BUKU RANCANGAN PEMBELAJARAN

PRAKTIK KEPERAWATAN KARDIOVASKULAR

TINGKAT III SEMESTER 6 TA 2021/2022
DI RSUD BUDHI ASIH

KOORDINATOR :

Mutarobin, S.Kep., Ners., M.Kep., Sp.Kep.MB

KEMENTERIAN KESEHATAN REPUBLIK INDONESIA

POLITEKNIK KESEHATAN JAKARTA I
JURUSAN KEPERAWATAN
PRODI D3 KEPERAWATAN
JAKARTA, 2022
 FORM/PR/SPMI/PRODI/13/01

BUKU RANCANGAN PEMBELAJARAN

Institusi : Poltekkes Kemenkes Jakarta I

Jurusan : Keperawatan
Program Studi : D3 Keperawatan
Mata Kuliah : Praktik Klinik Keperawatan Kardiovaskular
Kode mata kuliah : WAT.5427
Bobot/SKS : 4 SKS (P= 4 SKS)
Sifat : Praktik
Pra-syarat : Kep.Das,PKK Kep.Dasar,KMB I,KMB II,PKK KMB I,PKK KMB II
Semester : 6 (Enam)
Periode Praktik : 24 Januari – 19 Februari 2022
Jumlah pertemuan mata kuliah : 4 minggu (24 hari)
Penanggunng jawab mata kuliah : Mutarobin, S.Kep., Ners., M.Kep., Sp.Kep.MB
Dosen Pengampu :
 Uun Nurulhuda, S.Kep., Ners., M.Kep, Sp.KMB
 Mutarobin, S.Kep., Ners., M.Kep., Sp.Kep.MB
 Amelia Arnis, S.Kp., M.Nurs
 Bara Miradwiyana, S.Kp., MMKM
 Tri Endah Pangastuti, S.Kep., Ners., M.Kep., Sp.Kep.MB
 Tarwoto, S.Kep., Ners., M.Kep
 Dr.Tutiany, S.Kp.,M.Kes
Instruktur :
 Emilza Maizar, S.Kep., Ners
 Kartikaning Kusumaastuti, S.Kep., Ners
 Dwi Setiadi, S.Kep., Ners
 Nurul M J, S.Kep., Ners

1. Deskripsi Mata Kuliah

Mata kuliah Keperawatan Kardiovaskular I merupakan muatan lokal pada Kurikulum Institusi Jurusan
Keperawatan Politeknik Kesehatan Jakarta I khususnya bagi mahasiswa tingkat III semester VI. Mata
kuliah yang mempunyai bobot 4 SKS ini merupakan bagian dari 6 SKS muatan lokal Keperawatan
Kardiovaskular yang terdiri atas 2 SKS PBC dan PBP (Keperawatan Kardiovaskular) dan 4 SKS PBK
(Praktik Klinik Keperawatan Kardiovaskular). Mata kuliah ini memiliki tujuan untuk memperdalam
kompetensi klinik calon perawat yang berfokus pada sistem kardiovaskular. Proses pembelajaran dan
manajemen asuhan keperawatan dilakukan menggunakan pendekatan Nursing Care Plan dan Nursing
Process masalah kesehatan yang terjadi pada pasien usia dewasa, baik yang bersifat akut maupun
kronik dengan penanganan konservatif maupun tindakan pembedahan dengan tetap berorientasi
kepada upaya preventif, kuratif, dan rehabilitatif melalui tindakan keperawatan mandiri maupun
kolaboratif untuk mempraktekkan teori dan konsep yang telah dipelajari di kelas pada mata kuliah
Keperawatan Kardiovaskular dan laboratorium mengenai keperawatan klien dengan gangguan sistem
kardiovaskular. Proses pembelajaran praktik klinik akan memberikan kesempatan kepada peserta didik
dalam lingkup penanganan kegawatan, perawatan intensif dan perawatan rehabilitasi, dengan
memfokuskan pada pemenuhan kebutuhan dasar klien. Adapun metode pembelajaran yang akan
diterapkan dalam proses pembelajaran klinik ini adalah bed side teaching, conference, ronde
keperawatan, dan seminar keperawatan, metode pengalaman (metode penugasan klinik dan tertulis)
dan metode pengarahan.
2. Capaian pembelajaran program studi (Program Learning Outcome)
a. Mampu bertanggung gugat terhadap praktik professional meliputi kemampuan menerima
tanggung gugat terhadap keputusan dan tindakan professional sesuai dengan lingkup praktik
di bawah tanggungjawabnya, dan hokum/peraturan perundangan
b. Memiliki sikap menghormati hak privasi, nilai budaya yang yang dianut dan martabak klien,
menghormati hak klien untuk memilih dan menentukan sendiri asuhan keperawatan dan
kesehatan yang diberikan, serta bertanggung jawab atas kerahasiaan dan keamanan
informasi tertulis, verbal dan elektronik yang diperoleh dalam kapasitas sesuai dengan lingkup
tanggungjawabnya.
c. Menguasai konsep dan prinsip “patient safety”
d. Menguasai teknik, prinsip, dan prosedur pelaksanaan asuhan/ praktek keperawatan yang
dilakukan secara mandiri atau berkelompok.

