LAPORAN
ASUHAN KEBIDANAN KELUARGA BERENCANA(KB)
Tanggal :
Jam :
I. Pengkajian
A. DATA SUBYEKTIF
1. Biodata
Nama : Nama Suami :
Umur : Umur :
Agama : Agama :
Pendidikan : Pendidikan :
Penghasilan : Penghasilan :
Alamat : Alamat :
2. Keluhan Utama
....................................................................................................................
....................................................................................................................
....................................................................................................................
3. Riwayat Kesehatan Yang Lalu
....................................................................................................................
....................................................................................................................
....................................................................................................................
....................................................................................................................
4. Riwayat Kesehatan sekarang
....................................................................................................................
....................................................................................................................
....................................................................................................................
5. Riwayat Perkawinan
Menikah :……..X Umur Pertama Nikah :……….
Lama :……...Thn Jumlah Anak :……….
6. Riwayat Kehamilan, persalinan, nifas dan KB yang lalu
· Kehamilan
..............................................................................................................
..............................................................................................................
..............................................................................................................
..............................................................................................................
..............................................................................................................
· Persalinan
..............................................................................................................
..............................................................................................................
..............................................................................................................
..............................................................................................................
..............................................................................................................
· Nifas
..............................................................................................................
..............................................................................................................
..............................................................................................................
..............................................................................................................
· Rwayat KB
..............................................................................................................
..............................................................................................................
Gangguan : Spoting : Perdarahan :
7. Data psikososial dan spiritual
....................................................................................................................
....................................................................................................................
....................................................................................................................
....................................................................................................................
B. DATA OBYEKTIF
1. Pemeriksaan Umum
Keadaan Umum :
Kesadaran :
Nadi :
RR :
BB Sekarang :
BB Sebelum Hamil :
2. Pemeriksaan Fisik
A. Inspeksi
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
B. Palpasi
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
C. Auskultasi
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
D. Perkusi
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
E. Pemeriksaan Penunjang
..............................................................................................................
..............................................................................................................
..............................................................................................................
..............................................................................................................
F. Diagnosa / masalah
..............................................................................................................
..............................................................................................................
..............................................................................................................
..............................................................................................................
..............................................................................................................
..............................................................................................................
G. Identifikasi kebutuhan
..............................................................................................................
..............................................................................................................
..............................................................................................................
..............................................................................................................
..............................................................................................................
..............................................................................................................
..............................................................................................................
H. Masalah potensial
..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
I. Intervensi
..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
J. Implementsi
..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
K. Evaluasi
..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
|
| ||||||
| |||||||
