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RESUME ASUHAN KEPERAWATAN

Nama Mahasiswa : …………………………………………………………

NIM : …………………………………………………………
Ruang : …………………………………………………………

A. IDENTITAS PASIEN
Nama : ………………………………………………...........
Umur : ………………………………………………….......
Alamat : ……………………………………………………...
Jenis Kelamin : ……………………………………………………...
Agama : ……………………………………………………...
Suku/Bangsa : ……………………………………………………...
Diagnosa Medis : ……………………………………………………...
Tanggal Masuk RS : ………………………………………………………...
Tanggal Pengkajian : ………………………………………………………...

B. DATA FOKUS
DS :
………………………………………………………………………………
………………………………………………………………………………
………………………………………………………………………………
………………………………………………………………………………
………………………………………………………………………………

DO :
………………………………………………………………………………
………………………………………………………………………………
………………………………………………………………………………
………………………………………………………………………………
………………………………………………………………………………
ANALISA DATA

Nama Pasien : Mahasiswa :

No.RM : Ruang :

Tgl/Jam Data Problem Paraf

C. DIAGNOSA KEPERAWATAN
1. ………………………………………………………………………………………
2. ………………………………………………………………………………………
3. ………………………………………………………………………………………
D. INTERVENSI KEPERAWATAN

Nama Pasien : Mahasiswa :

RM/Ruang :

Tgl/Jam Diagnosa Keperawatan TUM/TUK Intervensi Nama/

paraf

Hari/
Tgl/ Diagnosa Keperawatan
Implementasi Evaluasi TTD
Jam
S:

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