3. Capaian pembelajaran mata kuliah (Courses Learning Outcome)

a. Melaksanakan pengkajian keperawatan dan kesehatan yang sistematis pada gangguan
sistem kardiovaskular.
b. Merumuskan rencana asuhan sedapat mungkin berkolaborasi dengan pasien/klien
dan/atau pemberi asuhan / pelayanan pada gangguan sistem kardiovaskular.
c. Melakukan implementasi asuhan keperawatan dan kolaborasi dengan klien dan/atau tim
kesehatan lain pada gangguan sistem kardiovaskular.
d. Mendokumentasikan rencana asuhan keperawatan pada gangguan sistem
kardiovaskular.
e. Mengevaluasi dan mendokumentasikan kemajuan arah pencapaian hasil yang
diharapkan pada gangguan sistem kardiovaskular.
f. Memastikan pemberian substansi terapeutik yang aman pada gangguan sistem
kardiovaskular.
g. Mengkontribusi pada kerja tim multidisiplin yang efektif dengan memelihara hubungan
kolaboratif pada gangguan sistem kardiovaskular.
h. Mengajarkan strategi pengurangan stres pada gangguan sistem kardiovaskular.
i. Menggunakan langkah/tindakan aman untuk mencegah cidera pada klien/pasienpada
gangguan sistem kardiovaskular.
j. Berkomunikasi dengan sikap yang dapat memberdayakan klien/pasien dan/atau pemberi
asuhanpada gangguan sistem kardiovaskular.
k. Mempersiapkan klien/pasien untuk prosedur diagnostik dan penatalaksanaan dengan
mempergunakan sumber-sumber yang sesuai/ tepat pada gangguan sistem
kardiovaskular.
l. Memberikan asuhan kepada klien/pasien selama menjalani pre-operativepada gangguan
sistem kardiovaskular.
m. Memberikan asuhan kepada klien/pasien selama intra operativepada gangguan sistem
kardiovaskular.
n. Memberikan asuhan kepada klien/pasien selama Post-Operativepada gangguan sistem
kardiovaskular.
o. Memfasilitasi pemenuhan kebutuhan oksigen pada gangguan sistem kardiovaskular.
p. Memfasilitasi pemenuhan kebutuhan sirkulasi/ peredaran darah pada gangguan sistem
kardiovaskular.
q. Memfasilitasi pemenuhan kebutuhan cairan dan elektrolit pada gangguan sistem
kardiovaskular.
r. Memfasilitasi pemenuhan kebutuhan eliminasi urin pada gangguan sistem
kardiovaskular.
 s. Memfasilitasi pemenuhan kebutuhan eliminasi fekalpada gangguan sistem
kardiovaskular.
t. Memberikan obat secara aman dan tepat pada gangguan sistem kardiovaskular.
u. Mempersiapkan kepulangan klien/pasien pada gangguan sistem kardiovaskular.
v. Memberikan perawatan pendukung kepada klien/pasien dengan penyakit kronis pada
gangguan sistem kardiovaskular.
w. Memberikan pelayanan terhadap klien/pasien yang mengalami kehilangan/berduka pada
gangguan sistem kardiovaskular.
x. Membantu mengelola nyeri dengan tindakan tanpa bantuan obat pada gangguan sistem
kardiovaskular.
y. Membantu mengelola nyeri dengan bantuan obat pada gangguan sistem kardiovaskular.
z. Memfasilitasi pemenuhan kebutuhan nutrisi per oral dan parenteral.

4. Bahan/materi kajian
a. Askep pada pasien ACS (UAP, STEMI, dan NSTEMI)
b. Askep klien yang mengalami gangguan irama jantung
c. Askep klien gagal jantung
d. Askep klien perioperatif kardiovaskular
e. Askep klien dengan bedah jantung
f. Askep pada kegawatan kardiovaskular
g. Askep pada klien dengan rehabilitasi kardiovaskular
h. Pendidikan Kesehatan pada klien gangguan kardiovaskular dan tindakan kolaboratif

5. Wahana Praktik
Whana praktik yang akan digunakan adalah RSUD BUDHI ASIH, dengan rincian sebagai berikut:
1. Poli Jantung
2. Cathlab

6. Strategi/metode
Program praktik klinik Keperawatan kardiovaskular ini ditujukan untuk mahasiswa Jurusan Keperawatan
Prodi D III Keperawatan Politeknik Kesehatan Jakarta I semester 6 Tahun Akademik 2021/2022
berjumlah 8 orang yang akan berpraktik klinik di RSUD BUDHI ASIH selama 4 minggu (24 Januari – 19
Februari 2022.

Persiapan :
a. Mempersiapkan program Praktik Klinik Keperawatan Kardiovaskular, format pendokumentasian
asuhan keperawatan, format evaluasi laporan mingguan dan penampilan klinik, daftar hadir
mahasiswa dan pembimbing.
b. Rapat koordinasi antar pembimbing dari institusi pendidikan dan instruktur klinik (CI) Rumah
Sakit .
c. Kontrak program praktik klinik dengan mahasiswa.
d. Orientasi ke Rumah Sakit sebagai persiapan praktik.

Pelaksanaan :
a. Mahasiswa dibagi menjadi 4 kelompok, setiap kelompok terdiri dari 2 orang.
b. Setiap kelompok ditempatkan di ruang perawatan dan akan berpindah ke ruangan lain secara
bergilir (jadwal terlampir).
c. Setiap mahasiswa diberi tanggung jawab untuk memberikan asuhan keperawatan pada 1 orang
klien yang menjadi kelolaannya dengan gangguan sistem sesuai target kompetensi sistem
kardiovaskular yang ada di ruangan tersebut.
d. Pembelajaran akan dilakukan dengan strategi student active learning. Dosen akan mendorong
dan memfasilitasi mahasiswa untuk aktif mencari dan menemukan berbagai konsep yang harus
 dikuasai. Untuk memenuhi kondisi tersebut, ada 5 kegiatan utama yang akan dilaksanakan,
yaitu:
1) Pre conference dan post conference
adalah pertemuan pembimbing lahan praktik klinik dengan mahasiswa setiap hari ketika
akan dimulainya atau berakhirnya shift praktik.
2) Bed side teaching/ demonstrasi
3) Case Conference
4) Diskusi kelompok
Setiap kelompok mendapat kesempatan untuk presentasi paper kelompok dalam
diskusi kelas. Pada setiap akhir diskusi kelas, dosen harus memberikan presentasi
untuk mengklarifikasi materi yang dibahas dalam diskusi.
5) Penugasan klinik

e. Setiap melakukan target tindakan, mahasiswa wajib mendokumentasikannya di dalam format

kompetensi kritis yang ditandatangani oleh pembimbing akademik atau CI atau kepala ruangan
atau penanggung jawab ruangan.
f. Setiap mahasiswa diwajibkan untuk selalu membawa pendokumentasian yang dilakukan setiap
harinya selama masa praktik. Jika tidak, mahasiswa tidak boleh mengikuti kegiatan praktik hari
tersebut.
g. Setiap mahasiswa disyaratkan untuk lulus pada ujian praktik.

