KEMENTRIAN KESEHATAN RI

POLITEKNIK KESEHATAN KEMENKES MALANG

JURUSAN KEPERAWATAN
PROGRAM STUDI D-IV KEPERAWATAN LAWANG

FORMAT RESUME KEPERAWATAN

KASUS :…………………………………….

I. Pengertian / Definisi :
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II. Etiologi :
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III. Pengkajian
 Identitas :
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 Riwayat :
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 Pemeriksaan Fisik :
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 Pemeriksaan Diagnostik :
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IV. Masalah Keperawatan/ Diagnosa Keperawatan :
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V. Penatalaksanaan Terapi/ Implementasi
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VI. Evaluasi :
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Mahasiswa

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NIM:.....................................
KEMENTRIAN KESEHATAN RI
POLITEKNIK KESEHATAN KEMENKES MALANG
JURUSAN KEPERAWATAN
PROGRAM STUDI D-IV KEPERAWATAN LAWANG

FORMAT LAPORAN PENDAHULUAN

I. DEFINISI

II. PATOFISIOLOGI (POHON MASALAH)

III. ETIOLOGI
IV. GEJALA/ TANDA
V. MASALAH KEPERAWATAN

VI. PEMERIKSAAN PENUNJANG

Pemeriksaan Diagnostik Hasil
1. ………………………………………………… 1. …………………………………………………
2. ………………………………………………… 2. …………………………………………………
3. ………………………………………………… 3. …………………………………………………

VII. PENATALAKSANAAN
a. Penatalaksanan Medis
 b. Penatalaksanaan Keperawatan :

VIII. ASUHAN KEPERAWATAN

a. Pengkajian Fokus (sesuai kasus)
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b. Diagnosa yang mungkin muncul
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c. Rencana Keperawatan
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Mahasiswa

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NIM:.....................................