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LEMBAR OBSERVASI
A. MASUK KAMAR BERSALIN ANAMNESE
Tgl : .............................. Jam : .................... His mulai tgl : .............................. Jam : .................... Darah : ............................................................... Lendir : ............................................................... Ketuban pecah / belum Jam : .................... Keluhan lain : ...............................................................
B. KEADAAN UMUM
Tensi Suhu/ Nadi Oedema Lain-lain
: ............................................................... : ............................................................... : ............................................................... : ...............................................................
C. PEMERIKSAAN OBSTETRI
1. Palpasi 2. DJJ 3. His 10” 4. VT. Tgl 5. Hasil 6. Pemeriksa
: ............................................................... :............................................................... : ........................ x, lama :............... detik : .............................. Jam : .................... : ............................................................... : ...............................................................
OBSERVASI KALA I (Fase Laten Ø < 4 cm) Tanggal
Jam
His dlm 10” Berapa kali
Lamanya
DJJ
Tensi
Suhu
Nadi
VT
Keterangan
Tanggal
Jam
His dlm 10” Berapa kali
Lamanya
DJJ
Tensi
Suhu
Nadi
VT
Keterangan
A. MASUK KAMAR BERSALIN ANAMNESE
Tgl : .............................. Jam : .................... His mulai tgl : .............................. Jam : .................... Darah : ............................................................... Lendir : ............................................................... Ketuban pecah / belum Jam : .................... Keluhan lain : ...............................................................
B. KEADAAN UMUM
Tensi Suhu/ Nadi Oedema Lain-lain
: ............................................................... : ............................................................... : ............................................................... : ...............................................................
C. PEMERIKSAAN OBSTETRI
1. Palpasi 2. DJJ 3. His 10” 4. VT. Tgl 5. Hasil 6. Pemeriksa
: ............................................................... :............................................................... : ........................ x, lama :............... detik : .............................. Jam : .................... : ............................................................... : ...............................................................
OBSERVASI KALA I (Fase Laten Ø < 4 cm) Tanggal
Jam
His dlm 10” Berapa kali
Lamanya
DJJ
Tensi
Suhu
Nadi
VT
Keterangan
Tanggal
Jam
His dlm 10” Berapa kali
Lamanya
DJJ
Tensi
Suhu
Nadi
VT
Keterangan
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