Format Pengkajian Self Care - Orem

FORMAT PENGKAJIAN APLIKASI TEORI MODEL SELF MODEL SELF CARE OREM CARE OREM STIKES HANG TUAH SURABAYA

A. PENG PENGKA KAJI JIAN AN

1. Universal Universal Self Care a. Kebutuh Kebutuhan an oksige oksigen n ................................................................................................................................................... ...................................................................................................................................................   b. Kebutuhan Kebutuhan Cairan Cairan ................................................................................................................................................... ................................................................................................................................................... c. Kebutuhan Kebutuhan Nutrisi Nutrisi ................................................................................................................................................... ................................................................................................................................................... d. Kebutuhan Kebutuhan Eliminasi Eliminasi

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 b. Halangan Halangan untuk melakukan melakukan tindakan tindakan preventi preventif  f  ................................................................................................................................................... ...................................................................................................................................................

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B. DIAG DIAGNO NOSA SA KEPE KEPERAW RAWAT ATAN AN

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

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RENCANA KEPERAWATAN

No dx

Penuh/wholly

Sebagian/partial

Supportif Edukatif  

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IMPLEMENTASI DAN EVALUASI

No. Dx

Implementasi

Evaluasi

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