ASUHAN KEBIDANAN PADA BAYI BARU LAHIR DENGAN KASUS FISIOLOGI TANPA MASALAH

ANAMNESA / PENGKAJIAN
Tanggal :
Oleh :

DATA SUBYEKTIF
A. Identitas Bayi
Nama Bayi :
Jenis Kelamin :
Tanggal Lahir :
Jam :
Anak ke :

B. Identitas Orang Tua

Nama Ayah : Nama Ibu:
Umur : Umur :
Agama : Agama :
Suku / bgs : Suku/bgs :
Pendidikan : Pendidikan :
Pekerjaan : Pekerjaan :
Alamat : Alamat :

C. Riwayat Antenatal
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D. Riwayat Natal
 Usia Kehamilan :
 Cara Persalinan :
 Lama Persalinan
 Kala I : jam
 Kala II : jam
 Kala III : jam
 Kala IV : jam
  Keadaan saat Lahir : ……………………….
 A/S : ………… LK : ……… cm
 BB : …………gr LD : ……… cm
 PB : …………cm LP : ……… cm

 Tempat dan Penolong Persalinan : ……………………………………………….

E. Riwayat Obstetri
No Tanggal Jenis UK Penolong Tempat Keadaan Bayi JK BB/PB Ket
Persalinan Persalinan LH LM M
Pemeriksaan Fisik Pada Bayi Baru Lahir Dengan Kasus Fisiologi Tanpa Masalah

Tanggal :
Nama Bayi :
Umur :

DATA OBYEKTIF
A. Pemeriksaan Umum
 Keadaan Umum :
 Kesadaran :
 Tanda Vital :
Suhu : °C, RR : x/mnt, HR : x/mnt, BB : gram
B. Pemeriksaan Fisik
 Kepala :
 Mata :
 Hidung :
 Mulut :
 Telinga :
 Leher :
 Dada :
 Abdomen :
 Tali pusat :
 Kulit :
 Ekstermitas :
 Genitalia :
 Anus :
 Reflex :
 Moro :
 Rooting :
 Sucking :
C. Eliminasi
 BAB
Frekuensi : x/hari, Warna : …………………. Bau : ……………..
 BAK
Frekuensi : x/hari, Warna : …………………. Bau : ……………..
D. Therapy
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Diagnosa Kebidanan Pada Bayi Baru Lahir Dengan Kasus Fisiologi Tanpa Masalah

Tanggal :
Nama Bayi :
Umur :

Diagnosa
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Data Dasar
- DS
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- DO
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Rencana Asuhan Kebidanan Pada Bayi Baru Lahir Dengan Kasus Fisiologi Tanpa Masalah

Tanggal :
Nama Bayi :
Umur :

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Evaluasi Asuhan Kebidanan Pada Bayi Baru Lahir Dengan Kasus Fisiologi Tanpa Masalah

Tanggal :
Nama Bayi :
Umur :

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