for sepsis.

Care plan for pneumonia

The pneumonia care plan centres on Ineffective Airway Clearance and Impaired Gas Exchange. SMART goal: "Patient will maintain oxygen saturation above 94 percent on room air and demonstrate effective coughing with productive sputum clearance within 72 hours." Interventions include incentive spirometry hourly while awake, chest physiotherapy, early ambulation, and antibiotic timing per Community-Acquired Pneumonia guidelines.

Care plan for stroke

A stroke care plan addresses Risk for Aspiration, Impaired Physical Mobility, Impaired Verbal Communication, and Self-Care Deficit. Interventions anchor on dysphagia screening before oral intake, scheduled repositioning every two hours to protect skin integrity, early physical and occupational therapy consultation, and family caregiver education for discharge transition.

Care plan for chronic pain

Chronic pain care plans use Chronic Pain with defining characteristics including Numeric Rating Scale score, functional limitation, and psychosocial distress. Interventions combine pharmacological and non-pharmacological management: scheduled analgesia rather than as-needed dosing, heat or cold therapy, cognitive behavioural techniques, paced activity, and referral for interdisciplinary chronic pain management.

Care plan for postpartum hemorrhage

The postpartum hemorrhage care plan addresses Risk for Deficient Fluid Volume and Risk for Impaired Parenting related to acute maternal illness. Interventions follow the four-T framework, meaning Tone, Trauma, Tissue, and Thrombin, with fundal massage, uterotonic administration per order, quantitative blood loss measurement, and vital-sign trending every 15 minutes until stable.

Care plan for major depressive disorder

The major depressive disorder care plan prioritises Risk for Suicide and Hopelessness. SMART goal: "Patient will contract for safety, identify three reasons for living, and engage in one therapeutic activity daily for the next 72 hours, scoring 3 or higher on Nursing Outcomes Classification Suicide Self-Restraint (1408)." Interventions include every 15-minute safety checks when indicated, Columbia Protocol reassessment each shift, therapeutic communication using active listening, and collaboration with psychiatry for pharmacotherapy titration.

Downloadable care plan templates

EssayFount offers four nursing care plan template variants, each stripped of patient-identifiable information and ready to populate. Each template is built in Microsoft Word format for typing and Portable Document Format for printing.

Three-column blank template

The three-column template lists Nursing Diagnosis, Goal/Expected Outcome, and Interventions. This is the minimum viable format for a shift care plan or a brief academic assignment. Best for introductory fundamentals courses and short acute encounters where evaluation occurs verbally at handoff.

Five-column ADPIE-expanded template

The five-column template assigns one column each to Assessment Data, NANDA Diagnosis, Goals with NOC Outcomes, Interventions with NIC Codes and Rationale, and Evaluation. This is the preferred academic format because it forces the student to document the evidence trail from data to evaluation. Every column has a required field, so the grader can score the plan against ADPIE standards without hunting.

Concept-map style template

The concept-map template places the medical diagnosis in a central circle, radiates nursing diagnoses as branches, and connects interventions and outcomes as sub-branches with linking phrases. Concept maps help students see relationships that a columned grid flattens. Many nursing programs use the concept map in first-year fundamentals and transition to columned plans in medical-surgical rotations. See Nursing concept maps for a full concept-map guide.

Pediatric template

The pediatric template adds developmental milestone notes, family-centred-care goals, weight-based medication calculations, and growth-chart columns. It also includes a parent or caregiver education row because pediatric discharge teaching almost always targets the adult more than the child.

Nutrition care plans

A nutrition care plan documents dietetic assessment, diagnosis, intervention, and monitoring using the Academy of Nutrition and Dietetics framework. It complements, rather than replaces, the nursing care plan in patients with complex dietary needs.

The four-step Nutrition Care Process

The Academy of Nutrition and Dietetics Nutrition Care Process uses a Problem, Etiology, Signs and Symptoms statement to document the nutrition diagnosis (Academy of Nutrition and Dietetics, 2020). The four steps are Nutrition Assessment, Nutrition Diagnosis, Nutrition Intervention, and Nutrition Monitoring and Evaluation. The framework parallels ADPIE deliberately, so interdisciplinary teams can align nursing and dietetic documentation under the same patient problem list.

