buku Log DI

Format Buku Log untuk Usaha Kesehatan Perorangan (UKP)

Tanggal Kode Kegiata

n

Kegiatan Catatan dan usulan pendamping terhadap

kinerja

Tanda tangan

Pendamping

KeteranganDiagnosis Penatalaksanaan

(1) (2) (3) (4) (5) (6) (7) 16/05/12

A DM, jenis kelamin.........Umur

- OR- Diet- Obat

perbaiki kinerja pemeriksaan fisik diagnostik

£Dr. Widjaya

Umpan balik positif untuk peserta

Keterangan format: (1)Tanggal pelaksanaan kegiatan(2)Kode kegiatan sebagai berikut :

A. Kasus MedikB. Kasus BedahC. Kasus Kegawat daruratanD. Kasus Kejiwaan

(3)Diagnosis untuk kegiatan A s/d D(4)Penatalaksanaan untuk kegiatan A s/d D(5)Catatan dan usulan pendamping ( lihat evalasi kinerja dan check list )

a. Evaluasi kinerja pesertab. Usulan perbaikan kinerja

(6) Tanda tangan pendamping : DPJP (kp, kalau pendamping tidak mengamati langsung) + Pendamping(7)Keterangan

Hal-hal lain yang dianggap perlu Sebut tempat pemeriksaan al polikilink, kamar terima , ugd, ruangan/bangsal, puskesmas, posyandu, dll

Format Buku Log untuk Usaha Kesehatan Perorangan (UKP)

Tanggal Kode Kegiat

an


kinerja

Tanda tangan

Pendamping

KeteranganDiagnosis Penatalaksanaan

(1) (2) (3) (4) (5) (6) (7)

21/05/12 B Vulnus appertum , L, 35 Rawat luka

Hecting

Cefadroxil 3 x 1 tab

Asam mefenamat 3 x 1 tab

Dr. Luh Putu Kusumawati

21/05/12 A Faringitis, L,12 Amoxicillin 3 x 1 tab

Paracetamol 3 x 1 tab


21/05/12 A Otitis Eksterna, L, 3 Amoxicilin syr 3 x C I

Ibuprofen tetes telinga


22/05/12 B BPH, L, 70 - IVFD RL 20 tpm

- Cek laboratorium ( DL, Ureum, creatinin, SGOT,SGPT, Gula darah sewaktu, BT, CT)

- EKG

- Konsul dr. spB

- Rencana tindakan prostatectomy


22/05/12 A Thypoid , P, 38 Cek laboratorium (DL, Widal)


