LAPORAN STUDI KASUS KEPERAWATAN MEDIKAL BEDAH

PADA RUANG KEPERAWATAN KHUSUS (0K/HD)

Nama Mahasiswa :
NIM :
Ruan Praktik :

A. RINGKASAN KASUS (Narasikan)

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
B. PENGKAJIAN RIWAYAT KESEHATAN (Narasikan Pengkajian focus perjalan
penyakit pasien)
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
C. PEMERIKSAAN PENUNJANG
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
D. INDIKASI TINDAKAN (HEMODIALISASI/OPERASI)
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

E. DIAGNOSA KEPERAWATAN

Subjektif :
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Objektif :
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Analisis Diagnosa Keperawatan :
___________________________________________________________________________
___________________________________________________________________________
Berhubungan dengan :
___________________________________________________________________________
___________________________________________________________________________
NOC : Ditingkatkan ke _________________________________________________
Keterangan Level
 1 ______________________________________________________________________
 2 ______________________________________________________________________
 3 ______________________________________________________________________
 4 ______________________________________________________________________
 5 ______________________________________________________________________
 Dengan Indicator/Kriteria hasil :
 [ ] ____________________________________________________________________
 [ ] ____________________________________________________________________
 [ ] ____________________________________________________________________
 [ ] ____________________________________________________________________
 [ ] ____________________________________________________________________

Planning NIC : ______________________________________________________

Aktivitas keperawatan
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________

F. GAMBARAN PROSEDUR TINDAKAN

(TINDAKAN DI PERSIAPAN OPERATIF/ TINDAKAN INTRAOPERATIF/
TINDAKAN PEMULIHAN TINDAKAN HEMODIALISA) *coret yang tidak perlu

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
 _______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

G. EVALUASI TINDAKAN
(TINDAKAN DI PERSIAPAN OPERATIF/ TINDAKAN INTRAOPERATIF/
TINDAKAN PEMULIHAN TINDAKAN HEMODIALISA) *coret yang tidak perlu

Subjektif :
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Objektif :
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Analisis :
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Planning :
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

Preceptor Klinik Preceptor Akademik

Ns. Firman Oswari, S.Kep Ns. Nehru Nugroho, S.Kep., M.Kep