Format Resume Asuhan Keperawatan

Nama Mahasiswa :
NIM :

1. Identitas Pasien :
Nama : ..................................................
Umur : ..................................................
Jenis kelamin : ..................................................
Pekerjaan : ..................................................
Pendidikan : ..................................................
Agama : ..................................................
Tanggal MRS : ..................................................
Alasan Masuk : ..................................................
Dx Medis : ..................................................

2. Analisa Data

No Data Fokus Etiologi Problem

3. Diagnosa Keperawatan Utama

.....................................................................................................................................
.....................................................................................................................................
.....................................................................................................................................
.....................................................................................................................................
................................................................
4. Intervensi Keperawatan

Tgl/ Diagnosa Tujuan dan

No Intervensi Paraf
jam Keperawatan Kriteria Hasil

5. Implementasi Keperawatan
 Tgl/
No Implementasi Respon/Evaluasi proses Paraf
jam

6. Evaluasi
 Tgl/ Para
No Diagnosa Medis Catatan perkembangan
jam f

Singaraja, November 2021

Mahasiswa,

NIM.