Tiampenichol 3 x 1 tab

Paracetamol 3x1 tab

22/05/12 A Dispepsia, L, 60 Injeksi Ranitidin 1 amp

Lagesil syr 3 x C I


Lapibion 1 x 1 tab


22/05/12 A LBP, P, 20 Injeksi ketorolac 1 amp



22/05/12 A Tension Headeace, P, 25 Paracetamol 3 x 1 tab

Yudavit 1 x 1 tab


22/05/12 A Gastro enteritis akut , P , 1 IVFD 12 tpm micro

Cefotaxim inj 3 x 1 gr

Zinc kid


22/05/12 B FAM, P, 18 Konsul dr.spB

Cefotaxim 3 x 1 gr


23/05/12 A Selulitis , L, 65 Cefotaxim inj 3 x 1 gr



23/05/12 A ISPA, L, 11 Amoxicillin 3 x 1 tab


Dexamethason 3 x 1 tab

Dekstrometorphan 3 x 1 tab


23/05/12 B Plegmon , L, 70 IFVD RL 20 tpm

Cefotaxim 3 x 1 gr

Remopain 3 x 1 amp

Konsul dr spB


23/05/12 C Plegmon , L, 70 IFVD RL 20 tpm

Cefotaxim 3 x 1 gr

Remopain 3 x 1 amp

Konsul dr spB


23/05/12

23/05/12 A Dispepsia, P, 40 Injeksi Ranitidin 2 x 1 amp

Antasida 3 x 1 tab


23/05/12 A TB paru, L, 65 Amoxicilin 3 x 1 tab

Dextrosin 3 x 1 tab

Rencana pemberian OAT


23/05/12 A Gastritis, L, 30 Ranitidin 2x 1

Antasida 3 x 1 tab

Neurobiad 3 x 1 tab


23/05/12 A Konjungtivitis, L , 11 Cendo litters 3 x 2 tetes

Interistin 2 x 1 tab


23/05/12 A ISK, L, 44 Opicef 3 x 1 tab

Yudavit 1 x 1 tab


23/05/12 A Dispepsia, L, 42 Lagesil syr 3 x C I

Acran 3 x 1 tab


24/05/12 B Abses , L, 3 bln Insisi abses

Amoxicilin 3 x 1 tab

Ibuprofen 3 x 1 tab


24/05/12 A ISPA , P 41 Grafed 3 x 1 tab

Yudavit 1 x 1 tab


24/05/12 A Faringitis, P, 8 bln Paracetamol 3 x 1 tab



24/05/12 A Dermatittis Kontak Iritan, P, 1 Amoxiciln 3 x 1 tab

Salep betametason


25/5/2012 A myalgia, P, 36 Asam mefenamat 3 x 1 tab

Sangobiad 1 x 1 tab


25/5/2012 C Obs sianosis, L, 1 bln O2 10 lt/mnt

Rujuk RSAD Denpasar


25/5/2012 A Mialgia , P, 45 Diazepam tab 3 x 2 mg


Neurobiad 1x 1 tab


25/5/2012 A Hepatitis,L,41 Methicol 3 x 1 tab

Neuribiad 1x 1 tab


25/5/2012 B Vulnus appertum,L,35 Rawat luka


Asam Mefenamat 3 x 1 tab


25/5/2012 B Abses pedis, L , 35 Insisi abses


Natrium declofenac 3 x 1 tab


25/5/2012 A Dispepsia ,L,42 Cefotaxim inj 3x 1gr

Ondansentron 3 x 1 tab

Ulceramin inj 2 x 1 amp

Lactopain inj 2x 1 amp


28/5/2012 B Hemoroid , L, 26 Ardium 3 x 1 tab

Lavadive 3 x 1 tab


28/5/2012 A Varicela, L, 23 Acyclovir 4 x 800 mg Dr. Luh Putu Kusumawati

28/5/2012 A Obs febris, P, 35 Tiampenicol 3 x 1 tab


Yudavit 1 x 1 tab


28/5/2012 A Konjungtivitis, P, 18 Cendoxitrol 3 x 2 tts Dr. Luh Putu Kusumawati

28/5/2012 B Vulnus appertum, L, 49 Heacting

Tetagam inj IM 1 amp




29/5/2012 A Gout Arthritis, L, 65 Neurobat inj 1 amp

Allupurinol 2x1 tab


Dexametason 3 x 1 tab

Lapibion 1x 1 tab

29/5/2012 C Asma, P, 43 Nebulizer combivent 1 amp

Methilprednisolon 3 x 1 tab

Lasal syr 3 x C I

Mucera syr 3 x C I


29/5/2012 A DB, P, 25 IVFD RL 20 tpm


Lapimox 3 x 1 tab


29/5/2012 A Mialgia , L, 47 Ponstan 3 x 1 tab

Lapibion 1x 1 tab


30/5/2012 A Otitis media, L, 10 Clorampenicol tetes telinga




29/5/2012 B Colic abdomen, L, 45 IVFD D5% 20 tpm

Antrain inj 2 x 1 amp


EKG

BOF


29/5/2012 C Colic abdomen, L, 45 IVFD D5% 20 tpm

Antrain inj 2 x 1 amp



EKG

BOF

30/5/2012 A ISK, P, 28 Lapiprox 2x1 tab

Lapistan 3x1 tab

Dulcolax


1/6/2012 C Kejang demam, P, 7 bln Stesolid sup 5 mg

Pamol sup 12g mg

Cefotaxim 3 x 200 mg

Paracetamol syr 3 x C I


1/6/2012 A Cepalgia, P, 30 Neuralgad 3x1 tab

Yudavit 1x1 tab


1/6/2012 A ISK, P , 28 Lapiprox 2x1 tab

Lapistan 3x1 tab

Dulcolax sup


1/6/2012 A Sinusitis, L, 22 Amoxicilin tab 3 x 1

Zentra tab 3x 1

Neuralgad tab 3x 1


1/6/2012 A Obs febris, L, 80 Konsul dr SpPD

IVFD RL

Cefotaxim 3 x 1 gr

Ulceranin 2 x 1 amp

Sanmol 3 x 1 tab


Parbion drip

Lab

EKG

1/6/2012 A Dispepsia + Hipertensi, L, 41 Hufamag 3 x 2 ab

Captopril 2 x 12,5 mg


1/6/2012 A Mialgia, L, 15 Renvol 3 x 1 tab Dr. Luh Putu Kusumawati

