tag:blogger.com,1999:blog-91627580755014996292024-02-20T03:59:17.798-08:00ARTIKEL KESEHATANINGAAAT!!
SEHAT ITU ANUGRAH TERMAHAL..
SOO...JAGALAH..himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.comBlogger52125tag:blogger.com,1999:blog-9162758075501499629.post-7480636157320989352013-07-30T16:13:00.001-07:002013-07-30T16:17:48.556-07:00MATERI KULIAH KEWIRAUSAHAWAN SEMESTER 6buat temen2 mahasiswa keperawatan..<br />
atau siapa ja yang maw...<br />
mga bermanfaat...<br />
<br />
<ul>
<li><a href="http://www.tusfiles.net/cno3ighqi7kf" style="font-family: 'Helvetica Neue', Helvetica, Arial, Verdana, sans-serif; font-size: 14px; line-height: 32px; margin: 0px; outline: none; padding: 0px; text-decoration: none;"><span style="color: blue;">Home Care 01.pptx</span></a></li>
<li><a href="http://www.tusfiles.net/q6p7hxf1gc8z" style="font-family: 'Helvetica Neue', Helvetica, Arial, Verdana, sans-serif; font-size: 14px; line-height: 32px; margin: 0px; outline: none; padding: 0px; text-decoration: none;"><span style="color: blue;">Home care 02.pptx</span></a></li>
<li><a href="http://www.tusfiles.net/9313wms7ot55" style="font-family: 'Helvetica Neue', Helvetica, Arial, Verdana, sans-serif; font-size: 14px; line-height: 32px; margin: 0px; outline: none; padding: 0px; text-decoration: none;"><span style="color: blue;">Home Care 03.pptx</span></a></li>
<li><a href="http://www.tusfiles.net/6eospkiiaqjx" style="font-family: 'Helvetica Neue', Helvetica, Arial, Verdana, sans-serif; font-size: 14px; line-height: 32px; margin: 0px; outline: none; padding: 0px; text-decoration: none;"><span style="color: blue;">Home Care 04.pptx</span></a></li>
<li><a href="http://www.tusfiles.net/j5ku3rhnbb1i" style="font-family: 'Helvetica Neue', Helvetica, Arial, Verdana, sans-serif; font-size: 14px; line-height: 32px; margin: 0px; outline: none; padding: 0px; text-decoration: none;"><span style="color: blue;">Home Care 05.pptx</span></a></li>
<li><a href="http://www.tusfiles.net/ymd4nuxqhtn2" style="font-family: 'Helvetica Neue', Helvetica, Arial, Verdana, sans-serif; font-size: 14px; line-height: 32px; margin: 0px; outline: none; padding: 0px; text-decoration: none;"><span style="color: blue;">Kep. Keluarga 02.ppt</span></a></li>
<li><a href="http://www.tusfiles.net/28own4js5o4v" style="font-family: 'Helvetica Neue', Helvetica, Arial, Verdana, sans-serif; font-size: 14px; line-height: 32px; margin: 0px; outline: none; padding: 0px; text-decoration: none;"><span style="color: blue;">Kep.Keluarga 04.ppt</span></a></li>
<li><span style="color: blue;"><span style="font-family: 'Helvetica Neue', Helvetica, Arial, Verdana, sans-serif; font-size: 14px; line-height: 32px;">K</span><a href="http://www.tusfiles.net/ozhi9kuyciea" style="font-family: 'Helvetica Neue', Helvetica, Arial, Verdana, sans-serif; font-size: 14px; line-height: 32px; margin: 0px; outline: none; padding: 0px; text-decoration: none;">EP.kELUARGA 03.ppt</a></span></li>
<li><span style="color: blue; font-family: 'Helvetica Neue', Helvetica, Arial, Verdana, sans-serif; font-size: 14px; line-height: 32px; margin: 0px; outline: none; padding: 0px; text-decoration: none;"><a href="http://www.tusfiles.net/d2sd6ym8yihv" style="font-family: 'Helvetica Neue', Helvetica, Arial, Verdana, sans-serif; font-size: 14px; line-height: 32px; margin: 0px; outline: none; padding: 0px; text-decoration: none;">kONSEP KELUARGA 01.ppt</a></span></li>
</ul>
jangan lupa hilangkan centang di <span style="background-color: white; font-family: 'Helvetica Neue', Helvetica, Arial, Verdana, sans-serif; font-size: 12px;"><u style="font-style: italic;">Use our download manager and get recommended downloads </u> sebelum mendownload okeee...</span><span style="font-family: 'Helvetica Neue', Helvetica, Arial, Verdana, sans-serif; font-size: 12px; margin: 0px; padding: 0px;"><br style="margin: 0px; padding: 0px;" /></span><ul>
</ul>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-38942519017033327672013-03-18T00:08:00.000-07:002013-03-18T00:10:02.127-07:00LAPORAN PENDAHULUAN ASFIKSIA<!--[if gte mso 9]><xml>
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<span lang="EN-GB">LANDASAN TEORI</span></div>
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<b><span lang="EN-GB"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-GB">Pengertian</span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: .5in;">
<span lang="EN-GB">Asfiksia adalah keadaan dimana bayi baru
lahir tidak dapat bernapas secara spontan dan teratur saat bayi baru lahir atau
beberapa saat sesudah lahir. (buku APN 2007).</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l21 level1 lfo22; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-GB"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Penyebab </span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: .5in;">
<span lang="EN-GB">Perkembangan paru-paru neonates terkadi pada
menit pertama kelahiran dan kemudian di susul dengan pernapasan teratur,bila
terjadi gangguan pertukaran gas atau pengangkutan O2 dari ibu ke janin akan
terjadi asfiksia janin atau neonates (towel,1996).kondisi tertentu pada ibu
hamil juga dapat menyebabkan gangguan sirkulasi darah uteroplasenter sehingga
pasokan oksigen ke bayi menjadi berkurang. Hipoksia bayi dalam rahim di
tunjukkan dengan gawat janin yang dapat berlanjut menjadi asfiksia bayi baru
lahir (APN 2007).</span></div>
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<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">Penyebab kegagalan pernapasan pada bayi :</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="EN-GB"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Faktor ibu</span></b></div>
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<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Preeklamsia dan Eklamsia</span></div>
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<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Perdarahan abnormal (plasenta previa atau solusio plasenta ).</span></div>
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<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Partus lama atau partus macet</span></div>
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<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Demam selama persalinan</span></div>
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<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Infeksi berat (malaria,sifilis,TBC,HIV)</span></div>
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<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Kehamilan lewat waktu (Serotinus).</span></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="EN-GB"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Faktor tali pusat</span></b></div>
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<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Lilitan tali pusat</span></div>
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<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Tali pusat pendek</span></div>
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<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Simpul tali pusat</span></div>
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<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Prolapsus tali pusat</span></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="EN-GB"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Faktor janin</span></b></div>
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<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Premature </span></div>
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<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Persalinan dengan tindakan
(sungsang,gemeli,distosia bahu,ekstraksi vakum,ekstraksi forcep)</span></div>
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<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Kelainan bawaan (congenital)</span></div>
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<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Air ketuban bercampur dengan mekonium</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-align: justify;">
Penolong persalinan harus mengetahui factor-faktor resiko berpotensi
untuk menumbuhkan asfiksia.apabila di temukan adanya faktor resiko tersebut
maka hal itu harus dibicarakan dengan ibu dan keluarga tentang kemungkinan
perlunya tindakan resusitasi.akan tetapi ada kalanya factor resiko menjadi
sulit dikenali atau 9sepengetahuan penolong )tidak dijumpai tetapi asfiksia
tetap terjadi.oleh karena itu penolong harus selalu siap melakukan resusitasi
bayi pada setiap pertolongsn persalinan.</div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="EN-GB"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Perubahan patofisiologi dan gangguan klinik</span></b></div>
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<span lang="EN-GB">Pernafasan
spontan bayi baru lahir bergantung pada kondisi janin pada masa kehamilan dan
persalinan.proses kelahiran sendiri selalu menimbulkanasfiksia ringan yang
bersifat sementara pada bayi.proses ini di anggap sangat perlu untuk merangsang
kemoreseptor pusat pernapasan agar terjadi <i style="mso-bidi-font-style: normal;">“primary
Gasping”</i> yang kemudian akan berlanjut dengan pernapasan teratur
(James,1958). </span></div>
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<span lang="EN-GB">Sifat
asfiksia ini tidak mempunyai pengaruh buruk karena reaksi adaptasi bayi dapt
mengatasinya.bila terdapat gangguan pertukaran gas atau pengangkutan oksigen
selama kehamilan atau persalinan akan terjadi asfiksia yang lebih berat.keadaan
ini akan mempengaruhi fungsi sel tubuh dan bila tidak teratasi akan menyebabkan
kematian.</span></div>
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<span lang="EN-GB">Asfiksia
yang terjadi dimulai dengan satu periode apnu di sertai dengan penurunan
frekuensi jantung,selanjutnya bayi akan diikuti pernafasan teratur.pada
penderita asfiksia berat usaha bernafas ini tidak nampak dan bayi selanjutnya
berada pada periode kedua.pada tingkat ini di samping adanya perubahan klinis
akan terjadi pula gangguan metabolisme dan pengaruh asam basa pada tubuh bayi.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-indent: -.5in;">
<span style="mso-tab-count: 1;"> </span><b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">Tindakan-tindakan yang dilakukan pada bayi
dapat di bagi dalam 2 golongan :</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="EN-GB"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Tindakan umum</span></b></div>
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<span lang="EN-GB">Tindakan ini
dilakukan pada setiap bayi tnanpa memandang nilai APGAR yaitu segera setelah
bayi lahir,</span></div>
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<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">di usahakan agar bayi mendapatkan pemanasan yang baik.harus dicegah
atau di kurangi kehilangan panas dari tubuhnya yaitu bias dengan pemanasan luar
dengan sinar lampu dan untuk mengeringkan tubuh bayi mengurangi evaporasi.</span></div>
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<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bayi diletakkan dengan kepala lebih rendah
</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l34 level1 lfo28; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Penghisapan saluran pernapasan bagian atas</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l34 level1 lfo28; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bila bayi belum memperlihatkan usaha
bernapas lakukan rangsangan nyeri dengan dengan menyentil kedua telapak kaki .</span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">2. Tindakan khusus </span></b><span lang="SV" style="mso-ansi-language: SV;"></span></div>
<div class="MsoBodyTextIndent" style="text-align: justify;">
<span lang="SV">Tindakan
ini dilakukan setelah tindakan umum diselenggarakan tanpa hasil.prosedur yang
dilakukan sesuai dengan berat atau ringannya asfiksia yang timbul pada
bayi,yang dinyatakan oleh tinggi rendahnya nilai APGAR.</span></div>
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<span lang="EN-GB" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Klasifikasi asfiksia</span></b></div>
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<span lang="EN-GB"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Asfiksia berat (nilai APGAR 0-3)</span></div>
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<span lang="EN-GB">Resusitasi aktif dalam
keadaan ini harus segera dilakukan, langkah utama ialah memperbaiki ventilasi
paru-paru dngan memberikan O2 secara tekanan langsung<span style="mso-spacerun: yes;"> </span>dan berulang-ulang<b style="mso-bidi-font-weight: normal;">.</b>bila setelah beberapa waktu pernapasan spontan tidak timbul dan
frekuensi jantung menurun (<100/menit) maka pemberian obat-obatan lain serta
masasse jantung sebaiknya segera dilakukan.masasse jantung dikerjakan dengan
melakukan penekanan di atas tulang dada secara teratur 80-100x/menit.</span></div>
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<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l31 level2 lfo29; tab-stops: list 1.5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB">Asfiksia sedang (nilai APGAR
4-6)</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; text-align: justify;">
<span lang="EN-GB">Di sini dapat dicoba
dengan melakukan rangsangan untuk menimbulkan reflek pernapasan,hal ini dapat
dikerjakan selama 30-60 detik setelah penilaian menurut APGAR 1 menit.</span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 0in; mso-add-space: auto;">
<br /></div>
<div class="Style1" style="margin-left: 1.5in; mso-list: l31 level1 lfo29; text-align: justify; text-indent: -.25in;">
<span lang="FI" style="font-family: Symbol; mso-ansi-language: FI; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="mso-ansi-language: FI;">Komplikasi
yang dapat terjadi pada bayi asfiksia adalah kerusakan pada otak.</span></div>
<div class="Style1" style="text-align: justify;">
<br /></div>
<div class="Style1" style="margin-left: 0in; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-spacerun: yes;"> </span></span><span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¨</span></span><span style="mso-ansi-language: FI;"> <b style="mso-bidi-font-weight: normal;"><span lang="FI">TINDAKAN RESUSITASI<span style="mso-bidi-font-weight: bold;"> </span></span></b></span></div>
<div class="Style1" style="margin-left: .25in; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">Langkah awal asuahn bayi baru lahir dengan BBLR
adalah :</span></div>
<div class="Style1" style="margin-left: .25in; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">Langkah awal perlu dilakukan secara cepat (dalam
waktu 30 detik),secar umum 6 langkah awal dibawah ini cukup untuk mernagsang
bayi baru lahir untuk bernapas spontan dan teratur.adapun langkah awal
RESUSITASI adalah sbb :</span></div>
<div class="Style1" style="margin-left: .5in; mso-list: l30 level1 lfo30; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Jaga bayi tetap hangat</div>
<div class="Style1" style="margin-left: 78.0pt; mso-list: l9 level1 lfo32; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">letakkan
bayi diatas kain yang ada di atas perut ibu atau dekat dengan<span style="mso-spacerun: yes;"> </span>perineum.</span></div>
<div class="Style1" style="margin-left: 78.0pt; mso-list: l9 level1 lfo32; text-align: justify; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>selimuti bayi dengan kain tersebut,potong tali
pusat.</div>
<div class="Style1" style="margin-left: 78.0pt; mso-list: l9 level1 lfo32; text-align: justify; text-indent: -.25in;">
<span lang="FI" style="font-family: Symbol; mso-ansi-language: FI; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="mso-ansi-language: FI;">pindahkan
bayi ke atas kain ketempat resusitasi</span></div>
<div class="Style1" style="margin-left: .5in; mso-list: l30 level1 lfo30; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>Atur posisi bayi</div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l5 level1 lfo33; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Baringkan
bayi terlentang dengan kepala didekat penolong.ganjal bahu agar kepala sedikit
Ekstensi.</span></div>
<div class="Style1" style="margin-left: .5in; mso-list: l30 level1 lfo30; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>Isap lendir</div>
<div class="Style1" style="margin-left: .5in; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Gunakan alat penghisap lender DeLee atau Bola
karet.</span></div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l3 level1 lfo34; text-align: justify; text-indent: -.25in;">
<span lang="IT" style="font-family: Wingdings; mso-ansi-language: IT; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IT" style="mso-ansi-language: IT;">Pertama,isap
lendir di dalam mulut,kemudianbaru isap lender di hidung.</span></div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l3 level1 lfo34; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Hisap
lender sambil menarik keluar penghisap (bukan pada saat memasukan).</span></div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l3 level1 lfo34; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bila
menggunakan penghisap lender DeLee,jangan memasukan ujung penghisap terlalu
dalam (lebih dari 5cm kea lam mulut atau lebih dari 3cm ke dalm hidung) karena
dapat menyebabkan denyut jantung bayi melambat atau henti napas bayi</span></div>
<div class="Style1" style="margin-left: .75in; text-align: justify;">
<br /></div>
<div class="Style1" style="margin-left: .5in; mso-list: l30 level1 lfo30; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span>Keringkan dan rangsang taktil</div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l8 level1 lfo35; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span>Keringkan
bayi mulai dari muka,kepala dan bagisn tubuh lainnya dengan sedikit
tekanan.Rangsangan ini dapat memulai pernapasan bayi atau bernapas lebih baik.</div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l8 level1 lfo35; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span>Lakukan
rangsangan taktil dengan menepuk atau menyentil telapak kaki dan menggosok
punggung,perut,dada,atau tungkai bayi dengan telapak tangan.</div>
<div class="Style1" style="margin-left: .5in; mso-list: l30 level1 lfo30; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="FI" style="mso-ansi-language: FI;">Reposisi atau atur kembali posisi kepala
dan selimut bayi.</span></div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l32 level1 lfo36; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Ganti
kain yang telah basah dengan kain bersih dan kering yang baru (disiapkan).</span></div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l32 level1 lfo36; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Selimiti
bayi dengan kain tersebut,jangan tutupi bagian muka dan dada agar pemantauan
pernapasan bayi dapat diteruskan.</span></div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l32 level1 lfo36; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span>Atur
kembali posisi terbaik kepala bayi (sedikit ekstensi).</div>
<div class="Style1" style="margin-left: .5in; mso-list: l30 level1 lfo30; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Penilaian apakah bayi menangis atau
bernapas spontan dan teratur.</span></div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l28 level1 lfo37; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Lakukan
penilaian bayi apakah bayi bernapas normal,megap-megap,atau tidak bernapas.</span></div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l28 level1 lfo37; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">bila
bayi bernapas normal berikan pada ibunya :</span></div>
<div class="Style1" style="margin-left: 1.0in; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Letakkan bayi di atas dada ibu dan selimuti
keduanya untuk menjaga kehangatan tubuh bayi melalui persentuhan kulit
ibu-bayi.</span></div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l26 level1 lfo38; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bila
bayi tak bernapas atau megap-megap segera lakukan tindakan fentilasi.</span></div>
<div class="Style1" style="margin-left: 1.0in; text-align: justify;">
<br /></div>
<div class="Style1" style="margin-left: 1.0in; text-align: justify;">
<br /></div>
<div class="Style1" style="margin-left: 0in; text-align: justify;">
<b style="mso-bidi-font-weight: normal;">VENTILASI TEKANAN POSITIF (VTP)</b></div>
<div class="Style1" style="margin-left: .5in; mso-list: l39 level1 lfo39; text-align: justify; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span></b><b style="mso-bidi-font-weight: normal;">Pemasangan
sungkup</b></div>
<div class="Style1" style="margin-left: .5in; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pasang dan pegang sungkup agar menutupi mulut dan
hidung bayi.</span></div>
<div class="Style1" style="margin-left: .5in; mso-list: l39 level1 lfo39; text-align: justify; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span></b><b style="mso-bidi-font-weight: normal;">Ventilasi
percobaan (2 kali)</b></div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l5 level1 lfo33; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">Lakukan tiupan udara dengan tekanan 30 cm
air</span></b></div>
<div class="Style1" style="margin-left: 1.0in; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Tiupan awal sangat penting untuk membuka alveoli
paru agar bayi bisa mulai bernapasdan sekaligus menguji apakh jalan napaas
terbuka atau bebas.</span></div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l5 level1 lfo33; text-align: justify; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;">Lihat
apakah dada bayi mengembang </b></div>
<div class="Style1" style="margin-left: 1.5in; mso-list: l26 level2 lfo38; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: "Courier New"; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bila
tidak mengembang,periksa posisi kepala,pastikan posisinya sudah benar,</span></div>
<div class="Style1" style="margin-left: 1.5in; mso-list: l26 level2 lfo38; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: "Courier New"; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Periksa
pemasangan sungkup dan pastikan tidak terjadi kebocoran</span></div>
<div class="Style1" style="margin-left: 1.5in; mso-list: l26 level2 lfo38; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: "Courier New"; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Periksa
ulang apakah jalan napas tersumbat cairan atau lendir (isap kembali) dan bila
dada<span style="mso-spacerun: yes;"> </span>mengembang,lakukan tahap
berikutnya.</span></div>
<div class="Style1" style="margin-left: 0in; text-align: justify;">
<br /></div>
<div class="Style1" style="margin-left: .5in; mso-list: l39 level1 lfo39; text-align: justify; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span lang="IT" style="mso-ansi-language: IT;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IT" style="mso-ansi-language: IT;">Ventiulasi definitive (20 kali dalam 30 detik).</span></b></div>
<div class="Style1" style="margin-left: .85in; mso-list: l25 level1 lfo40; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Lakukan
tiupan dengan tekanan 20 cm air,20 kali dalam 30 detik.</span></div>
<div class="Style1" style="margin-left: .85in; mso-list: l25 level1 lfo40; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Pastikan
udara masuk (dada mengembang) dalam 30 detik tinddakan.</span></div>
<div class="Style1" style="text-align: justify;">
<br /></div>
<div class="Style1" style="margin-left: .5in; mso-list: l39 level1 lfo39; text-align: justify; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";">
</span></span></b><b style="mso-bidi-font-weight: normal;">Lakukan
penilaian bayi</b></div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l5 level1 lfo33; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bila
bayi sudah bernapas normal,hentikan ventilasi dan pantau bayi.bayi<span style="mso-spacerun: yes;"> </span>diberikan asuhan pasca resusitasi.</span></div>
<div class="Style1" style="margin-left: 1.0in; mso-list: l5 level1 lfo33; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bila
bayi belum bernapas atau megap-megap : </span></div>
<div class="Style1" style="margin-left: 1.5in; mso-list: l2 level1 lfo41; text-align: justify; text-indent: -.5in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">lanjutkan
ventilasi dengan tekanan 20 cm ai,20x untuk 30 detik berikutnya,</span></div>
<div class="Style1" style="margin-left: 1.5in; mso-list: l2 level1 lfo41; text-align: justify; text-indent: -.5in;">
<span lang="IT" style="font-family: Wingdings; mso-ansi-language: IT; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IT" style="mso-ansi-language: IT;">Engevaluasi
hasil ventilaasi setiap 30 detik.</span></div>
<div class="Style1" style="margin-left: 1.5in; mso-list: l2 level1 lfo41; text-align: justify; text-indent: -.5in;">
<span lang="IT" style="font-family: Wingdings; mso-ansi-language: IT; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IT" style="mso-ansi-language: IT;">Lakukan
penilaian bayi apakah bernapas,tidak bernapas atau megap-megap.bila bayi sudah
mulai bernapas normal,hentikan ventilasi dan pantau bayi dengan seksama,berikan
asuhan pasca resusitas.tetapi bila bayi tidak bernapas atau megap-mega,teruskan
ventilasi dengan tekanan 20 cm air,20xuntuk 30 detik berikutnya and nilai
hasilnya setiap 30 detik.</span></div>
<div class="Style1" style="text-align: justify;">
<span lang="IT" style="mso-ansi-language: IT;">Siapkan Rujukan bila bayi belum bernapas normal sesudah 2 menit di
ventilasi : </span></div>
<div class="Style1" style="margin-left: .85in; text-align: justify; text-indent: .15in;">
<span lang="IT" style="mso-ansi-language: IT;"><span style="mso-spacerun: yes;"> </span>-
Minta keluarga membantu persiapan rujukan</span></div>
<div class="Style1" style="text-align: justify;">
<span lang="IT" style="mso-ansi-language: IT;"><span style="mso-tab-count: 2;"> </span><span style="mso-spacerun: yes;"> </span></span><span lang="FI" style="mso-ansi-language: FI;">- Teruskan resusitasi sementara persiapan rujukan dilakukan.</span></div>
<div class="Style1" style="text-align: justify;">
<span lang="IT" style="mso-ansi-language: IT;">Bila bayi tidak bisa di rujuk :</span></div>
<div class="Style1" style="margin-left: .75in; text-align: justify;">
<span lang="IT" style="mso-ansi-language: IT;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>-<span style="mso-spacerun: yes;">
</span>Lanjutkan ventilasi sampai 20 menit </span></div>
<div class="Style1" style="margin-left: 1.25in; text-align: justify; text-indent: -.25in;">
<span lang="IT" style="mso-ansi-language: IT;"><span style="mso-spacerun: yes;"> </span>-
Pertimbangkan untuk menghentikan tindakan resusitasi jika<span style="mso-spacerun: yes;"> </span>setelah 2 menit upay ventilasi tidak
berhasil.</span></div>
<div class="Style1" style="text-align: justify;">
<span lang="IT" style="mso-ansi-language: IT;">Bayi yang tidak bernapas normal selama 20 menit diresusitasi akan mengalami
kerusakan pada otak sehingga bayi akan menderita kecacatan yang berta atau
meninggal.</span></div>
<div class="Style1" style="text-align: justify;">
<br /></div>
<div class="Style1" style="margin-left: 0in; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span lang="IT" style="mso-ansi-language: IT;">ASUHAN PASCA RESUSITASI</span></b></div>
<div class="Style1" style="margin-left: 0in; text-align: justify;">
<span lang="IT" style="mso-ansi-language: IT;">Asuhan pasca resusitasi diberikan sesuai dengan
keadaan bayi setelah menerima tindakan resusitas.Asuhan pasca resusitasi
dilakukan pada keadaan :</span></div>
<div class="Style1" style="margin-left: .5in; mso-list: l36 level1 lfo31; text-align: justify; text-indent: -.25in;">
<span lang="IT" style="font-family: Symbol; mso-ansi-language: IT; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IT" style="mso-ansi-language: IT;">Resusitasi
berhasil : bayi menangis dan bernapas normal sesudah langkah awal atau sesudah
ventilasi.perlu pemantauan dan dukungan.</span></div>