7. Tagihan
Ada 7 tugas (sebagai tagihan) yang harus dikerjakan dan diserahkan oleh mahasiswa, selama
mengikuti perkuliahan, yaitu :
NO EVALUASI TAGIHAN

1 Laporan minggu 1 :  Kasus pada minggu 1 sebagai kasus kelolaan kelompok

Kelolaan kelompok  Dipresentasikan pada hari Jum’at di minggu ke-4 praktik.
 Masing-masing mahasiswa membuat laporan pendahuluan
dengan kasus yang berbeda dan asuhan keperawatan kasus
kelolaan kelompok (tidak ada kasus individu)
 Asuhan keperawatan di log book kelompok.
 Log book kelompok berisi format asuhan keperawatan dari
pengkajian sampai evaluasi
 Makalah kelompok dikonsultasikan kepada pembimbing
minggu 1, 2, dan 3 minimal 3 kali

2 Laporan minggu 2 :  Kasus yang diambil pada minggu 2

Kelolaan individu  Membuat laporan pendahuluan dan asuhan keperawatan
(kasus individu)
 Asuhan keperawatan/resume di log book individu.
 Log book individu berisi format asuhan keperawatan dari
pengkajian sampai evaluasi
 Penilaian bersifat individu

3 Laporan minggu 3 :  Kasus yang diambil pada minggu 3

Kelolaan individu  Membuat laporan pendahuluan dan asuhan keperawatan
(kasus individu)
 Asuhan keperawatan/resume di log book individu.
 Log book individu berisi format asuhan keperawatan dari
pengkajian sampai evaluasi
 Penilaian bersifat individu
 4 Laporan minggu 4 :
Kelolaan kelompok
 Kasus diambil pada minggu 4
 Membuat laporan pendahuluan dan asuhan keperawatan
(kasus individu)
 Asuhan keperawatan/resume di log book individu.
 Log book individu berisi format asuhan keperawatan dari
pengkajian sampai evaluasi
 Penilaian bersifat individu

5 Ujian klinik
 Ujian terdiri atas : Ujian prosedur EKG, interpretasi EKG, dan
responsi (bawa PA dan format ujian) diutamakan kasus
dengan UAP, STEMI, NSTEMI, Gagal jantung, dan Aritmia.
 Ujian responsi dilakukan oleh dosen, sedangkan ujian
prosedur dilakukan oleh CI
 Ujian dilakukan di minggu ke-3 untuk hari ujian sesuai dengan
kesepakatan antara mahasiswa, dosen, dan CI
 Penilaian bersifat individu

6 Target tindakan Dikumpulkan dan dinilai oleh koordinator PJMA

keperawatan
7 Penampilan klinik  Dinilai tiap minggu oleh CI ruangan yang bersangkutan

Catatan:
Untuk poli jantung dan cathlab laporan dibuat dalam bentuk resume

8. Penilaian
a. Evaluasi hasil belajar dilakukan dengan mengadakan penilaian melalui pendekatan proses dan
hasil
b. Aspek yang dinilai meliputi pengetahuan (responsi, seminar kelompok), psikomotor (laporan
mingguan, demonstrasi), sikap (terintegrasi dalam penilaian psikomotor). Adapun rincian penilaian
akan dilakukan seperti di bawah ini :

NO EVALUASI BOBOT

1 Tugas (40%)
a. Laporan individu 25%
b. Laporan kelompok 15%
2 Ujian Praktik (30%)
a. Laporan kasus ujian 10%
b. Ujian praktik (tindakan keperawatan) 10%
c. Ujian praktik (responsi) 10%
3 Target tindakan keperawatan (25%) 25%
4 Penampilan klinik (5%) 5%
Total 100%

c. Sasaran mutu
1) Ketercapaian kompetensi : 100 %
2) Nilai Rata-rata : ≥ 3.00
3) Ujian Ulang Ujian praktik :<5%
Catatan :
 Kehadiran harus 100%
 Nilai batas lulus = 3.25 atau 75 (B)
9. Peraturan/tata tertib
a. Setiap mahasiswa wajib hadir 100% untuk mengikuti kegiatan praktik klinik yang terjadwal.
b. Apabila mahasiswa tidak hadir karena sakit wajib menunjukkan surat dokter, dan
mahasiswa yang bersangkutan akan diberikan penugasan.
c. Saat menjalankan aktivitas praktik, mahasiswa wajib menggunakan seragam profesi
beserta atribut lengkap sesuai dengan aturan institusi dan lahan praktik.
d. Mahasiswa wajib membawa nursing kit, handscoen, masker dan hand rub sendiri.
e. Mahasiswa wajib mengikuti praktik selama 24 hari, 6 hari/minggu dengan dinas pagi
(07.30 – 12.00) , sore (14.00 – 19.00), dan malam (20.30 – 07.30)
f. Mahasiswa wajib mengumpulkan laporan praktik setiap hari Senin di minggu berikutnya,
maksimal pukul 16.00 WIB. Laporan praktik dimasukkan dalam map plastik warna biru
dengan format penilaian laporan concept map dan laporan (lampiran 2) di bagian depan.
1) Jika terlambat 1 hari, nilai laporan dikurangi 5%
2) Jika terlambat 2 hari, nilai laporan dikurangi 10%
3) Terlambat lebih dari 3 hari, laporan tidak dinilai dan mahasiswa wajib mengambil
kasus baru.
g. Buku panduan praktik harus selalu dibawa.
h. Buku referensi harus tersedia di ruang rawat.
i. Mahasiswa wajib melengkapi target kompetensi yang dibuktikan dengan tanda tangan CI.
j. Mahasiswa wajib melakukan test swab antigen 3 hari sebelum praktik klinik. Apabila
hasil, swab positif, maka mahasiswa tersebut tidak diperbolehkan mengikuti praktik klinik.
k. Apabila selama proses praktik klinik mahasiswa kontak dengan pasien terkonfirmasi covid-
19, maka mahasiswa tersebut wajib melekukan swab antigen secara mandiri (biaya
mandiri)
l. Mahasiswa wajib mematuhi protokol kesehatan di wahana praktik dengan tetap
mengunakan masker bedah dan face shield sendiri serta menjaga jarak minimal 1 meter.
m. Bila didapatkan mahasiswa tidak mematuhi protocol new normal wahana praktik, maka
mahasiswa tidak diperkenankan untuk mengikuti praktik klinik.

