Pharmaceutical Care Patient Profile: 1. Form Soap
Pharmaceutical Care Patient Profile: 1. Form Soap
Pharmaceutical Care Patient Profile: 1. Form Soap
FORM SOAP
PHARMACEUTICAL CARE
PATIENT PROFILE
Tn. / Ny.
Presenting Complaint
Diagnosa kerja :
Diagnosa banding :
Drug Allergies:
LABORATORY TEST
Test (normal range) tgl tgl
WBC (4000-10000/mm3)
Hb (L: 13-17 g/dL)
RBC (4-6x106/mm3)
Hct (L:40-54%)
PLT (150000-450000/mm3)
Gula darah puasa (76-110 mg/dL)
Gula darah 2 jam PP (90-130 mg/dL)
Cholesterol (150-250 mg/dL)
TG (50-200 mg/dl)
Uric acid (L:3,4-7 mg/dL)
Albumin (3,5-5,0 g/dL)
SGOT (0-35 u/L)
SGPT (0-37 u/L)
BUN (10-24 mg/dL)
Kreatinin (0,5-1,5 mg/dl)
Natrium (135-15 mEq/L)
Kalium (3,5-5,0 mEq/L)
No Further Information Required Alasan
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PHARMACEUTICAL PROBLEM
Subjective (symptom)
- Objective (signs)
Assesment (with evidence) dan Plan (including primary care implications)
Plan
Monitoring
Efektivitas
DAFTAR PUSTAKA