1. IDENTITAS PASIEN a. Nama Pasien : .................................., Umur : .............th,( L ) / ( P ) b. Register : .................................., Tanggal MRS : ............................. c. Agama : .................................., Tanggal Pengkajian: ..................... d. Status : ( Menikah ) / ( Tidak menikah ) e. Pekerjaan : ................................., Pendidikan:…............................... f. Alamat : .........................................................................................
B. STATUS MENTAL 1. KEADAAN UMUM ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..……………………………
C. KEADAAN AFEK ……………………………………………………………..………………………………. …………………………………………………………..…………………………………. ………………………………………………………..……………………………………. ……………………………………………………………..……………………………….
D. PROSES PIKIR ……………………………………………………………..………………………………. …………………………………………………………..…………………………………. ………………………………………………………..……………………………………. ……………………………………………………………..………………………………. …………………………………………………………..…………………………………. ………………………………………………………..…………………………………….
E. PERSEPSI ……………………………………………………………..………………………………. …………………………………………………………..…………………………………. ………………………………………………………..……………………………………. ……………………………………………………………..………………………………. …………………………………………………………..…………………………………. ………………………………………………………..……………………………………. ……………………………………………………………..………………………………. …………………………………………………………..………………………………….
F. DIAGNOSA KEPERAWATAN ……………………………………………………………..………………………………. …………………………………………………………..…………………………………. ………………………………………………………..…………………………………….
G. RENCANA KEPERAWATAN 1. TUJUAN UMUM ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..……………………………
2 LAPORAN RESUME KEPERAWATAN JIWA PROGRAM STUDI ILMU KEPERAWATAN FAKULTAS KEPERAWATAN UNIVERSITAS AIRLANGGA
2. TUJUAN KHUSUS ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..…………………………… ……………………………………………………………..……………………………
E. TERAPI ……………………………………………………………..………………………………. …………………………………………………………..…………………………………. ………………………………………………………..…………………………………….
F. EVALUASI ……………………………………………………………..………………………………. …………………………………………………………..…………………………………. ………………………………………………………..……………………………………. ……………………………………………………………..………………………………. …………………………………………………………..…………………………………. ………………………………………………………..……………………………………. ……………………………………………………………..………………………………. …………………………………………………………..…………………………………. ………………………………………………………..……………………………………. 3 LAPORAN RESUME KEPERAWATAN JIWA PROGRAM STUDI ILMU KEPERAWATAN FAKULTAS KEPERAWATAN UNIVERSITAS AIRLANGGA