10. Pembimbing
1. Kriteria Pembimbing Institusi: pendidikan minimal S1 Keperawatan
2. Pembimbing Klinik/ CI: pendidikan minimal S1 keperawatan + pengalaman diruang rawat/
ICU/ICCU/HCU/IGD minmal 3 tahun.
3. Peran dan Tanggungjawab

Pembimbing Institusi Pembimbing Klinik/ CI

Memberikan bimbingan kepada
mahasiswa (askep individu &
kelompok/makalah seminar)
Memberikan bimbingan klinik (bedside
teaching, conference)
Menguji mahasiswa : ujian responsi
Menilai laporan resume mahasiswa:
 Poli Jantung
 Cathlab
Memfasilitasi penentuan pasien kelolaan
Memberikan bimbingan klinik (bedside teaching,
conference)
Membimbing mahasiswa dalam askep kasus,
terutama seminar
Menguji mahasiswa : ujian tindakan
Memvalidasi (paraf) pada form daftar hadir
mahasiswa
Menyetujui izin/penggantian jadwal dinas
mahasiswa (berkoordinasi dengan pembimbing
institusi)

Memvalidasi (paraf) pada form daftar
hadir mahasiswa
Menyetujui izin/penggantian jadwal dinas
mahasiswa (berkoordinasi dengan
pembimbing klinik)
Memvalidasi (paraf) pada lembar target
kompetensi mahasiswa
Memberikan penilaian penampilan klinik
 4. Frekuensi Bimbingan
Selama praktik klinik berlangsung, pembimbing akademik akan melakukan bimbingan di RS
sebanyak 2x/minggu.

11. Sumber/referensi
Bare, S. (2010). Mannual of Nursing Practice. Philladelphia : The Lippincott.
Susan, L. (2010). Cardiac Nursing. 5th edition. Philadelphia, PA 19106: Lippincott Williams & Wilkins
Ignatavisius, Donna and Bayne V. Marilyn. (1995). Medical Surgical Nursing. Philadelphia :
WB Saunder
Long, Barbara C and Wilma J Phillips. (1991). Essential of Medical Surgical Nursing. Philadelphia : WB
saunders
Luckmann, Joan and Karen C Sorensen. (1997). Medical Surgical Nursing : Psychophisiologic
Approach. Philadelphia : WB Saunders
Hudak & Gallo. (2000) Critical Care Nursing: A Holistic Approach. JB Lippincott Company, Philadelphia.
Rokhaeni, Purnamasari, Rahayoe (2001). Buku Ajar Keperawatan Kardiovaskuler. Pusat Jantung
Nasional Harapan Kita.
Smith, Sandra F. et al (2004). Clinnical Nursing Skills : Basic to Advanced skills, 6 edition, New Jersey :
Upper Saddle River.

Mengetahui Jakarta, 16 Desember 2022

Ketua Program Studi DIII Keperawatan PJMA,

Ii Solihah, S.Kp., MKM Mutarobin, S.Kep., Ners., M.Kep., Sp.Kep.MB

NIP.19631013198901202 NIP. 198008262010121002

Kementerian Kesehatan RI
Politeknik Kesehatan Jakarta I Jurusan Keperawatan
Jl. Wijaya Kusuma Raya No. 47 Jakarta Selatan

TARGET KOMPETENSI

LOGBOOK PRAKTIK KEPERAWTAN KARDIOVASKULAR (KMB III)

ROGRAM STUDI D3 KEPERAWATAN

Nama Mahasiswa : …………………………….

NIM : …………………………….
Ruangan : …………………………….

Kompetensi/Jenis Tindakan Level Supervisi

No
Observasi Asistensi Mandiri
dengan
supervisi
1 Mengelola Kasus: ACS, CHF, dan Aritmia 1 kali 1 kali 1 kali
2 Pengkajian KV terfokus 1 kali 2ali 4 kali
3 Pemberian transfusi darah 1 kali 1 kali 2 kali

4 Pemasangan NGT 1 kali 2 kali 1 kali

5 Pemasangan Douwer kateter 1 kali 2 kali 1 kali

6 Pemberian terapi O2 (kolaborasi) 1 kali 1 kali 5 kali

7 Penghisapan Sekret/suction 1 kali 2 kali 3 kali

8 Pendidikan kesehatan pada pasien gangguan 1 kali 1 kali 4 kali
kardiovaskuler
9 Fisioterapi dada 1 kali 1 kali 2 kali
10 Pemeriksaan EKG 1 kali 1 kali 5 kali
11 Interpretasi EKG 1 kali 1 kali 5 kali
12 Pemberian obat-obatan jantung 1 kali 1 kali 5 kali
13 Pemberian BHD / RJP 1 kali 1 kali 2 kali
14 Persiapan operasi/cathlab 1 kali 1 kali 1 kali
15 Perawatan post op 1 kali 1 kali 1 kali
16 Tindakan rehabilitasi fase II (mobilisasi, ambulasi) 1 kali 1 kali 1 kali

FORMAT DAFTAR HADIR PRAKTIK MAHASISWA & PEMBIMBING

PRAKTIK KLINIK KEPERAWATAN ............

JURUSAN KEPERAWATAN POLTEKKES KEMENKES JAKARTA 1
PRODI D3 KEPERAWATAN
 Kelompok : ......................... Ruang : .........................

Tanggal
No Nama Mahasiswa

TTD Pembimbing
Institusi
TTD
Pembimbing
Klinik

FORMAT AKTIVITAS HARIAN (ADL) MAHASISWA

PRAKTIK KLINIK KEPERAWATAN ................

JURUSAN KEPERAWATAN
PRODI D3 KEPERAWATAN
POLTEKKES KEMENKES JAKARTA 1

Ruang : ……………………………. Hari/Tanggal : ……………………

Jam Kegiatan

Mengetahui,
Pembimbing Klinik

(…………………)

 Ditulis dalam buku tulis biasa

Wajib dibawa dan diisi setiap hari

Kementerian Kesehatan RI
Politeknik Kesehatan Jakarta I Jurusan Keperawatan
Jl. Wijaya Kusuma Raya No. 47 Jakarta Selatan

FORMAT PENILAIAN
Nama mahasiswa : ........................................
Minggu ke : ...........................................
I. LAPORAN PENDAHULUAN CONCEPT MAP

No Aspek yang dinilai Nilai

10 20 30 40 50 60 70 80 90 100
1 Konsep dasar
(lihat : kelengkapan isi)
2 Asuhan keperawatan
(lihat : kelengkapan isi)
3 Referensi yang digunakan (minimal 5 buku
maksimal 10 tahun terakhir)

Nilai = Total = .......................... Jakarta, ..................

