8/9/2019 CP SC1

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CLINICAL PATHWAYSECTIO CAESARIA ELEKTIF TANPA KOMPLIKASI

NAMA PASIEN: UMUR : BERAT

BADAN:

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

Kg

TINGGI

BADAN:

...........c

m

No Rekam Medik:

DIAGNOSA AWAL: G...P.....A.....H....... KODE ICD 10: RENCANA RAWAT: 4 HARI

AKTIVITAS

PELAYANAN

R.RAWAT TGL/JAM

MASUK

.

TGL/JAM

KELUAR

Indikai S! LAMARAWAT

"#ARI$

.

KELA

S

TARI%/#R BIA&A "RP$

#ARI RAWAT ' #ARI RAWAT ( #ARI RAWAT ) #ARI

RAWAT *

P+e o, - ,o o, Po0, 1a+i

'

Po o, 1a+i ke( Po 0,

1a+i ke)DIAGNOSA

UTAMA G....P....A....#.........

PENYERTA

ASSESMENT KLINIS P+eo, Po 0,PEMERIKSAAN

DOKTER

-. Anamn!a

a. K"#$an

%. U!&a &%#

'. (#m"a$)

'a*a +*!a"&nan

!%"#m

,. HPHT . R&/ KPD

PPV

. R&aa/

A"*&

-.GCS

-. T2anan Da*a$

-. Na,&

-. S#$#

-. Sa/#*a!&

O2!&n

-. F#n,#!

P"a!n/a:a. T&n&

%. L/a2 ana2

3+*-+5

'. P"a!n/a

,. D66

. D&"a/a!&

'*7&8

9. a&an

aa$ (an&n

-. L'$&a :

-. Ham*$&,

a. Y ; Y!

%. N ; N

-. n/#2 P#/&n

S#!#

-. APGAR S'*

310 Mn&/5

S,.0G2 S,.An S,.0G2

S,.An

3 3

3

3

33

3

3

3 3

3 3

3 3

3 3

3 3

3 3

3

3

3

3

3

3 3

3 3

3 3

4 Meni

:

'5Meni :

S,.0G2 S,.An

3

3

3

3

3

3

3

3

3

3

S,.0G S,.0G

3 3

3 3

3 3

3 3

3 3

3 3

3 3

3 3

3 3

3 3

KONSULTASI S,. An S,.AnS,.0G S,.0G

S,.A

S,.An

S,.0G

S,0G S,.0G

PEMERIKSAAN

PENUN(ANG

Da+a1 +6in

2 GDS2 #7 ,o

o,

#7SAg2 GDS2

Da+a1

+6in2 GDS

TINDAKAN .In8o+m 369a 1;gine 369a 1igiene 369a

8/9/2019 CP SC1

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!onen S!

- Aneei

. Paang D!

.Paang I3 9ine

. Tindakan S!

Maage

,6ing

#igiene

Maage ,6ing Maage

,6ing

Gani Ba96 Gani

Ba96

A< in86 - !a1ee+

OAT-OATAN:

"$ P#"an

P* O+:' =am ,+eo, '. In= !e8+ia>on 'g

i

3

(. RL 455 cc/? =am). Raniidin i.. '

am,.*. 0ndanen+on ?

mg ' am, i..4. 0( Naa9 kan69

3

3

3

3 3

P!/ O+ : 07a o+a9

07a 0+a9

'. RL 455 cc/ @ =am 3 3(. 0>c;ocin D+i,

'am,/a). 0ndanen+on

?mg in=. )>'*. Raniidin in=. (>'

am,.

3

3

3

3

3

3

4. In=.!e8+ia>on

(>' g+ 3 3

@. Po,a+gin )>'

a7

SL 3 3

3

. DiaCe,am *>(mg 3 3

3

?. Anaida ;+6,*>'5cc 3 33. Ro7o+ania (>'

a7 3 3 3

'5. Pa+aceamo9 )>

455 mg 3 3 3

NUTRISI P6aa ? =am Die 96nakTKTP '( =am

,o o,/Biing

66 no+ma9

Die TKTP Die

TKTP

MOILISASI Ba+ing (* =am2 7o9e1mi+ing kanan/ki+i

See9a1 (* =am

,o o, :

d6d6k2 =a9an

KRS

HASIL>V5) *%*an/&a ?81 /a% 3875

8/9/2019 CP SC1

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VARIANS:

AHAN HAIS

PAKAI

1. In9#! RL?. O%a/ In62!&

-.C9/*&a8n &n6.-. Ran&/&,&n In6.

-. On,an!n/*n

In6.

-. O8/'&n ,*&+.

-.R%*an/&a &7.

=. O%a/ O*a"

-.P!+a*&n

-.D&a@+am

-.An/a!&,a !&*#+

-. R%*an/&a

/a%.

-. Pa*a'/am"

/a%

-. C9a,*8&" *a"

4. Pa2/ Gan/&

%a"#/ !,an.

. DC

B. Pa2/ +a!an

&n9#!

. O? Na!a"

2an#"

.&aa O+*a!&

RA

. (a!a ,2/*

S+.An.10. (a!a ,2/*

S+.OG

11. (a!a ,2/*

S+.A

1?. P*&2!a La%

Bi9a !B! ,o o, men6n=6kkan andaanda in8eki ani7ioika ,o :

'9a,*8&" =800m 3>V5 a/a# 'am8&'"a7 =8 1 /a% 3>V5

R,.(55.555

R,.'45.555

R,. (5.555R,. 4@.555

R,. '55.555

R,. 45.555

R,.45.555

R,. )5.555

R,.45.555

R,. 45.555

R,. 45.555

R,. '55.555

R,. ''5.555

R,. (4.555

R,. '5.555

R,. 5.555

R,. '.@55.555

R,. ?55.555

R,. '.(55.555

R,. '(4.555

R,. )55.555

R,.(5.55 (UMLAH IAYA R,. 4.*)5.555NAMA PERAWAT DIAGNOSA AKHIR KODE

ICD 10

(ENIS TINDAKAN KODE ICD CM

UTAMA : P...A...

PEN&ERTA :DP(P : D2/* OPERATOR : TTD

S+.OG :

D2/* ANAESTESI

:

TTD S+.An :

NAMA

PELAKSANA

VERIFIKASI

AGIAN KEUANGAN : TT

Ka!&* :

SPI : TTD SPI :