ASUHAN KEPERAWATAN KELUARGAI. PENGKAJIAN KELUARGAA. DATA UMUM 1. Nama kepala keluarga:2. Alamat:3. Pekerjaan kepala keluarga:4. Pendidikan kepala keluarga:5. Komposisi keluarga:

NoNamaJ KHub Dg KkUmurPendImunisasiKet

BCGPolioDPTHep BCampak

GENOGRAM

Keterangan :

6. Tipe Keluarga ...................................................................................................................................................................................................................................................... ............................................................................................................................................................................................................................................................

7. Suku Bangsa ............................................................................................... ...........................................................................................................................................................................................................................................................

8. Agama dan kepercayaan yang mempengaruhi kesehatan : .................................................................................................................................... ....................................................................................................................................

9. Status sosial ekonomi keluarga .................................................................................................................................. ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................ .........................................................................................................................

10. Aktivitas Rekreasi Keluarga............................................................................................................................................................................................................................................................................................................................................................................................... .................................................................................................................................... ......................................................................................................................................

B. RIWAYAT TAHAP PERKEMBANGAN KELUARGAa. Tahap perkembangan keluarga saat ini...............................................................................................................................................................................................................................................................................................................................................................................................................

b. Tahap perkembangan keluarga yang belum terpenuhi.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

c. Riwayat keluarga intiTn. .........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................Ny. ............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... ........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................ ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................d. Riwayat keluarga sebelumnya.............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

C. DATA LINGKUNGANa. Karakteristik rumah1. Luas rumah : .........................................................................................................2. Type rumah ........................................................................................................................................................................................................................................3. Kepemilikan .........................................................................................................4. Jumlah ruangan ......................................................................................................5. Ventilasi / jendela .....................................................................................................6. Pemanfaatan ruangan .............................................................................................7. Septic tank ...................letak ................................................................................8. Kamar mandi/WC .................................................................................................9. Sampah ......................................................limbah RT ..........................................10. Kebersihan lingkungan ......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Denah Rumah :

Keterangan :

b. Karakteristik tetangga dan komunitas RW1) Kebiasaan .................................................................................................................................................................................................................................................

2) Aturan/kesepakatan ....................................................................................................................................................................................................................................

3) Budaya ....................................................................................................................

c. Mobilitas geografis keluarga ..............................................................................................................................................................................................................................................................................

d. Perkumpulan keluarga dan interaksi dengan masyarakat...............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

e. Sistem pendukung keluarga................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

D. STRUKTUR KELUARGAa. Pola komunikasi keluarga.............................................................................................................................................................................................................................................................................................................................................................................................................................

b. Struktur kekuatan keluarga........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

c. Struktur PeranPeran Formal .......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Peran Informal.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

d. Nilai atau norma keluarga..............................................................................................................................................................................................................................................................................................................................................................................................................................

E. FUNGSI KELUARGAa. Fungsi afektif..............................................................................................................................................................................................................................................................................................................................................................................................................................

b. Fungsi sosial1. Interaksi dan hubungan dalam keluarga........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

2. Anggota keluarga yang dominan dalam pengambilan keputusan.........................................................................................................................................................................................................................................................................................................................................................................................................

3. Kegiatan keluarga di waktu senggang.........................................................................................................................................................................................................................................................................................................................................................................................................

c. Fungsi perawatan kesehatan1. Keluarga mampu mengenal masalah kesehatan.........................................................................................................................................................................................................................................................................................................................................................................................................

2. Keluarga mampu mengambil keputusan untuk melakukan tindakan.........................................................................................................................................................................................................................................................................................................................................................................................................3. Keluarga mampu melakukan perawatan terhadap anggota yang sakit.........................................................................................................................................................................................................................................................................................................................................................................................................

4. Keluarga mampu memodifikasi lingkungan yang dapat meningkatkan kesehatan.........................................................................................................................................................................................................................................................................................................................................................................................................

5. Keluarga mampu memanfaatkan fasilitas kesehatan yang terdapat di lingkungan......................................................................................................................................................................................................................................................................................................................................................................................................... d. Fungsi reproduksi.........................................................................................................................................................................................................................................................................................................................................................................................................................

e. Fungsi ekonomi.....................................................................................................................................................................................................................................................................................................................................................................................................................F. STRESS DAN KOPING KELUARGA1. Stressor jangka pendek yang dialami keluarga saat ini......................................................................................................................................................................................................................................................................................

2. Stressor jangka panjang yang dialami keluarga....................................................................................................................................................................................................................................................................................................................................................................................................................................

3. Kemampuan keluarga berespon terhadap stressor .....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

4. Strategi koping yang digunakan.........................................................................................................................................................................................................................................................................................................................................................................................................................

5. Strategi adaptasi disfungsional.........................................................................................................................................................................................................................................................................................................................................................................................................................

G. PEMERIKSAAN FISIK (HEAD TO TOE)PF/Nama

TD:RR:N:BB:

Kulit dan kuku :

Kepala:

Mata:

Hidung:

Mulut:

Telinga:

Leher:

Dada:a. Paru paruI:

P:

P:

A:

b. JantungI:

P:

P:

A:

c. Abdomen :I:

P:

P:

A:

EkstremitasEks atas:

Eks Bawah:

Rentang gerak :

Refleks Bisep :

Refleks Trisep :

Refleks Patella :

Refleks Achilles :

Genitalia:

Tn Ny. G.

H. HARAPAN KELUARGA.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

II. ANALISA DATANoDataEtiologiMasalah Keperawatan

Skoring dan prioritas masalahMasalah : KriteriaSkorBobotNilaiPembenaran

Jumlah

III. Diagnosa Keperawatan1.

2.

3.

4.

5.

IV. Rencana Tindakan Keperawatan KeluargaNoDx. Kep.TujuanEvaluasiIntervensiRasional

UmumKhususKriteriaStandar

V. ImplementasiTgglDx KeperawatanImplementasiEvaluasi FormatifTTD

VI. Catatan PerkembanganTgglDx KeperawatanEvaluasi SumatifTTD

PORTOFOLIOPRAKTEK KLINIK KEPERAWATAN KELUARGADI DESA LERAP RW 7

Di Susun Oleh :

PROGRAM STUDI ILMU KEPERAWATANSEKOLAH TINGGI ILMU KESEHATAN NGUDI WALUYOJl. Gedongsongo, Candirejo, UngaranTahun Ajaran 2014/2015