....
3
II. LAPORAN ASUHAN KEPERAWATAN

No Aspek yang dinilai Nilai

10 20 30 40 50 60 70 80 90 100
1 Pengkajian keperawatan
(lihat : kelengkapan, kesesuaian data
fokus dengan masalah keperawatan)
2 Diagnosa keperawatan
(lihat : prioritas penyusunan prioritas
diagnosa, penulisan diagnosa
keperawatan)
3 Perencanaan keperawatan
(lihat : ketepatan penyusunan tujuan,
kriteria hasil, perencanaan keperawatan
dan rasionalisasinya)
4 Implementasi keperawatan
(lihat : kesesuaian tindakan dengan
perencanaan, ketepatan tindakan dan
dokumentasi implementasi keperawatan)
5 Evaluasi keperawatan
(lihat : kesesuaian dengan implementasi,
dokumentasi evaluasi keperawatan)

Nilai = Total = .......................... Jakarta, .....................

.
5

Kementerian Kesehatan RI
Politeknik Kesehatan Jakarta I Jurusan Keperawatan
Jl. Wijaya Kusuma Raya No. 47 Jakarta Selatan
FORMAT PENILAIAN
PRE CONFERENCE / POST CONFERENCE MA PKK KEPERAWATAN KARDIOVASKULAR

Nama Mahasiswa : …………………………….

NIM : …………………………….
Ruangan : …………………………….

No Aspek yang dinilai Nilai

55 60 65 70 75 80 85 90 95 100
1 Mendiskusikan laporan pendahuluan
concept map yang sudah dibuat

2 Mendiskusikan laporan asuhan

keperawatan yang telah dibuat
Pengkajian keperawatan

Perumusan diagnosa

Perencanaan keperawatan

Implementasi keperawatan

Evaluasi keperawatan

Jakarta, ......................
Nilai = Total = ...........................
______________________
6
Penilai
Kementerian Kesehatan RI
Politeknik Kesehatan Jakarta I Jurusan Keperawatan
Jl. Wijaya Kusuma Raya No. 47 Jakarta Selatan

PENILAIAN PENAMPILAN KLINIK

Nama Mahasiswa : …………………………….

NIM : …………………………….
Ruangan : …………………………….
Waktu / tanggal : …………………………….

Nilai
4 3 2 1
No Aspek yang dinilai Selalu Sering Kadang Jarang
2x
1 Berpakaian lengkap (sesuai dengan peraturan akademik &
RS) dan rapi
2 Kehadiran (datang & pulang) tepat waktu

3 Berpartisipasi aktif dalam pre & post conference

4 Berpenampilan & bersikap profesional selama memberikan

askep
5 Menghargai anggota tim keperawatan dan tim kesehatan
lain
6 Bekerjasama yang baik dengan anggota tim kesehatan
7 Memberikan askep yang aman & holistik

8 Memelihara lingkungan yang aman dan kondusif untuk klien

9 Menghargai dan menghormati martabat dan rahasia klien
10 Mampu berfungsi cepat dan efektif pada situasi gawat

11 Mampu menyesuaikan diri terhadap perubahan beban kerja

& kreatif
12 Melaporkan informasi yang berhubungan dengan
keperawatan klien secara tepat kepada kepala ruangan /
ketua tim

13 Berkomunikasi secara pantas (sopan & asertif) dengan

rekan sekerja dan anggota tim kesehatan lainnya

Total

Nilai = Total nilai x 100 = ...........................

------------- Jakarta, ..................
52 ....

Kementerian Kesehatan RI
Politeknik Kesehatan Jakarta I Jurusan Keperawatan
Jl. Wijaya Kusuma Raya No. 47 Jakarta Selatan

PENILAIAN SEMINAR (20%)

MATA AJAR : ..............................................
TOPIK : ..............................................
HARI/TANGGAL : ..............................................
KELOMPOK : ..............................................

NO ASPEK YANG DINILAI BOBOT NILAI BOBOT x

0 1 2 3 4 SKOR
I MAKALAH :
1. Sistematika 1
2. Pengetikan 2
3. Tidak ada pengulangan atau bahasa 1
4. Kelengkapan isi, khususnya keperawatan 4
5. Kemampuan mengemukakan pembahasan, 4
kesimpulan dan saran
6. Kejelasan keseluruhan materi 4
7. Jumlah dan relevansi pustaka/referensi 2
JUMLAH

II PRESENTASI :
1. Ketepatan waktu (20 menit) 2
2. Penggunaan waktu penyajian 2
3. Penampilan bahan yang disajikan 3
4. Kemampuan menjelaskan materi yang disajikan 4
5. Efektivitas alat bantu 2
JUMLAH

III TANYA JAWAB/DISKUSI/MASUKAN :

1. Kemampuan menjawab pertanyaan 4
2. Kemampuan memberikan argumentasi 4
3. Kemampuan mengorganisasi dalam diskusi 3
4. Penampilan profesional dalam tanya jawab 3
JUMLAH
NILAI TOTAL 45

Jumlah NIlai
Nilai = ---------------- = ……….
45
Nilai III = Nilai x ....% = …………
Jakarta, ………………….
Peserta didik Pembimbing
( …………………….) ( ........................... )

PEMBIMBING PRAKTIK KLINIK KEPERAWATAN KARDIOVASKULAR

 KELAS REGULER SEMESTER VI TAHUN AKADEMIK 2021/2022
JURUSAN KEPERAWATAN PRODI D III KEPERAWATAN POLTEKKES KEMENKES JAKARTA 1
TANGGAL 24 JANUARI – 19 FEBRUARI 2022

NO TEMPAT/RUANGAN PRAKTIK PEMBIMBING

1. RSUD BUDHI ASIH

1. Ruang Cathlab Tarwoto, S.Kep., Ners., M.Kep

2. Poli Jantung Tarwoto, S.Kep., Ners., M.Kep

DAFTAR NAMA KELOMPOK PRAKTIK KLINIK KEPERAWATAN KARDIOVASKULAR

KELAS REGULER SEMESTER I TAHUN 2021/2022
JURUSAN KEPERAWATAN PRODI D III KEPERAWATAN POLTEKKES KEMENKES JAKARTA 1
TANGGAL 24 JANUARI – 19 FEBRUARI 2022