<div class="Style1" style="margin-left: .5in; mso-list: l36 level1 lfo31; text-align: justify; text-indent: -.25in;">
<span lang="IT" style="font-family: Symbol; mso-ansi-language: IT; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IT" style="mso-ansi-language: IT;">Resusitasi
tidak atau kurang berhasil,bayi perlu rujukan yaitu sesudah ventilasi 2 menit
belum bernapas atau bayi sudah bernapas tetapi masih megap-megap atau pada
pemantauan ternyata kondisinya makin memburuk.</span></div>
<div class="Style1" style="margin-left: .5in; mso-list: l36 level1 lfo31; text-align: justify; text-indent: -.25in;">
<span lang="IT" style="font-family: Symbol; mso-ansi-language: IT; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IT" style="mso-ansi-language: IT;">Resusitasi
gagal setelah 20 menit di ventilasi,bayi gagal bernapas.</span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto;">
<br /></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">ASUHAN KEBIDANAN PADA BAYI NY. “S”</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">DENGAN ASFIKSIA BERAT</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">DI RUANG NICU RSUP NTB</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">TANGGAL 24 – 26 JUNI 2009</span></b></div>
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<br /></div>
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<b style="mso-bidi-font-weight: normal;">Data Subjektif ( S )</b></div>
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<b style="mso-bidi-font-weight: normal;">HARI PERTAMA : Tgl 24 Juni 2009</b></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Identitas</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Nama bayi<span style="mso-tab-count: 1;"> </span>: Bayi Ny.”S”</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Usia<span style="mso-tab-count: 2;"> </span>: 1 hari</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Anak ke<span style="mso-tab-count: 1;"> </span>: 1 (Satu)</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Jenis Kelamin<span style="mso-tab-count: 1;"> </span>: Laki-laki ( ♂)</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">No RM<span style="mso-tab-count: 2;"> </span>: </span></div>
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<br /></div>
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<span lang="SV" style="mso-ansi-language: SV;">Nama Ibu<span style="mso-tab-count: 1;"> </span>: Ny.”S”<span style="mso-tab-count: 2;"> </span>Nama Bapak<span style="mso-tab-count: 2;"> </span>:
Tn.”S”</span></div>
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<span lang="FI" style="mso-ansi-language: FI;">Umur<span style="mso-tab-count: 2;"> </span>: 25 tahun<span style="mso-tab-count: 2;"> </span>Umur<span style="mso-tab-count: 3;"> </span>: 30 tahun</span></div>
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<span lang="FI" style="mso-ansi-language: FI;">Suku<span style="mso-tab-count: 2;"> </span>: Sasak<span style="mso-spacerun: yes;"> </span>Suku<span style="mso-tab-count: 3;"> </span>: Sasak</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Agama<span style="mso-tab-count: 2;"> </span>: Islam<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span>Agama <span style="mso-tab-count: 2;"> </span>:
Islam</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Pendidikan<span style="mso-tab-count: 1;"> </span>: TTSD<span style="mso-spacerun: yes;"> </span>Pendidikan<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>SD</span></div>
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<span lang="FI" style="mso-ansi-language: FI;">Pekerjaan<span style="mso-tab-count: 1;"> </span>: IRT<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span>Pekerjaan<span style="mso-tab-count: 2;"> </span>:
Buruh</span></div>
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<span lang="FI" style="mso-ansi-language: FI;">Alamat<span style="mso-tab-count: 2;"> </span>: Kebonfalo - Lembar</span></div>
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<br /></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Riwayat
perjalanan penyakit</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Bayi lahir tgl 23 – 06 – 2009,
Pukul : 23.30 wita, lahir secara SC di Ruang OK RSUP NTB dengan indikasi tindakan
partus kasep. Bayi masuk ke NICU tgl 24 – 06 – 2009, Pukul : 00.05 wita dengan
tangis merintih, nafas berat, ada retraksi, hipotermi (+),cyanosis (+), dengan
A-S : 3 – 5.</span></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Riwayat
kehamilan sekarang</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Ibu mengatakan hamil pertama,
umur kehamilan 9 bulan (40-41 minggu), HPHT 10-09-2008, HTP 17-06-2009, ANC
teratur di polindes, TT 2 kali (lengkap).</span></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Riwayat
persalinan</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Bayi lahir tgl 23 – 06 – 2009,
Pukul : 23.30 wita, lahir secara SC di Ruang OK RSUP NTB ditolong dokter
spesialis, dengan indikasi : partus kasep, BBL 3100 gram, PB 45 cm, LILA 11 cm,
Lika 34 cm, A-S : 3-5, jenis kelamin laki-laki ( ♂ ).</span></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Riwayat
post natal</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Bayi lahir dengan asfeksia berat,
sesuai masa kehamilan A-S : 3-5, tangis merintih, nafas berat, ada retraksi,
hipotermi (+),cyanosis (+).</span></div>
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<br /></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">OBYEKTIF ( O )</span></b></div>
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<span style="mso-list: Ignore;">a)<span style="font: 7.0pt "Times New Roman";">
</span></span>Pemeriksaan Umum</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 31.35pt; text-align: justify;">
Keadaan umum bayi <span style="mso-tab-count: 1;"> </span>: Lemah</div>
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Tanda Vital:</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.45pt; mso-list: l22 level2 lfo5; text-align: justify; text-indent: -17.1pt;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Laju Nafas <span style="mso-tab-count: 2;"> </span>:
32 x/menit</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.45pt; mso-list: l22 level2 lfo5; text-align: justify; text-indent: -17.1pt;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Laju Jantung<span style="mso-tab-count: 1;"> </span>:
142 x/menit</div>
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Berat Badan<span style="mso-tab-count: 2;"> </span>: 3100
gram</div>
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Panjang Badan<span style="mso-tab-count: 2;"> </span>: 45 cm</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 31.35pt; text-align: justify;">
Lila/Lika <span style="mso-tab-count: 2;"> </span>: 11
cm/34cm</div>
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<span style="mso-tab-count: 1;"> </span></div>
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<span style="mso-list: Ignore;">b)<span style="font: 7.0pt "Times New Roman";">
</span></span>Pemeriksaan Fisik</div>
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<span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span>Kepala :</div>
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<span lang="PT-BR" style="mso-ansi-language: PT-BR;">Bersih, distribusi
rambut merata, tidak ada luka/lesi, terdapat sutura, tidak ada molase, benjolan
(-), caput sucsedaneum (-), </span>fontanel mayor : teraba lunak, berdenyut,
batasnya tegas, datar dan tidak menonjol/cekung.<span style="mso-ansi-language: PT-BR;"> </span>sutura sagitalis : teraba tepat/rapat dan tidak
terpisah/menjauh.<span style="mso-ansi-language: PT-BR;"> </span>Lika : 34 cm<span lang="PT-BR" style="mso-ansi-language: PT-BR;"></span></div>
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<span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span>Telinga</div>
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<span lang="SV" style="mso-ansi-language: SV;">Simetris, bersih, tidak ada
luka, daya pegas daun telinga kembali cepat, pina melengkung dengan sempurna.</span></div>
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<span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span>Mata</div>
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Simetris, bersih, tidak ada tanda-tanda infeksi, konjungtiva tidak pucat,
sklera tidak ikterus, mata tidak cekung, reflek terhadap cahaya ( reaksi pupil
: isokhor = normal )</div>
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<span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";">
</span></span>Hidung dan mulut</div>
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Bersih, tidak ada lelehan saliva berlebih, nafas cuping hidung (+),
laboskisis (-), labiopalatoskisis (-), labiognatoskisis (-), refleks hisap <span style="mso-spacerun: yes;"> </span>(-),<span style="mso-spacerun: yes;">
</span>Oksigen terpasang 1 liter.</div>
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<span style="mso-list: Ignore;">5)<span style="font: 7.0pt "Times New Roman";">
</span></span>Leher</div>
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<span lang="SV" style="mso-ansi-language: SV;">Pergerakan : aktif, tidak ada
massa atau benjolan, tidak ada fraktur klavikula.</span></div>
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<span style="mso-list: Ignore;">6)<span style="font: 7.0pt "Times New Roman";">
</span></span>Dada</div>
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<span lang="SV" style="mso-ansi-language: SV;">Puting susu simetris, retraksi
dinding dada (+), RR : 32 x/menit,irama nafas reguler, denyut jantung 142
x/menit,irama jantung vesikuler.</span></div>
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<span style="mso-list: Ignore;">7)<span style="font: 7.0pt "Times New Roman";">
</span></span>Bahu, lengan dan tangan</div>
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<span lang="FI" style="mso-ansi-language: FI;">Gerakan lemah, jumlah jari
lengkap.</span></div>
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<span style="mso-list: Ignore;">8)<span style="font: 7.0pt "Times New Roman";">
</span></span>Abdomen</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.3pt; text-align: justify;">
Bentuknya simetris, tidak terdapat penonjolan sekitar tali pusat pada
saat menangis, pendarahan tali pusat tidak ada, perut teraba lunak/lembek (saat
tidak menangis) tidak ada tonjolan.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.3pt; mso-list: l22 level3 lfo5; text-align: justify; text-indent: -19.95pt;">
<span style="mso-list: Ignore;">9)<span style="font: 7.0pt "Times New Roman";">
</span></span>Punggung dan anus</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.3pt; text-align: justify;">
Tidak terdapat pembengkakan dan cekungan pada punggung, anus (+),
kelainan lain tidak ada, mekonium berwarna kuning kecoklatan.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.3pt; mso-list: l22 level3 lfo5; text-align: justify; text-indent: -19.95pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">10)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Ekstermitas atas : Simetris, gerakan
aktif, jumlah jari normal, infus terpasang Dex 10 %, 12 tetes/menit.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.3pt; mso-list: l22 level3 lfo5; text-align: justify; text-indent: -19.95pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">11)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Ekstremitas bawah : Simetris, gerakan
aktif, jumlah jari normal.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.3pt; mso-list: l22 level3 lfo5; text-align: justify; text-indent: -19.95pt;">
<span style="mso-list: Ignore;">12)<span style="font: 7.0pt "Times New Roman";">
</span></span>Genitalia</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.3pt; text-align: justify;">
Laki-laki, testis sudah turun pada skrotum, penis berlubang pada
ujungnya, ruggae skrotum bagus (banyak).</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.3pt; mso-list: l22 level3 lfo5; text-align: justify; text-indent: -19.95pt;">
<span style="mso-list: Ignore;">13)<span style="font: 7.0pt "Times New Roman";">
</span></span>Kulit</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.3pt; text-align: justify;">
Warna pucat, tanda lahir tidak ada, tidak terdapat vernik caseosa dan
tidak terdapat pembengkakan dan bercak-bercak hitam, tidak tampak kuning.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.25pt; text-align: justify;">
c.<span style="mso-tab-count: 1;"> </span>Pemeriksaan Laboraturium :
tgl 24 – 06 – 2009, pukul : 12.08 wita. </div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="mso-tab-count: 1;"> </span>Hasil : HGB : 4,50 x/10 <sup>6</sup>
/ul</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="mso-tab-count: 2;"> </span>HCT : 46,7 % </div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="mso-tab-count: 2;"> </span>WBC : 16,3 / ul</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b style="mso-bidi-font-weight: normal;">ASSASMENT ( A )</b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.6pt; mso-list: l27 level2 lfo6; text-align: justify; text-indent: -17.1pt;">
<span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span>Diagnosa : Bayi baru lahir, sesuai masa kehamilan, K/U
lemah dengan asfeksia berat.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.6pt; text-align: justify;">
Data dasar :</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 65.55pt; mso-list: l27 level3 lfo6; tab-stops: list 36.7pt; text-align: justify; text-indent: -19.95pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bayi baru
lahir, dengan cara SC.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 65.55pt; mso-list: l27 level3 lfo6; tab-stops: list 36.7pt; text-align: justify; text-indent: -19.95pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="mso-ansi-language: FI;">Usia
kehamilan 40 – 41 <span style="mso-spacerun: yes;"> </span>minggu</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 65.55pt; mso-list: l27 level3 lfo6; tab-stops: list 36.7pt; text-align: justify; text-indent: -19.95pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">AS :
3 – 5 , BB : 3100 gram, PB : 45 cm, Lila :11 cm, Lika : 34 cm.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 65.55pt; mso-list: l27 level3 lfo6; tab-stops: list 36.7pt; text-align: justify; text-indent: -19.95pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Kelainan fisik tidak ada.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 65.55pt; mso-list: l27 level3 lfo6; tab-stops: list 36.7pt; text-align: justify; text-indent: -19.95pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="mso-ansi-language: FI;">Denyut
jantung :142 x/menit, napas : 32 x/menit, S : 36 º c.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 65.55pt; mso-list: l27 level3 lfo6; tab-stops: list 36.7pt; text-align: justify; text-indent: -19.95pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="mso-ansi-language: FI;">Jenis
kelamin laki-laki, alat kelamin normal, anus (+) dan tidak ada kelainan bawaan.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.6pt; mso-list: l27 level2 lfo6; text-align: justify; text-indent: -17.1pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="FI" style="mso-ansi-language: FI;">Masalah<span style="mso-tab-count: 1;"> </span>:
Gangguan pemenuhan kebutuhan O<sub>2 </sub>(oksigen)</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.75pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Data dasar<span style="mso-tab-count: 1;"> </span>: Napas berat, pucat, cyanosis</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.6pt; mso-list: l27 level2 lfo6; text-align: justify; text-indent: -17.1pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="FI" style="mso-ansi-language: FI;">Kebutuhan<span style="mso-tab-count: 1;"> </span>:
Bebaskan jalan napas, kepala posisi ekstensi, ganti selimut tiap kali basah.</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 28.5pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">PLANNING ( P )</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">Tanggal<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>: 24 Juni 2009</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">Jam<span style="mso-tab-count: 1;"> </span> : 00.15 Wita</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.75pt; mso-list: l20 level1 lfo7; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="FI" style="mso-ansi-language: FI;">Mengobservasi K/U bayi yaitu bayi masih
tampak lemah, tangis merintih, napas berat (+), napas cuping hidung (+),
tarikan dinding dada (+), cyanosis (+)</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.75pt; mso-list: l20 level1 lfo7; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Meletakan bayi di atas radia warmer, dan
atur pengaturan suhunya secara normal yaitu 36,5 ºc.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.75pt; mso-list: l20 level1 lfo7; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="FI" style="mso-ansi-language: FI;">Mengatur posisi yaitu posisi kepala
ekstensi untuk membebaskan jalan napas.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.75pt; mso-list: l20 level1 lfo7; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span>Membersihkan lendir dengan sedot lendir (suction)</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.75pt; mso-list: l20 level1 lfo7; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span>Memberikan rangsangan taktil dengan cara menggosok
punggung bayi dan seluruh tubuh sambil mengeringkannya, kemudian hasilnya bayi
menangis.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.75pt; mso-list: l20 level1 lfo7; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi fisik dan tanda-tanda vital : warna kulit
merah ekstremitas masih biru, bayi menangis, tonus otot sedikit fleksi, bersin,
Denyut jantung 144 x/menit.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; text-align: justify; text-indent: -43.95pt;">
Pukul 00.10 wita : Memasang infus pada lengan
sebelah kiri, infuse yang diberikan adalah D 10 % ( 12 tetes x/menit).</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; text-align: justify; text-indent: -43.95pt;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul
00.15 wita : menginjeksikan obat : Ampicillin 2 x 125 mg</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 225.0pt; text-align: justify; text-indent: -196.95pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Gentamicyn 1 x 15 mg</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 225.0pt; text-align: justify; text-indent: -196.95pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Vitamin K 0,1 ml</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; tab-stops: list -2.5in; text-align: justify; text-indent: -43.95pt;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 01.00 wita : Mengganti selimut dan kain bayi
dengan kain bersih, menyelimuti seluruh tubuh bayi dan menutup kepala bayi.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 03.00 wita </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l38 level2 lfo9; tab-stops: list 1.0in; text-align: justify; text-indent: 27.0pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="mso-ansi-language: FI;">mengobservasi
tetesan infus </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 06.00 wita </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l38 level2 lfo9; tab-stops: list 1.0in; text-align: justify; text-indent: 27.0pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">mengukur
TTV, S = 36,5<sup>0 </sup>C, RR = 36 x/menit, DJ = 140 x/menit </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; text-align: justify; text-indent: -46.35pt;">
<span lang="SV" style="mso-ansi-language: SV;">Pukul
07.00 wita : </span><span lang="PT-BR" style="mso-ansi-language: PT-BR;">k/u lemah,
tangis (+), syanosis (-), syanosis (-), oksigen terpasang, muntah (-), BAB/BAK
(+/+), infus D 10 % terpasang.</span><span lang="SV" style="mso-ansi-language: SV;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 63.0pt; text-align: justify; text-indent: -9.0pt;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;">-<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>menyeka
bayi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;">Pukul 08.00 wita </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l17 level1 lfo10; text-align: justify; text-indent: -.25in;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="PT-BR" style="mso-ansi-language: PT-BR;">visite
dokter</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 10.00 wita </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l13 level1 lfo11; text-align: justify; text-indent: -.25in;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="PT-BR" style="mso-ansi-language: PT-BR;">BAB,
warna : kecoklatan, dan BAK.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l13 level1 lfo11; text-align: justify; text-indent: -.25in;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="PT-BR" style="mso-ansi-language: PT-BR;">ganti
selimut bayi </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; text-align: justify;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;">Pukul 12.00 </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l1 level1 lfo12; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi k/u bayi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l1 level1 lfo12; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi TTV, S: 36°C, RR : 52 x/mnt, DJ: 136x/mnt</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; text-align: justify; text-indent: -45.0pt;">
Siang : k/u lesu, tangis keras dn rewel, coba minum
PASI <span style="mso-spacerun: yes;"> </span>± 5 cc, tidak cianosis, BAK/BAB
lancar, infus terpasang</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify;">
Pukul 14.00 wita : </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l19 level1 lfo13; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi k/u bayi </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l19 level1 lfo13; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengatur posisi tidur </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l19 level1 lfo13; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengganti selimut </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; text-align: justify;">
Pukul 15.00 wita : </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l11 level1 lfo14; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Bayi rewel </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l11 level1 lfo14; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi lokasi dan tetesan infus</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; text-align: justify;">
Pukul 17.00 wita : </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l11 level2 lfo14; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Memberi PASI ± 5 cc</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l11 level2 lfo14; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi TTV : S : 36,7°C, RR : 40 x/mnt, DJ: 120
x/mnt</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; text-align: justify;">
Pukul 19.00 wita : </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l24 level1 lfo15; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Minum PASI ± 5 cc</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; text-align: justify; text-indent: -46.35pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; text-align: justify; text-indent: -46.35pt;">
Malam : k/u lesu, tangis (+), minun PASI ± 5 cc,
muntah (-), BAB/BAK (+/+), hipotermi (-), kembung (-), infus terpasang.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; text-align: justify; text-indent: -46.35pt;">
Pukul : 20.00 wita : </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l24 level1 lfo15; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Observasi k/u bayi </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l24 level1 lfo15; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Ganti selimut</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; text-align: justify;">
Pukul 21.00 wita :</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l12 level1 lfo16; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Minum PASI 15 cc</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l12 level1 lfo16; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Kembung (+), bayi rewel. </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l12 level1 lfo16; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Menagatur posisi bayi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; text-align: justify;">
Pukul 23.00 wita :</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l23 level1 lfo17; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Memberi injeksi Ampicillin 125 mg</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l23 level1 lfo17; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Pasang
NGT, retensi 5 cc, spul PZ 5 cc, lendir coklat + susu + gumpalan coklat.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pukul 01.00 wita :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l6 level1 lfo18; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Mengganti
selimut bayi </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pukul 03.00 wita : </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l6 level1 lfo18; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Menarik
retensi, R </span><span lang="PT-BR" style="mso-ansi-language: PT-BR;">= 5 cc
lendir kecoklatan + susu,</span><span lang="SV" style="mso-ansi-language: SV;">
spul PZ 5 cc </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l6 level1 lfo18; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Minum PASI 15 cc</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pukul 05.00 wita : </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l6 level1 lfo18; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Mengobservasi
bayi </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l6 level1 lfo18; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Menatur
posisi bayi.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pukul 06.00 wita : </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l10 level1 lfo19; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Mengganti
tempat infus pada lengan sebelah kanan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.85pt; mso-list: l10 level1 lfo19; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi TTV : S : 36,7°C, RR : 40 x/mnt, DJ: 130
x/mnt.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; mso-list: l27 level1 lfo6; text-align: justify; text-indent: -25.65pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="PT-BR" style="mso-ansi-language: PT-BR;"><span style="mso-list: Ignore;">III.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="PT-BR" style="mso-ansi-language: PT-BR;">EVALUASI</span></b><span lang="PT-BR" style="mso-ansi-language: PT-BR;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; text-align: justify;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;">Tanggal<span style="mso-tab-count: 1;"> </span>: 25 juni 2009 </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 25.65pt; text-align: justify;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;">Jam<span style="mso-tab-count: 1;"> </span>: 07.00 WITA</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.75pt; mso-list: l16 level1 lfo8; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="PT-BR" style="mso-ansi-language: PT-BR;">K/U bayi lesu, tangis (+),
hipotermi(-), minum pasi 5 cc, muntah (-), BAB/BAK(+)/(+), kembung(-),infus dex
10% masih terpasang 12 tts/mnt.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.75pt; mso-list: l16 level1 lfo8; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">NGT masih terpasang, retensi 5 cc lendir
kental + susu dan gumpalan coklat.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.75pt; mso-list: l16 level1 lfo8; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Tanda-tanda vital</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.75pt; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">DJ : 120x/menit, RR : 40m
x/menit, Suhu : 36, 7<sup>0</sup>C</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.75pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 28.35pt; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">HARI KE-2 ( Tanggal 25 juni 2009)</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">DS </span></b><span lang="FI" style="mso-ansi-language: FI;"><span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span>:
