LAPORAN RESUME ASUHAN KEPERAWATAN GERONTIK

A. Identitas Pasien
Nama :
Umur :
Jenis Kelamin : L/P
Agama :
Status perkawinan :
Pendidikan terakhir :
Pekerjaan terakhir :
Alamat rumah :

Alasan Berada Di Panti:

RIWAYAT KESEHATAN
1. Masalah kesehatan yang pernah dialami dan dirasakan saat ini:

2. Masalah kesehatan keluarga/ keturunan:

B. Keadaan umum
Keadaan umum : ...................................................................................................................
TTV (Tanda-tanda Vital)
TD : ...................................................................................................................
Nadi : ...................................................................................................................
RR : ...................................................................................................................
Suhu : ...................................................................................................................
Kesadaran : ...................................................................................................................
GCS : ...................................................................................................................
Keluhan Utama : ...................................................................................................................
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C. Data Fokus
1. Data Subyektif

2. Data Obyektif

D. Diagnosa Keperawatan yang muncul

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E. Rencana Keperawatan
Diagnosa Nama
No Tujuan dan Kriteria Hasil Intervensi
Keperawatan /TTD
 F. Implementasi
Tgl/ Diagnosa Nama/
No Implementasi Respon Klien
Jam Keperawatan TTD
 G. Evaluasi
Diagnosa Nama/
No Tgl/Jam Evaluasi
keperawatan TTD