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FORMULIR LAPORAN UJIAN STUDI KASUS

KEPERAWATAN ANAK

Nama Mahasiswa : ___________________________________


NIM : ___________________________________
Ruang Praktik : ___________________________________
Nama Penguji :
Nama Penguji :

A. RINGKASAN KASUS (Identititas dan keluhan utama pasien)


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B. PENGKAJIAN RIWAYAT KESEHATAN (Narasikan Pengkajian focus perjalan penyakit pasien secara
sistematis)
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C. PEMERIKSAAN PENUNJANG
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DIAGNOSA KEPERAWATAN
Subjektif :
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Objektif :
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Analisis Diagnosa keperawatan:
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Berhubungan dengan:
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NOC/SLKI :Ditingkatkan ke ………………………………………
Keterangan Level
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Dengan indicator/Kriteria hasil:
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Planning NIC/SIKI :
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Aktivitas Keperawatan (minimal 10)
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IMPLEMENTASI KEPERAWATAN:
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________________RESPON HASIL :
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________________EVALUASI KEPERAWATAN :
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LAPORAN UJIAN STUDI KASUS


PRAKTIK PROFESI NERS
ASUHAN KEPERAWATAN ANAK
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Nama :
NIM :

PRECEPTOR LAHAN PRAKTIK PRECEPTOR INSTITUSI PENDIDIKAN

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KEMENTERIAN KESEHATAN REPUBLIK INDONESIA


POLITEKNIK KESEHATAN KEMENTERIAN KESEHATAN BENGKULU
JURUSAN KEPERAWATAN PROGRAM STUDI PENDIDIKAN PROFESI
NERS
TAHUN AKADEMIK 2020/2021

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