ibu mengeluh bayinya masih lemah</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 78.0pt; tab-stops: 70.9pt; text-align: justify; text-indent: -48.75pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">DO </span></b><span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span>:
Keadaan umum lesu, tangis (+), minum pasi 5- 10 cc, muntah (-),<span style="mso-spacerun: yes;"> </span>kembung (-), cyanosis (-), sesak (-),O2
terpasang 1 liter, BAB/BAK (+)/(+),infus dextrose 10% terpasang 6 tts/mnt.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.85pt; text-align: justify; text-indent: -43.5pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">A</span></b><span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 2;"> </span>: Bayi lahir
cukup bulan sesuai masa kehamilan umur 2 hari, K/U <span style="mso-spacerun: yes;"> </span>lemah dengan asfeksia ringan.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.85pt; text-indent: -43.5pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">P</span></b><span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span>: Pukul 07.00 wita : mengobservasi
keadaan umum bayi yaitu keadaan umum bayi masih lemah, menyeka dan menimbang
berat badan (BB : 3000 gram), mengganti selimut,NGT dilepaskan, visite dokter (terapi
lanjut).</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.75in; text-indent: -.75in;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 09.00 wita : memberi
injeksi ampicillin 125 mg dan <span style="mso-spacerun: yes;"> </span>gentamisin
15 mg.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.85pt; text-indent: -35.85pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span>Pukul 09.30 wita : memberi minum pasi 5 – 10 cc</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.75in; text-indent: -.75in;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 12.00 wita :
mengobservasi tanda-tanda vital s : 37,4ºc, RR : 42 x/mnt, DJ : 136 x/mnt</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.85pt; text-indent: -35.85pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span>Pukul 13.00 wita : mengganti selimut dan memberi minum
pasi.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.85pt; text-indent: -35.85pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span>Pukul 14.00 wita : mengatur posisi tidur, mengganti
selimut.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.85pt; text-indent: -35.85pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span>Pukul 15.00 wita : memberi minum pasi 5-10 cc</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.75in; text-indent: -.75in;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 17.00 wita : observasi
tanda-tanda vital : s : 37,0 ºc , RR : 40 <span style="mso-spacerun: yes;"> </span>x/mnt , DJ : 140 x/mnt.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.75in; text-indent: -.75in;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 19.00 wita :<span style="mso-spacerun: yes;"> </span>memberi minum pasi 5-10 cc, mengganti
selimut.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; text-indent: -35.85pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.85pt; text-indent: -35.85pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">Evaluasi (25 juni 2009, pukul 14.00 wita)</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; mso-list: l4 level1 lfo20; text-indent: -16.9pt;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span>Keadaan
umum bayi masih lemah, tangis (+), minum pasi 5- 10 cc,cyanosis(-), sesak (-),
kembung (-),muntah (-), O2 masih terpasang 1 liter, infus terpasang dextrose
10% 6 tts/mnt.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; mso-list: l4 level1 lfo20; text-indent: -16.9pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Tanda-tanda vital S : 37,0ºc, RR : 40
x/mnt, DJ : 140 x/mnt.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: 28.35pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">HARI KE-3 ( tanggal 26 juni 2009)</span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: 28.35pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">DS </span></b><span lang="SV" style="mso-ansi-language: SV;">: Ibu mengatakan
keadaan bayinya sudah baik</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 56.7pt; text-indent: -28.35pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">DO</span></b><span lang="SV" style="mso-ansi-language: SV;"> : Keadaan umum
baik, tangis (+), minum asi langsung dari ibu, muntah (-), BAB/BAK (+)/(+),
ikterus (-), hipotermi (-).</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 56.7pt; text-indent: -28.35pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">A</span></b><span lang="FI" style="mso-ansi-language: FI;"><span style="mso-spacerun: yes;"> </span>: Bayi lahir cukup bulan sesuai masa
kehamilan umur 3 hari.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.75in; text-indent: -97.65pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">P</span></b><span lang="SV" style="mso-ansi-language: SV;"><span style="mso-spacerun: yes;"> </span>: <span style="mso-spacerun: yes;"> </span>Pukul
07.00 wita : menyeka, mengganti selimut bayi, dan menimbang berat badan bayi
(3000 gram).</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; text-indent: -21.3pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-tab-count: 1;"> </span>Pukul 08.00 wita : memberi minum asi langsung dari ibu</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.75in; text-indent: -81.0pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-spacerun: yes;"> </span>Pukul 09.00 wita : visite dokter, yaitu
keadaan umum bayi sudah baik dan sudah diperbolehkan pulang.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; text-indent: -21.3pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: 27.0pt;">
<b style="mso-bidi-font-weight: normal;">Evaluasi (pukul 09.30 wita)</b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 64.35pt; mso-list: l18 level1 lfo21; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Keadaan umum bayi baik, tangis (+), minum asi langsung
dari ibu, muntah (-), BAB/BAK (+)/(+), hipotermi (-), ikterus (-).</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 64.35pt; mso-list: l18 level1 lfo21; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>Bayi sudah di pulangkan.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 56.7pt; text-indent: -28.35pt;">
<span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: 28.35pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.85pt; text-indent: -43.5pt;">
<span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 28.35pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 28.35pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in; text-align: justify; text-indent: -87.6pt;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.7pt; text-align: justify;">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-25860345136238885472013-01-30T23:26:00.001-08:002013-01-30T23:31:11.254-08:00PERAWATAN KATETER<br />
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;">
Perawatan
kateter adalah suatu tindakan keperawatan dalam memelihara kateter dengan
antiseptik untuk membersihkan ujung uretra dan selang kateter bagian luar serta
mempertahankan kepatenan posisi kateter</div>
<div class="MsoNormal" style="line-height: 150%;">
<b>Tujuan:</b></div>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo2; tab-stops: list .5in;">Menjaga kebersihan saluran kencing</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo2; tab-stops: list .5in;">Mempertahankan kepatenan (fiksasi) kateter</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo2; tab-stops: list .5in;">Mencegah terjadinya infeksi</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo2; tab-stops: list .5in;">Mengendalikan infeksi</li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b>Persiapan alat dan bahan:</b></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="mso-spacerun: yes;"> </span>Meja/trolly yang berisi:</div>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Sarung tangan steril</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Pengalas </li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Bengkok</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Lidi waten steril</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Kapas steril</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Kasa steril</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Antiseptic (Bethadin)</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Aquadest / air hangat</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Korentang</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Plester </li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Gunting</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Bensin </li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Pinset </li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-align: justify;">Kantung sampah</li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;">Pelaksanaan:</b></div>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Siapkan alat dan bahan</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Beritahu pasien maksud dan tujuan tindakan </li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Dekatkan alat dan bahan yang sudah disiapkan</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Pasang tirai, gorden yang ada </li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Cuci tangan</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Oles bensin pada plester dan buka dengan pinset </li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Buka balutan pada kateter </li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Pakai sarung tangan steril</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Perhatikan kebersihan dan tanda-tanda infeksi dari
ujung penis serta kateter</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Oles ujung uretra dan kateter memakai kapas steril
yang telah dibasahi dengan aquadest / air hangat dengan arah menjauhi
uretra </li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Oles ujung uretra dan kateter memakai lidi waten +
bethadin dengan arah menjauhi uretra </li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Balut ujung penis dan kateter dengan kasa steril
kemudian plester</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Posisikan kateter ke arah perut dan plester</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Rapikan klien dan berikan posisi yang nyaman bagi
pasien</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Kembalikan alat ke tempatnya</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Cuci tangan </li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo3; tab-stops: list .5in;">Dokumentasikan tindakan</li>
</ol>
<div class="MsoNormal" style="line-height: 150%; text-indent: 3.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: 3.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;">Daftar Pustaka</b></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level2 lfo3; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Smeltzer, C. Suzanne, Bare, G. Brenda. <i style="mso-bidi-font-style: normal;">Brunner and Suddarth’s</i> <i style="mso-bidi-font-style: normal;">Text Book of Medical Surgical Nursing</i>. 8<sup>th<span style="mso-spacerun: yes;"> </span></sup>vol 2 alih bahasa Kuncoro, Andry
Hartono, Monica Ester, Yasmin Asih. Jakarta: EGC; 2001</div>
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<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>Perry, Anne, Griffin, Potter A. Patricia. <i style="mso-bidi-font-style: normal;">Pocket Guide to Basic Skills and Procedures</i>.
Alih bahasa: Monica Ester, Jakarta: EGC; 2000</div>
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<br />himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-50851107669545560512013-01-30T23:20:00.003-08:002013-01-30T23:33:43.681-08:00LAPORAN OLIGOMENOREA<br />
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<b><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: SV;">KATA PENGANTAR</span></b></div>
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<br /></div>
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<span lang="IN" style="color: black; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IN;">Puji syukur kita panjatkan atas kehadiran
Tuhan Yang Maha Esa, karena berkat limpahan rahmat dan karunia yang telah
diberikanNya penulis dapat menyelesaikan makalah yang berjudul “</span><span lang="SV" style="color: black; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV;">Oligomenorea</span><span lang="IN" style="color: black; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IN;">” ini tanpa adanya hambatan yang berarti.</span></div>
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<span lang="IN" style="color: black; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IN;">Keberhasilan penulis dalam menyelesaikan
makalah ini, tidak lepas dari bimbingan pihak. Oleh karena itu, penulis
menyampaikan terima kasih kepada : dosen pembimbing KMB kami serta teman-teman
yang telah memberikan motivasi dan juga bimbingan kepada penulis dalam menyusun
makalah ini.</span></div>
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<span lang="IN" style="color: black; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IN;">Tiada gading yang tak retak, begitu pula
dengan makalah ini yang masih jauh dari kesempurnaan. Oleh karena itu, penulis
mengharapkan kritik dan saran yang bersifat membangun sebagai bahan pelajaran
penulis. Terima kasih penulis ucapkan semoga makalah ini dapat bermanfaat.</span></div>
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<span lang="IN" style="color: black; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN;">Mataram,
21 April 2012</span></div>
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<span lang="IN" style="color: black; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN;"><span style="mso-spacerun: yes;"> </span></span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">PENULIS</span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%;">DAFTAR
ISI</span></b></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">Kata Pengantar <span style="mso-tab-count: 1 dotted;">..................................................................................................... </span>1</span></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">Daftar Isi<span style="mso-tab-count: 1 dotted;">................................................................................................................ </span>2</span></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">BAB I PENDAHULUAN.<span style="mso-tab-count: 1 dotted;">................................................................................... </span>3</span></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">A.<span style="mso-spacerun: yes;"> </span>Latar Belakang<span style="mso-tab-count: 1 dotted;">................................................................................................. </span>3</span></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">B.<span style="mso-spacerun: yes;"> </span>Tujuan<span style="mso-tab-count: 1 dotted;">.............................................................................................................. </span>3</span></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">BAB II<span style="mso-spacerun: yes;"> </span>Pembahasan<span style="mso-tab-count: 1 dotted;">............................................................................................. </span>4</span></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">A. Pengertian<span style="mso-tab-count: 1 dotted;">......................................................................................................... </span>4</span></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">B. Etiologi<span style="mso-tab-count: 1 dotted;">.............................................................................................................. </span>5</span></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-ansi-language: SV;">C. manifestasi klinik<span style="mso-tab-count: 1 dotted;">.............................................................................................. </span>6</span></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-ansi-language: SV;">D.
Komplikasi.........................................................................................................7<span style="mso-tab-count: 1;"> </span></span></div>
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<span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN;">E.<b> </b></span><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">Konsep
asuhan keperawatan pada pasien Oligomenorea...................…………8</span></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">BAB III PENUTUP.<span style="mso-tab-count: 1 dotted;">........................................................................................... </span>11</span></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">A. Kesimpulan.<span style="mso-tab-count: 1 dotted;">.................................................................................................... </span>11</span></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">Daftar Pustaka<span style="mso-tab-count: 1 dotted;">..................................................................................................... </span>12</span></div>
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<b><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">BAB I</span></b></div>
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<b><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">PENDAHULUAN</span></b></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">LATAR
BELAKANG</span></div>
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<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Menstruasi atau
haid mengacu kepa</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">da pengeluaran secara periodik darah dan
sel-sel tubuh dari vagina yang berasal dari dinding rahim wanita. Menstruasi
dimulai saat pubertas dan menandai kemampuan seorang wanita untuk mengandung
anak, walaupun mungkin faktor-faktor kesehatan lain dapat membatasi kapasitas
ini. Menstruasi biasanya dimulai antara umur 10 dan 16 tahun, tergantung pada
berbagai faktor, termasuk kesehatan wanita, status nutrisi, dan berat tubuh
relatif terhadap tinggi tubuh. Menstruasi berlangsung kira-kira sekali sebulan
sampai wanita mencapai usia 45 - 50 tahun, sekali lagi tergantung pada
kesehatan dan pengaruh-pengaruh lainnya. Akhir dari kemampuan wanita untuk
bermenstruasi disebut menopause dan menandai akhir dari masa-masa kehamilan
seorang wanita. Panjang rata-rata daur menstruasi adalah 28 hari, namun
berkisar antara 21 hingga 40 hari. Panjang daur dapat bervariasi pada satu
wanita selama saat-saat yang berbeda dalam hidupnya, dan bahkan dari bulan ke
bulan tergantung pada berbagai hal, termasuk kesehatan fisik, emosi, dan
nutrisi wanita tersebut. </span></div>
<div style="line-height: 150%; margin-left: .25in; text-align: justify; text-indent: .5in;">
<span lang="SV" style="mso-ansi-language: SV;">Menstruasi merupakan bagian
dari proses reguler yang mempersiapkan tubuh wanita setiap bulannya untuk
kehamilan. Daur ini melibatkan beberapa tahap yang dikendalikan oleh interaksi
hormon yang dikeluarkan oleh hipotalamus, kelenjar dibawah otak depan, dan
indung telur. </span><span lang="ES" style="mso-ansi-language: ES;">Pada permulaan
daur, lapisan sel rahim mulai berkembang dan menebal. Lapisan ini berperan
sebagai penyokong bagi janin yang sedang tumbuh bila wanita tersebut hamil.
Hormon memberi sinyal pada telur di dalam indung telur untuk mulai berkembang.
Tak lama kemudian, sebuah telur dilepaskan dari indung telur wanita dan mulai
bergerak menuju tuba Falopii terus ke rahim. Bila telur tidak dibuahi oleh
sperma pada saat berhubungan intim (atau saat inseminasi buatan), lapisan rahim
akan berpisah dari dinding uterus dan mulai luruh serta akan dikeluarkan
melalui vagina. Periode pengeluaran darah, dikenal sebagai periode menstruasi
(atau mens, atau haid), berlangsung selama tiga hingga tujuh hari. Bila seorang
wanita menjadi hamil, menstruasi bulanannya akan berhenti. Oleh karena itu,
menghilangnya menstruasi bulanan merupakan tanda (walaupun tidak selalu) bahwa
seorang wanita sedang hamil. </span>Kehamilan dapat di konfirmasi dengan
pemeriksaan darah sederhana. </div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">TUJUAN</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Untuk
mengetahui proses terjadinya oligomenorea.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Untuk
mengetahui jalannya suatu proses asuhan keperawatan tentang oligomenorea.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><o:p> </o:p></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%;"><br /></span></b></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%;">BAB
II</span></b></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%;">PEMBAHASAN</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">PENGERTIAN</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Oligomenorea
merupakan suatu kondisi dimana siklus haid lebih panjang, lebih dari 35 hari
(nomal: 25-35 hari). Apabila panjangnya siklus lebih dari tiga bulan, hal itu
sudah dinamakan amenorea. Perdarahan pada oligomenorea biasanya berkurang.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Oligomenorea
merupakan suatu keadaan dimana siklus menstruasi memanjang lebih dari 35 hari,
sedangkan jumlah perdarahan tetap sama. Wanita yang mengalami oligomenorea akan
mengalami menstruasi yang lebih jarang daripada biasanya. Namun, jika
berhentinya siklus menstruasi ini berlangsung selama lebih dari 3 bulan, maka
kondisi tersebut dikenal sebagai amenorea sekunder.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">PENYEBAB/
ETIOLOGI</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Oligomenore biasanya berhubungan
dengan anovulasi atau dapat juga disebabkan kelainan endokrin seperti
kehamilan, gangguan hipofise-hipotalamus, dan menopouse atau sebab sistemik
seperti kehilangan berat badan berlebih.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Oligomenore sering terdapat pada
wanita astenis. Dapat juga terjadi pada wanita dengan sindrom ovarium
polikistik dimana pada keadaan ini dihasilkan androgen yang lebih tinggi dari
kadara pada wanita normal. </span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Oligomenore dapat juga terjadi pada
stress fisik dan emosional, penyakit kronis, tumor yang mensekresikan estrogen
dan nutrisi buruk. Oligomenorrhe dapat juga disebabkan ketidakseimbangan
hormonal seperti pada awal pubertas.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Oligomenore yang menetap dapat
terjadi akibat perpanjangan stadium folikular, perpanjangan stadium luteal,
ataupun perpanjang kedua stadium tersebut. Bila siklus tiba-tiba memanjang maka
dapat disebabkan oleh pengaruh psikis atau pengaruh penyakit. Disamping itu,
oligomenorea dapat juga terjadi pada :</span></div>
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<span lang="SV" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Gangguan indung telur, misal : Sindrome Polikistik
Ovarium (PCOS).</span></div>
<div class="MsoListParagraph" style="line-height: 150%; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Stress
dan depresi.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Sakit
kronik.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Pasien
dengan gangguan makan (seperti anorexia nervosa, bulimia).</span></div>
<div class="MsoListParagraph" style="line-height: 150%; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Penurunan
berat badan berlebihan.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Olahraga
berlebihan, misal atlet.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Adanya tumor yang melepaskan estrogen.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Adanya kelainan pada struktur rahim atau serviks yang
menghambat pengeluaran darah menstruasi.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Penggunaan
obat-obatan tertentu.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: .25in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Umumnya oligomenorea tidak menyebabkan masalah,
namun pada beberapa kasus oligomenorea dapat menyebabkan gangguan kesuburan.
Pemeriksaan ke dokter kandungan harus segera dilakukan ketika oligomenorea
sudah berlangsung lebih dari 3 bulan dan mulai menimbulkan gangguan kesuburan.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: .25in; text-align: justify;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">GEJALA/ MANIFESTASI KLINIK</span></div>
<div class="MsoListParagraph" style="line-height: 150%; mso-list: l1 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: .5in; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Periode siklus menstruasi yang lebih
dari 35 hari sekali, dimana hanya didapatkan 4-9 periode dalam 1 tahun.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; mso-list: l1 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: .5in; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span></span><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Haid
yang tidak teratur dengan jumlah yang tidak tentu. Pada beberapa wanita yang
mengalami oligomenore terkadang juga mengalami kesulitan untuk
hamil.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; mso-list: l1 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: .5in; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Bila kadar estrogen yang menjadi penyebab,
wanita tersebut mungkin mengalami osteoporosis dan penyakit
kardiovaskular. Wanita tersebut juga memiliki resiko besar untuk mengalami
kanker uterus.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: 49.5pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: .5in; text-align: justify;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">KOMPLIKASI</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Komplikasi
yang paling menakutkan adalah terganggunya fertilitas dan stress emosional pada
penderita sehingga dapat meperburuk terjadinya kelainan haid lebih lanjut.
Prognosa akan buruk bila oligomenore mengarah pada infertilitas atau tanda dari
keganasan.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo6; text-align: justify; text-indent: -.25in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">PATOFISIOLOGI</span></div>
<div class="MsoListParagraph" style="line-height: 150%; text-align: justify; text-indent: .5in;">
<span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN;">Oligomenorea
biasanya terjadi akibat adanya gangguan keseimbangan hormonal pada aksis
hipotalamus-hipofisis-ovarium. Gangguan hormon tersebut menyebabkan lamanya
siklus menstruasi normal menjadi memanjang, sehingga menstruasi menjadi lebih
jarang terjadi. Oligomenorea sering terjadi pada 3-5 tahun pertama setelah haid
pertama ataupun beberapa tahun menjelang terjadinya menopause. Oligomenorea
yang terjadi pada masa-masa itu merupakan variasi normal yang terjadi karena
kurang baiknya koordinasi antara hipotalamus, hipofisis dan ovarium pada awal
terjadinya menstruasi pertama dan menjelang terjadinya menopause, sehingga
timbul gangguan keseimbaangan hormon dalam tubuh.<br />
<span style="mso-spacerun: yes;"> </span>Oligomenorea dan amenorea
sering kali mempunyai dasar yang sama, perbedaannya terletak dalam tingkat.
Pada kebanyakan kasus oligomenorea kesehatan wanita tidak terganggu, dan
fertilitas cukup baik. Siklus haid biasanya juga ovulatoar dengan masa
proliferasi lebih panjang dari biasanya<br />
Oligomenore yang terjadi pada remaja, seringkali disebabkan karena kurangnya
sinkronisasi antara hipotalamus, kelenjar pituari & indung telur.
Hipotalamus merupakan bagian otak yang mengatur suhu tubuh, metabolisme sel
& fungsi dasar seperti makan, tidur & reproduksi. Hipotalamus mengatur
pengeluaran hormon yang mengatur kelenjar pituari. Kemudian kelenjar pituari
akan merangsang produksi hormon yang mempengaruhi pertumbuhan & reproduksi.
