ASUHAN KEPERAWATAN

A. PENGKAJIAN KEPERAWATAN KELUARGA

Hari, tanggal : …………, ……………………. Jam : ………….

1. DATA UMUM
a. Nama Kepala Keluarga : …………………………………………………………………….
b. Umur KK : …………………………………………………………………….
c. Alamat dan telepon : …………………………………………………………………….
d. Pekerjaan KK : …………………………………………………………………….
e. Pendidikan KK : .........................................................................................................
f. Agama KK : .........................................................................................................
g. Suku bangsa KK : .........................................................................................................
h. Komposisi keluarga :
No Nama JK Hub. dg Umur Pendidikan Agama Pekerjaan
KK

i. Genogram
 j. Tipe Keluarga
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k. Suku Bangsa
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l. Agama
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m. Status sosial ekonomi keluarga

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n. Aktivitas rekreasi keluarga

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2. RIWAYAT TAHAP PERKEMBANGAN KELUARGA

a. Tahap perkembangan keluarga saat ini
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 b. Tahap perkembangan keluarga yang belum terpenuhi
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c. Riwayat kesehatan keluarga inti

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d. Riwayat kesehatan keluarga sebelumnya

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3. LINGKUNGAN
a. Karakteristik rumah
1). Denah rumah
2). Keadaan lingkungan dalam rumah
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3) Keadaan lingkungan di luar rumah

a). Pemanfaatan halaman
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b). Sumber air minum
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c). Pembuangan air kotor
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d). Pembuangan sampah
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e). Jamban
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f). Sumber pencemaran
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 g). Sanitasi rumah
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b. Karakteristik tetangga dan komunitas

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c. Mobilitas geografi keluarga

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d. Perkumpulan keluarga dan interaksi dengan masyarakat

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e. Sistem pendukung keluarga dan ecomap

4. STRUKTUR KELUARGA
a. Pola komunikasi
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b. Struktur kekuatan atau kekuasaan keluarga
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c. Struktur peran (formal dan informal)
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d. Nilai dan norma
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5. FUNGSI KELUARGA
a. Fungsi afeksi
1). Kebutuhan – kebutuhan keluarga, pola – pola respon
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2). Hubungan keakraban
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 3). Pertalian hubungan (diagram kedekatan dalam keluarga)

4). Perpisahan dan kekerabatan

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b. Fungsi sosial
1). Cara pola asuh pada anak
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2). Siapa yang menjadi pelaku sosialisasi anak–anak
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3). Nilai anak–anak dalam keluarga
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 4). Keyakinan budaya yang mempengaruhi pola asuh
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5). Pengaruh kelas sosial dalam pengasuhan
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6). Estimasi resiko masalah pengasuhan
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7). Kelayakan lingkungan rumah untuk bermain bagi anak
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c. Fungsi perawatan kesehatan
1). Keadaan kesehatan
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2). Kebersihan perorangan
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3). Penyakit yang sering diderita
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4). Penyakit keturunan
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5). Penyakit kronis atau menular
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6). Kecacatan
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7). Pola makan
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8). Pola istirahat
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9). Ketergantungan obat atau bahan
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10). Mencari pelayanan kesehatan
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d. Fungsi reproduksi
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6. STRESS DAN KOPING KELUARGA

a. Stressor jangka pendek dan jangka panjang
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b. Kemampuan berespon terhadap stressor
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c. Strategi koping yang digunakan
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d. Strategi adaptasi disfungsional
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7. PEMERIKSAAN FISIK
Hari Senin, 10 Januari 2011
TB BB LLA TD N R
No Nama S ºC Keterangan keluhan
Cm Kg Cm Mm/Hg x/’ x/’

8. HARAPAN KELUARGA TERHADAP PERAWATAN KESEHATAN KELUARGA

a. Persepsi terhadap masalah
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b. Harapan terhadap masalah
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Perawat yang mengkaji,

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