NO KELOMPOK 1 KELOMPOK 2 KELOMPOK 3 KELOMPOK 4

1 Salamah Widia Tania Sri Ramadayanti Vera Febryana Yulianti

2 Sara Oktavianti Tarissa Fikah Lorenzia Virizky Nursyabani Zahra Rizqya Wirachma

DATA PESERTA DIDIK & PEMBIMBING

Mata Ajaran : Keperawatan Kardiovaskular
Prodi/Jurusan : D3 Keperawatan
Penanggung Jawab Mata Ajaran : Mutarobin, S.Kep., Ners., M.Kep., Sp.Kep.MB

Nama Lengkap : Salamah Widia

NPM : P17120019029
Email : salamah.widia@gmail.com
1 No. Ponsel : 081296049089

Nama Lengkap : Sara Oktavianti

NPM : P17120019073
Email : saraoktavianti@gmail.com
2 No. Ponsel : 085814433822

Nama Lengkap : Tania Sri Ramadayanti

NPM : P17120019034
Email : ramadayanti39@gmail.com
3 No. Ponsel : 0895326509205

Nama Lengkap : Tarissa Fikah Lorenzia

NPM : P17120019035
Email : rissatarissa121@gmail.com
4 No. Ponsel : 081316418423/ 081776060708

Nama Lengkap : Vera Febryana

NPM : P17120019076
Email : verafebryana21@gmail.com
5 No. Ponsel :082111452465

Nama Lengkap : Virizky Nursyabani Hermawan

NPM : P17120019077
Email : vinisyabani9@gmail.com
6 No. Ponsel : 081213357095

Nama Lengkap : Yulianti

NPM : P17120019079
Email : yullianti43@gmail.com
7 No. Ponsel : 08158975788

8 Nama Lengkap : Zahra Rizqya Wirachma

NPM : P17120019080
Email :
zhrrizqya@gmail....................................................................................................................
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............com
No. Ponsel : 081282121041
ROSTER DINAS KEPERAWATAN KARDIOVASKULAR
RSUD BUDHI ASIH
 RUANG POLI JANTUNG & CATH LAB

No Nama Kelompok 3 No Nama Kelompok 4

24 – 29 Januari 2022 31 Januari – 5 Februari 2022
24 25 26 27 28 29 31 1 2 3 4 5
1 Vera Febryana PJ PJ CL CL PJ L 1 Yulianti PJ PJ CL CL PJ L

2 Virizky PJ PJ CL CL PJ L 2 Zahra Rizqya PJ PJ CL CL PJ L

Nursyabani

No Nama Kelompok 1 No Nama Kelompok 2

7 – 12 Februari 2022 14 – 19 Februari 2022
7 8 9 10 11 12 14 15 16 17 18 19
1 Salamah Widia PJ PJ CL CL PJ L 1 Tania Sri R PJ PJ CL CL PJ L

2 Sara Oktavianti PJ PJ CL CL PJ L 2 Tarissa PJ PJ CL CL PJ L

Fikah L

Keterangan:
PJ : Poli Jantung
CL : Cath Lab
 FORMAT PENGKAJIAN KEPERAWATAN KARDIOVASKULAR

I. INFORMASI UMUM Tanggal : _____________ Waktu:___________

A. Identitas Pasien

Nama : ________________ RM : ____________________

Umur : ________________ Jenis kelamin :L/P*
Agama : ________________ Pendidikan : SD /SMP /SMA /S1 /S2 /S3 *
terakhir

Pekerjaan : PNS / Swasta / Pensiun / ________

Alamat : ____________________________________________________________

Diagnosa : ____________________________________________________________
Medis

B. Identitas Penanggung Jawab

Nama : ________________ Umur : ________________

Pendidikan : SD /SMP /SMA /S1 /S2 /S3 *
terakhir

Pekerjaan : PNS / Swasta / Pensiun / ________

Hubungan : Orangtua / Suami / Istri / Anak/ Saudara/ Lainnya ________________________
No Tlp : _________________________________________________________________

Alamat : __________________________________________________________

C. Riwayat Kesehatan

Keluhan utama : _______________________________________________

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________

Riwayat Kesehatan Sekarang :

Riwayat Kesehatan Masa Lalu :

Alergi
 Obat : _______________________________________________________________
 Makanan : _______________________________________________________________
 Lainnya : _______________________________________________________________
Riwayat operasi
 ___________________________________ tahun _________________
 ___________________________________ tahun _________________
 ___________________________________ tahun _________________

Riwayat penyakit keturunan :

 Diabetes  Hipertensi  Asma  Jantung  Kanker Lainnya : ______________

Konsumsi obat/ suplemen saat ini

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________

23 PKK Keperawatan Kardiovaskular – Poltekkes Kemenkes Jakarta I

 FORMAT PENGKAJIAN KEPERAWATAN KARDIOVASKULAR

II. Pengkajian Kardiovaskular Terfokus

1. Oksigenasi
a. Fisik
Batuk :  Tidak  Ya  Produktif  Non Produktif
Warna  Bersih  Putih
 Hijau  Kuning
 Merah
Sesak :  Tidak  Ya Fatique  Tidak  Ya
Inspeksi :
Nafas : RR _________ Irama :  Normal  Bradypnea  Takypnea
 Cheyne-stokes  Kussmaul
Simetris :  Tidak  Ya
Retraksi dada :  Tidak  Ya
Palpasi :
Taktil Fermitus : Kanan _____ Kiri ______

Perkusi :
 Resonance Letak ____________
 Hiperresonance Letak ____________
 Flat Letak ____________
 Dullnes Letak ____________
 Tympany Letak ____________

Auskultasi : Letak Letak

 Bronchial ___________________  Krakles ___________________
 Bronchovesikuler ___________________  Whezze ___________________
 Vesicukuler ___________________  Ronchi ___________________
 Friction Rub ___________________

b. Lab
Nilai Nilai normal H/L
pH ___________________ 7,35 – 7,45
PO2 ___________________ 35,00 – 45,00 mm Hg
PCO2 ___________________ 75,00 – 100,00 mmHg
HCO3 ___________________ 21,00 – 25,00 mEq/liter
Total CO2 ___________________ 21,00 – 27,00 mEq/liter
Sa02 ___________________ 95 – 100%
BE (Base excess / kelebihan ___________________ - 2 smp 2 mEq/liter
basa)

c. Pemeriksaan diagnostik lain (Radiologi Thorax paru dll)