Pada awal & akhir masa reproduksi wanita, beberapa hormon tersebut dapat
menjadi kurang tersinkronisasi, sehingga akan menyebabkan terjadinya haid yang
tidak teratur.<br />
<span style="mso-spacerun: yes;"> </span>Pada PCOS (polycystic ovary
syndrome), oligomenore dapat disebabkan oleh kadar hormon wanita & hormon
pria yang tidak sesuai. Hormon pria diproduksi dalam jumlah yang kecil oleh
setiap wanita, tetapi pada wanita yang mengalami PCOS, kadar hormon pria
tersebut (androgen) lebih tinggi dibandingkan pada wanita lain. Pada atlet
wanita, model, aktris, penari ataupun yang mengalami anorexia nervosa,
oligomenore terjadi karena rasio antara lemak tubuh dengan berat badan turun
sangat jauh.<br style="mso-special-character: line-break;" />
<br style="mso-special-character: line-break;" />
</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo6; text-align: justify; text-indent: -.25in;">
<span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI;">KONSEP
ASUHAN KEPERAWATAN PADA PASIEN OLIGOMENORE</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: 0in; text-align: justify;">
<span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI;">A. Pengkajian</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt; text-indent: -14.2pt;">
<span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span><i>Data dasar</i></span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: FI;">Pengumpulan data pada pasien dan keluarga dilakukan dengan cara anamnesa,
pemeriksaan fisik dan melalui pemeriksaan penunjang</span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<i><span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: FI;">Data pasien :</span></i></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: FI;">Identitas pasien, usia, status perkawinan, pekerjaan jumlah anak, agama,
alamat jenis kelamin dan pendidikan terakhir.</span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<i><span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: FI;">Keluhan utama</span></i><span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: FI;"> : pasien
biasanya datang dengan keluhan periode siklus menstruasi yang lebih dari 35
hari sekali, haid yang tidak teratur dengan jumlah yang tidak tentu. <span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">B. Diagnosa keperawatan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l2 level1 lfo8; tab-stops: list .5in; text-indent: -.25in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Kurang
pengetahuan tentang gangguan menstruasi dan terapinya berhubungan dengan kurang
informasi.</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo8; tab-stops: list .5in; text-indent: -.25in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Resiko/actual
gangguan citr</span><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">a tubuh berhubungan
dengan adanya gangguan menstruasi.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">C. Intervensi Keperawatan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-list: l8 level1 lfo10; tab-stops: list .25in; text-indent: -.25in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Kurang
pengetahuan tentang gangguan menstruasi dan terapinya berhubungan dengan kurang
informasi.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in;">
<i><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN;">Tujuan<span style="mso-tab-count: 1;"> </span>:</span></i><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN;"> setelah diberikan penyuluhan klien akan mengetahui
tentang gangguan menstruasi<br />
<i>Kriteria evaluasi:</i> klien menyebutkan jenis gangguan menstruasi,
penyebab, gejalanya, serta penanganannya, menjelaskan menstruasi yang normal.<br style="mso-special-character: line-break;" />
<br style="mso-special-character: line-break;" />
</span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .25in;">
<i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Intervensi:</span></i></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l7 level1 lfo7; tab-stops: list .5in; text-indent: -.25in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Kaji
tingkat pengetahuan klien mengenai menstruasi yang normal, jenis gangguan
menstruasi,penyebab, gejala dan penanganannya.<br />
R/mengidentifikasi luasnya masalah klien dan perlunya intervensi.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l7 level1 lfo7; tab-stops: list .5in; text-indent: -.25in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Jelaskan
mengenai siklus menstruasi yang normal, jenis gangguan menstruasi, penyebab,
gejala, dan penanganannya.<br />
R/dengan memiliki pengetahuan tentang menstruasi klien dapat meningkatkan
toleransi terhadap nyeri dan dapat mencari jalan keluar untuk masalah gangguan
menstruasinya.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l7 level1 lfo7; tab-stops: list .5in; text-indent: -.25in;">
<span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI;">Beri
kesempatan klien untuk bertanya.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-list: l8 level1 lfo10; tab-stops: list .25in; text-indent: -.25in;">
<span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI;">Resiko/actual
gangguan citra tubuh berhubungan dengan adanya gangguan menstruasi.<br />
<i>Tujuan</i>: setelah diberikan asuhan keperawatan …..x 24 citra diri klien
akan meningkat.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in;">
<i><span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI;">Kriteria evaluasi: </span></i><span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI;">klien mengatakan tidak malu, merasa berguna, penampilan
klien rapi, menerima apa yang sedang terjadi.</span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: .25in;">
<i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Intervensi:</span></i></div>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l6 level1 lfo9; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Bina
hubungan saling percaya dengan klien<br />
R/klien dengan mudah mengungkapkan masalahnya hanya kepada orang yang
dipercayainya.</span></li>
<li class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l6 level1 lfo9; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Dorong
klien untuk mengekspresikan perasaan, pikiran, dan pandangan tentang
dirinya.<br />
R/meningkatkan kewaspadaan diri klien dan membantu perawat dalam membuat
penyelesaian.</span></li>
<li class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l6 level1 lfo9; tab-stops: list .5in;"><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Diskusikan dengan system pendukung klien tentang
perlunya menyampaikan nilai dan arti klien bagi mereka.<br />
R/ penyampaian arti dan nilai klien dari system pendukung membuat klien
merasa diterima.</span></li>
<li class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l6 level1 lfo9; tab-stops: list .5in;"><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Gali kekuatan dan sumber-sumber yang ada pada klien
dan dukung kekuatan tersebut sebagai aspek positif.<br />
R/ mengidentifikasi kekuatan klien dapat membantu klien berfokus pada
karakteristik positif yang mendukung keseluruhan konsep diri.</span></li>
<li class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l6 level1 lfo9; tab-stops: list .5in;"><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Libatkan klien pada setiap kegiatan di kelompok<br /> R/ Memungkinkan menerima stimulus social dan intelektual yang dapat
meningkatkan konsep diri klien. ingkatkan pemahaman yang lebih dalam
tentang menstruasi.</span></li>
</ol>
<div align="center" class="MsoNormal" style="line-height: normal; margin-left: .25in; text-align: center; text-indent: -.25in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;">BAB III</span></b></div>
<div align="center" class="MsoNormal" style="line-height: normal; margin-left: .25in; text-align: center; text-indent: -.25in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;">PENUTUP</span></b></div>
<div align="center" class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: center; text-indent: -.25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify; text-indent: -.25in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">KESIMPULAN</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Oligomenorea
merupakan suatu keadaan dimana siklus menstruasi memanjang lebih dari 35 hari,
sedangkan jumlah perdarahan tetap sama. Wanita yang mengalami oligomenorea akan
mengalami menstruasi yang lebih jarang daripada biasanya. Namun, jika
berhentinya siklus menstruasi ini berlangsung selama lebih dari 3 bulan, maka
kondisi tersebut dikenal sebagai amenorea sekunder. Oligomenorea dapat juga
terjadi pada :</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: 13.5pt; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -13.5pt;">
<span lang="SV" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Gangguan indung telur, misal : Sindrome Polikistik
Ovarium (PCOS).</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: 13.5pt; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -13.5pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Stress
dan depresi.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: 13.5pt; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -13.5pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Sakit
kronik.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: 13.5pt; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -13.5pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Pasien
dengan gangguan makan (seperti anorexia nervosa, bulimia).</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: 13.5pt; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -13.5pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Penurunan
berat badan berlebihan.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: 13.5pt; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -13.5pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Olahraga
berlebihan, misal atlet.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: 13.5pt; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -13.5pt;">
<span lang="SV" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Adanya tumor yang melepaskan estrogen.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: 13.5pt; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -13.5pt;">
<span lang="SV" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Adanya kelainan pada struktur rahim atau serviks yang
menghambat pengeluaran darah menstruasi.</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-left: 13.5pt; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -13.5pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Penggunaan
obat-obatan tertentu.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 13.5pt; text-align: justify; text-indent: -13.5pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">DAFTAR
PUSTAKA</span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Prawirohardjo
Sarwono. 2005. <i>Ilmu Kandungan Edisi 2 Cetakan 4</i>. Jakarta: Yayasan Bina
Pustaka.</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Diakses
dari <b>Zumrohhasanah's Blog.htm</b> pada tanggal 18 april 2012 Pukul 11:07.</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Diakses
dari <b>Chin Blog.htm</b> pada tanggal 18 April 2012 puku 11:15.</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<cite><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">elamardiana.blogspot.com/2011_04_01_archive.html
</span></cite></div>
<br />himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-16260441878217727362013-01-30T23:15:00.003-08:002013-01-30T23:34:23.762-08:00ASUHAN KEPERAWATAN PADA IBU DENGAN “VAGINITIS”<br />
<div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">A. PENGKAJIAN</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><br />
</span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">1. Identitas Klien<br />
2. Keluhan Utama<br />
• Nyeri<br />
• Luka<br />
• Perubahan fungsi seksual<br />
3. Riwayat Penyakit<br />
a. Sekarang<br />
Keluhan Klien menderita infeksi alat kelamin<br />
b. Dahulu<br />
Riwayat keluarga mempunyai penyakit serupa, gangguan reproduksi<br style="mso-special-character: line-break;" />
<br style="mso-special-character: line-break;" />
</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">B. PEMERIKSAAN FISIK<br />
1.</span></b><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"> <b style="mso-bidi-font-weight: normal;">Pemeriksaan Bagian Luar<br />
</b>-Inspeksi<br />
• Rambut pubis, distribusi, bandingkan sesuai usia perkembangan klien<br />
• Kulit dan area pubis, adakah lesi, eritema, visura, leokoplakia dan eksoria<br />
• Labia mayora, minora, klitoris, meatus uretra terhadap pemebengkakan ulkus,
keluaran dan nodul<br />
<b style="mso-bidi-font-weight: normal;">2. Pemeriksaan Bagian Dalam</b><br />
-Inspeksi<br />
Serviks: ukuran, laserasi, erosi, nodula, massa, keluaran dan warnanya<br />
-Palpasi<br />
• Raba dinding vagina: Nyeri tekan dan nodula,<br />
• Serviks: posisi, ukuran, konsistensi, regularitas, mobilitas dan nyeri tekan<br />
• Uterus: ukuran, bentuk, konsistensi dan mobilitas<br />
• Ovarium: ukuran, mobilitas, bentuk, konsistensi dan nyeri tekan<br style="mso-special-character: line-break;" />
<br style="mso-special-character: line-break;" />
</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">C. DIAGNOSA KEPERAWATAN</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><br />
</span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">1.
Perubahan kenyamanan b/d infeksi pada system reproduksi<br />
</span></b><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kriteria hasil:<br />
Memperhatikan bahwa nyeri ini ada mengidentifikasi aktivitas yang meningkatkan
dan menurunkan nyeri dapat mengidentifikasi dan menurunan sumber-sumber nyeri<br />
Intervensi:<br />
• Berikan pengurang rasa nyeri yang optimal<br />
• Meluruskan kesalahan konsep pada keluarga<br />
• Bicarakan mengenai ketakutan, marah dan rasa frustasi klien<br />
• Berikan privasi selama prosedur tindakan<br />
<br />
<b style="mso-bidi-font-weight: normal;">2. Disfungsi seksual b/d perubahan
kesehatan seksual<br />
</b>Kriteria hasil:<br />
Menceritakan masalah mengenai fungsi seksual, mengekspresikan peningkatan
kepuasan dengan pola seksual. Melaporkan keinginan untuk melanjutkan aktivitas
seksual<br />
Intervensi:<br />
• Kaji riwayat seksual mengenai pola seksual, kepuasan, pengetahuan seksual,
masalah seksual<br />
• Identifikasi masalah penghambat untuk memuaskan seksual<br />
• Berikan dorongan bertanya tentang seksual atau fungsi seksual<br />
<br />
<b style="mso-bidi-font-weight: normal;">3. Resiko terhadap infeksi b/d kontak
dengan mikroorganisme</b><br />
Kriteria hasil:<br />
Klien mampu memperlihatkan teknik cuci tangan yang benar, bebas dari proses
infeksi nasokomial selama perawatan dan memperlihatkan pengetahuan tentang
fakor resiko yang berkaitan dengan infeksi dan melakukan pencegahan yang tepat.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Intervensi:<br />
• Teknik antiseptik untuk membersihan alat genetalia<br />
• Amati terhadap manefestasi kliniks infeksi<br />
• Infomasikan kepada klien dan keluarga mengenai penyebab, resiko-resiko pada
kekuatan penularan dari infeksi<br />
• Terafi antimikroba sesuai order dokter<br />
<br />
<b style="mso-bidi-font-weight: normal;">4. Kurang pengetahuan b/d kurangnya
informasi mengenai penyakit, prognosis dan kebutuhan pengobatan<br />
</b>Kriteria hasil:<br />
Menunjukan pemahaman akan proses penyakit dan prognosis, mampu menunjukan
prosedur yang diperlukan dan menjelaskan rasional dari tindakan dan pasien ikut
serta dalam program pengobatan<br />
Intervensi:<br />
• Tinjau proses penyakit dan harapan masa depan<br />
• Berikan informasi mengenai terafi obat-obatan, interaksi, efek samping dan <span style="mso-spacerun: yes;"> </span>pentingnya pada program<br />
• Tinjau factor-faktor resiko individual dan bentuk penularan/tempat masuk
infeksi<br />
• Tinjau perlunya pribadi dan kebersihan lingkungan.<br />
<br style="mso-special-character: line-break;" />
</span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 16.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;"><o:p> </o:p></span></b></div>
<div align="center" class="MsoNormal" style="margin-left: 1.0in; text-align: center; text-indent: -1.0in;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 16.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;"><br /></span></b></div>
<br />himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-12948645242228103552012-12-12T20:41:00.000-08:002012-12-12T20:42:08.273-08:00LAPORAN PENDAHULUAN CAMPAK<div align="center" style="line-height: 150%; text-align: center;">
<b><span lang="EN-US" style="font-size: 18.0pt; line-height: 150%;">BAB II PEMBAHASAN<o:p></o:p></span></b></div>
<div style="line-height: 150%; margin-left: 24.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><b><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">1.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">PENGERTIAN<o:p></o:p></span></b></div>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">Penyakit
Campak adalah suatu infeksi virus yang sangat menular, yang ditandai dengan
demam, batuk, konjungtivitis (peradangan selaput ikat mata/konjungtiva) dan
ruam kulit. Penyakit ini disebabkan karena infeksi virus campak golongan <i>Paramyxovirus</i>.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Penularan infeksi terjadi karena menghirup percikan ludah
penderita campak. Penderita bisa menularkan infeksi ini dalam waktu 1-4 hari
sebelum timbulnya ruam kulit(rash) dan 4 hari setelah ruam kulit ada.puncak
penularan pada saat fase prodromal yaitu pada 1-3 hari pertama sakit.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Sebelum vaksinasi campak digunakan secara meluas, wabah
campak terjadi setiap 2-3 tahun, terutama pada anak-anak usia pra-sekolah dan
anak-anak SD. Jika seseorang pernah menderita campak, maka seumur hidupnya dia
akan kebal terhadap penyakit ini.<o:p></o:p></span></div>
<br />
<h2 style="line-height: 150%; margin-left: 24.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">2.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span class="mw-headline"><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">PENYEBAB</span></span><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;"><o:p></o:p></span></h2>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">Campak,
rubeola, atau measles Adalah penyakit infeksi yang sangat mudah menular atau
infeksius sejak awal masa prodromal, yaitu kurang lebih 4 hari pertama sejak
munculnya ruam. Campak disebabkan oleh <i><a href="file:///H:/kumpulan%20askep/ASKEP/w/index.php" title="Paramiksovirus (halaman belum tersedia)"><span style="color: black; text-decoration: none; text-underline: none;">paramiksovirus</span></a></i>
( virus campak). Penularan terjadi melalui udara,ludah (dorplet)dari hidung,
mulut maupun tenggorokan penderita campak (air borne disease). Masa inkubasi
adalah 10-14 hari sebelum gejala muncul.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 24.0pt; tab-stops: 423.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">Kekebalan terhadap campak diperoleh setelah vaksinasi,
infeksi aktif dan kekebalan pasif pada seorang bayi yang lahir ibu yang telah
kebal (berlangsung selama 1 tahun). Orang-orang yang rentan terhadap campak
adalah: - bayi berumur lebih dari 1 tahun bayi yang tidak mendapatkan imunisasi
remaja dan dewasa muda yang belum mendapatkan imunisasi kedua. Faktor yang berhubungan
dengan status imunisasi campak pada batita yang diteliti dalam penelitian ini
adalah pendidikan ibu, pengetahuan ibu, aktivitas ibu, status anak, dan tempat
pencarian pengobatan.<strong> </strong>sebenarnya bayi sudah mendapatkan
kekebalan campak dari ibunya. Namun seiring bertambahnya usia, antibodi dari
ibunya semakin menurun sehingga butuh antibodi tambahan lewat pemberian vaksin
campak. Apalagi penyakit campak mudah menular, dan mereka yang daya tahan
tubuhnya lemah gampang sekali terserang penyakit yang disebabkan virus <em>Morbili
</em>ini. Untungnya campak hanya diderita sekali seumur hidup. Jadi, sekali
terkena campak, setelah itu biasanya tak akan terkena lagi.<o:p></o:p></span></div>
<h2 style="line-height: 150%; margin-left: 24.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">3.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span class="mw-headline"><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">GEJALA</span></span><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;"><o:p></o:p></span></h2>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">Gejala
mulai timbul dalam waktu 7-14 hari setelah terinfeksi, yaitu berupa: - Panas
badan, nyeri tenggorokan, hidung meler ( Coryza ), batuk ( Cough ), Bercak
Koplik’s spot, nyeri otot,mata merah ( conjuctivitis ). Ruam (kemerahan di
kulit) yang terasa agak gatal muncul 4-7 hari setelah timbulnya gejala diatas.
Ruam ini bisa berbentuk makula (ruam kemerahan yang mendatar) maupun papula
(ruam kemerahan yang menonjol). Pada awalnya ruam tampak di wajah, yaitu di
depan dan di bawah telinga serta di leher sebelah samping. Dalam waktu 1-2
hari, ruam menyebar ke batang tubuh, lengan dan tungkai,dan berubah warna
menjadi kehitam-hitaman serta kulit bersisik, sedangkan ruam di wajah mulai
memudar.</span><span style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Pada puncak penyakit, penderita merasa sangat sakit,
ruamnya meluas serta suhu tubuhnya mencapai 40° Celsius. 3-5 hari kemudian suhu
tubuhnya turun, penderita mulai merasa baik dan ruam yang tersisa segera
menghilang.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Demam, kecapaian, pilek, batuk dan mata yang radang dan
merah selama beberapa hari diikuti dengan ruam jerawat merah yang mulai pada
muka dan merebak ke tubuh dan ada selama 4 hari hingga 7 hari.</span><span style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: IN;"><o:p></o:p></span></div>
<h2 style="line-height: 150%; margin-left: 24.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">4.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span class="mw-headline"><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">KOMPLIKASI</span></span><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;"><o:p></o:p></span></h2>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">Pada
anak yang sehat dan gizinya cukup, campak jarang berakibat serius. Beberapa
komplikasi yang bisa menyertai campak:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l4 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 18.0pt; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Infeksi bakteri : <i><a href="file:///H:/kumpulan%20askep/ASKEP/wiki/Pneumonia" title="Pneumonia"><span style="text-decoration: none; text-underline: none;">Pneumonia</span></a></i> dan Infeksi telinga tengah <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 18.0pt; text-align: justify; text-indent: -24.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Kadang terjadi trombositopenia
(penurunan jumlah trombosit), sehingga
pendeita mudah memar dan mudah mengalami perdarahan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l4 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 12.0pt list 48.0pt; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">3.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Bronkopneumoni</span><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 54.0pt; text-align: justify; text-indent: 30.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">4.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Ensefalopati</span><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 18.0pt; text-align: justify; text-indent: 30.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">5.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Enteritis</span><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 18.0pt; text-align: justify; text-indent: 30.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">6.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Ensefalitis</span><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 18.0pt left 48.0pt; text-align: justify; text-indent: 30.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">7.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Panas tinggi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 18.0pt left 48.0pt; text-align: justify; text-indent: 30.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">8.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Diare<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 18.0pt; text-align: justify; text-indent: 30.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">9.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Radang mulut dan tenggorokan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<h2 style="line-height: 150%; margin-left: 24.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">5.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span class="mw-headline"><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">PEMERIKSAAN DIAGNOSTIK</span></span><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;"><o:p></o:p></span></h2>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Diagnosis ditegakkan berdasarkan gejala dan ruam kulit
yang khas. Pemeriksaan lain yang mungkin perlu dilakukan: pemeriksaan darah,
pemeriksaan darah tepi - pemeriksaan Ig M anti campak - Pemeriksaan komplikasi
campak <o:p></o:p></span></div>
<h2 style="line-height: 150%; margin-left: 24.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">6.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span class="mw-headline"><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">PENGOBATAN</span></span><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;"><o:p></o:p></span></h2>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Tidak ada pengobatan khusus untuk campak. Anak sebaiknya
menjalani tirah baring. Untuk menurunkan demam, diberikan asetaminofen atau
ibuprofen. Jika terjadi infeksi bakteri, diberikan antibiotik.<o:p></o:p></span></div>
<h2 style="line-height: 150%; margin-left: 24.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">7.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span class="mw-headline"><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">PENCEGAHAN</span></span><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;"><o:p></o:p></span></h2>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Vaksin campak merupakan bagian dari imunisasi rutin pada
anak-anak. Vaksin biasanya diberikan dalam bentuk kombinasi dengan gondongan
dan campak Jerman (vaksin MMR/mumps, measles, rubella), disuntikkan pada otot
paha atau lengan atas.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Jika hanya mengandung campak, vaksin dibeirkan pada umur
9 bulan. Dalam bentuk MMR, dosis pertama diberikan pada usia 12-15 bulan, dosis
kedua diberikan pada usia 4-6 tahun.</span><span style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">selain itu penderita juga harus disarankan untuk
istirahat minimal 10 hari dan makan makanan yang bergizi agar kekebalan tubuh
meningkat.<o:p></o:p></span></div>
<h2 style="line-height: 150%; margin-left: 24.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">8.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span class="mw-headline"><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">TEMPO PENGERAMAN</span></span><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;"><o:p></o:p></span></h2>
<div style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-justify: inter-ideograph;">
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<o:lock v:ext="edit" aspectratio="t"/>
</v:shapetype><v:shape id="_x0000_s1026" type="#_x0000_t75" style='position:absolute;
left:0;text-align:left;margin-left:75pt;margin-top:1428.1pt;width:168.75pt;
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</v:shape><![endif]--><!--[if !vml]--><span style="height: 154px; left: 0px; margin-left: 100px; margin-top: 1904px; mso-ignore: vglayout; position: absolute; width: 225px; z-index: -2;"><img height="154" src="file:///C:/Users/SAPTA7~1/AppData/Local/Temp/msohtmlclip1/01/clip_image002.jpg" v:shapes="_x0000_s1026" width="225" /></span><!--[endif]--><!--[if gte vml 1]><v:shape id="_x0000_s1027"
type="#_x0000_t75" style='position:absolute;left:0;text-align:left;
margin-left:293.85pt;margin-top:1446.1pt;width:189.75pt;height:151.5pt;
z-index:-1'>
<v:imagedata src="file:///C:\Users\SAPTA7~1\AppData\Local\Temp\msohtmlclip1\01\clip_image003.png"
o:title="" gain="112993f"/>
</v:shape><![endif]--><!--[if !vml]--><span style="height: 202px; left: 0px; margin-left: 392px; margin-top: 1928px; mso-ignore: vglayout; position: absolute; width: 253px; z-index: -1;"><img height="202" src="file:///C:/Users/SAPTA7~1/AppData/Local/Temp/msohtmlclip1/01/clip_image004.jpg" v:shapes="_x0000_s1027" width="253" /></span><!--[endif]--><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">Waktu terdedah sampai kena penyakit: Kira-kira 10
sampai 12 hari sehingga gejala pertama, dan 14 hari sehingga ruam muncul.
