Professional Documents
Culture Documents
Client:__Ny. Sona__________________________________________________
MR#_________
Second diagnosis:________________________________________________________
________________________________________________________________________
Psychosocial Status
10300 Sunset Drive, Suite 236. Miami, FL 33173 T.786.991.2300 F.786.991.2304 www.hhsgroup.net
NURSING ASSESSMENT FORM (Cont.) Client:
Assistive device: __cane ✓__quad cane __walker __ rolling walker __reg. wheelchair
__electric wheelchair __crutches other____________________________________
Device/equipment needed at home:_clean clothen, sugar check tool, alcohol awan, penidel,
and lanset._________________________________________
Significant
other:__family_______________________________________________________
________________________________________________________________________
10300 Sunset Drive, Suite 236. Miami, FL 33173 T.786.991.2300 F.786.991.2304 www.hhsgroup.net
NURSING ASSESSMENT FORM (Cont.) Client:
Ambulation ✓
Stairs ✓
Dressing ✓
Feeding ✓
Household tasks ✓
Transfer ✓
Self-care(grooming/bath) ✓
Toiling ✓
__________________________________ ______________________________
History given by Relationship to client
__________________________________ _____________________________
RN signature Date
10300 Sunset Drive, Suite 236. Miami, FL 33173 T.786.991.2300 F.786.991.2304 www.hhsgroup.net
DX= istability of blood glucose dd diabetes melitus
Intervensi
O= identifikasi perubahan nafsu makan dan aktifitas akhir-akhir ini
N= lakukan pemeriksaan laboratorium
E= -
K= -