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Diagnosa Utama        : ...............................................................................Diagnosa Tambahan : ...............................................................................Diagnosa Banding      : ............................................................................... <table class="MsoNormalTable" border="0" cellspacing="0" cellpadding="0" width="514" style="background-color: rgb(249, 247, 243); width: 385.8pt;"><tbody><tr style="height: 14.4pt;"><td width="256" nowrap="" colspan="2" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border: 1pt solid windowtext; height: 14.4pt;">RENCANA TATALAKSANA<o:p></o:p></td><td width="256" nowrap="" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border-top: 1pt solid windowtext; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-image: initial; border-left: none; height: 14.4pt;">INTRUKSI (DENGAN TARGET TERUKUR)<o:p></o:p></td><td width="2" style="padding: 0cm; border: none;"> </td><td width="0" height="24" style="height: 14.4pt; border: none;"></td></tr><tr style="height: 20.4pt;"><td width="256" nowrap="" colspan="2" rowspan="2" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; height: 20.4pt;">1. Edukasi</td><td width="256" rowspan="2" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; height: 20.4pt;">[  ] Ya (isi edukasi terlampir)     [  ] Tidak<o:p></o:p></td><td width="2" style="padding: 0cm; border: none;"> </td><td width="0" height="34" style="height: 20.4pt; border: none;"></td></tr><tr style="height: 14.4pt;"><td width="2" nowrap="" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 1.8pt; height: 14.4pt;"></td><td width="0" height="24" style="height: 14.4pt; border: none;"></td></tr><tr style="height: 14.4pt;"><td width="256" colspan="2" rowspan="2" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; height: 14.4pt;">2. Pemeriksaan Penunjang  (Diagnostik) Lanjutan<o:p></o:p></td><td width="256" nowrap="" rowspan="2" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; height: 14.4pt;"> <o:p></o:p></td><td width="2" style="padding: 0.75pt 5.4pt 0cm; width: 1.8pt; height: 14.4pt;"></td><td width="0" height="24" style="height: 14.4pt; border: none;"></td></tr><tr style="height: 14.4pt;"><td width="2" nowrap="" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 1.8pt; height: 14.4pt;"></td><td width="0" height="24" style="height: 14.4pt; border: none;"></td></tr><tr style="height: 14.4pt;"><td width="256" colspan="2" rowspan="2" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; height: 14.4pt;">3. Diet<o:p></o:p></td><td width="256" nowrap="" rowspan="2" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; height: 14.4pt;"> <o:p></o:p></td><td width="2" style="padding: 0.75pt 5.4pt 0cm; width: 1.8pt; height: 14.4pt;"></td><td width="0" height="24" style="height: 14.4pt; border: none;"></td></tr><tr style="height: 14.4pt;"><td width="2" nowrap="" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 1.8pt; height: 14.4pt;"></td><td width="0" height="24" style="height: 14.4pt; border: none;"></td></tr><tr style="height: 14.4pt;"><td width="256" colspan="2" rowspan="2" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; height: 14.4pt;">4. Nyeri (Khusus nyeri sedang-berat<o:p></o:p></td><td width="256" nowrap="" rowspan="2" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; height: 14.4pt;"> <o:p></o:p></td><td width="2" style="padding: 0.75pt 5.4pt 0cm; width: 1.8pt; height: 14.4pt;"></td><td width="0" height="24" style="height: 14.4pt; border: none;"></td></tr><tr style="height: 14.4pt;"><td width="2" nowrap="" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 1.8pt; height: 14.4pt;"></td><td width="0" height="24" style="height: 14.4pt; border: none;"></td></tr><tr style="height: 14.4pt;"><td width="87" nowrap="" rowspan="5" style="padding: 0.75pt 5.4pt 0cm; width: 65.5pt; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; height: 14.4pt;">5. Terapi<o:p></o:p></td><td width="169" rowspan="3" style="padding: 0.75pt 5.4pt 0cm; width: 126.5pt; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; height: 14.4pt;">Non farmakologis<o:p></o:p></td><td width="256" nowrap="" rowspan="3" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; height: 14.4pt;"> <o:p></o:p></td><td width="2" style="padding: 0.75pt 5.4pt 0cm; width: 1.8pt; height: 14.4pt;"></td><td width="0" height="24" style="height: 14.4pt; border: none;"></td></tr><tr style="height: 14.4pt;"><td width="2" nowrap="" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 1.8pt; height: 14.4pt;"></td><td width="0" height="24" style="height: 14.4pt; border: none;"></td></tr><tr style="height: 14.4pt;"><td width="2" nowrap="" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 1.8pt; height: 14.4pt;"></td><td width="0" height="24" style="height: 14.4pt; border: none;"></td></tr><tr style="height: 14.4pt;"><td width="169" nowrap="" rowspan="2" style="padding: 0.75pt 5.4pt 0cm; width: 126.5pt; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; height: 14.4pt;">Farmakologis<o:p></o:p></td><td width="256" nowrap="" rowspan="2" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; height: 14.4pt;"> <o:p></o:p></td><td width="2" style="padding: 0.75pt 5.4pt 0cm; width: 1.8pt; height: 14.4pt;"></td><td width="0" height="24" style="height: 14.4pt; border: none;"></td></tr><tr style="height: 14.4pt;"><td width="2" nowrap="" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 1.8pt; height: 14.4pt;"></td><td width="0" height="24" style="height: 14.4pt; border: none;"></td></tr><tr style="height: 14.4pt;"><td width="256" nowrap="" colspan="2" rowspan="3" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; height: 14.4pt;">6. Tindakan<o:p></o:p></td><td width="256" nowrap="" rowspan="3" valign="bottom" style="padding: 0.75pt 5.4pt 0cm; width: 192pt; border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; height: 14.4pt;"> </td></tr></tbody></table>

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