Imunisasi (MMR) pada usia 12 bulan dan 4 tahun. Orang yang dekat dan tidak
mempunyai kekebalan seharusnya tidak menghadiri sekolah atau bekerja selama 14
hari. </span><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Dianjurkan selama sekurang-kurangnya 4 hari setelah ruam muncul.<o:p></o:p></span></div>
<div style="line-height: 150%; tab-stops: 12.0pt; text-align: justify; text-justify: inter-ideograph;">
<b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">9. DIAGNOSA
BANDING<o:p></o:p></span></b></div>
<div style="line-height: 150%; margin-left: 48.0pt; mso-list: l3 level1 lfo6; tab-stops: 12.0pt list 48.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">a.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Rubella(campak jerman): terdapat
pembesaran kelenjar getah bening di belakang telinga.<b><o:p></o:p></b></span></div>
<div style="line-height: 150%; margin-left: 48.0pt; mso-list: l3 level1 lfo6; tab-stops: 12.0pt list 48.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">b.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">DHF : dalam 2-3 hari bisa terjadi
mimisan .turniket test (rumple leede) positif, perdarahan diikiti
syok,laboratorium menunjukan trombosit <100.000/ml dan serologi positif DHF <b><o:p></o:p></b></span></div>
<div style="line-height: 150%; margin-left: 48.0pt; mso-list: l3 level1 lfo6; tab-stops: 12.0pt list 48.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><b><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">c.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Cacar air (varisella) : ditemukan
vesikula atau gelembung berisi cairan.<b><o:p></o:p></b></span></div>
<div style="line-height: 150%; margin-left: 48.0pt; mso-list: l3 level1 lfo6; tab-stops: 12.0pt list 48.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><b><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">d.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Alergi obat : adanya kemerhan di tubuh serta ggatal-gatal setelah disuntikan /minum obat<b><o:p></o:p></b></span></div>
<div style="line-height: 150%; margin-left: 48.0pt; mso-list: l3 level1 lfo6; tab-stops: 12.0pt list 48.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">e.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Miliaria (keringat buntet) :
gatal-gatal,bintil kemerahan.<b><o:p></o:p></b></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; tab-stops: 12.0pt; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div style="line-height: 150%; margin-left: 54.0pt; tab-stops: 12.0pt; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">10. PEMBERIAN
IMUNISASI CAMPAK<o:p></o:p></span></b></div>
<div style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">a.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Persiapan alat dan bahan<o:p></o:p></span></b></div>
<div style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level2 lfo3; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Gunakkan
vaccine carrrier dengan 4 kotak dingin dan pastikan vaksin terlindungi dari
cahaya matahari lanngsung serta tetap berada dalam vaccine carrier selama waktu
pelayanan.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level2 lfo3; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Sebelum
hari H pelarut vaksin harus disimpan di lemari es agar suhu pelarut sama dengan
suhu vaksin.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level2 lfo3; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Periksa
tanggal kadarluasa vaksin.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level2 lfo3; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Cantumkan
jam dan tanggal pelarutan vaksin pada label vial segera setelah melarutkan
vaksin.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level2 lfo3; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Jika
tidak ada antrian untuk imunisasi,maka vaksin yang sudah dilarutkan disimpan
diantara busa(spons) di dalam vaccine carrier.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level2 lfo3; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Jangan
mengisi vaksin ke dalan spuit sebelum sasaran siap untuk disuntik.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level2 lfo3; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Vaksin
yang telah dilarutkan hanya dapat digunakan dalam waktu 6 jam,setelah itu harus
dibuang.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level2 lfo3; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Alat dan
bahan:<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level3 lfo3; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Vaksin campak dan pelarutnya dalam vaccine carrier<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level3 lfo3; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">Spuit disposible 2 cc , 5
cc dan 10 cc<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level3 lfo3; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Bengkok<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level3 lfo3; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Kapas alkohol<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level3 lfo3; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Obat penurun panas dan oralit<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level3 lfo3; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">KMS<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level3 lfo3; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Status bayi/balita<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level3 lfo3; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Formulir tindakan<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level3 lfo3; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Handscoon<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level3 lfo3; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Baki dan pengal<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">b.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Persiapan pasien<o:p></o:p></span></b></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Memberikan
salam pada pasien/keluarga<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Mengenalkan
diri pada pasien/keluarga<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Menjelaskan
tujuan dilakukan tindakan<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Memberi
tahudan menjelaskan prosedur yang akan
dilakukan<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">c.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Persiapan lingkungan<o:p></o:p></span></b></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Beri
lingkungan yang nyaman pada pasien /keluarga <o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Pasang
sampiran<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Dekatkan
anak dengan orang tua,orang terdekat /keluarga.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">d.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Pelaksanaan<o:p></o:p></span></b></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Perawat
mencuci tangan dan mengeringkannya<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Menenangkan posisi pasien<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Mengatur
posisi pasien dan membaringkan di tempat pemeriksaan<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Menyiapkan
spuit 2 cc dan 5 cc<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;"> Menyiapkan vaksin dan pelarutnya<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Larutkan
vaksin campak:<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 99.0pt; mso-list: l2 level3 lfo3; tab-stops: list 99.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Spuit 10 cc digunakan untuk melarutkan
vaksin 20 dosis.spuit yang telah terpakai tidak boleh digunakan untik
melarutkan vaksin lagi.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 99.0pt; mso-list: l2 level3 lfo3; tab-stops: list 99.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Gunakan seluruh isi cairan dalam ampul
pelarut untuk melarutkan vaksin<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 99.0pt; mso-list: l2 level3 lfo3; tab-stops: list 99.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Jari tangan jangan mennyentuh jarum
selama melarutkan .menyedot vaksin atau pada saat menyuntik sasaran<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 99.0pt; mso-list: l2 level3 lfo3; tab-stops: list 99.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Setelah dilarutkan, kocok perlahan
beberapa kali dengan memegang leher vial .jangan memutar vial vaksin di antara
kedua tangan.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Tusuk
jarum pada vial vaksin .pastikan jarum selalu berada di dalam cairan vaksin
sehingga tidak ada udara yang masuk ke dalam spuit<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="FI" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="FI" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: FI;">Hisap
vacsin ,dan cabut jarum dari vial ..keluarkan udara yang tersisa dengan
mengetuk spuit dan dorong torak sam pai pada sekala 0,5 cc sesuai dosis (0,5
cc)<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Kembalikan
vaksin dalam vaccine carrier dan tutup kembali vaccine carrier<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Desinfektan
kulit ,tunggu hingga kering<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Suntik
pasien secara SC (45 derajat) pada lengan kiri atas<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Rapikan
pasien dan lingkungan<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Beri
tahu orang tua /keluarga bahwa prosedur tindakan telah selesai dilakukan<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Beri
penyuluhan tentan g efek samping vaksin<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Berikan
obat untuk diminum dirumah<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 99.0pt; mso-list: l2 level3 lfo3; tab-stops: list 99.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Menentukan dosis obat(1/2 tablet)<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 99.0pt; mso-list: l2 level3 lfo3; tab-stops: list 99.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Cara minum obat(3x sehari)<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 99.0pt; mso-list: l2 level3 lfo3; tab-stops: list 99.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">LGG(1 sdt gula + sejumput garam + 200 cc air hangat)<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Catat
tindakan pada status dan KMS <o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Memberitahu
orang tua kapan jadwal kembali lagi untuk tindakan /program selanjutnya<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Rapikan
alat-alat<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Cuci
tangan <o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level2 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Lakukan
tindakan dengan teliti dan hati-hati.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 54.0pt; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">11.EFEK
SAMPING(KIPI)<o:p></o:p></span></b></div>
<div style="line-height: 150%; margin-left: 36.0pt; mso-list: l5 level1 lfo4; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Imunisasi campak dapat menimbulkan
anafilaksis syok,namun sangat jarang<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 36.0pt; mso-list: l5 level1 lfo4; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Dapat terjadi 5-30 menit setelah
penyuntikan, dimana tiba-tiba seluruh kulit menjadi kemerahan,seluruh nafas
tersumbat dan terjadi kehilangan kesadaran(menurunnya tekanan darah)<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 36.0pt; mso-list: l5 level1 lfo4; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Baringkan penderita tanpa bantal,tungkai
di tinggikan.air way harus dijamin terbuka ,nadi dan tekanan darah serta
resperatory rate dipantau.pasang torniket proksimal dari daerah suntikan dan
buka setiap 10-15 menit.<o:p></o:p></span></div>
<div style="line-height: 150%; margin-left: 36.0pt; mso-list: l5 level1 lfo4; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Berikan suntikan adrenalin dan rujuk ke
rumah sakit.dosis adrenalin 1:1.000 adrenalin (epineprin) dengan dosis 0,01
ml/kg BB perkali. Dosis maksimum 0,3 ml perkali dan disuntikan subkutan/ IM.
Dosis maksimum dapat diulangi dengan
jarak 15-20 menit sampai 2-3 kali.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span lang="SV" style="font-size: 18.0pt; line-height: 150%; mso-ansi-language: SV;">BAB III
PENUTUP<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l1 level1 lfo5; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">A.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">KESIMPULAN<o:p></o:p></span></b></div>
<div style="line-height: 150%; margin-left: 36.0pt; tab-stops: 423.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Imunisasi campak merupakan usaha
memberikan kekebalan pada bayi dan anak dengan memasukkan vaksin campak kedalam
tubuh agar tubuh membuat zat anti untuk mencegah terhadap penyakit campak, yang
diberikan pada umur bayi 9-11 bulan. Faktor yang berhubungan dengan status
imunisasi campak pada batita yang diteliti dalam penelitian ini adalah
pendidikan ibu, pengetahuan ibu, aktivitas ibu, status anak, dan tempat
pencarian pengobatan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l1 level1 lfo5; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">B.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">SARAN<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Jika
semua vaksin yang baru dan logistik lainnya belum terpakai, maka beri tanggal
pelayanan sebelum dikembalikan ke puskesmas<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l1 level2 lfo5; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Simpan
kembali vaksin dengan teratur di dalam lemari es puskesmas dan pisahhkan untuk
dipakai pada pelayanan berikutnya<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l1 level2 lfo5; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Wingdings; font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 14.0pt; line-height: 150%; mso-ansi-language: SV;">Semua
vaksin yang telah dilarutkan harus segera dimusnahkan segera setelah pelayanan.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span lang="DE" style="font-size: 18.0pt; line-height: 150%; mso-ansi-language: DE;">DAFTAR
PUSTAKA<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-justify: inter-ideograph;">
<span lang="DE" style="font-size: 14pt; line-height: 150%;"><a href="http://id.wikipedia.org/wiki/Campak"><span style="color: black;">http://id.wikipedia.org/wiki/Campak</span></a><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 42.0pt; text-align: justify; text-indent: -24.0pt; text-justify: inter-ideograph;">
<span lang="SV" style="font-size: 14pt; line-height: 150%;">Direktorat
jenderal PP-.PL DEPKES RI. 2006. </span><span lang="FI" style="font-size: 14pt; line-height: 150%;">Buku Pedoman tenaga
Kesehatan Di Lapangan, Ed. Khusus untuk
pulau Kalimantan, sulawesi, bali dan NTB. Jakarta: DIT. EPIM-KESMA, SUBDIT
Imunisasi.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 42.0pt; text-align: justify; text-indent: -24.0pt; text-justify: inter-ideograph;">
<span lang="SV" style="font-size: 14pt; line-height: 150%;">Direktorat
jenderal PP-.PL DEPKES RI. 2006. Petunjuk Teknis Surveilans Campak. Jakarta:
DIT.EPIM-KESMA SURVEILANS EPIDEMIOLOGI<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 42.0pt; text-align: justify; text-indent: -24.0pt; text-justify: inter-ideograph;">
<span lang="SV" style="font-size: 14pt; line-height: 150%;">DINAS
KESEHATAN PROP. NTB. 2006. </span><span lang="EN-US" style="font-size: 14pt; line-height: 150%;">INTEGRASI SURVEILEN; AFP, CAMPAK, TN. </span><span lang="SV" style="font-size: 14pt; line-height: 150%;">NTB:
DIPA P2P. DIKES PROP.NTB<o:p></o:p></span></div>
<br />himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com1tag:blogger.com,1999:blog-9162758075501499629.post-50097616179648279312012-10-26T16:41:00.000-07:002012-10-26T16:41:51.449-07:00ASFIKSIA LANDASAN TEORI<!--[if gte mso 9]><xml>
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<div class="MsoListParagraphCxSpFirst" style="line-height: 115%; mso-list: l21 level1 lfo22; text-indent: -.25in;">
<b><span lang="EN-GB"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-GB">Pengertian</span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; text-align: justify; text-indent: .5in;">
<span lang="EN-GB">Asfiksia adalah keadaan dimana bayi baru
lahir tidak dapat bernapas secara spontan dan teratur saat bayi baru lahir atau
beberapa saat sesudah lahir. (buku APN 2007).</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; mso-list: l21 level1 lfo22; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-GB"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Penyebab </span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; text-align: justify; text-indent: .5in;">
<span lang="EN-GB">Perkembangan paru-paru neonates terkadi pada
menit pertama kelahiran dan kemudian di susul dengan pernapasan teratur,bila
terjadi gangguan pertukaran gas atau pengangkutan O2 dari ibu ke janin akan
terjadi asfiksia janin atau neonates (towel,1996).kondisi tertentu pada ibu
hamil juga dapat menyebabkan gangguan sirkulasi darah uteroplasenter sehingga
pasokan oksigen ke bayi menjadi berkurang. Hipoksia bayi dalam rahim di
tunjukkan dengan gawat janin yang dapat berlanjut menjadi asfiksia bayi baru
lahir (APN 2007).</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 0in; mso-add-space: auto;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">Penyebab kegagalan pernapasan pada bayi :</span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: .75in; mso-add-space: auto; mso-list: l37 level1 lfo23; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-GB"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Faktor ibu</span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Preeklamsia dan Eklamsia</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Perdarahan abnormal (plasenta previa atau solusio plasenta ).</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Partus lama atau partus macet</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Demam selama persalinan</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Infeksi berat (malaria,sifilis,TBC,HIV)</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Kehamilan lewat waktu (Serotinus).</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: .75in; mso-add-space: auto; mso-list: l37 level1 lfo23; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-GB"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Faktor tali pusat</span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l40 level1 lfo25; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Lilitan tali pusat</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l40 level1 lfo25; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Tali pusat pendek</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l40 level1 lfo25; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Simpul tali pusat</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l40 level1 lfo25; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Prolapsus tali pusat</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: .75in; mso-add-space: auto; mso-list: l37 level1 lfo23; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-GB"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Faktor janin</span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l35 level1 lfo26; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Premature </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l35 level1 lfo26; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Persalinan dengan tindakan
(sungsang,gemeli,distosia bahu,ekstraksi vakum,ekstraksi forcep)</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l35 level1 lfo26; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Kelainan bawaan (congenital)</span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l35 level1 lfo26; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Air ketuban bercampur dengan mekonium</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; text-align: justify;">
Penolong persalinan harus mengetahui factor-faktor resiko berpotensi
untuk menumbuhkan asfiksia.apabila di temukan adanya faktor resiko tersebut
maka hal itu harus dibicarakan dengan ibu dan keluarga tentang kemungkinan
perlunya tindakan resusitasi.akan tetapi ada kalanya factor resiko menjadi
sulit dikenali atau 9sepengetahuan penolong )tidak dijumpai tetapi asfiksia
tetap terjadi.oleh karena itu penolong harus selalu siap melakukan resusitasi
bayi pada setiap pertolongsn persalinan.</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 115%; margin-left: .75in; mso-add-space: auto; mso-list: l37 level1 lfo23; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-GB"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Perubahan patofisiologi dan gangguan klinik</span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 49.65pt; mso-add-space: auto; text-align: justify; text-indent: 22.35pt;">
<span lang="EN-GB">Pernafasan
spontan bayi baru lahir bergantung pada kondisi janin pada masa kehamilan dan
persalinan.proses kelahiran sendiri selalu menimbulkanasfiksia ringan yang
bersifat sementara pada bayi.proses ini di anggap sangat perlu untuk merangsang
kemoreseptor pusat pernapasan agar terjadi <i style="mso-bidi-font-style: normal;">“primary
Gasping”</i> yang kemudian akan berlanjut dengan pernapasan teratur
(James,1958). </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 49.65pt; mso-add-space: auto; text-align: justify; text-indent: 22.35pt;">
<span lang="EN-GB">Sifat
asfiksia ini tidak mempunyai pengaruh buruk karena reaksi adaptasi bayi dapt
mengatasinya.bila terdapat gangguan pertukaran gas atau pengangkutan oksigen
selama kehamilan atau persalinan akan terjadi asfiksia yang lebih berat.keadaan
ini akan mempengaruhi fungsi sel tubuh dan bila tidak teratasi akan menyebabkan
kematian.</span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 115%; margin-left: 49.65pt; mso-add-space: auto; text-align: justify; text-indent: 22.35pt;">
<span lang="EN-GB">Asfiksia
yang terjadi dimulai dengan satu periode apnu di sertai dengan penurunan
frekuensi jantung,selanjutnya bayi akan diikuti pernafasan teratur.pada
penderita asfiksia berat usaha bernafas ini tidak nampak dan bayi selanjutnya
berada pada periode kedua.pada tingkat ini di samping adanya perubahan klinis
akan terjadi pula gangguan metabolisme dan pengaruh asam basa pada tubuh bayi.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; text-indent: -.5in;">
<span style="mso-tab-count: 1;"> </span><b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">Tindakan-tindakan yang dilakukan pada bayi
dapat di bagi dalam 2 golongan :</span></b></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 115%; margin-left: .75in; mso-add-space: auto; mso-list: l7 level1 lfo27; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-GB"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Tindakan umum</span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: .75in; mso-add-space: auto; text-align: justify;">
<span lang="EN-GB">Tindakan ini
dilakukan pada setiap bayi tnanpa memandang nilai APGAR yaitu segera setelah
bayi lahir,</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l34 level1 lfo28; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">di usahakan agar bayi mendapatkan pemanasan yang baik.harus dicegah
atau di kurangi kehilangan panas dari tubuhnya yaitu bias dengan pemanasan luar
dengan sinar lampu dan untuk mengeringkan tubuh bayi mengurangi evaporasi.</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l34 level1 lfo28; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bayi diletakkan dengan kepala lebih rendah
</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l34 level1 lfo28; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Penghisapan saluran pernapasan bagian atas</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l34 level1 lfo28; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bila bayi belum memperlihatkan usaha
bernapas lakukan rangsangan nyeri dengan dengan menyentil kedua telapak kaki .</span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 115%; margin-left: .75in; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">2. Tindakan khusus </span></b><span lang="SV" style="mso-ansi-language: SV;"></span></div>
<div class="MsoBodyTextIndent" style="line-height: 115%; text-align: justify;">
<span lang="SV">Tindakan ini dilakukan setelah tindakan umum diselenggarakan tanpa
hasil.prosedur yang dilakukan sesuai dengan berat atau ringannya asfiksia yang
timbul pada bayi,yang dinyatakan oleh tinggi rendahnya nilai APGAR.</span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; mso-list: l31 level1 lfo29; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Klasifikasi asfiksia</span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.5in; mso-add-space: auto; mso-list: l31 level2 lfo29; tab-stops: list 1.5in; text-indent: -.25in;">
<span lang="EN-GB"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-GB">Asfiksia berat (nilai APGAR 0-3)</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.5in; mso-add-space: auto; text-align: justify;">
<span lang="EN-GB">Resusitasi aktif dalam
keadaan ini harus segera dilakukan, langkah utama ialah memperbaiki ventilasi
paru-paru dngan memberikan O2 secara tekanan langsung<span style="mso-spacerun: yes;"> </span>dan berulang-ulang<b style="mso-bidi-font-weight: normal;">.</b>bila setelah beberapa waktu pernapasan spontan tidak timbul dan
frekuensi jantung menurun (<100/menit) maka pemberian obat-obatan lain serta
masasse jantung sebaiknya segera dilakukan.masasse jantung dikerjakan dengan
melakukan penekanan di atas tulang dada secara teratur 80-100x/menit.</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;">
<br /></div>
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<span lang="EN-GB"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB">Asfiksia sedang (nilai APGAR
4-6)</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 1.5in; mso-add-space: auto; text-align: justify;">
<span lang="EN-GB">Di sini dapat dicoba
dengan melakukan rangsangan untuk menimbulkan reflek pernapasan,hal ini dapat
dikerjakan selama 30-60 detik setelah penilaian menurut APGAR 1 menit.</span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 115%; margin-left: 0in; mso-add-space: auto;">
<br /></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.5in; mso-list: l31 level1 lfo29; text-align: justify; text-indent: -.25in;">
<span lang="FI" style="font-family: Symbol; mso-ansi-language: FI; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="mso-ansi-language: FI;">Komplikasi
yang dapat terjadi pada bayi asfiksia adalah kerusakan pada otak.</span></div>
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<br /></div>
<div class="Style1" style="line-height: 115%; margin-left: 0in; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-spacerun: yes;"> </span></span><span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¨</span></span><span style="mso-ansi-language: FI;"> <b style="mso-bidi-font-weight: normal;"><span lang="FI">TINDAKAN RESUSITASI<span style="mso-bidi-font-weight: bold;"> </span></span></b></span></div>
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<span lang="FI" style="mso-ansi-language: FI;">Langkah awal asuahn bayi baru lahir dengan
BBLR adalah :</span></div>
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<span lang="FI" style="mso-ansi-language: FI;">Langkah awal perlu dilakukan secara cepat
(dalam waktu 30 detik),secar umum 6 langkah awal dibawah ini cukup untuk
mernagsang bayi baru lahir untuk bernapas spontan dan teratur.adapun langkah
awal RESUSITASI adalah sbb :</span></div>
<div class="Style1" style="line-height: 115%; margin-left: .5in; mso-list: l30 level1 lfo30; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Jaga bayi tetap hangat</div>
<div class="Style1" style="line-height: 115%; margin-left: 78.0pt; mso-list: l9 level1 lfo32; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">letakkan
bayi diatas kain yang ada di atas perut ibu atau dekat dengan<span style="mso-spacerun: yes;"> </span>perineum.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 78.0pt; mso-list: l9 level1 lfo32; text-align: justify; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>selimuti bayi dengan kain tersebut,potong tali
pusat.</div>
<div class="Style1" style="line-height: 115%; margin-left: 78.0pt; mso-list: l9 level1 lfo32; text-align: justify; text-indent: -.25in;">
<span lang="FI" style="font-family: Symbol; mso-ansi-language: FI; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="mso-ansi-language: FI;">pindahkan
bayi ke atas kain ketempat resusitasi</span></div>
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<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>Atur posisi bayi</div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l5 level1 lfo33; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Baringkan
bayi terlentang dengan kepala didekat penolong.ganjal bahu agar kepala sedikit
Ekstensi.</span></div>
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<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>Isap lendir</div>
<div class="Style1" style="line-height: 115%; margin-left: .5in; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Gunakan alat penghisap lender DeLee atau
Bola karet.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l3 level1 lfo34; text-align: justify; text-indent: -.25in;">
<span lang="IT" style="font-family: Wingdings; mso-ansi-language: IT; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IT" style="mso-ansi-language: IT;">Pertama,isap lendir di dalam
mulut,kemudianbaru isap lender di hidung.</span></div>
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<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Hisap lender sambil menarik keluar
penghisap (bukan pada saat memasukan).</span></div>
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<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bila menggunakan penghisap lender
DeLee,jangan memasukan ujung penghisap terlalu dalam (lebih dari 5cm kea lam
mulut atau lebih dari 3cm ke dalm hidung) karena dapat menyebabkan denyut
jantung bayi melambat atau henti napas bayi</span></div>
<div class="Style1" style="line-height: 115%; margin-left: .75in; text-align: justify;">
<br /></div>
<div class="Style1" style="line-height: 115%; margin-left: .5in; mso-list: l30 level1 lfo30; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span>Keringkan dan rangsang taktil</div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l8 level1 lfo35; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Keringkan bayi mulai dari muka,kepala dan bagisn
tubuh lainnya dengan sedikit tekanan.Rangsangan ini dapat memulai pernapasan
bayi atau bernapas lebih baik.</div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l8 level1 lfo35; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Lakukan rangsangan taktil dengan menepuk atau
menyentil telapak kaki dan menggosok punggung,perut,dada,atau tungkai bayi
dengan telapak tangan.</div>
<div class="Style1" style="line-height: 115%; margin-left: .5in; mso-list: l30 level1 lfo30; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="FI" style="mso-ansi-language: FI;">Reposisi atau atur kembali posisi kepala
dan selimut bayi.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l32 level1 lfo36; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Ganti kain yang telah basah dengan kain
bersih dan kering yang baru (disiapkan).</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l32 level1 lfo36; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Selimiti bayi dengan kain tersebut,jangan
tutupi bagian muka dan dada agar pemantauan pernapasan bayi dapat diteruskan.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l32 level1 lfo36; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Atur kembali posisi terbaik kepala bayi (sedikit
