Nama : Devy puja lestari

NPM : 2020206203045

Kelas : 3B S1 Ilmu Keperawatan

Data Cara Bertanya

1. Name 1. What is your name ? My name is Mrs Fatima
2. Age 2. When were you born ? I was born 1978, my age 35
3. Nationality & Race years old
4. Address & Telephone 3. What is your natonality ? I come from Indonesia
5. Religion and my race is Javanese
6. Material status 4. What is your address and telephone number ? My
7. Occupation address is nakulo st 26, Medan
5. What is your religion ? My religion is Muslim
6. Are you married ? I am married
7. What is your occupational? My occupation is
teacher

Chief complaint/keluhan utama What’s your problem ? My problem is contraction in

uterus after working

History of present illness related to the chief

complaint or problem
1. Date and time onset 1. When did the complaint start ? After I work since 3
2. Specific location day ago.
3. Type of pain or discomfort 2. Where is the location ? Contraction in my uterus
3. What is the pain like ?

Menstrual history
1. Age at menarche 1. When did you get the first time period? Menarche
2. Duration when I was 13 years old
3. Last menstrual period,duration and amount 2. How many days usually it happened?
4. Dysmenorrhoea 3. When did you have your last menstrual period ?
my last menstrual period was on march 13th 2013
4. Is there any problem during period like
dysmenorrhoea or premenstrual syndrome ? never
had problem, reguler every month,normal.
Obstetric history
1. Gravida / para 1. How many children do you have ? I had 1 son 3
2. Each pregnancy years old
a. Date of termination 2. a. When was your previous baby born ? he was
b. Weeks gestation born on march 5th
c. Place of delivery b. How many weeks was your previous pregnancy ?
d. Any problem during pregnancy,labour and normal, term
postpartum period? c. Where were you deliver your previous baby ? at
e. Weight of baby birth independent midwife
f. Sex of baby d. Did you have any problem for your previous
g. Any complication h. status of infant at birth pregnancy,labour and postpartum ? no I didn’t
i. Present status of infant e. How many kilos was your previous baby born ?
his weight was 3000 gram
f. Is it a boy or a girl? A boy
g. Were there any complications for your previous
baby born? no problem with that
i. How is your child now ? he was healthy

Contraceptive history
Present contraceptive nethod a. What type of contraceptive did you use before ?
a. Type I had never used any contraceptive method
b. Side effect b. Are there any side effects ? never had problem
c. Length of time using this method c. How long did you use this method of
contraceptive ? no, I didn’t use any contraceptive
method