Professional Documents
Culture Documents
Formulir Laporan Ujian Studi Kasus
Formulir Laporan Ujian Studi Kasus
KEPERAWATAN ANAK
DIAGNOSA KEPERAWATAN
Subjektif :
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
Objektif :
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
…………………………………………………………………………………………..
Analisis Diagnosa keperawatan:
.………………………………………………………………………………..…………
Berhubungan dengan:
……………………………………………………………………………………………
……………………………………………………………………………………………
NOC/SLKI :Ditingkatkan ke ………………………………………
Keterangan Level
1……………………………………………………………………………
2……………………………………………………………………………
3……………………………………………………………………………
4……………………………………………………………………………
5……………………………………………………………………………
Dengan indicator/Kriteria hasil:
[ ] .…………………………………………………………………………
[ ] ...……………………………………………………………………..…
[ ]………………………………………………………………………..…
[ ] ………………………………………………………………………..…
[ ] ………………………………………………………………………..…
Planning NIC/SIKI :
……………………………………………………………………………………
Aktivitas Keperawatan (minimal 10)
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
…………………………………………………………………………………………...
IMPLEMENTASI KEPERAWATAN:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
________________RESPON HASIL :
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
________________
_________________________________________________________________________________________
____
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
________________EVALUASI KEPERAWATAN :
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
____________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
____________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
____________________
Nama :
NIM :
(__________________________) (_________________________)