1/6/2012 A Cephalgia , P, 41 Analsik 3 x 1 tab

Neurobion 1x1 tab


1/6/2012 A ISPA, L, 8 Lafidril 3 x C I

Amoxicilin 3 x ½ tab


1/6/2012 A ISPA, L, 47 Stopfluad 3 x 1 tab



1/6/2012 A Cephalgia , P, 41 thn Analsik 3 x 1 tab

Neurobion 1xi tab


1/6/2012 A GEA, L, 60 thn MRS

IVFD RL + drip sohorobion 20 tts/menit

Cefotaxim inj 3 x 1 gr

Ulceranin inj 3 x 1 amp

Buscopan 3 x 1 tab


4/6/2012 B Vulnus appertum, L, 33 thn Hecting Dr. Luh Putu



Kusumawati

4/6/2012 A Parotitis , P, 6 thn Paracetamol 3 x 1 tab


Hufavit 1 x 1 tab


4/6/2012 A Obs febris, L , 10 thn Amoxicilin syr 3 x C II

Paracetamol syr 3 x C II

Metoclorpramid 3 x ½ tab


4/6/2012 B Vulnus ekskoriatum, L, 4 thn Rawat luka

Amoxicilin syr 3 x Cth I


4/6/2012 B Combutio gr I, P, 41 thn Bulectomi

Dermasin




4/6/2012 A Susp. TBC, L, 21 thn Cefadroxil 3 x 1 tab


Pemeriksaan BTA

Rongent Thorax


4/6/2012 A Alergi + HT gr 1, L, 75 thn Interistin 3 x 1 tab


Inj deladril 1 cc IM


5/6/2012 A Faringitis , L, 51 thn Flutamol 3 x 1 tab Dr. Luh Putu

Amoxicilin 3 x 1 tab Kusumawati

5/6/2012 A ISPA, L, 52 thn Flutamol 3 x 1 tab

Amoxicilin 3x 1 tab

Yudavit 1 x 1 tab


5/6/2012 A Gastritis, P, 38 thn Antasida syr 3 x C I

Ranitidin 3 x 1 tab

Neuralgad 3x 1 tab

Inj neurotropin 1 cc IM


5/6/2012 A DM tipe 2, L, 65 thn Cek GDS

Inj neurobion 1 amp IM

Metformin 2 x 1 tab

Glibenclamid 1 x 1 tab


5/6/2012 A Obs febris, L, 51 thn MRS

IVFD RL 20 tpm

Cefotaxim 3 x 1 gr


Yudavit 1 x 1 tab


5/6/2012 A Hipertiroid, L, 45 thn PTU 3 x 1 tab

Propanolol 2 x 1 tab


5/6/2012 A Dermatitis, P, 29 thn Betametason Dr. Luh Putu Kusumawati

5/6/2012 D Psikosomatik, P, 22 thn Diazepam tab 5 mg (malam) Dr. Luh Putu

Yudavit 1 x 1 tab Kusumawati

5/6/2012 A GEA, L, 65 thn MRS

IVFD RL 20 tpm

Ceftriaxone 2 x 1 gr

Ranitidin 2 x 1 amp

Neurobat 1 amp drip

Diagit 3 x 1 tab


5/6/2012 A ISPA, P, 25 thn Flutamol 3 x 1 tab



7/6/2012 A Dermatitis , L, 21 thn Betametason salep Dr. Luh Putu Kusumawati

7/6/2012 A ISPA, P, 3 thn Paracetamol syr 3 x cth I

Amoxicilin syr 3 x cth I


8/6/2012 A Mialgia, L , 33 thn Asam Mefenamat 3 x 1 tab




8/6/2012 B Abses, P, 8 thn Amoxicilin 3 x ½ tab

Asam mefenamat 3 x ½ tab

Gravaderm salep


8/6/2012 A ISPA + HT, L , 52 thn Flutamol 3 x 1 tab


Hufavit 1 x 1 tab


8/6/2012 A Obs febris, L, 9 thn Ibuprofen syr 3 x C II

Cefadroxil syr 3 x C II


8/6/2012 A ISK, P, 50 thn MRS

IVFD RL 20 tpm

Trimoxol 2 x 2 tab

Antrem 1gr IV



10/6/2012 B Abses, P, 6 thn Relapen syr 3 x C II

Lapicef syr 2x C II


10/6/2012 C Asma eksersebasi akut, P, 43 thn

MRS

IVFD RL + drip aminophilin 1 amp 10 tpm

Dexametason 3 x 1 amp

Ulceranin 2 x 1 amp

Nebul ventolin @ 8 jam

Mucera syr 3 x C I


10/6/2012 A OA, P, 52 thn Meloxicam 2 x 1 tab


Ranitidin 2 x 1 tab

Inj dexametason 1 amp IM


10/6/2012 A GEA, P, 2 thn Ibuprofen syr 3 x C I

Cefadroxil syr 3 x C I

L bio 2 x 1 sach


11/6/2012 A Cephalgia, P, 18 thn Analsik 3 x 1 tab

Neurobion 1x 1 tab


11/6/2012 A DM + HT, P, 70 thn Metformin 2 x 1 tab

Glibenclamid 2 x 1 tab

B blocker 1 x ½ tab


11/6/2012 C Kejang demam, L , 8 bln MRS

IVFD ka en 4B 12 tpm


Antrain ¼ cc IV

Dexametason 0,5 cc IV

Puyer luminal 2 x 30 mg


11/6/2012 A Tyfoid Fever, L , 19 thn MRS

IVFD RL 20 tpm

Opimox 3 x 1 gr

Lafimag syr 3 x C I


Mirapect 3 x 1 tab


11/6/2012 B Abses digiti 1 pedis S, P, 17 thn Insisi abses




11/6/2012 A Obs febris, L, 7 thn MRS

IVFD Ka En 3B 20 tpm


Opimox 3 x 200 mg

Paracetamol 3 x 250 mg

Imunos 1 x 1 tab

Pamol supp 125 mg

11/6/2012 A Obs febris, L, 30 Lapiflox 2 x 500 mg



12/6/2012 B Vulnus appertum, P, 77 thn Tequinol 2 x 1 tab

Lapistan 3 x 1 tab

Rawat luka


12/6/2012 B Susp fraktur compresive th 9-11 Lapistan 3 x 1 tab Dr. Luh Putu Kusumawati

