DAFTAR DIAGNOSA KEPERAWATAN NAMA PASIEN UMUR NO REGISTER
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NO TANGGAL MUNCUL
DIAGNOSA KEPERAWATAN
TANGGAL TERATASI
TANDA TANGAN
ANALISA DATA NAMA PASIEN UMUR NO REGISTER
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DATA SUBJEKTIF DATA OBJEKTIF
FAKTOR YANG BERHUBUNGAN/RESIKO (E)
MASALAH KEPERAWATAN (NANDA)
RENCANA ASUHAN KEPERAWATAN
NAMA PASIEN :.......................................................... UMUR :.......................................................... NO REGISTER :.......................................................... . Diangnosa Keperawatan : .............................................................................................................. 1. NOC:...................................................................................................(kode:......................) a. ...........................................................dipertahankan/ditingkatkan pada......................... b. ...........................................................dipertahankan/ditingkatkan pada......................... c. ...........................................................dipertahankan/ditingkatkan pada......................... d. ...........................................................dipertahankan/ditingkatkan pada......................... e. ...........................................................dipertahankan/ditingkatkan pada......................... f. ...........................................................dipertahankan/ditingkatkan pada......................... g. ...........................................................dipertahankan/ditingkatkan pada......................... h. ...........................................................dipertahankan/ditingkatkan pada......................... i. ...........................................................dipertahankan/ditingkatkan pada......................... j. ...........................................................dipertahankan/ditingkatkan pada......................... k. ...........................................................dipertahankan/ditingkatkan pada......................... 2. NOC:...................................................................................................(kode:......................) a. ...........................................................dipertahankan/ditingkatkan pada......................... b. ...........................................................dipertahankan/ditingkatkan pada......................... c. ...........................................................dipertahankan/ditingkatkan pada......................... d. ...........................................................dipertahankan/ditingkatkan pada......................... e. ...........................................................dipertahankan/ditingkatkan pada......................... f. ...........................................................dipertahankan/ditingkatkan pada......................... g. ...........................................................dipertahankan/ditingkatkan pada......................... h. ...........................................................dipertahankan/ditingkatkan pada......................... i. ...........................................................dipertahankan/ditingkatkan pada......................... j. ...........................................................dipertahankan/ditingkatkan pada......................... k. ...........................................................dipertahankan/ditingkatkan pada......................... 3. NOC:...................................................................................................(kode:......................) a. ...........................................................dipertahankan/ditingkatkan pada......................... b. ...........................................................dipertahankan/ditingkatkan pada......................... c. ...........................................................dipertahankan/ditingkatkan pada......................... d. ...........................................................dipertahankan/ditingkatkan pada......................... e. ...........................................................dipertahankan/ditingkatkan pada......................... f. ...........................................................dipertahankan/ditingkatkan pada......................... g. ...........................................................dipertahankan/ditingkatkan pada......................... h. ...........................................................dipertahankan/ditingkatkan pada......................... i. ...........................................................dipertahankan/ditingkatkan pada......................... j. ...........................................................dipertahankan/ditingkatkan pada......................... k. ...........................................................dipertahankan/ditingkatkan pada.........................
RENCANA ASUHAN KEPERAWATAN NAMA PASIEN :.......................................................... UMUR :.......................................................... NO REGISTER :.......................................................... . Diangnosa Keperawatan : .............................................................................................................. 1. NOC:...................................................................................................(kode:......................) a. ...........................................................dipertahankan/ditingkatkan pada......................... b. ...........................................................dipertahankan/ditingkatkan pada......................... c. ...........................................................dipertahankan/ditingkatkan pada......................... d. ...........................................................dipertahankan/ditingkatkan pada......................... e. ...........................................................dipertahankan/ditingkatkan pada......................... f. ...........................................................dipertahankan/ditingkatkan pada......................... g. ...........................................................dipertahankan/ditingkatkan pada......................... h. ...........................................................dipertahankan/ditingkatkan pada......................... i. ...........................................................dipertahankan/ditingkatkan pada......................... j. ...........................................................dipertahankan/ditingkatkan pada......................... k. ...........................................................dipertahankan/ditingkatkan pada......................... 2. NOC:...................................................................................................(kode:......................) a. ...........................................................dipertahankan/ditingkatkan pada......................... b. ...........................................................dipertahankan/ditingkatkan pada......................... c. ...........................................................dipertahankan/ditingkatkan pada......................... d. ...........................................................dipertahankan/ditingkatkan pada......................... e. ...........................................................dipertahankan/ditingkatkan pada......................... f. ...........................................................dipertahankan/ditingkatkan pada......................... g. ...........................................................dipertahankan/ditingkatkan pada......................... h. ...........................................................dipertahankan/ditingkatkan pada......................... i. ...........................................................dipertahankan/ditingkatkan pada......................... j. ...........................................................dipertahankan/ditingkatkan pada......................... k. ...........................................................dipertahankan/ditingkatkan pada......................... 3. NOC:...................................................................................................(kode:......................) a. ...........................................................dipertahankan/ditingkatkan pada......................... b. ...........................................................dipertahankan/ditingkatkan pada......................... c. ...........................................................dipertahankan/ditingkatkan pada......................... d. ...........................................................dipertahankan/ditingkatkan pada......................... e. ...........................................................dipertahankan/ditingkatkan pada......................... f. ...........................................................dipertahankan/ditingkatkan pada......................... g. ...........................................................dipertahankan/ditingkatkan pada......................... h. ...........................................................dipertahankan/ditingkatkan pada......................... i. ...........................................................dipertahankan/ditingkatkan pada......................... j. ...........................................................dipertahankan/ditingkatkan pada......................... k. ...........................................................dipertahankan/ditingkatkan pada.........................
TINDAKAN KEPERAWATAN NAMA PASIEN UMUR NO REGISTER
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NO NO.DX TGL/JAM
TINDAKAN KEPERAWATAN
TANDA TANGAN
CATATAN PERKEMBANGAN NAMA PASIEN UMUR NO REGISTER
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NO NO.DX
JAM
EVALUASI