ANALISA DATA

NO DATA PENYEBAB MASALAH

NO DATA PENYEBAB MASALAH
 DIAGNOSA KEPERAWATAN
1. ...................................................................................................................................................................................
2. ...................................................................................................................................................................................
3. ...................................................................................................................................................................................
4. ...................................................................................................................................................................................
5. ...................................................................................................................................................................................

DAFTAR PRIORITAS DIAGNOSA KEPERAWATAN

Ditemukan Teratasi
No. DIAGNOSA KEPERAWATAN
Tgl Paraf Tgl Paraf
 INTERVENSI KEPERAWATAN
No.
DIAGNOSA KEPERAWATAN TUJUAN & KRITERIA HASIL RENCANA KEPERAWATAN RASIONAL
DX
No.
DIAGNOSA KEPERAWATAN TUJUAN & KRITERIA HASIL RENCANA KEPERAWATAN RASIONAL
DX
 IMPLEMENTASI KEPERAWATAN
Tgl DIAGNOSA KEPERAWATAN JAM IMPLEMENTASI PARAF
Tgl DIAGNOSA KEPERAWATAN JAM IMPLEMENTASI PARAF

EVALUASI KEPERAWATAN (CATATAN PERKEMBANGAN)

Hari / Tanggal
NO
DX
KEP

Hari / Tanggal
NO
DX
KEP

EVALUASI KEPERAWATAN
 DIAGNOSA
Tgl EVALUASI PARAF
KEPERAWATAN
S: .......................................................................................
1. .......

O: .......................................................................................
.......

A: .......................................................................................
.......

P: .......................................................................................
.......

2. S : ......................................................................................
........

O : ......................................................................................
........

A : ......................................................................................
........

P : ......................................................................................
.........
3.
S : ......................................................................................
........

O : ......................................................................................
........

A : ......................................................................................
........

P : ......................................................................................
.........