12/6/2012 A Thypoid fever, P, 9 thn Tiampenicol 3 x 1 tab


Litavit syr 1 x C I


12/6/2012 A Mialgia, P, 23 thn Diazepam 2 x 1 tab

Lapistan 3 x 1 tab

Lagesil syr 3 x C I

Ro thorax AP


13/6/2012 A ISPA, L, 64 thn RO thorax

Inj B12 1 cc IM

Simplox 2 x1 tab

Mucera syr 3 x C I


13/6/2012 A Ektima , L, 8 thn Gentamisin salep


Interistin 2 x 1 tab


13/6/2012 A ISPA + Dermatitis, P, 28 thn Inj dipenhidramin 1cc IM

Flutamol 3 x 1 tab


Betametason


13/6/2012 HNP, P, 42 thn Meloxicam 2 x 1 tab

Myman 2 x 1 tab

Calsium 1 x 1 tab

KIE fisioterapi


13/6/2012 A Dispepdia , L, 80 thn MRS

IVFD D5 : RL 20 tpm

Drip sohobion

Ranitidin 2 x 1 amp


13/6/2012 A Dispepdia , P, 80 thn MRS

IVFD D5 : RL 20 tpm

Drip sohobion

Ranitidin 2 x 1 amp


15/7/2012 B Tetanus , L , 70 thn IVFD RL 20 tpm

Cefotaxim 3 x 1 gr

Diazepam drip 2 amp


Ruangan

ATS

Pemasangan NGT

15/7/2012 A GE , L , 65 thn IVFD RL 30 tpm

Cefotaxim 3 x 1 gr

Ranitidin 2 x 1 amp

Neo diatab 3 x 1 tab


Ruangan

15/7/2012 A GE, P, 62 thn IVFD RL 20 tpm

Cefotaxim 3 x 1 gr

Ranitidin 2 x 1 amp

ODR 3 x 1 amp

Antrain 3 x 1 amp


Ruangan

17/7/2012 B CKR, L, 55 thn IVFD RL 20 tpm

Piracetam 2 x 1 amp

Remopacain 2 x 1 amp


Ruangan

17/7/2012 A Obs febris, P, 40 thn IVFD RL : Dex 5 % 3 : 1 24 tpm

Lamxim 2 x 1 gr IV

Antrain 3 x 1 amp

Pamol tab 3 x 1


Ruangan

17/7/2012 A GE, L, 7 thn IVFD RL 20 tpm

Opimox 500 mg IV @ 8 jam

Piralen ½ amp IV @ 8 jam

L bio 1 x 1 sachet


Ruangan

17/7/2012 B G2P1001 aterm LMR mg pro SC, P, 25 thn

Pro SC Dr. Luh Putu Kusumawati

Ruangan

17/7/2012 B G1P0000 40-41 mgg prolong fase aktif, P, 18 thn

Pro SC Dr. Luh Putu Kusumawati

Ruangan

17/7/2012 A ISPA + HT, L, 68 thn IVFD NACl 20 tpm

Mucera syr 3xC1

Opimox tablet 3x500mg

Amlodipin tab 1x10mg

Bisolon injeksi 3x1 ampul


Ruangan

18/7/2012 A Obs Febris + DM + Post stroke, L, 71 thn

IVFD RL 16 tpm

Cefotaxime 3x1 gr iv

Ranitidine 2x1 ampul

Ondansentron 3x1 ampul

Parasetamol 3x1 tablet

Captopril 3x25mg

Terapi dm lanjut


Ruangan

18/7/2012 A Obs Febris , P, 48 thn IVFD RL + drip 1 ampul neurobat 20tpm

Opimox injeksi 3x1gram

Ulceranin injeksi 2x1 ampul

Sanmol 3x1 tablet

Ondansentron 3x1 ampul


Ruangan

18/7/2012 A Mialgia + HT , L, 54 thn IFVD RL + ! ampul sohobion 20 tpm

Ketorolac injeksi 3x1 Ampul

Captopril 2x12.5mg


Ruangan

18/7/2012 B CKR, L, 40 thn IFVD RL 20 tpm

Opimox 3x1 gr

Ketorolac injeksi 3x1 ampul

Metoclopramid 3x1 ampul

Ranitidin 3x1 ampul

Cendocitrol 6x2 tts eds


Ruangan

18/7/2012 A Kejang Demam sederhana, P, 9,5 bln

Konsul Sp A

IVFD KAEN 4B 20tpm mikro

Pamol supp 3x1

Cefotaxime injeksi 3x200mg

Diazepam tablet 2x1 mg


Ruangan

19/7/2012 A Susp stroke Iskemik, L, 80 thn Konsul SPPD

IVFD RL 20tpm

Piracetam 3x1 ampul

Farbion 2x1 ampul

Captopril 3x25mg


Ruangan

19/7/2012 A HT grade 2, P, 47 thn Konsul SPPD

IVFD RL 20 tpm

Antrain 3x1 ampul


Ruangan


Simvastatin 2x5 mg

Captopril 3x25mg

Amlodipin 1x5mg

19/7/2012 A Obs Febris ec Pneumonia dd TB

Konsul SPPD

IVFD RL 16 TPM

Cefotaxime 3x1 gr


Antrain 3x1 ampul

Sanmol 3x1 tablet


Ruangan

20/7/2012 B akut appendisitis, P, 20 thn Konsul SP B

IFVD RL 20tpm

Antrain 2x1 ampul

Laxime 3x1 ampul


Ruangan

20/7/2012 B CKR + V. Appertum, L, 32 thn Konsul Sp B

IVFD RL 20 tpm

Teamic 3x1 ampul

Lapistan 3x1 ampul


Ruangan

21/7/2012 B G3P2002 38 mgg, P, 30 thn Konsul SP OG: Pro Sc Dr. Luh Putu Kusumawati