ekstensi).</div>
<div class="Style1" style="line-height: 115%; margin-left: .5in; mso-list: l30 level1 lfo30; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Penilaian apakah bayi menangis atau
bernapas spontan dan teratur.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l28 level1 lfo37; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Lakukan penilaian bayi apakah bayi
bernapas normal,megap-megap,atau tidak bernapas.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l28 level1 lfo37; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">bila bayi bernapas normal berikan pada
ibunya :</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Letakkan bayi di atas dada ibu dan
selimuti keduanya untuk menjaga kehangatan tubuh bayi melalui persentuhan kulit
ibu-bayi.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l26 level1 lfo38; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bila bayi tak bernapas atau megap-megap
segera lakukan tindakan fentilasi.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; text-align: justify;">
<br /></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; text-align: justify;">
<br /></div>
<div class="Style1" style="line-height: 115%; margin-left: 0in; text-align: justify;">
<b style="mso-bidi-font-weight: normal;">VENTILASI TEKANAN POSITIF (VTP)</b></div>
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<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b style="mso-bidi-font-weight: normal;">Pemasangan sungkup</b></div>
<div class="Style1" style="line-height: 115%; margin-left: .5in; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pasang dan pegang sungkup agar menutupi
mulut dan hidung bayi.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: .5in; mso-list: l39 level1 lfo39; text-align: justify; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b style="mso-bidi-font-weight: normal;">Ventilasi percobaan (2 kali)</b></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l5 level1 lfo33; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">Lakukan tiupan udara dengan tekanan 30 cm
air</span></b></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Tiupan awal sangat penting untuk membuka
alveoli paru agar bayi bisa mulai bernapasdan sekaligus menguji apakh jalan
napaas terbuka atau bebas.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l5 level1 lfo33; text-align: justify; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;">Lihat
apakah dada bayi mengembang </b></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.5in; mso-list: l26 level2 lfo38; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: "Courier New"; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bila
tidak mengembang,periksa posisi kepala,pastikan posisinya sudah benar,</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.5in; mso-list: l26 level2 lfo38; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: "Courier New"; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Periksa
pemasangan sungkup dan pastikan tidak terjadi kebocoran</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.5in; mso-list: l26 level2 lfo38; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: "Courier New"; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Periksa
ulang apakah jalan napas tersumbat cairan atau lendir (isap kembali) dan bila
dada<span style="mso-spacerun: yes;"> </span>mengembang,lakukan tahap
berikutnya.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 0in; text-align: justify;">
<br /></div>
<div class="Style1" style="line-height: 115%; margin-left: .5in; mso-list: l39 level1 lfo39; text-align: justify; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span lang="IT" style="mso-ansi-language: IT;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IT" style="mso-ansi-language: IT;">Ventiulasi definitive (20 kali dalam 30
detik).</span></b></div>
<div class="Style1" style="line-height: 115%; margin-left: .85in; mso-list: l25 level1 lfo40; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Lakukan tiupan dengan tekanan 20 cm air,20
kali dalam 30 detik.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: .85in; mso-list: l25 level1 lfo40; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Pastikan udara masuk (dada mengembang)
dalam 30 detik tinddakan.</span></div>
<div class="Style1" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="Style1" style="line-height: 115%; margin-left: .5in; mso-list: l39 level1 lfo39; text-align: justify; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b style="mso-bidi-font-weight: normal;">Lakukan penilaian bayi</b></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l5 level1 lfo33; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bila
bayi sudah bernapas normal,hentikan ventilasi dan pantau bayi.bayi<span style="mso-spacerun: yes;"> </span>diberikan asuhan pasca resusitasi.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.0in; mso-list: l5 level1 lfo33; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bila
bayi belum bernapas atau megap-megap : </span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.5in; mso-list: l2 level1 lfo41; text-align: justify; text-indent: -.5in;">
<span lang="SV" style="font-family: Wingdings; mso-ansi-language: SV; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">lanjutkan ventilasi dengan tekanan 20 cm
ai,20x untuk 30 detik berikutnya,</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.5in; mso-list: l2 level1 lfo41; text-align: justify; text-indent: -.5in;">
<span lang="IT" style="font-family: Wingdings; mso-ansi-language: IT; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IT" style="mso-ansi-language: IT;">Engevaluasi hasil ventilaasi setiap 30
detik.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: 1.5in; mso-list: l2 level1 lfo41; text-align: justify; text-indent: -.5in;">
<span lang="IT" style="font-family: Wingdings; mso-ansi-language: IT; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IT" style="mso-ansi-language: IT;">Lakukan penilaian bayi apakah
bernapas,tidak bernapas atau megap-megap.bila bayi sudah mulai bernapas
normal,hentikan ventilasi dan pantau bayi dengan seksama,berikan asuhan pasca
resusitas.tetapi bila bayi tidak bernapas atau megap-mega,teruskan ventilasi
dengan tekanan 20 cm air,20xuntuk 30 detik berikutnya and nilai hasilnya setiap
30 detik.</span></div>
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<span lang="IT" style="mso-ansi-language: IT;">Siapkan Rujukan bila bayi belum bernapas normal
sesudah 2 menit di ventilasi : </span></div>
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<span lang="IT" style="mso-ansi-language: IT;"><span style="mso-spacerun: yes;"> </span>- Minta keluarga membantu persiapan rujukan</span></div>
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<span lang="IT" style="mso-ansi-language: IT;"><span style="mso-tab-count: 2;"> </span><span style="mso-spacerun: yes;"> </span></span><span lang="FI" style="mso-ansi-language: FI;">- Teruskan resusitasi sementara persiapan rujukan dilakukan.</span></div>
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<span lang="IT" style="mso-ansi-language: IT;">Bila bayi tidak bisa di rujuk :</span></div>
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<span lang="IT" style="mso-ansi-language: IT;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>-<span style="mso-spacerun: yes;">
</span>Lanjutkan ventilasi sampai 20 menit </span></div>
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<span lang="IT" style="mso-ansi-language: IT;"><span style="mso-spacerun: yes;"> </span>- Pertimbangkan untuk menghentikan tindakan
resusitasi jika<span style="mso-spacerun: yes;"> </span>setelah 2 menit upay
ventilasi tidak berhasil.</span></div>
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<span lang="IT" style="mso-ansi-language: IT;">Bayi yang tidak bernapas normal selama 20 menit
diresusitasi akan mengalami kerusakan pada otak sehingga bayi akan menderita
kecacatan yang berta atau meninggal.</span></div>
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<br /></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="IT" style="mso-ansi-language: IT;">ASUHAN PASCA RESUSITASI</span></b></div>
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<span lang="IT" style="mso-ansi-language: IT;">Asuhan pasca resusitasi diberikan sesuai
dengan keadaan bayi setelah menerima tindakan resusitas.Asuhan pasca resusitasi
dilakukan pada keadaan :</span></div>
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<span lang="IT" style="font-family: Symbol; mso-ansi-language: IT; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IT" style="mso-ansi-language: IT;">Resusitasi
berhasil : bayi menangis dan bernapas normal sesudah langkah awal atau sesudah
ventilasi.perlu pemantauan dan dukungan.</span></div>
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<span lang="IT" style="font-family: Symbol; mso-ansi-language: IT; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IT" style="mso-ansi-language: IT;">Resusitasi
tidak atau kurang berhasil,bayi perlu rujukan yaitu sesudah ventilasi 2 menit
belum bernapas atau bayi sudah bernapas tetapi masih megap-megap atau pada
pemantauan ternyata kondisinya makin memburuk.</span></div>
<div class="Style1" style="line-height: 115%; margin-left: .5in; mso-list: l36 level1 lfo31; text-align: justify; text-indent: -.25in;">
<span lang="IT" style="font-family: Symbol; mso-ansi-language: IT; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IT" style="mso-ansi-language: IT;">Resusitasi
gagal setelah 20 menit di ventilasi,bayi gagal bernapas.</span></div>
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<br /></div>
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<br /></div>
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<br /></div>
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<br /></div>
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<br /></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">ASUHAN KEBIDANAN PADA BAYI NY. “S”</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">DENGAN ASFIKSIA BERAT</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">DI RUANG NICU RSUP NTB</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">TANGGAL 24 – 26 JUNI 2009</span></b></div>
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<br /></div>
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<b style="mso-bidi-font-weight: normal;">Data Subjektif ( S )</b></div>
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<b style="mso-bidi-font-weight: normal;">HARI PERTAMA : Tgl 24 Juni 2009</b></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Identitas</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Nama bayi<span style="mso-tab-count: 1;"> </span>: Bayi Ny.”S”</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Usia<span style="mso-tab-count: 2;"> </span>: 1 hari</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Anak ke<span style="mso-tab-count: 1;"> </span>: 1 (Satu)</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Jenis Kelamin<span style="mso-tab-count: 1;"> </span>: Laki-laki ( ♂)</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">No RM<span style="mso-tab-count: 2;"> </span>: </span></div>
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<br /></div>
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<span lang="SV" style="mso-ansi-language: SV;">Nama Ibu<span style="mso-tab-count: 1;"> </span>: Ny.”S”<span style="mso-tab-count: 2;"> </span>Nama Bapak<span style="mso-tab-count: 2;"> </span>:
Tn.”S”</span></div>
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<span lang="FI" style="mso-ansi-language: FI;">Umur<span style="mso-tab-count: 2;"> </span>: 25 tahun<span style="mso-tab-count: 2;"> </span>Umur<span style="mso-tab-count: 3;"> </span>: 30 tahun</span></div>
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<span lang="FI" style="mso-ansi-language: FI;">Suku<span style="mso-tab-count: 2;"> </span>: Sasak<span style="mso-spacerun: yes;"> </span>Suku<span style="mso-tab-count: 3;"> </span>: Sasak</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Agama<span style="mso-tab-count: 2;"> </span>: Islam<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span>Agama <span style="mso-tab-count: 2;"> </span>:
Islam</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Pendidikan<span style="mso-tab-count: 1;"> </span>: TTSD<span style="mso-spacerun: yes;"> </span>Pendidikan<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>SD</span></div>
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<span lang="FI" style="mso-ansi-language: FI;">Pekerjaan<span style="mso-tab-count: 1;"> </span>: IRT<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span>Pekerjaan<span style="mso-tab-count: 2;"> </span>:
Buruh</span></div>
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<span lang="FI" style="mso-ansi-language: FI;">Alamat<span style="mso-tab-count: 2;"> </span>: Kebonfalo - Lembar</span></div>
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<br /></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Riwayat
perjalanan penyakit</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Bayi lahir tgl 23 – 06 – 2009,
Pukul : 23.30 wita, lahir secara SC di Ruang OK RSUP NTB dengan indikasi tindakan
partus kasep. Bayi masuk ke NICU tgl 24 – 06 – 2009, Pukul : 00.05 wita dengan
tangis merintih, nafas berat, ada retraksi, hipotermi (+),cyanosis (+), dengan
A-S : 3 – 5.</span></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Riwayat
kehamilan sekarang</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Ibu mengatakan hamil pertama,
umur kehamilan 9 bulan (40-41 minggu), HPHT 10-09-2008, HTP 17-06-2009, ANC
teratur di polindes, TT 2 kali (lengkap).</span></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Riwayat
persalinan</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Bayi lahir tgl 23 – 06 – 2009,
Pukul : 23.30 wita, lahir secara SC di Ruang OK RSUP NTB ditolong dokter
spesialis, dengan indikasi : partus kasep, BBL 3100 gram, PB 45 cm, LILA 11 cm,
Lika 34 cm, A-S : 3-5, jenis kelamin laki-laki ( ♂ ).</span></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Riwayat
post natal</span></div>
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<span lang="SV" style="mso-ansi-language: SV;">Bayi lahir dengan asfeksia berat,
sesuai masa kehamilan A-S : 3-5, tangis merintih, nafas berat, ada retraksi,
hipotermi (+),cyanosis (+).</span></div>
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<br /></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">OBYEKTIF ( O )</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 31.35pt; mso-list: l22 level1 lfo5; text-align: justify; text-indent: -17.1pt;">
<span style="mso-list: Ignore;">a)<span style="font: 7.0pt "Times New Roman";">
</span></span>Pemeriksaan Umum</div>
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Keadaan umum bayi <span style="mso-tab-count: 1;"> </span>: Lemah</div>
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Tanda Vital:</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 48.45pt; mso-list: l22 level2 lfo5; text-align: justify; text-indent: -17.1pt;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Laju Nafas <span style="mso-tab-count: 2;"> </span>:
32 x/menit</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 48.45pt; mso-list: l22 level2 lfo5; text-align: justify; text-indent: -17.1pt;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Laju Jantung<span style="mso-tab-count: 1;"> </span>:
142 x/menit</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 31.35pt; text-align: justify;">
Berat Badan<span style="mso-tab-count: 2;"> </span>: 3100
gram</div>
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Panjang Badan<span style="mso-tab-count: 2;"> </span>: 45 cm</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 31.35pt; text-align: justify;">
Lila/Lika <span style="mso-tab-count: 2;"> </span>: 11
cm/34cm</div>
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<span style="mso-tab-count: 1;"> </span></div>
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<span style="mso-list: Ignore;">b)<span style="font: 7.0pt "Times New Roman";">
</span></span>Pemeriksaan Fisik</div>
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<span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span>Kepala :</div>
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<span lang="PT-BR" style="mso-ansi-language: PT-BR;">Bersih, distribusi
rambut merata, tidak ada luka/lesi, terdapat sutura, tidak ada molase, benjolan
(-), caput sucsedaneum (-), </span>fontanel mayor : teraba lunak, berdenyut,
batasnya tegas, datar dan tidak menonjol/cekung.<span style="mso-ansi-language: PT-BR;"> </span>sutura sagitalis : teraba tepat/rapat dan tidak
terpisah/menjauh.<span style="mso-ansi-language: PT-BR;"> </span>Lika : 34 cm<span lang="PT-BR" style="mso-ansi-language: PT-BR;"></span></div>
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<span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span>Telinga</div>
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<span lang="SV" style="mso-ansi-language: SV;">Simetris, bersih, tidak ada
luka, daya pegas daun telinga kembali cepat, pina melengkung dengan sempurna.</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; mso-list: l22 level3 lfo5; text-align: justify; text-indent: -19.95pt;">
<span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span>Mata</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; text-align: justify;">
Simetris, bersih, tidak ada tanda-tanda infeksi, konjungtiva tidak pucat,
sklera tidak ikterus, mata tidak cekung, reflek terhadap cahaya ( reaksi pupil
: isokhor = normal )</div>
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<span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";">
</span></span>Hidung dan mulut</div>
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Bersih, tidak ada lelehan saliva berlebih, nafas cuping hidung (+),
laboskisis (-), labiopalatoskisis (-), labiognatoskisis (-), refleks hisap <span style="mso-spacerun: yes;"> </span>(-),<span style="mso-spacerun: yes;">
</span>Oksigen terpasang 1 liter.</div>
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<span style="mso-list: Ignore;">5)<span style="font: 7.0pt "Times New Roman";">
</span></span>Leher</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pergerakan : aktif, tidak ada
massa atau benjolan, tidak ada fraktur klavikula.</span></div>
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<span style="mso-list: Ignore;">6)<span style="font: 7.0pt "Times New Roman";">
</span></span>Dada</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Puting susu simetris, retraksi
dinding dada (+), RR : 32 x/menit,irama nafas reguler, denyut jantung 142
x/menit,irama jantung vesikuler.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; mso-list: l22 level3 lfo5; text-align: justify; text-indent: -19.95pt;">
<span style="mso-list: Ignore;">7)<span style="font: 7.0pt "Times New Roman";">
</span></span>Bahu, lengan dan tangan</div>
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<span lang="FI" style="mso-ansi-language: FI;">Gerakan lemah, jumlah jari
lengkap.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; mso-list: l22 level3 lfo5; text-align: justify; text-indent: -19.95pt;">
<span style="mso-list: Ignore;">8)<span style="font: 7.0pt "Times New Roman";">
</span></span>Abdomen</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; text-align: justify;">
Bentuknya simetris, tidak terdapat penonjolan sekitar tali pusat pada
saat menangis, pendarahan tali pusat tidak ada, perut teraba lunak/lembek (saat
tidak menangis) tidak ada tonjolan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; mso-list: l22 level3 lfo5; text-align: justify; text-indent: -19.95pt;">
<span style="mso-list: Ignore;">9)<span style="font: 7.0pt "Times New Roman";">
</span></span>Punggung dan anus</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; text-align: justify;">
Tidak terdapat pembengkakan dan cekungan pada punggung, anus (+),
kelainan lain tidak ada, mekonium berwarna kuning kecoklatan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; mso-list: l22 level3 lfo5; text-align: justify; text-indent: -19.95pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">10)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Ekstermitas atas : Simetris, gerakan
aktif, jumlah jari normal, infus terpasang Dex 10 %, 12 tetes/menit.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; mso-list: l22 level3 lfo5; text-align: justify; text-indent: -19.95pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">11)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Ekstremitas bawah : Simetris, gerakan
aktif, jumlah jari normal.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; mso-list: l22 level3 lfo5; text-align: justify; text-indent: -19.95pt;">
<span style="mso-list: Ignore;">12)<span style="font: 7.0pt "Times New Roman";">
</span></span>Genitalia</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; text-align: justify;">
Laki-laki, testis sudah turun pada skrotum, penis berlubang pada
ujungnya, ruggae skrotum bagus (banyak).</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; mso-list: l22 level3 lfo5; text-align: justify; text-indent: -19.95pt;">
<span style="mso-list: Ignore;">13)<span style="font: 7.0pt "Times New Roman";">
</span></span>Kulit</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; text-align: justify;">
Warna pucat, tanda lahir tidak ada, tidak terdapat vernik caseosa dan
tidak terdapat pembengkakan dan bercak-bercak hitam, tidak tampak kuning.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 51.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 14.25pt; text-align: justify;">
c.<span style="mso-tab-count: 1;"> </span>Pemeriksaan Laboraturium :
tgl 24 – 06 – 2009, pukul : 12.08 wita. </div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<span style="mso-tab-count: 1;"> </span>Hasil : HGB : 4,50 x/10 <sup>6</sup>
/ul</div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<span style="mso-tab-count: 2;"> </span>HCT : 46,7 % </div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<span style="mso-tab-count: 2;"> </span>WBC : 16,3 / ul</div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<b style="mso-bidi-font-weight: normal;">ASSASMENT ( A )</b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45.6pt; mso-list: l27 level2 lfo6; text-align: justify; text-indent: -17.1pt;">
<span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span>Diagnosa : Bayi baru lahir, sesuai masa kehamilan, K/U
lemah dengan asfeksia berat.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45.6pt; text-align: justify;">
Data dasar :</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 65.55pt; mso-list: l27 level3 lfo6; tab-stops: list 36.7pt; text-align: justify; text-indent: -19.95pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Bayi baru
lahir, dengan cara SC.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 65.55pt; mso-list: l27 level3 lfo6; tab-stops: list 36.7pt; text-align: justify; text-indent: -19.95pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="mso-ansi-language: FI;">Usia
kehamilan 40 – 41 <span style="mso-spacerun: yes;"> </span>minggu</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 65.55pt; mso-list: l27 level3 lfo6; tab-stops: list 36.7pt; text-align: justify; text-indent: -19.95pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">AS :
3 – 5 , BB : 3100 gram, PB : 45 cm, Lila :11 cm, Lika : 34 cm.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 65.55pt; mso-list: l27 level3 lfo6; tab-stops: list 36.7pt; text-align: justify; text-indent: -19.95pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Kelainan fisik tidak ada.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 65.55pt; mso-list: l27 level3 lfo6; tab-stops: list 36.7pt; text-align: justify; text-indent: -19.95pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="mso-ansi-language: FI;">Denyut
jantung :142 x/menit, napas : 32 x/menit, S : 36 º c.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 65.55pt; mso-list: l27 level3 lfo6; tab-stops: list 36.7pt; text-align: justify; text-indent: -19.95pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="mso-ansi-language: FI;">Jenis
kelamin laki-laki, alat kelamin normal, anus (+) dan tidak ada kelainan bawaan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45.6pt; mso-list: l27 level2 lfo6; text-align: justify; text-indent: -17.1pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="FI" style="mso-ansi-language: FI;">Masalah<span style="mso-tab-count: 1;"> </span>:
Gangguan pemenuhan kebutuhan O<sub>2 </sub>(oksigen)</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Data dasar<span style="mso-tab-count: 1;"> </span>: Napas berat, pucat, cyanosis</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45.6pt; mso-list: l27 level2 lfo6; text-align: justify; text-indent: -17.1pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="FI" style="mso-ansi-language: FI;">Kebutuhan<span style="mso-tab-count: 1;"> </span>:
Bebaskan jalan napas, kepala posisi ekstensi, ganti selimut tiap kali basah.</span></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 28.5pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">PLANNING ( P )</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">Tanggal<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>: 24 Juni 2009</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">Jam<span style="mso-tab-count: 1;"> </span> : 00.15 Wita</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; mso-list: l20 level1 lfo7; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="FI" style="mso-ansi-language: FI;">Mengobservasi K/U bayi yaitu bayi masih
tampak lemah, tangis merintih, napas berat (+), napas cuping hidung (+),
tarikan dinding dada (+), cyanosis (+)</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; mso-list: l20 level1 lfo7; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Meletakan bayi di atas radia warmer, dan
atur pengaturan suhunya secara normal yaitu 36,5 ºc.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; mso-list: l20 level1 lfo7; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="FI" style="mso-ansi-language: FI;">Mengatur posisi yaitu posisi kepala
ekstensi untuk membebaskan jalan napas.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; mso-list: l20 level1 lfo7; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span>Membersihkan lendir dengan sedot lendir (suction)</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; mso-list: l20 level1 lfo7; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span>Memberikan rangsangan taktil dengan cara menggosok
punggung bayi dan seluruh tubuh sambil mengeringkannya, kemudian hasilnya bayi
menangis.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; mso-list: l20 level1 lfo7; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi fisik dan tanda-tanda vital : warna kulit
merah ekstremitas masih biru, bayi menangis, tonus otot sedikit fleksi, bersin,
Denyut jantung 144 x/menit.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; text-align: justify; text-indent: -43.95pt;">
Pukul 00.10 wita : Memasang infus pada lengan
sebelah kiri, infuse yang diberikan adalah D 10 % ( 12 tetes x/menit).</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; text-align: justify; text-indent: -43.95pt;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul
00.15 wita : menginjeksikan obat : Ampicillin 2 x 125 mg</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 225.0pt; text-align: justify; text-indent: -196.95pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Gentamicyn 1 x 15 mg</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 225.0pt; text-align: justify; text-indent: -196.95pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Vitamin K 0,1 ml</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; tab-stops: list -2.5in; text-align: justify; text-indent: -43.95pt;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 01.00 wita : Mengganti selimut dan kain bayi
dengan kain bersih, menyelimuti seluruh tubuh bayi dan menutup kepala bayi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 27.0pt; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 03.00 wita </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 27.0pt; mso-list: l38 level2 lfo9; tab-stops: list 1.0in; text-align: justify; text-indent: 27.0pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="mso-ansi-language: FI;">mengobservasi
tetesan infus </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 27.0pt; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 06.00 wita </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 27.0pt; mso-list: l38 level2 lfo9; tab-stops: list 1.0in; text-align: justify; text-indent: 27.0pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">mengukur
TTV, S = 36,5<sup>0 </sup>C, RR = 36 x/menit, DJ = 140 x/menit </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; text-align: justify; text-indent: -46.35pt;">
<span lang="SV" style="mso-ansi-language: SV;">Pukul
07.00 wita : </span><span lang="PT-BR" style="mso-ansi-language: PT-BR;">k/u lemah,
tangis (+), syanosis (-), syanosis (-), oksigen terpasang, muntah (-), BAB/BAK
(+/+), infus D 10 % terpasang.</span><span lang="SV" style="mso-ansi-language: SV;"></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63.0pt; text-align: justify; text-indent: -9.0pt;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;">-<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>menyeka
bayi</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 27.0pt; text-align: justify;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;">Pukul 08.00 wita </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l17 level1 lfo10; text-align: justify; text-indent: -.25in;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="PT-BR" style="mso-ansi-language: PT-BR;">visite
dokter</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 10.00 wita </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l13 level1 lfo11; text-align: justify; text-indent: -.25in;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="PT-BR" style="mso-ansi-language: PT-BR;">BAB,
warna : kecoklatan, dan BAK.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l13 level1 lfo11; text-align: justify; text-indent: -.25in;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="PT-BR" style="mso-ansi-language: PT-BR;">ganti
selimut bayi </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; text-align: justify;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;">Pukul 12.00 </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level1 lfo12; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi k/u bayi</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level1 lfo12; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi TTV, S: 36°C, RR : 52 x/mnt, DJ: 136x/mnt</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 27.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; text-align: justify; text-indent: -45.0pt;">
Siang : k/u lesu, tangis keras dn rewel, coba minum
PASI <span style="mso-spacerun: yes;"> </span>± 5 cc, tidak cianosis, BAK/BAB
lancar, infus terpasang</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 27.0pt; text-align: justify;">
Pukul 14.00 wita : </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l19 level1 lfo13; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi k/u bayi </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l19 level1 lfo13; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengatur posisi tidur </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l19 level1 lfo13; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengganti selimut </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; text-align: justify;">
