ANALISA DATA

Nama Pasien : Ruang :

Umur : Hari/tgl :
No Data Fokus Etiologi Problem/Masalah
PRIORITAS MASALAH
1. ..............................................................................................................................................................
..............................................................................................................................................................
.....................................................................................................................................................
2. ..............................................................................................................................................................
..............................................................................................................................................................
.....................................................................................................................................................
3. ..............................................................................................................................................................
..............................................................................................................................................................
.....................................................................................................................................................
4. ..............................................................................................................................................................
..............................................................................................................................................................
.....................................................................................................................................................
5. ..............................................................................................................................................................
..............................................................................................................................................................
.....................................................................................................................................................
6. ..............................................................................................................................................................
..............................................................................................................................................................
.....................................................................................................................................................
7. ..............................................................................................................................................................
..............................................................................................................................................................
.....................................................................................................................................................
8. ..............................................................................................................................................................
..............................................................................................................................................................
.....................................................................................................................................................
RENCANA KEPERAWATAN
Nama Pasien : Ruang :
Umur : Hari/tgl :
Diagnosa Tujuan (NOC) Intervensi (NIC)
 CATATAN PERKEMBANGAN
Diagnosa Keperawatan: ................................................................................................................................................................
Hari/Tgl/Jam Implementasi Paraf Evaluasi (SOAP)