_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________

2. Sirkulasi
a. Fisik
TD : _______mmHg Nadi : _______x/mnt Irama :  Reguler  Irreguler
Konjungtiva :  Normal  Pucat Kekuatan : Kuat  Lemah
 Absent
Membran :  Normal  Pucat Sianosis :  Ya  Tidak
mukosa/ bibir Kulit pucat :  Ya  Tidak
Kapillary refill : __________detik Akral dingin :  Ya  Tidak
CVP : ______ JVP : ______
Bunyi jantung :  S1 – S2 normal  Gallop

24 PKK Keperawatan Kardiovaskular – Poltekkes Kemenkes Jakarta I

 FORMAT PENGKAJIAN KEPERAWATAN KARDIOVASKULAR

 Paradoksial  Murmur

b. Lab
Nilai Nilai normal H/L
Enzim jantung
Creatinin Kinaze total ___________________ ___________________
CK – MB ___________________ ___________________
Serum Lipid
Lipid ___________________ ___________________
Kholesterol ___________________ ___________________
Triglycerida ___________________ ___________________
Plasma High-density ___________________ ___________________
lipoproteins (HDLs)
Plasma Low-density ___________________ ___________________
lipoprotein (LDLs)
Serum markers
Troponins ___________________ ___________________
Myoglobin ___________________ < 90 mcg/l

Hematologi
Red Blood Cell (RBC) ___________________ ___________________
Hemoglobin (Hgb) ___________________ 12 – 18 g/dL
Hematocrit (Hct) ___________________ 40% – 50%
White Blood Cell (WBC) ___________________ ___________________
Prothrombin time (PT) ___________________ ___________________

c. Pemeriksaan diagnostik lain (EKG dll)

_____________________________________________________________________________________________
_____________________________________________________________________________________________
________________________________

3. Nutrisi
a. Fisik
TB : _______cm BB : _______Kg IMT : ________
Gangguan makan :  Tidak nafsu makan  Mual  Muntah : _________cc/hr
 Sariawan  Gangguan mengunyah  Gangguan menelan
Diet sebelumnya : Porsi makan besar _________x/hr
Jenis makanan dan minuman
Karbohidrat/ Protein/ Lemak/ Sayur dan buah :
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________

Jenis makan ringan/selingan ________________________________

________________________________________________________
________________________________________________________
________________________________________________________

Konsumsi suplemen:  Ya  Tidak

Nama :___________________________________________________
________________________________________________________
_______________________________________________________
Kebiasaan:
 merokok : _____________________btg/hr/minggu
 alkohol : _____________________gls/hr/minggu
 soda : _____________________gls/hr/minggu
25 PKK Keperawatan Kardiovaskular – Poltekkes Kemenkes Jakarta I
FORMAT PENGKAJIAN KEPERAWATAN KARDIOVASKULAR

 kopi : _____________________gls/hr/minggu
 teh : _____________________gls/hr/minggu
 konsumsi gula : _____________________sdk/hr/minggu
 konsumsi garam : _____________________sdk/hr/minggu

Diet saat ini : Porsi makan besar _________x/hr

 Cair Jenis makanan dan minuman
 Lunak Karbohidrat/ Protein/ Lemak/ Sayur dan buah/pantangan :
 Padat ________________________________________________________
________________________________________________________
________________________________________________________

Jenis makan ringan/selingan ________________________________

________________________________________________________
________________________________________________________
________________________________________________________

Abdomen :
Inspeksi :  Normal  Asites _______cm  Stoma  Luka
 Caput medusa  Spider nevi

Auskultasi : Bowel Sound

RUQ :  normal  meningkat  menurun  absent
LUQ :  normal  meningkat  menurun  absent
RLQ :  normal  meningkat  menurun  absent
LLQ :  normal  meningkat  menurun  absent
Perkusi  Normal  Abnormal di Quadran ______________
Palpasi  Lunak  Padat  Tegang
Quadran ____________
Kesimpulan  Pembesaran hati  Pembesaran Spleen

b. Lab
Nilai Nilai normal H/L
Hemoglobin (Hgb) ___________________ 12 – 18 g/dL
Hematocrit (Hct) ___________________ 40% – 50%
Serum Albumin ___________________ 3.5 – 5.5 g/dL
Bilirubin total ___________________ 0.1 – 1.0 mg/dL
Bilirubin direk ___________________ 0.1 – 0.3 mg/dL
Bilirubin inderik ___________________ 0.2 – 0.8 mg/dL
Calcium ___________________ ___________________
Potasium ___________________ ___________________
SGOT ___________________ ___________________
SGPT ___________________ ___________________
Ammonia ___________________ ___________________
Transferin ___________________ 240 -480 mg/dL

26 PKK Keperawatan Kardiovaskular – Poltekkes Kemenkes Jakarta I

 FORMAT PENGKAJIAN KEPERAWATAN KARDIOVASKULAR

c. Pemeriksaan diagnostik lain (USG abdomen dll)

_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________

4. Eliminasi
a. Fisik
BAK : Keluhan
 Anuria (< 50 ml/hr)  Dysuria (kesusahan kemih)
 Nocturia  Polyuria  Inkontenensia
 Rasa Panas  Distensi bladder
Frekuensi Sebelum sakit : __________x/hr Saat sakit : ___________x/hr
Jumlah Sebelum sakit : __________cc Saat sakit : ___________cc
Warna  Kuning  Merah
Penggunaan obat _________________________________________________________
dieuretik

BAB : Keluhan
 Belum BAB ______hari
 Konstipasi ________hari
 Diare ____________hari
 Hemoroid
Frekuensi Sebelum sakit : __________x/hr Saat sakit : ___________x/hr
Warna  Kuning  Merah  Hitam
Penggunaan obat _________________________________________________________
pencahar

b. Lab
Nilai Nilai normal H/L
Kreatinin serum ___________________ ___________________
Blood urea nitrogen (BUN) ___________________ ___________________
pH urine ___________________ ___________________
Ketone ___________________ ___________________
Protein ___________________ ___________________
Crystal ___________________ ___________________
Sodium ___________________ ___________________
Calsium ___________________ ___________________
Chloride ___________________ ___________________

c. Pemeriksaan diagnostik lain (Kultur urin atau feces )

_____________________________________________________________________________________________
_____________________________________________________________________________________________
________________________