Nutrition diagnosis using the PES statement

The PES statement, meaning Problem, Etiology, Signs and Symptoms, is the nutrition-specific equivalent of NANDA's three-part statement. Example: Inadequate Protein-Energy Intake related to decreased ability to consume sufficient energy as evidenced by a 5 percent weight loss in 30 days and intake of less than 75 percent of estimated needs over 5 days. The PES statement isolates the nutritional problem from medical comorbidities, allowing targeted dietary intervention.

Sample nutrition care plan for Type 2 diabetes medical nutrition therapy

Medical nutrition therapy for Type 2 diabetes targets carbohydrate consistency, portion control, and glycated hemoglobin reduction. A typical plan prescribes a 1,800 to 2,000 kilocalorie pattern with 45 to 50 percent carbohydrate, 20 to 25 percent protein, and 30 percent fat distributed across three meals and two snacks. Monitoring indicators include glycated hemoglobin at 3 months, weight, blood pressure, and dietary adherence documented in a two-week food log. See Nutrition care plan examples for full dietetic plans across 20 conditions.

Sample nutrition care plan for eating disorders

Eating disorder nutrition care plans emphasise refeeding safety, weight restoration trajectory, and therapeutic alliance. The PES statement might read: Disordered Eating Pattern related to body-image distress as evidenced by restrictive intake, body mass index 16.2, and amenorrhea. Interventions include a structured meal plan with exchange system, supervised meals in the acute phase, phosphorus and electrolyte monitoring to prevent refeeding syndrome, and coordination with the psychology team.

Sample nutrition care plan for weight management

Weight management plans balance energy deficit, nutrient adequacy, and behaviour change. A sustainable 500-kilocalorie daily deficit produces roughly 0.45 kilograms of weight loss per week, considered safe and achievable in most adults. Interventions emphasise behavioural strategies such as self-monitoring, goal setting, and stimulus control rather than restrictive short-term diets. Monitoring includes weight, waist circumference, blood pressure, and lipid panel at 3-month intervals.

Mental health nursing care plans

Psychiatric mental health nursing care plans align with the American Psychiatric Nurses Association scope of practice (American Psychiatric Nurses Association, 2022). A mental health nursing care plan differs from a medical-surgical plan in three ways: it emphasises the therapeutic relationship, it uses behaviour-based SMART goals rather than physiologic ones, and it integrates safety contracts where risk of self-harm exists.

Psychiatric mental health nursing care plan structure

Psychiatric care plans open with a comprehensive psychosocial assessment covering mood, thought process, perception, cognition, insight and judgment, safety screening, and social support. Nursing diagnoses commonly include Risk for Suicide, Hopelessness, Anxiety, Ineffective Coping, and Disturbed Sleep Pattern. Interventions use therapeutic communication, milieu management, medication education, and coordinated safety planning.

Sample care plan for major depressive disorder

See the condition example above. The plan prioritises Risk for Suicide, uses the Columbia Protocol for ongoing screening, and tracks Nursing Outcomes Classification Suicide Self-Restraint (1408) and Mood Equilibrium (1204) across shifts.

Sample care plan for anxiety disorders

The anxiety care plan targets Anxiety and Ineffective Coping. SMART goal: "Patient will identify two personal anxiety triggers and demonstrate one grounding technique during each shift for the next 72 hours, scoring 4 on Nursing Outcomes Classification Anxiety Self-Control (1402)." Interventions include diaphragmatic breathing coaching, progressive muscle relaxation, cognitive reframing education, and referral for cognitive behavioural therapy.

Sample care plan for bipolar disorder

The bipolar care plan addresses Risk for Self-Directed Violence during depressive episodes and Risk for Injury during manic episodes. SMART goal in acute mania: "Patient will sleep 6 or more hours per night, decline participation in overstimulating activities, and take scheduled medication doses with 100 percent adherence for the next 5 days." Interventions include low-stimulation environment, structured routine, mood-stabiliser education, and family involvement in relapse prevention planning.