Pukul 15.00 wita : </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l11 level1 lfo14; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Bayi rewel </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l11 level1 lfo14; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi lokasi dan tetesan infus</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; text-align: justify;">
Pukul 17.00 wita : </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l11 level2 lfo14; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Memberi PASI ± 5 cc</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l11 level2 lfo14; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi TTV : S : 36,7°C, RR : 40 x/mnt, DJ: 120
x/mnt</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; text-align: justify;">
Pukul 19.00 wita : </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l24 level1 lfo15; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Minum PASI ± 5 cc</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; text-align: justify; text-indent: -46.35pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; text-align: justify; text-indent: -46.35pt;">
Malam : k/u lesu, tangis (+), minun PASI ± 5 cc,
muntah (-), BAB/BAK (+/+), hipotermi (-), kembung (-), infus terpasang.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; text-align: justify; text-indent: -46.35pt;">
Pukul : 20.00 wita : </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l24 level1 lfo15; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Observasi k/u bayi </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l24 level1 lfo15; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Ganti selimut</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; text-align: justify;">
Pukul 21.00 wita :</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l12 level1 lfo16; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Minum PASI 15 cc</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l12 level1 lfo16; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Kembung (+), bayi rewel. </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l12 level1 lfo16; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Menagatur posisi bayi</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; text-align: justify;">
Pukul 23.00 wita :</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l23 level1 lfo17; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Memberi injeksi Ampicillin 125 mg</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l23 level1 lfo17; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Pasang
NGT, retensi 5 cc, spul PZ 5 cc, lendir coklat + susu + gumpalan coklat.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pukul 01.00 wita :</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l6 level1 lfo18; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Mengganti
selimut bayi </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pukul 03.00 wita : </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l6 level1 lfo18; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Menarik
retensi, R </span><span lang="PT-BR" style="mso-ansi-language: PT-BR;">= 5 cc
lendir kecoklatan + susu,</span><span lang="SV" style="mso-ansi-language: SV;">
spul PZ 5 cc </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l6 level1 lfo18; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Minum PASI 15 cc</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pukul 05.00 wita : </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l6 level1 lfo18; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Mengobservasi
bayi </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l6 level1 lfo18; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Menatur
posisi bayi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pukul 06.00 wita : </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l10 level1 lfo19; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Mengganti
tempat infus pada lengan sebelah kanan </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 68.85pt; mso-list: l10 level1 lfo19; tab-stops: list 68.85pt; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Mengobservasi TTV : S : 36,7°C, RR : 40 x/mnt, DJ: 130
x/mnt.</div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; mso-list: l27 level1 lfo6; text-align: justify; text-indent: -25.65pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="PT-BR" style="mso-ansi-language: PT-BR;"><span style="mso-list: Ignore;">III.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="PT-BR" style="mso-ansi-language: PT-BR;">EVALUASI</span></b><span lang="PT-BR" style="mso-ansi-language: PT-BR;"></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; text-align: justify;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;">Tanggal<span style="mso-tab-count: 1;"> </span>: 25 juni 2009 </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 25.65pt; text-align: justify;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;">Jam<span style="mso-tab-count: 1;"> </span>: 07.00 WITA</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; mso-list: l16 level1 lfo8; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span lang="PT-BR" style="mso-ansi-language: PT-BR;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="PT-BR" style="mso-ansi-language: PT-BR;">K/U bayi lesu, tangis (+),
hipotermi(-), minum pasi 5 cc, muntah (-), BAB/BAK(+)/(+), kembung(-),infus dex
10% masih terpasang 12 tts/mnt.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; mso-list: l16 level1 lfo8; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">NGT masih terpasang, retensi 5 cc lendir
kental + susu dan gumpalan coklat.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; mso-list: l16 level1 lfo8; tab-stops: list 46.75pt; text-align: justify; text-indent: -18.7pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Tanda-tanda vital</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; text-align: justify;">
<span lang="FI" style="mso-ansi-language: FI;">DJ : 120x/menit, RR : 40m
x/menit, Suhu : 36, 7<sup>0</sup>C</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 46.75pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 28.35pt; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">HARI KE-2 ( Tanggal 25 juni 2009)</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 28.35pt; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">DS </span></b><span lang="FI" style="mso-ansi-language: FI;"><span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span>:
ibu mengeluh bayinya masih lemah</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 78.0pt; tab-stops: 70.9pt; text-align: justify; text-indent: -48.75pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">DO </span></b><span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span>:
Keadaan umum lesu, tangis (+), minum pasi 5- 10 cc, muntah (-),<span style="mso-spacerun: yes;"> </span>kembung (-), cyanosis (-), sesak (-),O2
terpasang 1 liter, BAB/BAK (+)/(+),infus dextrose 10% terpasang 6 tts/mnt.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 71.85pt; text-align: justify; text-indent: -43.5pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">A</span></b><span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 2;"> </span>: Bayi lahir
cukup bulan sesuai masa kehamilan umur 2 hari, K/U <span style="mso-spacerun: yes;"> </span>lemah dengan asfeksia ringan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 71.85pt; text-indent: -43.5pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">P</span></b><span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span>: Pukul 07.00 wita : mengobservasi
keadaan umum bayi yaitu keadaan umum bayi masih lemah, menyeka dan menimbang
berat badan (BB : 3000 gram), mengganti selimut,NGT dilepaskan, visite dokter (terapi
lanjut).</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.75in; text-indent: -.75in;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 09.00 wita : memberi
injeksi ampicillin 125 mg dan <span style="mso-spacerun: yes;"> </span>gentamisin
15 mg.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 71.85pt; text-indent: -35.85pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span>Pukul 09.30 wita : memberi minum pasi 5 – 10 cc</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.75in; text-indent: -.75in;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 12.00 wita :
mengobservasi tanda-tanda vital s : 37,4ºc, RR : 42 x/mnt, DJ : 136 x/mnt</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 71.85pt; text-indent: -35.85pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span>Pukul 13.00 wita : mengganti selimut dan memberi minum
pasi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 71.85pt; text-indent: -35.85pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span>Pukul 14.00 wita : mengatur posisi tidur, mengganti
selimut.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 71.85pt; text-indent: -35.85pt;">
<span lang="FI" style="mso-ansi-language: FI;"><span style="mso-tab-count: 1;"> </span>Pukul 15.00 wita : memberi minum pasi 5-10 cc</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.75in; text-indent: -.75in;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 17.00 wita : observasi
tanda-tanda vital : s : 37,0 ºc , RR : 40 <span style="mso-spacerun: yes;"> </span>x/mnt , DJ : 140 x/mnt.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.75in; text-indent: -.75in;">
<span lang="FI" style="mso-ansi-language: FI;">Pukul 19.00 wita :<span style="mso-spacerun: yes;"> </span>memberi minum pasi 5-10 cc, mengganti
selimut.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; text-indent: -35.85pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 71.85pt; text-indent: -35.85pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">Evaluasi (25 juni 2009, pukul 14.00 wita)</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 70.9pt; mso-list: l4 level1 lfo20; text-indent: -16.9pt;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span>Keadaan
umum bayi masih lemah, tangis (+), minum pasi 5- 10 cc,cyanosis(-), sesak (-),
kembung (-),muntah (-), O2 masih terpasang 1 liter, infus terpasang dextrose
10% 6 tts/mnt.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 70.9pt; mso-list: l4 level1 lfo20; text-indent: -16.9pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="SV" style="mso-ansi-language: SV;">Tanda-tanda vital S : 37,0ºc, RR : 40
x/mnt, DJ : 140 x/mnt.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-indent: 28.35pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">HARI KE-3 ( tanggal 26 juni 2009)</span></b></div>
<div class="MsoNormal" style="line-height: 115%; text-indent: 28.35pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">DS </span></b><span lang="SV" style="mso-ansi-language: SV;">: Ibu mengatakan
keadaan bayinya sudah baik</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 56.7pt; text-indent: -28.35pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">DO</span></b><span lang="SV" style="mso-ansi-language: SV;"> : Keadaan umum
baik, tangis (+), minum asi langsung dari ibu, muntah (-), BAB/BAK (+)/(+),
ikterus (-), hipotermi (-).</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 56.7pt; text-indent: -28.35pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="FI" style="mso-ansi-language: FI;">A</span></b><span lang="FI" style="mso-ansi-language: FI;"><span style="mso-spacerun: yes;"> </span>: Bayi lahir cukup bulan sesuai masa
kehamilan umur 3 hari.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.75in; text-indent: -97.65pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">P</span></b><span lang="SV" style="mso-ansi-language: SV;"><span style="mso-spacerun: yes;"> </span>: <span style="mso-spacerun: yes;"> </span>Pukul
07.00 wita : menyeka, mengganti selimut bayi, dan menimbang berat badan bayi
(3000 gram).</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 49.65pt; text-indent: -21.3pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-tab-count: 1;"> </span>Pukul 08.00 wita : memberi minum asi langsung dari ibu</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.75in; text-indent: -81.0pt;">
<span lang="SV" style="mso-ansi-language: SV;"><span style="mso-spacerun: yes;"> </span>Pukul 09.00 wita : visite dokter, yaitu
keadaan umum bayi sudah baik dan sudah diperbolehkan pulang.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 49.65pt; text-indent: -21.3pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-indent: 27.0pt;">
<b style="mso-bidi-font-weight: normal;">Evaluasi (pukul 09.30 wita)</b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 64.35pt; mso-list: l18 level1 lfo21; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Keadaan umum bayi baik, tangis (+), minum asi langsung
dari ibu, muntah (-), BAB/BAK (+)/(+), hipotermi (-), ikterus (-).</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 64.35pt; mso-list: l18 level1 lfo21; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>Bayi sudah di pulangkan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 56.7pt; text-indent: -28.35pt;">
<span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: 115%; text-indent: 28.35pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 71.85pt; text-indent: -43.5pt;">
<span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 28.35pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 28.35pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-align: justify; text-indent: -87.6pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-36557527889499689882012-10-13T10:54:00.002-07:002012-10-13T10:54:58.572-07:00LAPORAN PENDAHULUAN BATUK DARAH<!--[if gte mso 9]><xml>
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<br />
<h2 style="line-height: 150%;">
<span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";">
</span></span><span style="mso-spacerun: yes;"> </span>Pendahuluan</h2>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Batuk darah adalah suatu gejala
yang paling penting pada penyakit paru karena :</span></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 14.2pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="mso-tab-count: 1;"> </span>adanya bahaya potensial terhadap perdarahan
yang gawat</span></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 70.9pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="mso-spacerun: yes;"> </span>hampir selalu hemoptysis disebabkan oleh
penyakit bronkopulmonal </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Oleh sebab itu perlu dibuktikan
apakah benar bahwa darah berasal dari saluran pernafasan bagian<span style="mso-spacerun: yes;"> </span>bawah<span style="mso-spacerun: yes;">
</span></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="mso-spacerun: yes;">
</span>apakah benar-benar batuk darah dan bukan muntah darah</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h2 style="line-height: 150%;">
<span style="mso-list: Ignore;">II.<span style="font: 7.0pt "Times New Roman";">
</span></span>Definisi</h2>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>Batuk darah adalah darah atau dahak bercampur
darah yang dibatukkan yang berasal dari saluran pernafasan bagian bawah (mulai
glotis ke arah distal}</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">_ batuk darah adalah suatu keadaan
menakutkan /<span style="mso-spacerun: yes;"> </span>mengerikan yang
menyebabkan<span style="mso-spacerun: yes;"> </span>beban mental bagi penderita
dan keluarga penderita sehingga menyebabakan takut untuk berobat ke dokter .</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">_ penderita menahan batuk karena
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karena bekuan darah.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">_sebetulnya sudah ada penyakit
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<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">_batuk darah pada dasarnya akan
berhenti sendiri asal tidak ada robekan pembuluh darah,berhenti sedikit-sedikit
pada pengobatan penyakit dasar.</span></div>
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<br /></div>
<h3 style="line-height: 150%;">
III<span style="mso-spacerun: yes;">
</span>Etiologi</h3>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Berdasar etiologi<span style="mso-spacerun: yes;"> </span>maka dapat digolongkan : </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo2; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Batuk darah idiopatik.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo2; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Batuk darah sekunder.</span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Ad 1.<span style="mso-spacerun: yes;"> </span>Batuk darah idiopatik.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>Yaitu batuk darah yang tidak
diketahui penyebabnya: </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>_ insiden 0,5<span style="mso-spacerun: yes;"> </span>sampai<span style="mso-spacerun: yes;">
</span>58%<span style="mso-spacerun: yes;"> </span>{+ 15 %}</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>_ pria :wanita = 2 : 1</span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>_ umur 30- 50 tahun kebanyakan
40-60 tahun </span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>_<span style="mso-spacerun: yes;">
</span>berhenti spontan dengan suportif terapi.</span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Ad<span style="mso-spacerun: yes;">
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>Yaitu batuk darah yang diketahui
penyebabnya</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt; mso-list: l7 level1 lfo3; tab-stops: list 49.5pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Oleh karena keradangan , ditandai<span style="mso-spacerun: yes;"> </span>vascularisasi arteri bronkiale > 4%
{normal 1%}</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">TB </span><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">è</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> batuk sedikit-sedikit </span><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">è</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">masif darah melulu,
bergumpal.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Bronkiektasis
</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">®</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">campur
purulen</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Apses paru </span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">®</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">campur purulen</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pneumonia</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">®</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">warna merah bata encer
berbuih</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Bronkitis</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">®</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">sedikit-sedikit campur darah
atau lendir</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt; mso-list: l7 level1 lfo3; tab-stops: list 49.5pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Neoplasma</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">_ karsinoma
paru</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">_ adenoma</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt; mso-list: l7 level1 lfo3; tab-stops: list 49.5pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Lain-lain:</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">_ trombo
emboli paru – infark paru</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">_ mitral
stenosis</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">_ kelainan
kongenital aliran darah paru meningkat</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>@ ASD</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>@ VSD</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">_trauma
dada</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span></span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¨</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">tumpul: perlukaan oleh costa</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span></span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¨</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">tajam : tusukan benda tajam</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">_hemorhagic
diatese</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">_hipertensi
pulmonal primer</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pembagian lain </span></b></div>
<div class="MsoNormal" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Berdasar jumlah darah</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">:</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">PURSEL :</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> 1. Blood streak</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo2; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">minimal 1-30 cc</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo2; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">mild 30-150 cc</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo2; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">moderate 150-500 cc</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo2; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">massive 600 cc</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">JOHNSON </span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">: 1 singgle : kurang dari 7 hari</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>2. Repeated : lebih dari 7 hari dengan
interfal 2-3 hari</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">3. Frank : darah melulu tanpa dahak</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">RSUD Dr. Sutomo SMF paru > 90%
disebabkan :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l1 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">TB Paru</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l1 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Karsinoma paru</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l1 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Bronkiektasis</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l1 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Mitral stenosis</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h3 style="line-height: 150%;">
Patogenesis</h3>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Tergantung dr penyakit yang
mendasarinya.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h3 style="line-height: 150%;">
Gejala klinis</h3>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Kita harus memastikan bahwa
perdarahan dari nasofaring ,dengan cara membedakan ciri-ciri sebagai berikut :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l8 level1 lfo5; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Batuk darah</span></b></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo6; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Darah dibatukkan dengan rasa panas di tenggorokan</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo6; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Darah berbuih bercampur udara</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo6; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Darah segar berwarna merah muda</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo6; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Darah bersifat alkalis</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo6; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Anemia kadang-kadang terjadi</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo6; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Benzidin test negatif</span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l8 level1 lfo5; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Muntah
darah</span></b></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo7; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Darah dimuntahkan dengan rasa mual</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo7; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Darah bercampur sisa makanan </span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo7; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Darah berwarna hitam karena bercampur asam
lambung</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo7; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Darah bersifat asam</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo7; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Anemia seriang terjadi</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo7; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Benzidin test positif</span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l8 level1 lfo5; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Epistaksis</span></b></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo8; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Darah menetes dari hidung</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo8; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Batuk pelan kadang keluar</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo8; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Darah berwarna merah segar</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo8; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Darah bersifat alkalis</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo8; tab-stops: list .5in;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Anemia jarang terjadi</span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in;">
<br /></div>
<h3 style="line-height: 150%;">
Anamnesis</h3>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo9; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Dari anamnesis dipastikan asal darah</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo9; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Jumlah darah yang keluar, bentuk,warna,lama.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo9; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Penyakit batuknya</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo9; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Disertai nyeri dada</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo9; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Hubungan dengan kerja,istirahat,posisi penderita</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo9; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Hubungan penyakit masa lalu</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo9; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Anamnesa merokok</span></div>
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<br /></div>
<h3 style="line-height: 150%;">
Pemeriksaan fisik</h3>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">#<span style="mso-spacerun: yes;">
</span>Panas, berarti ada proses peradangan</span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">#<span style="mso-spacerun: yes;">
</span>Auskultasi: terdengar bunyi Rales</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Kemungkinan menujukkan lokasi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Ada aspirasi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Ronki menetap, wheezing lokal, kemungkinan penyumbatan
oleh : Ca, bekuan darah</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Friction rub:emboli paru ,infark paru</span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">#<span style="mso-spacerun: yes;">
</span>Clubbing finger: bronkiektasis, neoplasma</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Laboratorium:</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Hb</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Faal homeostasis dll<span style="mso-spacerun: yes;">
</span>menurut dugaan</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Radiologi :</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">tergantung etiologi :<span style="mso-spacerun: yes;">
</span>X-photo thorak, PA Lateral</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;">
</span>CT- scan</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pemeriksaan lain khusus</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">anamnesa : memastikan asal darah, berulang, jumlah,
warna, menahun dll</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">pemeriksaan fisik : kemungkinan penyebab</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">X-photo thorak : PA/Lateral, brokografi dll</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pemeriksaan sputum bakteriologi, sitologi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Bronkoskopi</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Komplikasi :</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Bahaya utama batuk darah adalah terjadi penyumbatan
trakea dan saluran nafas, sehingga timbul sufokasi yang sering fatal. Penderita
tidak nampak anemis tetapi sianosis, hal ini sering terjadi pada batuk darah
masif (600-1000 cc/24 jam)</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pneumonia aspirasi merupakan salah satu penyulit yang
terjadi karena darah terhisap kebagian paru yang sehat</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Karena saluran nafas tersumbat, maka paru bagiandistal
akan kolaps dan terjadi atelektasis</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Bila perdarahan banyak, terjadi dalam waktu lama.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h3 style="line-height: 150%;">
Penatalaksanaan </h3>
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<i style="mso-bidi-font-style: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Tujuan Umum</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.5pt; mso-list: l10 level1 lfo11; tab-stops: list 37.5pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">membebaskan jalan nafas</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.5pt; mso-list: l10 level1 lfo11; tab-stops: list 37.5pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">mencegah aspirasi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.5pt; mso-list: l10 level1 lfo11; tab-stops: list 37.5pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">menghentikan perdarahan dan pengobatan penyakit dasar.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h4 style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Konservative</span></h4>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>~ Hemoptoe sedikit (<200ml/24jam}
dapat berhenti</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>-obat: codein, doveri,
penyakit dasar</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>- diminta tenang, istirahat
total, kalau perlu obat penenang</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;">
</span>~<span style="mso-spacerun: yes;"> </span>Tidur setengah duduk:</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>13-31% hemopthoe berhenti sendiri MRS
1-4 hari,</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>87 % berhenti sendiri setelah 4hari
MRS</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;">
</span>~<span style="mso-spacerun: yes;"> </span>Infus atau transfusi</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Batuk darah
masif</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">:</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">tidur trendelenburg ke arah sisi yang sakit{agar tidak
aspirasi ke paru yang sehat}</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">infuse, penghisapan darah , pengambilan bekuan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt; mso-list: l3 level1 lfo10; tab-stops: list 75.0pt; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">waktu dulu setelah penderita agak tenang</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 75.0pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">kolaps
terapi: pnumoperitonium, pneumothoraks artifisial, operasi N. phrenicus</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">!