Ruangan

23/7/2012 A LBP + dispepsia, P, 30 thn IVFD RL 20 tpm

Lactopain 3x1 ampul


Ruangan

OMZ 3x1/2 ampul

Cerofid 2x1 ampul

Ciftamax 3x500mg

23/7/2012 A Obs Febris, L, 9 bln IVFD KAEN 3B 16tpm mikro

Cefotaxime 3x250mg

Parasetamol syrup 3x1cth


Ruangan

24/7/2012 A TIA + HT, P, 38 thn IVFD NaCl + Neurobat drip 20tpm

Piracetam 3x1 ampul

AB vask 1x1 tablet

Fetic supp 2x1

Antrain 3 x 1 ampul


Ruangan

24/7/2012 A KDS, L, 2 thn Opimox 3 x 250 mg

Pamol 250 mg supp

Pamol syr 3 x cth 1


Ruangan

24/7/2012 A Intoksikasi Baygon semprot, L, 40 thn

IVFD RL 20 tpm

Opimox 3 x 1 gr iv

Dexametason 3 x 1 amp

Ulceranin 2 x 1 amp

SA 1 amp

Lagesil syr 3 x C 1


Ruangan

24/7/2012 B Susp kista abdomen, P, 50 thn Konsul de SPB

IVFD RL 20 tpm


Ruangan

Cefotaxim 3 x 1gr

Ketorolac 3 x 1 ampul

24/7/2012 A Cefalgia + hipotensi, L, 75 thn IVFD RL 20 tpm

Lapistan 3 x 1 tab


Ruangan

24/7/2012 A GEA, P, 7 thn Konsul dr SPA

IVFD KAEN 4B 20 tpm



Ruangan

24/7/2012 B CKR + V. Appertum, L, 21 thn IVFD RL 20 tpm

Cefotaxim 3 x 1 gr

Toramine 3 x 1 ampul

Ranitidin 2 x 1 ampul


Ruangan

24/7/2012 A Dispepsia, L, 57 thn IVFD RL 20 tpm

ODR 3 x 1 ampul

Acital syr 3 x C 1


Ruangan

24/7/2012 A Obs abdominal pain, P, 17 thn IVFD RL 20 tpm

Cefotaxim 3 x 1gr

ODR 3 x 1 ampul

Ulceranin 2 x 1 ampul

Lactopain 3 x 1 ampul


Ruangan

25/7/2012 D Reaksi konversi, L, 16 thn IVFD RL 16 tpm

Diazepam 5 mg IV


Ruangan

Ulceranin 3 x 1 amp

26/7/2012 B CKR, P, 10 thn IVFD RL 20 tpm

Cefotaxim 3 x 1 gr

Ketorolac 3 x 1 ampul

As. Tranexamat 3 x 1 gr

Piracetam 3 x 1 ampul


Ruangan

27/7/2012 A Gastritis + febris, P, 45 thn IVFD RL 20 tpm

Opimox 3 x 1 gr



Ruangan

27/7/2012 A GEA, L, 9 bln IVFD KAEN 3 B 20 tpm micro


Zink kid syr 1 x 2 ½ C

Pamol syr 3 x C1

L bio 1 x 1


Ruangan

28/7/2012 A Dispepsia, L, 39 thn IVFD RL 20 tpm


Piralen 3 x 1 ampul

Opimox 3 x 1 gr

Acitral 3 x C 1


Ruangan

28/7/2012 A Cephalgia, P, 37 thn IVFD RL 20 tpm

Antrain 2 x 1 ampul



Ruangan

Opimox 3 x 500 mg

Magtral 3 x C 1

28/7/2012 A GEA, L, 51 thn IVFD RL 20 tpm

Metronidazole 3 x 1 tab

Ponstad 3 x 1 tab

Cefotaxim 3 x 1 gr


Ruangan

28/7/2012 A GE, P, 3 thn IVFD KAEN 3 B


Zink kid 3 x cth 1

L bio 1 x 1


Ruangan

29/7/2012 A Dispepsia + malaise IVFD RL + drip neurobat 20 tpm

Simexim 3 x 1 gr


ISDN tab 2 x 500 mg


Ruangan

29/7/2012 B CKS + Multiple v appertum, L, 29 thn

Konsul dr SPB

IVFD RL + drip ketorolac

Cefotaxim 3 x 1 gr


Ruangan

29/7/2012 A COPD, P, 66 thn IVFD RL + drip neurobat + drip aminophilin 20 tpm

Cefotaxim 3 x 1 gr

Ambroxol 3 x C 1

Nebulizer combivent @ 6


Ruangan

jam

31/7/2012 A ISPA, L, 6 thn IVFD kaen 1 B 16 tpm

Opimox 3 x 250 mg

Antrain 3 x ½ ampul

Dextrosin ped syr 3 x C 2

Pamol syr 3 c C 1


Ruangan

31/7/2012 A Susp nefrotic syndrom, P, 79 thn

Konsul dr SPPD

IVFD RL 20 tpm

Antalgin 1 amp drip


Ruangan

1/8/2012 A GE, P, 1 tahun IVFD Kaen 3 B 20 tpm


Metocloperamid 3 x 1/3 ampul

L bio 1 x 3 sachet


Ruangan

1/8/2012 A GE, L, 10 bln Konsul dr SPA

Cefotaxim 2 x 250 mg iv

Paracetamol syr 3 x C 1

Ondancentron 2 x 1 mg iv


Ruangan

2/8/2012 A Pneumonia, P, 7 bulan IVFD KAEN 3B 12tpm mikro

Ceftriaxone 1x250mg

Kalmetason 3x1/2 ampul

Ambroxol 3 x C1

Amoxilin 3 x C1


Ruangan

Parasetamol syr 3 x C1

2/8/2012 A GEA, P, 65 thn IVFD RL 20tpm

Cefotaxime 3x1gram

Diagit 3x1 tab

Neurobat drip 1 ampul

Buscopan 1x1 ampul


Ruangan

2/8/2012 A TIA, L, 50 thn IVFD RL + neurobion ! ampul 20tpm

Citicolin 3x1 ampul

Aspilet 1x160mg

Captopril 3x25mg

Furosemid k/p


Ruangan

2/8/2012 A GEA, L, 6 thn KAEN 3B 16 tpm

Lapixime injeksi 2x1 gram

Ondansentron 3x1/2 ampul

Zinc kid 2xC1

Biostrum 2xC1


Ruangan

2/8/2012 A Intoksikasi Portas, L, 31 thn IVFD RL 20 tpm

Omeprazol 2 x ½ vial

Ondancentron 3 x 1 ampul

Drip neurobat 1 ampul


Ruangan

3/8/2012 A Dispepsia + obs febris, L, 45 thn IVFD RL 20 tpm