Pediatric nursing care plans

Pediatric care planning incorporates developmental considerations documented by the American Academy of Pediatrics (American Academy of Pediatrics Bright Futures Guidelines, 4th edition, 2017). A pediatric nursing care plan cannot be a smaller adult plan. Weight-based dosing, developmental communication, family-centred care, and caregiver education are built into every diagnosis.

Pediatric assessment considerations

Begin with the pediatric assessment triangle, meaning appearance, work of breathing, and circulation to the skin. Use age-appropriate pain scales such as the FLACC scale for infants, the Wong-Baker FACES scale for ages 3 to 7, and the Numeric Rating Scale for older children. Plot weight, height, and head circumference on World Health Organization or Centers for Disease Control and Prevention growth charts. Always document the primary caregiver's health literacy and support system because the plan succeeds or fails at the caregiver level.

Sample care plan for pediatric asthma

The pediatric asthma care plan targets Ineffective Airway Clearance and Deficient Knowledge. SMART goal: "Child and caregiver will demonstrate correct metered-dose inhaler with spacer technique, identify three asthma triggers, and verbalise the written asthma action plan within 48 hours." Interventions follow the National Asthma Education and Prevention Program guidance for stepwise therapy, spacer use, and peak-flow monitoring in children over 5 years. See Pediatric asthma care plan for the full document.

Sample care plan for failure to thrive

Failure-to-thrive plans combine nursing and dietetic expertise. Nursing diagnoses include Imbalanced Nutrition: Less Than Body Requirements and Impaired Parenting when contributing. Interventions include feeding observation, caloric density calculations, feeding-cue education, and coordinated follow-up with pediatrics, lactation, dietetics, and social work. Evaluation tracks weight-for-age percentile trajectory over 2-week intervals.

Common care plan mistakes to avoid

Common care plan mistakes appear in both student and new-graduate work. Each one has a fix.

Using medical diagnoses instead of nursing diagnoses

Writing "Type 2 diabetes" or "heart failure" as the diagnosis line fails the plan. Those are medical diagnoses. The nursing diagnosis is the human response to the medical condition: Risk for Unstable Blood Glucose Level, Excess Fluid Volume, Activity Intolerance. Always open the current NANDA International taxonomy and copy the approved label.

Non-SMART goals such as "patient will feel better"

"Patient will feel better" is not measurable, not time-bound, and not achievable by any defined intervention. Rewrite every goal to include a subject, a measurable action, a numeric or scored indicator, and a time frame. If the goal cannot be audited in the electronic record, it is not a goal.

Interventions without rationale

An intervention without a rationale looks like an order, not nursing judgment. For every intervention, add one sentence of evidence-based reasoning with a citation: "Reposition every 2 hours to reduce tissue interface pressure and prevent pressure injury formation, consistent with National Pressure Injury Advisory Panel guidance." Rationale is the line that proves the nurse thought, not reacted.

Evaluation without measurement

"Patient tolerated intervention well" does not evaluate anything. Evaluation means comparing observed data to the goal and scoring a Nursing Outcomes Classification indicator. State whether the goal was met, partially met, or not met, document the NOC score, and decide whether to continue, modify, or resolve the diagnosis.

Stale NANDA references

NANDA International retires and revises diagnoses every 2 years. Citing a 2012 edition in 2026 looks careless. Always use the current 2024 to 2026 taxonomy and check each diagnosis against the current defining characteristics. See NANDA nursing diagnoses for a running summary of the current taxonomy with recent changes.

Care plan compared with concept map and SOAP note

Students often confuse the nursing care plan example with the nursing concept map and the SOAP note. All three document care, but they serve different purposes.

In practice, a nurse writes a care plan on admission, updates it each shift, and documents each encounter with a SOAP-style progress note. A concept map rarely enters the medical record but is a strong learning tool for tying data to diagnosis. Compare with sibling format pillars at SOAP note examples, Discussion post examples, Case study templates, and Lab report writing.