5. Aktivitas dan Istirahat

a. Fisik
ADL  Independent  Bantuan sebagian  Dependent
Kemampuan  Sendiri  Membutuhkan alat  Membutuhkan bantuan orang lain
berjalan  Membutuhkan alat dan orang lain
Kemampuan Kepala  Fleksi  Ektensi  Rotasi
rentang gerak Bahu  Elevasi  Depresi
27 PKK Keperawatan Kardiovaskular – Poltekkes Kemenkes Jakarta I
 FORMAT PENGKAJIAN KEPERAWATAN KARDIOVASKULAR

Ekstermitas atas kanan

 Flexi  Ekstensi  Abduksi  Aduksi
 Supinasi  Pronasi  Sirkumduksi
Ekstermitas atas kiri
 Flexi  Ekstensi  Abduksi  Aduksi
 Supinasi  Pronasi  Sirkumduksi
Ekstermitas bawah kanan
 Flexi  Ekstensi  Abduksi  Aduksi
 Supinasi  Pronasi  Sirkumduksi
Ekstermitas bawah kiri
 Flexi  Ekstensi  Abduksi  Aduksi
 Supinasi  Pronasi  Sirkumduksi
Kekuatan otot Segmen Kanan Kiri
 Lengan atas
 Lengan bawah
 Tangan
Keluhan Tidur dan  Tidak  Ya  Insomnia Lainnya:________________
Istirahat Kualitas tidur :  Cukup  Kurang
Kebiasaan tidur Malam : dari jam _________ sampai jam_________ total :_______jam
Siang : dari jam _________ sampai jam_________ total :_______jam
Kegiatan pengantar  Lampu redup  Lampu terang  Membaca
tidur  Minum minuman hangat  lainnya : ______________

b. Pemeriksaan diagnostik lain (Rongsen tulang dll)

_____________________________________________________________________________________________
_____________________________________________________________________________________________
________________________

6. Proteksi dan Perlindungan

a. Fisik
Suhu ___________0C
Luka  Tidak  Ya
 Panjang ________cm  Diameter _________cm
 Merah  Kuning  Hitam Balutan :  Bersih  Berair
Tanda tanda infeksi  Tidak  Ya
Gambar :

Risiko jatuh  Ya  Tidak

Tindakan invasif

28 PKK Keperawatan Kardiovaskular – Poltekkes Kemenkes Jakarta I

 FORMAT PENGKAJIAN KEPERAWATAN KARDIOVASKULAR

b. Lab
Nilai Nilai normal H/L
Hematologi
Eosinofil ___________________ ___________________
Neutrofil ___________________ ___________________
Limfosit ___________________ ___________________
Monosit ___________________ ___________________
LED ___________________ ___________________
c. Pemeriksaan diagnostik lain (dll)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_________________________________

7. Sensori
a. Fisik
Nyeri :
P : _______________________________________________________
Q: _______________________________________________________
R: _______________________________________________________
S: _______________________________________________________
T: _______________________________________________________

8. Cairan dan elektrolit

a. Fisik
Intake cairan sebelumnya : _________cc.
Intake Output
Minum : _____________ ml/hr Urine : _____________ ml/hr
Intravena : _____________ ml/hr Drain : _____________ ml/hr
IWL : _____________ ml/hr
Diare : _____________ ml/hr
Muntah : _____________ ml/hr
Perdarahan : _____________ ml/hr

Total : _____________ ml/hr Total : _____________ ml/hr

Balance :

Tanda  Rasa haus  Kulit kering  Mukosa bibir kering

Dehidrasi  Turgor kulit ______dtk
Distensi vena  Tidak  Ya
jugularis

Edema  Tidak  Ya  Sacral  Anasarca

29 PKK Keperawatan Kardiovaskular – Poltekkes Kemenkes Jakarta I
 FORMAT PENGKAJIAN KEPERAWATAN KARDIOVASKULAR

Ektermitas atas
RU +1 +2 +3 +4 LU +1 +2 +3 +4
RL +1 +2 +3 +4 LL +1 +2 +3 +4

Ektermitas bawah
RU +1 +2 +3 +4 LU +1 +2 +3 +4
RL +1 +2 +3 +4 LL +1 +2 +3 +4
Other : _____________

b. Lab
Nilai Nilai normal H/L
Natrium ___________________ ___________________
Kalium ___________________ ___________________
Kalsium ___________________ ___________________
Magnesium ___________________ ___________________
Phostpat ___________________ ___________________

c. Lainnya
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________

3. Analisa Data

NO DATA ETIOLOGI PROBLEM

30 PKK Keperawatan Kardiovaskular – Poltekkes Kemenkes Jakarta I

 FORMAT PENGKAJIAN KEPERAWATAN KARDIOVASKULAR

4. Diagnosa Keperawatan

Berdasarkan hasil pengkajian diatas, diagnosa yang muncul pada Tn/Ny.... berdasarkan SDKI Tahun 2018, antara
lain:
1. ...........................................................................................................................................................................
.................................................................................................................

2. ...........................................................................................................................................................................
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3. ...........................................................................................................................................................................
.................................................................................................................

4. ...........................................................................................................................................................................
......................................................................................................

31 PKK Keperawatan Kardiovaskular – Poltekkes Kemenkes Jakarta I

 FORMAT PENGKAJIAN KEPERAWATAN KARDIOVASKULAR

5. ...........................................................................................................................................................................
.................................................................................................................

32 PKK Keperawatan Kardiovaskular – Poltekkes Kemenkes Jakarta I

 FORMAT PENGKAJIAN KEPERAWATAN KARDIOVASKULAR

5. Intervensi Keperawatan (Kriteria SIKI dan SLKI)

No Diagnosa Keperawatan Tujuan Dan Kriteria Hasil Intervensi

............................................................. ................................................................................. .........................................................

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................... ......................................................... ..................
....................................... ........................................................
. ......................................................... ....................................
..................... ......................................................... ................
......................................... ......................................................
... ......................................................... ..................................
....................... .........................................................

....

6. Implementasi

33 PKK Keperawatan Kardiovaskular – Poltekkes Kemenkes Jakarta I

 FORMAT PENGKAJIAN KEPERAWATAN KARDIOVASKULAR

No Waktu Implementasi Tanda Tangan

...................
...................

7. Evaluasi

34 PKK Keperawatan Kardiovaskular – Poltekkes Kemenkes Jakarta I

 FORMAT PENGKAJIAN KEPERAWATAN KARDIOVASKULAR

Tanda
No Waktu Evaluasi
Tangan
...................
...................

35 PKK Keperawatan Kardiovaskular – Poltekkes Kemenkes Jakarta I