Ranitidine 3 x 1 ampul

Omeprazol 2 x 1 tablet

Antasida syr 3 x C I




Ruangan

3/8/2012 A Dispepsia, P, 80 thn IVFD RL + drip neurobat 1 ampul 20 tpm

Gastridin 2 x 1 ampul

ODR ink 3 x 1 ampul

Acitral syr 3 x C 1


Ruangan

5/8/2012 A Mialgia + obs febris, L, 46 thn IVFD RL + drip antrain 1 ampul 24 tpm

Opimox 3 x 1 tablet

Paracetamol 3 x 1 tablet


Ruangan

6/8/2012 A Gasrtopati diabetik , L, 49 thn Metocloperamid 3 x 1 ampul


Terapi DM lanjut


Ruangan

6/8/2012 A Dispepsia + intoksikasi Alkohol; L, 28 tahun

IVFD RL 20tpm

ODR 3 x1 ampul


Antasida 3x C1


Ruangan

7/82012 A DHF grade 2, L, 20 tahun IVFD RL 20 tpm Dr. Luh Putu Ruangan

Cefotaxime 3x1 gr

Ranitidin 3 x 1 tab


Kusumawati

7/8/2012 A Hematemesis + Diabetes tipe 2; L; 45 thn

IVFD RL + 1 ampul sohobion 20 tpm

Cefotaxime 3 x 1 gr

Ranitidine 3 x 1 amp

Ondansentron 3 x 1ampul


Ruangan

7/8/2012 A Dispepsia; P; 41 tahun IVFD RL 20tpm

Primperan injeksi 3 x 1 ampul

Buscopiad 2 x 1 tab

Ranitidin 3x1 ampul


Ruangan

7/8/2012

A Dispepsia; P; 75 tahun IVFD D5% 20tpm

Gastridin injeksi 2x1 ampul

Ceftopain 3x1 ampul


Ruangan

7/8/2012 B CKR + V. Appertum; L; 70 tahun IVFD RL 20tpm

Piracetam injeksi 3x1 ampul

Ranitidin injeksi 3x1 ampul

Antrain injeksi 3 x1 ampul

Cefotaxime 3x1 ampul


Ruangan

7/8/2012 B Akut Abdomen; L; 80 tahun IVFD RL + Neurobat 1 ampul 20 tpm


Ruangan

Gastridin injeksi 3x1 ampul

Antrain 3x1 ampul

7/8/2012 B Appendisitis akut; P; 16 tahun IVFD RL 20 tpm

Konsul Sp. B: appendiktomy


Ruangan

7/8/2012 B V. Ekskoriatum & Appertum + fr. Metacarpal digiti 5; L; 32 tahun

IVFD RL 20 tpm

Cefotaxime 3x1 gr

Lactopain injeksi 3x1 gram

Konsul Sp. B


Ruangan

8/8/2012 A Vertigo + Hipertensi; L; 41 tahun IVFD RL 20tpm

Lexigo 3 x1 tab

Captopril 1x25 mg

Metoclopramide 3x1 ampul


Ruangan

8/8/2012 A Obs Febris hari II; P; 69 thn IVFD RL 20 tpm

Cefotaxime 3x1 gr

Furosemid tab 1x1

Paracetamol tab 3x1

Konsul Sp.PD


Ruangan

8/8/2012 A GEA; L; 2.5 tahun IVFD KAEN 4B 18 tpm

Cefotaxime 3 x2oomg

Zinc kid 2x C I

L bio 2x1 sacchet

Paracetamol sirup 3xC I


Ruangan

9/8/2012 A Demam Tifoid; P; 59 tahun IVFD RL 20tpm

Cefotaxime 3x1 gr

Ranitidin 3x1 ampul

Antasida sir 3xCI


Ruangan

9/8/2012 A GEA; P; 70 thn IVFD RL 24 tpm

Cefotaxime 3x1 gr

Ranitidin 3x1 ampul

Primperan 3x1 ampul

New Diatab 3x1 tab


Ruangan

16/8/2012 A Faringitis, P, 36 thn Stopfluad 3 x1 tab


DMP 3 x 1 tab


Poli

16/8/2012 A ISPA, L, 5,5 thn Amoxicilin 3 x 1 tab

Lafidryl syr 3 x C 1


Poli

16/8/2012 A Faringitis, L, 29 thn Stopfluad 3 x 1 tab

Ciprofloxacin 2 x 1 tab


Poli

24/8/2012 A Gastritis, L, 39 thn Lafimag syr 3 x C 1

Omeprazol 2 x 1 tab


Poli

24/8/2012 A GEA, L, 51 thn Paracetamol 3 x 1 tab

Metronidazole 3 x 1 tab


Poli

27/8/2012 A ISPA, L, 43 thn Lafidryl 3 x C 1



Poli

CTM 3 x 1 tab

27/8/2012 A Dispepsia, L, 34 thn Omeprazole 2 x 1 tab

Lafimag 3 x 1 tab

Ranitidine 3 x 1 tab


Poli

27/8/2012 A ISPA + HT, L, 52 thn Captopril 25 mg 1x 1

Lafidryl 3 x C 1


Neurobiad 1 x 1 tab


Poli

27/8/2012 A ISPA, P, 27 thn Lafidryl 3 x C 1


Neurobiad 1 x 1 tab


Poli

27/8/2012 A ISPA + HT, P, 48 thn Lafidryl 3 x C 1


Captopril 1 x 25 mg


Poli

27/8/2012 A GEA, L, 50 thn Ciprofloxacin 2 x 1 tab

Imodiad 3 x 1 tab

Yudavit 1 x 1 tab


Poli

27/8/2012 A ISPA, L, 3thn Cefadroxil syr 3 x C 1



Poli

27/8/2012 A ISPA, L, 33 thn Ciprofloxacin 2 x 1 tab

Lafydryl 3 x C 1

Pseudoepidrin 3 x 1 tab


Poli

27/8/2012 A Cephalgia , P, 12 thn Neuralgad 3 x 1 tab

Hufavit 1 x 1tab


Poli


Zentra 3 x 1 tab

Lafydryl 3 x C 1


Poli

3/9/2012 A ISPA, P,45 thn Amoxicilin 3 x 1 tab

Flutamol 3 x 1 tab

Yudavit 1 x 1 tab


Poli

3/9/2012 A Dispepsia, P, 45 thn Lafimag 3 x 1 tab

Omeprazole 2 x 1 tab

Sangobiad 1 x 1 tab


Poli

3/9/2012 A Faringitis , L, 38 thn Ciprofloxacin 2 x 1 tab

Zentra 3 x 1 tab

Lafidryl 3 x C 1


Poli

3/9/2012 A Dispepsia, L, 34 thn Lafimag 3 x 1 tab




