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AKADEMI KEBIDANAN UMMI KHASANAH Jl. Pemuda Gandekan Bantul Yogyakarta 55711 Telp. 0274-368055, 7418523. www.akbiduk.ac.id

ASUHAN KEBIDANAN PADA BAYI BARU LAHIR

No RM

:………………………………..

Masuktgl/jam

:………………………………..

Tempat

:………………………………..

Pengkajian Tgl/jam

: ..............................................

SUBYEKTIF 1. Identitas Bayi Nama

:........................................................................................................................

Umur

:........................................................................................................................

Tanggal lahir

:........................................................................................................................

2. Identitas Penanggungjawab Nama

:........................................................................................................................

Umur

:........................................................................................................................

Agama

:........................................................................................................................

Pendidikan

:........................................................................................................................

Pekerjaan

:........................................................................................................................

Suku/bangsa

:........................................................................................................................

Alamat

:........................................................................................................................

Telp

:........................................................................................................................

3. Riwayat kelahiran a. Lama kala I

:........................................................................................................................

b. Lama Kala II

:........................................................................................................................

c. Warna air ketuban

:........................................................................................................................

d. Jumlah air ketuban

:........................................................................................................................

e. Jenis persalinan

:........................................................................................................................

f.

Komplikasi Persalinan : .......................................................................................................................

g. Penolong

:........................................................................................................................

h. Jam/tgl/lahir

:........................................................................................................................

i.

Jenis kelamin

:........................................................................................................................

j.

BB/PB

:........................................................................................................................

k. Caput

:........................................................................................................................

AKADEMI KEBIDANAN UMMI KHASANAH Jl. Pemuda Gandekan Bantul Yogyakarta 55711 Telp. 0274-368055, 7418523. www.akbiduk.ac.id

4. Eliminasi BAK

:..................................................................................................................................

BAB

:..................................................................................................................................

OBYEKTIF 1. Pemeriksaan Umum KU

:.......................................................................................................................

Vital sign

: N :.....................................S :................................R :.................................

Apgar score

: KRITERIA

0-1 MENIT

1-5 MENIT

5-10 MENIT

1. Denyut Jantung 2. Usaha Nafas 3. Tonus Otot 4. Reflek 5. Warna Kulit TOTAL 2. Pemeriksaan Fisik Kepala

:................................................................................................

Muka

:...............................................................................................

Ubun-Ubun

:................................................................................................

Hidung

:...............................................................................................

Bibir

:...............................................................................................

Telinga

:...............................................................................................

Leher

:...............................................................................................

Ekstremitas Atas (Kanan & Kiri)

: ..............................................................................................

Dada

:...............................................................................................

Tali Pusat

:...............................................................................................

Punggung

:...............................................................................................

Genetalia

:...............................................................................................

Anus

:............................................ ..................................................

Ekstremitas bawah (kanan & kiri) :...............................................................................................

AKADEMI KEBIDANAN UMMI KHASANAH Jl. Pemuda Gandekan Bantul Yogyakarta 55711 Telp. 0274-368055, 7418523. www.akbiduk.ac.id

3. Reflek Reflek moro

:Ada/tidak. Jika .....................

Reflek rooting

: Ada/tidak. Jika .....................

Reflek walking

:Ada/tidak. Jika .....................

Reflek graps

: Ada/tidak. Jika .....................

Reflek sucking

: Ada/tidak. Jika .....................

Reflek tonik neck

: Ada/tidak. Jika .....................

4. Antropometri BB

:………………………………………………………………………………………

PB

:………………………………………………………………………………………

Lingkar kepala

:.........................................................................................................................

Lingkar dada

:.........................................................................................................................

Lingkar lengan

:.........................................................................................................................

ASSESMENT

PENATALAKSANAAN Tanggal ..................................... jam ...............................