Poli

3/9/2012 A ISPA, L,21 thn Ciprofloxacin 2 x 1 tab

Stopfluad 3 x 1 tab

Ambroxol 3 x 1 tab


Poli

3/9/2012 A ISPA, L,9 bln Cefadroxil syr 3 X C1 Dr. Luh Putu Poli

Ambroxol 3 x C 1


Kusumawati

3/9/2012 A Dispepsia, P, 35 thn Lafimag 3 x 1 tab


Sangobiad 1 x 1 tab


Poli

4/9/2012 A Dispepsia + cephalgia, P, 46 thn

Lafimag 3 x 1 tab



Diazepam 2 x 2 mg


Poli

4/9/2012 A ISPA + cephalgia, L, 49 thn Neuralgad 3x 1 tab

Zentra 3 x 1 tab



Poli

4/9/2012 A Mialgia , P, 45 thn Meloxicam 1 x 1 tab

Lafimag 3 x 1 tab


Poli

4/9/2012 A Dermatitis, L, 16 thn Dextaco 3 x 1 tab


Betametaso N


Poli

4/9/2012 A ISPA, L, 6 thn Cefadroxil syr 3 x C 2

Paracetamol 3 x C2

Ambroxol syr 3 x C1


Poli

4/9/2012 A ISPA, L, 18 thn Cefadroxil 3x1 tab

Flutamol 3x1 tab


Poli

Ambroxol syr 3 x C1


Flutamol 3x1 tab

Ambroxol syr 3 x C1


Poli


Flutamol 3x1 tab

Ambroxol syr 3 x C1

Zentra 3 x 1 tab


Poli

4/9/2012 A ISPA, P, 26 thn Cefadroxil 3x1 tab

Flutamol 3x1 tab

Zentra 3 x 1 tab


Poli

5/9/2012 A Rinitis , P, 10 thn Zentra 2 x 1 tab Dr. Luh Putu Kusumawati

Poli

5/9/2012 A Obs febris, L, 7 thn Paracetamol syr 3 x C 2

Cefadroxil 3x C 2

Vitamin syr 1 x C 1


Poli

5/9/2012 A Mialgia, P, 42 thn Diazepam 2 x 2 mg

Neuralgad 3 x 1 tab

Neurobiad 1 x 1 tab


Poli


Lafidryl 3xC 1

Zentra 3 x 1 tab


Poli


Ambroxol syr 3 x C 1

Zentra 3 x 1 tab


Poli

5/9/2012 A Mialgia, L, 39 thn Diazepam 2 x 2 mg

Meloxicam 1 x 1 tab

Neurobiad 1 x 1 tab


Poli

6/9/2012 A Cephalgia, P, 41 thn Diazepam 2 x 2 mg

Neuralgad 3 x 1 tab

Neurobiad 1 x 1 tab


Poli

6/9/2012 A Dispepsia , P, 15 thn Lafimag 3 x 1 tab



Poli

6/9/2012 A ISPA, P, 3 thn Cefadroxil 3xC 1

Lafidryl 3xC 1


Poli

6/9/2012 A ISPA, L, 2 thn Cefadroxil 3xC 1

Zentra syr 3 x C1


Poli

6/9/2012 A Tinea cruris, L, 15 thn CTM 3 x 1 tab

Miconazole

Hidrocortison


Poli

6/9/2012 A ISPA, L, 19 thn Cefadroxil 3x 1 tab

Lafidryl 3x 1 tab

Zentra 3x 1 tab


Poli

6/9/2012 A ISPA, L, 42 thn Cefadroxil 3x 1 tab

Lafidryl 3x 1 tab

Zentra 3x 1 tab


Poli

10/9/2012 A Cephalgia, P, 40 thn Diazepam 2 x 2 mg

Na Diclopenac 2 x1 tab

Neurobiad 1 x 1 tab


Poli

10/9/2012 A ISPA, L, 9 thn Amoxicilin syr 3 x C 1

Lafidryl 3x C ½

Paracetamol syr 3 x C1


Poli

10/9/2012 A ISPA, L, 50 thn Amoxicilin 3 x 1 tab

Lafidryl 3x C 1



Poli

10/9/2012 A mialgia, L, 40 thn Diazepam 2 x 2 mg

Na Diclopenac 2 x1 tab

Neurobiad 1 x 1 tab


Poli

10/9/2012 A Dermatitis, P, 35 thn Carmeson 3 x 1 tab


Miconazole

Hidrocortison


Poli

10/9/2012 A ISPA, L, 44 thn Lafidryl 3x C 1 Dr. Luh Putu Poli

Ciprofloxacin 2 x 1 tab Kusumawati

10/9/2012 A GEA, P, 44 thn Imodiad 3 x 1 tab


Hufavit 1 x 1 tab


Poli

10/9/2012 A ISPA, P, 42 thn Cefadroxil 3 x 1 tab


Vitamin C


Poli

10/9/2012 A ISPA, P, 38 thn Ciprofloxacin 2 x 1 tab

Zentra 3 x 1 tab


Poli





Poli

11/9/2012 A GEA, P, 32 thn Imodiad 3 x 1 tab


Lafimag 3 x C 1

Metocloperamid 3 x 1 tab


Poli

11/9/2012 A Susp. Tumor paru, L, 45 thn Konsul dr Sp.P Dr. Luh Putu Kusumawati

Poli

11/9/2012 A GEA, P, 5 bln Paracetamol syr 3 x C 1

Cotrimoxazole syr 3 x C 1


Poli

11/9/2012 A Cephalgia, P, 44 thn Neuralgad 3 x 1 tab

Diazepam 2 x 2mg tab


Poli

11/9/2012 A Dermatitis, L, 18 thn Carmeson 3 x 1 tab

CTM 3 x 1 tab


Poli

17/9/2012 A Bayi sehat, P, 4 bulan Imunisasi polio IV, DPT HB III

KIE efek imunisasi


Poli Kebidanan

18/9/2012 A Akseptor KB, P, 24 thn Cycloven IM Dr. Luh Putu Kusumawati

Poli Kebidanan

19/9/2012 A Hiperemesis gravidarum, P , 34 thn

MRS

IVFD RL 20 tpm + neurobat 1 ampul

Metocloperamid 3 x 1 ampul



Poli Kebidanan

19/9/2012 A Akseptor KB, P, 47 thn Medroxyprogesteron acetate 150mg/3ml im


Poli Kebidanan

19/9/2012 A Bayi sehat, L, 18 hari Imunisasi BCGDr. Luh Putu Kusumawati

Poli Kebidanan


Poli Kebidanan

19/9/2012 A Bayi sehat, P, 0 hari Imunisasi BCGDr. Luh Putu Kusumawati

Poli Kebidanan


Poli Kebidanan

19/9/2012 A Bayi sehat, L, 0 hari Imunisasi BCGDr. Luh Putu Poli Kebidanan

Kusumawati


Poli Kebidanan


Poli Kebidanan


Poli Kebidanan


Poli Kebidanan


Poli Kebidanan


Poli Kebidanan

21/9/2012 B Akseptor KB, P, 42 thn Pemasangan IUD



Poli Kebidanan

21/9/2012 B Akseptor KB, P, 43 thn Ektraksi IUD



Poli Kebidanan



Poli Kebidanan

23/9/2012 A Bayi sehat, P, o hr Imunisasi polio, HB

KIE efek imunisasi


Poli Kebidanan

23/9/2012 B Akseptor KB, P, 29 thn Control IUDDr. Luh Putu Poli Kebidanan

Kusumawati

23/9/2012 B Akseptor KB, P, 31 thn Pemasangan IUDDr. Luh Putu Kusumawati

Poli Kebidanan



Poli Kebidanan

24/9/2012 A Bayi sehat, P, 2 hari Imunisasi polio IV, HB

KIE efek imunisasi


Poli Kebidanan

24/9/2012 A Bayi sehat, P, 2 bulan Imunisasi polio II, DPT HB I

KIE efek imunisasi


Poli Kebidanan


KIE efek imunisasi


Poli Kebidanan




Poli Kebidanan


KIE efek imunisasi


Poli Kebidanan




Poli Kebidanan



Poli Kebidanan

29/9/2012 A Akseptor KB, P, 35 thn Medroxyprogesteron acetate Dr. Luh Putu Poli Kebidanan

150mg/3ml imKusumawati

29/9/2012 B G4P1021 40-41 minggu inpartu, P, 27 thn

Konsul dr Sp.OG Dr. Luh Putu Kusumawati

Poli Kebidanan

30/9/2012 A Bayi sehat, P, 1 hari Imunisasi polio I,HB

KIE efek imunisasi


Poli Kebidanan

1/10/2012 A Bayi sehat, P,9 bulan Imunisasi campak

KIE efek imunisasi


Poli Kebidanan


KIE efek imunisasi


Poli Kebidanan

4/10/2012 A Hiperemesis gravidarum, L, 24 thn

MRS

IVFD RL 20 tpm + neurobat 1 ampul

Metocloperamid 3 x 1 ampul



Poli Kebidanan

8/10/2012 B Perdarahan post partum, P, 32 thn

Hecting robekan portio

Konsul dr Sp.OG


Poli Kebidanan

9/10/2012 B Mioma uteri, P, 45 thn USG

Konsul dr Sp.OG


Poli Kebidanan

12/10/2012 ISK + Urolithiasis, L, 49 thn Opimox 3 x 1 tab

Cotrimoxazole 2 x1 tab

Kejibling 3 x 1 tab

Lapistan 3 x 1 tab

12/10/2012 GEA, P, 6 thn Cotrimoxazole 2 x cth 1

Zink kid 1 x cth 1

L bio 1 x 1 sach

Piralen 3 x cth 1

12/10/2012 Bronchitis kronis, L, 62 thn Mucera syr 3 x C 1

Opimox 3 x 500 mg


Pamol 3 x 1 tab

12/10/2012 ISK + Dispepsia, P, 20 thn Pamol 3 x 1 tab

Cotrimoxazole 2 x1 tab

Maagtral 3 x C 1

12/10/2012 Colic abdomen, L, 20 thn MRS

IVFD RL 20 tpm

Ranitidine 2 x 1 amp

Ketorolac 3 x 1 amp

Antasida syr 3 x C 1

12/10/2012 GEA, P, 3 thn Cotrimoxazole 2 x cth 1

L bio 1 x 1 sach

New diatab

12/10/2012 Colic abdomen, L, 44 thn Inj ranitidin 1 amp

Ketoprofen 1 amp

Fetik sup per rectal

Format Buku Log untuk Usaha Kesehatan Masyarakat (UKM)

Tanggal

Kode Kegiata

n


kinerja

Tanda tangan Pendamping

KeteranganAssessme

ntPenatalaksanaa

n(1) (2) (3) (4) (5) (6) (7)

Contoh:12/4/10 E.1 Teknik penyuluhan belum tepat

£Dr. Widjaya

Laporan sudah diterimaMinimal tiap kegiatan 1 laporan

Keterangan format: (1) Tanggal pelaksanaan kegiatan(2) Kode kegiatan sebagai berikut :

E. Kesehatan MasyarakatE.1 Pencegahan dan Penanggulangan Penyakit Menular / Tidak MenularE.2 Pencegahan dan Penanggulangan Gizi BurukE.3 Sanitasi Lingkungan (tempat tinggal, makanan dan minuman, pelayanan umum)E.4 Promosi KesehatanE.5 Manajemen PuskesmasE.6 Manajemen BencanaE.7 Manajemen Kasus

(3) Assessment masalah untuk kegiatan E.1 s/d E.7Pengisian dengan diberi tanda () jika sudah dilakukan

(4) Penatalaksanaan untuk kegiatan E.1 s/d E.7Pengisian dengan diberi tanda () jika sudah dilakukan

(5) Catatan dan usulan pendampinga. Evaluasi kinerja pesertab. Usulan perbaikan kinerja

(6) Tanda tangan pendamping(7) Keterangan

Hal-hal lain yang dianggap perlu : alSebut tempat pemeriksaan al polikilink, kamar terima , ugd, ruangan/bangsal, puskesmas, posyandu, dll

Format Buku Log untuk Usaha Kesehatan Masyarakat (UKM)

Tanggal

Kode Kegiata

n


kinerja

Tanda tangan Pendamping

KeteranganAssessme

ntPenatalaksanaa

n(1) (2) (3) (4) (5) (6) (7)

buku Log DI

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Transcript of buku Log DI