Tindakan-tindakan lebih agresif</span></i></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>-rigid bronkoskopi,jalan nafas terbuka
dan penghisapan darah lebih mudah</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>-FOB untuk suction darah dan mencari
lokasi perdarahan + dengan endotrakeal tube untuk keluar.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>Masuk FOB lebih mudah</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>-pasang endotrakeal tamponade {balon
kateter tamponade}</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>- reseksi paru</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>-embolisasi a. bronkialis</span></div>
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<br /></div>
<h3 style="line-height: 150%;">
Prognose</h3>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">hemopthoe<200ml/24jam</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">®</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">supportifve baik</span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">profuse massive >600cc/24jam</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">®</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">prognose jelek 85% meninggal</span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>*<span style="mso-spacerun: yes;"> </span>dengan bilateral far advance</span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>*<span style="mso-spacerun: yes;">
</span>faal paru kurang baik</span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>*<span style="mso-spacerun: yes;"> </span>terdapat kelainan jantung</span></div>
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<br /></div>
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DAFTAR PUSTAKA</h3>
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</span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Adam F. D. Physical Diagnosis Edition 1958</span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="mso-spacerun: yes;"> </span>Prof. dr. Hood Alsegaff , dr. H. Abdul
mukti, DASAR-DASAR ILMU<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>PENYAKIT PARU, 1995</span></div>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-20650027734406086332012-09-30T02:40:00.001-07:002013-01-30T23:37:39.753-08:00ABORTUS IMMINEN<!--[if !mso]>
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<br />
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 14.0pt; line-height: 115%;"></span><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b style="mso-bidi-font-weight: normal;">Pengetian </b></div>
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Abortus imminen adalah perdarahan bercak yang
menunjukkan ancaman terhadap kelangsungan sauatu kehamilan. Dalam kondisi
seperti ini kehamilan masih mungkin berlanjut atau dipertahankan. (Syaifudin. Bari Abdul, 2000)</div>
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Abortus imminen adalah perdarahan pervaginam pada
kehamilan kurang dari 20 minggu, tanpa tanda-tanda dilatasi serviks yang
meningkat ( Mansjoer, Arif M, 1999)</div>
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Abortus imminen adalah pengeluaran secret pervaginam
yang tampak pada paruh pertama kehamilan ( William Obstetri, 1990)</div>
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<span style="mso-tab-count: 1;"> </span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b style="mso-bidi-font-weight: normal;">Etiologi</b></div>
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Abortus dapat terjadi karena beberapa sebab yaitu :</div>
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<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Kelainan pertumbuhan hasil konsepsi, biasanya
menyebabkan abortus pada kehamilan sebelum usia 8 minggu. Faktor yang
menyebabkan kelainan ini adalah :</div>
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<span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span>Kelainan kromosom, terutama trimosoma dan monosoma X </div>
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<span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span>Lingkungan sekitar tempat impaltasi kurang sempurna</div>
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<span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span>Pengaruh teratogen akibat radiasi, virus, obat-obatan
temabakau dan alkohol</div>
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<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>kelainan pada plasenta, misalnya endarteritis vili
korialis karena hipertensi menahun</div>
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<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>faktor maternal seperti pneumonia, typus, anemia berat,
keracunan dan toksoplasmosis.</div>
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<span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span>kelainan traktus genetalia, seperti inkompetensi
serviks (untuk abortus pada trimester kedua), retroversi uteri, mioma uteri dan
kelainan bawaan uterus.</div>
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<br /></div>
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<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b style="mso-bidi-font-weight: normal;">Gambaran Klinis</b></div>
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<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Terlambat haid atau amenorhe kurang dari 20 minggu</div>
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<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>pada pemeriksaan fisik : keadaan umum tampak lemah
kesadaran menurun, tekanan darah normal atau menurun, denyut nadi normal atau
cepat dan kecil, suhu badan normal atau meningkat</div>
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<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>perdarahan pervaginam mungkin disertai dengan keluarnya
jaringan hasil konsepsi</div>
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<span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span>rasa mulas atau kram perut, didaerah atas simfisis,
sering nyeri pingang akibat kontraksi uterus</div>
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<span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span>pemeriksaan ginekologi :</div>
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<span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span>Inspeksi Vulva :<span style="mso-spacerun: yes;">
</span>perdarahan pervaginam ada atau tidak jaringan hasil konsepsi, tercium
bau busuk dari vulva</div>
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<span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span>Inspekulo : perdarahan dari cavum uteri, osteum uteri
terbuka atau sudah tertutup, ada atau tidak jaringan keluar dari ostium, ada
atau tidak cairan atau jaringan berbau busuk dari ostium.</div>
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<span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span>Colok vagina : porsio masih terbuka atau sudah
tertutup, teraba atau tidak jaringan dalam cavum uteri, besar uterus sesuai
atau lebih kecil dari usia kehamilan, tidak nyeri saat porsio digoyang, tidak
nyeri pada perabaan adneksa, cavum douglas
tidak menonjol dan tidak nyeri.</div>
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<br /></div>
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<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b style="mso-bidi-font-weight: normal;">Patofisiologi</b></div>
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Pada awal abortus terjadi perdarahan desiduabasalis,
diikuti dengan nerkrosis jaringan sekitar yang menyebabkan hasil konsepsi
terlepas dan dianggap benda asing dalam uterus. Kemudian uterus berkontraksi
untuk mengeluarkan benda asing tersebut.</div>
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Pada kehamilan kurang dari 8 minggu, villi korialis
belum menembus desidua secara dalam jadi hasil konsepsi dapat dikeluarkan
seluruhnya. Pada kehamilan 8 sampai 14 minggu, penembusan sudah lebih dalam
hingga plasenta tidak dilepaskan sempurna dan menimbulkan banyak perdarahan.
Pada kehamilan lebih dari 14 minggu janin dikeluarkan terlebih dahulu daripada
plasenta hasil konsepsi keluar dalam bentuk seperti kantong kosong amnion atau
benda kecil yang tidak jelas bentuknya (blightes ovum),janin lahir mati, janin
masih hidup, mola kruenta, fetus kompresus, maserasi atau fetus papiraseus. </div>
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Komplikasi :</div>
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<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Perdarahan, perforasi syok dan infeksi</div>
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<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>pada missed abortion dengan retensi lama hasil konsepsi
dapat terjadi kelainan pembekuan darah.</div>
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<br /></div>
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<br /></div>
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<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b style="mso-bidi-font-weight: normal;">Pathway</b></div>
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<span style="mso-ignore: vglayout;">
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<span style="mso-ignore: vglayout; position: relative; z-index: 251645440;"><span style="height: 365px; left: -13px; left: 0px; position: absolute; top: -229px; width: 594px;"><img height="365" src="file:///C:\DOCUME~1\Himz\LOCALS~1\Temp\msohtmlclip1\01\clip_image002.gif" width="594" /></span></span> </div>
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<br /></div>
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<br /></div>
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<br /></div>
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<br /></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
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<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">F.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b style="mso-bidi-font-weight: normal;">Pemeriksaan penunjang</b></div>
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<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Tes kehamilan positif jika janin masih hidup dan
negatif bila janin sudah mati</div>
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<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>pemeriksaan Dopler atau USG untuk menentukan apakah
janin masih hidup</div>
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<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>pemeriksaan fibrinogen dalam darah pada missed abortion</div>
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<b style="mso-bidi-font-weight: normal;">Data laboratorium</b></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-align: justify;">Tes urine</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-align: justify;">hemoglobin dan hematokrit</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-align: justify;">menghitung trombosit</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-align: justify;">kultur darah dan urine</li>
</ol>
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<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">G.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b style="mso-bidi-font-weight: normal;">Masalah keperawatan </b></div>
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<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Kecemasan</div>
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<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>intoleransi aktifitas</div>
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<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>gangguan rasa nyaman dan nyeri</div>
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<span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span>defisit volume cairan</div>
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<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">H.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b style="mso-bidi-font-weight: normal;">Diagnosa keperawatan </b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Cemas berhubungan dengan pengeluaran konsepsi</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>nyeri berhubungan dengan kontraksi uterus</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>resiko tinggi defisit volume cairan berhubungan dengan
perdarahan </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span>kehilangan berhubungan dengan pengeluaran hasil
konsepsi </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span>intoleransi aktivitas berhubungan dengan nyeri</div>
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<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b style="mso-bidi-font-weight: normal;">Tujuan </b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-align: justify;">
DX I<span style="mso-tab-count: 1;"> </span>: Mengurangii atau
menghilangkan kecemasan</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-align: justify;">
DX II<span style="mso-tab-count: 1;"> </span>: Mengurangi atau
menghilangkan rasa sakit</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-align: justify;">
DX III<span style="mso-tab-count: 1;"> </span>: Mencegah terjadinya
defisit cairan</div>
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DX IV<span style="mso-tab-count: 1;"> </span>: Mengurangi atau
meminimalkan rasa kehilangan atau duka cita</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-align: justify;">
DX V<span style="mso-tab-count: 1;"> </span>: Klien dapat melakukan
aktifitas sesuai dengan toleransinya</div>
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<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-list: Ignore;">J.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b style="mso-bidi-font-weight: normal;">fokus intervensi</b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; tab-stops: .75in; text-align: justify;">
<i style="mso-bidi-font-style: normal;">DX I<span style="mso-tab-count: 1;"> </span>: Cemas berhubungan dengan pengeluaran hasil
konsepsi </i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; tab-stops: .5in; text-align: justify;">
<span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Intervensi :</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level2 lfo2; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Siapkan klien untuk reaksi atas kehilangan</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level2 lfo2; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Beri informasi yang jelas dengan cara yang tepat</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; tab-stops: .75in; text-align: justify;">
<i style="mso-bidi-font-style: normal;">DX II<span style="mso-tab-count: 1;"> </span>: nyeri berhubungan dengan kontraksi uteri</i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-align: justify;">
<span style="mso-tab-count: 1;"> </span>Intervensi</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level2 lfo2; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Menetapkan laporan dan tanda-tanda yang lain. Panggil
pasien dengan nama lengkap. Jangan tinggalkan pasien tanpa pengawasan dalam
waktu yang lama</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level2 lfo2; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Rasa sakit dan karakteristik, termasuk kualitas waktu
lokasi dan intensitas</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level2 lfo2; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Melakukan tindakan yang membuat klien merasa nyaman
seperti ganti posisi, teknik relaksasi serta kolaburasi obat analgetik</div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81.0pt; tab-stops: .5in .75in; text-align: justify; text-indent: -63.0pt;">
<i style="mso-bidi-font-style: normal;">DX III<span style="mso-tab-count: 1;"> </span>: Resiko tinggi defisit
volume cairan berhubungan dengan perdarahan </i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-align: justify;">
<span style="mso-tab-count: 1;"> </span>Intervensi :</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level2 lfo2; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Kaji perdarahan pada pasien, setiap jam atau dalam masa
pengawasan</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; mso-list: l2 level1 lfo3; tab-stops: list 1.25in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Kaji perdarahan Vagina : warna, jumlah pembalut yang
digunakan, derajat aliran dan banyaknya</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; mso-list: l2 level1 lfo3; tab-stops: list 1.25in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>kaji adanya gumpalan</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; mso-list: l2 level1 lfo3; tab-stops: list 1.25in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>kaji adanya tanda-tanda gelisah, taki kardia,
hipertensi dan kepucatan</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level2 lfo2; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>monitor nilai HB dan Hematokrit</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; text-align: justify;">
<i style="mso-bidi-font-style: normal;">DX IV :<span style="mso-spacerun: yes;">
</span>Kehilangan berhubungan dengan pengeluaran hasil konsepsi </i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; text-align: justify; text-indent: .25in;">
Intervensi :</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level2 lfo2; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Pasien menerima kenyataan kehilangan dengan tenang
tidak dengan cara menghakimi</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level2 lfo2; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Jika diminta bisa juga dilakukan perawatan janin</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level2 lfo2; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Menganjurkan pada pasien untuk mendekatkan diri pada
Tuhan YME</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; text-align: justify;">
<i style="mso-bidi-font-style: normal;">DX V : Intoleransi aktifitas berhubungan
dengan nyeri</i></div>
<div class="MsoNormal" style="line-height: 115%; tab-stops: .75in; text-align: justify;">
<span style="mso-tab-count: 1;"> </span>Intervensi </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level2 lfo2; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Menganjurkan pasien agar tiduran</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l1 level2 lfo2; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Tidak melakukan hubungan seksual</div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-3690627568843789082012-09-27T07:27:00.002-07:002012-09-27T07:28:17.903-07:00ASKEP DIAREA. Pengertian<br />
Beberapa pengertian diare:<br />
1. Diare adalah buang air besar (defekasi) dengan tinja <a href="http://zhayhacker.blogspot.com/">berbentuk</a>
cairan atau setengah cairan, dengan demikian kandungan air pada tinja
lebih banyak dari keadaan normal yakni 100-200 ml sekali defekasi
(Hendarwanto, 1999).<br />
<a name='more'></a><br />
2. Menurut WHO (1980) diare adalah buang air besar encer atau cair lebih dari tiga kali sehari.<br />
3. Diare ialah keadaan frekuensi buang air besar lebih dari 4 kali pada
bayi dan lebih dari 3 kali pada anak dengan konsistensi feses encer,
dapat berwarna hijau atau dapat bercampur lendir dan darah (Ngastiyah,
1997).<br />
<br />
B. Penyebab<br />
1. Faktor infeksi<br />
a. Infeksi enteral; infeksi saluran pencernaan yang merupakan penyebab
utama diare, meliputi infeksi bakteri (Vibrio, E. coli, Salmonella,
Shigella, Campylobacter, Yersinia, Aeromonas, dsb), infeksi virus
(Enterovirus, Adenovirus, Rotavirus, Astrovirus, dll), infeksi parasit
(E. hystolytica, G.lamblia, T. hominis) dan jamur (C. albicans).<br />
b. Infeksi parenteral; merupakan infeksi di luar sistem pencernaan yang
dapat menimbulkan diare seperti: otitis media akut, tonsilitis,
bronkopneumonia, ensefalitis dan sebagainya.<br />
<br />
2. Faktor Malabsorbsi<br />
Malabsorbsi karbohidrat: disakarida (intoleransi laktosa, maltosa dan
sukrosa), monosakarida (intoleransi glukosa, fruktosa dan galaktosa).
Intoleransi laktosa merupakan penyebab diare yang terpenting pada bayi
dan anak. Di samping itu dapat pula terjadi malabsorbsi lemak dan
protein.<br />
<br />
3. Faktor Makanan:<br />
Diare dapat terjadi karena mengkonsumsi makanan basi, beracun dan alergi terhadap jenis makanan tertentu.<br />
<br />
4. Faktor Psikologis<br />
Diare dapat terjadi karena faktor psikologis (rasa takut dan cemas).<br />
<br />
C. Patofisiologi<br />
Mekanisme dasar yang menyebabkan timbulnya diare ialah:<br />
1. Gangguan osmotik<br />
Adanya makanan atau zat yang tidak dapat diserap akan menyebabkan
tekanan osmotik dalam lumen usus meningkat sehingga terjadi pergeseran
air dan elektroloit ke dalam lumen usus. Isi rongga usus yang berlebihan
akan merangsang usus untuk mengeluarkannya sehingga timbul diare.<br />
<br />
2. Gangguan sekresi<br />
Akibat rangsangan tertentu (misalnya toksin) pada dinding usus akan
terjadi peningkatan sekresi, air dan elektrolit ke dalam lumen usus dan
selanjutnya timbul diare kerena peningkatan isi lumen usus.<br />
<br />
3. Gangguan motilitas usus<br />
Hiperperistaltik akan menyebabkan berkurangnya kesempatan usus untuk
menyerap makanan sehingga timbul diare. Sebaliknya bila peristaltik usus
menurun akan mengakibatkan bakteri tumbuh berlebihan, selanjutnya dapat
timbul diare pula.<br />
<br />
D. Manifestasi Klinis<br />
Diare akut karena infeksi dapat disertai muntah-muntah, demam, tenesmus,
hematoschezia, nyeri perut dan atau kejang perut. Akibat paling fatal
dari diare yang berlangsung lama tanpa rehidrasi yang adekuat adalah
kematian akibat dehidrasi yang menimbulkan renjatan hipovolemik atau
gangguan biokimiawi berupa asidosis metabolik yang berlanjut. Seseoran
yang kekurangan cairan akan merasa haus, berat badan berkurang, mata
cekung, lidah kering, tulang pipi tampak lebih menonjol, turgor kulit
menurun serta suara menjadi serak. Keluhan dan gejala ini disebabkan
oleh deplesi air yang isotonik.<br />
Karena kehilangan bikarbonat (HCO3) maka perbandingannya dengan asam
karbonat berkurang mengakibatkan penurunan pH darah yang merangsang
pusat pernapasan sehingga frekuensi pernapasan meningkat dan lebih dalam
(pernapasan Kussmaul)<br />
Gangguan kardiovaskuler pada tahap hipovolemik yang berat dapat berupa
renjatan dengan tanda-tanda denyut nadi cepat (> 120 x/menit),
tekanan darah menurun sampai tidak terukur. Pasien mulai gelisah, muka
pucat, akral dingin dan kadang-kadang sianosis. Karena kekurangan kalium
pada diare akut juga dapat timbul aritmia jantung.<br />
Penurunan tekanan darah akan menyebabkan perfusi ginjal menurun sampai
timbul oliguria/anuria. Bila keadaan ini tidak segera diatsi akan timbul
penyulit nekrosis tubulus ginjal akut yang berarti suatu keadaan gagal
ginjal akut.<br />
<br />
E. Penatalaksanaan<br />
Prinsip Penatalaksanaan<br />
Penatalaksanaan diare akut karena infeksi pada orang dewasa terdiri atas:<br />
1. Rehidrasi sebagai prioritas utama terapi.<br />
2. Tata kerja terarah untuk mengidentifkasi penyebab infeksi.<br />
3. Memberikan terapi simtomatik<br />
4. Memberikan terapi definitif.<br />
<br />
ad.1. Rehidrasi sebagai prioritas utama terapi.<br />
Ada 4 hal yang penting diperhatikan agar dapat memberikan rehidrasi yang cepat dan akurat, yaitu:<br />
1) Jenis cairan yang hendak digunakan.<br />
Pada saat ini cairan Ringer Laktat merupakan cairan pilihan karena
tersedia cukup banyak di pasaran meskipun jumlah kaliumnya rendah bila
dibandingkan dengan kadar kalium tinja. Bila RL tidak tersedia dapat
diberiakn NaCl isotonik (0,9%) yang sebaiknya ditambahkan dengan 1 ampul
Nabik 7,5% 50 ml pada setiap satu liter NaCl isotonik. Pada keadaan
diare akut awal yang ringan dapat diberikan cairan oralit untuk mencegah
dehidrasi dengan segala akibatnya.<br />
<br />
2) Jumlah cairan yang hendak diberikan.<br />
Pada prinsipnya jumlah cairan pengganti yang hendak diberikan harus
sesuai dengan jumlah cairan yang keluar dari badan. Jumlah kehilangan
cairan dari badan dapat dihitung dengan cara/rumus:<br />
<br />
- Mengukur BJ Plasma<br />
Kebutuhan cairan dihitung dengan rumus:<br />
BJ Plasma – 1,025<br />
———————- x BB x 4 ml<br />
0,001<br />
<br />
- Metode Pierce<br />
Berdasarkan keadaan klinis, yakni:<br />
* diare ringan, kebutuhan cairan = 5% x kg BB<br />
* diare sedang, kebutuhan cairan = 8% x kg BB<br />
* diare ringan, kebutuhan cairan = 10% x kg BB<br />
<br />
- Metode Daldiyono<br />
Berdasarkan skoring keadaan klinis sebagai berikut:<br />
* Rasa haus/muntah = 1<br />
* BP sistolik 60-90 mmHg = 1<br />
* BP sistolik <60 mmHg = 2 * Frekuensi nadi >120 x/mnt = 1<br />
* Kesadaran apatis = 1<br />
* Kesadaran somnolen, sopor atau koma = 2<br />
* Frekuensi napas >30 x/mnt = 1<br />
* Facies cholerica = 2<br />
* Vox cholerica = 2<br />
* Turgor kulit menurun = 1<br />
* Washer women’s hand = 1<br />
* Ekstremitas dingin = 1<br />
* Sianosis = 2<br />
* Usia 50-60 tahun = 1<br />
* Usia >60 tahun = 2<br />
Kebutuhan cairan =<br />
Skor<br />
——– x 10% x kgBB x 1 ltr<br />
15<br />
<br />
3) Jalan masuk atau cara pemberian cairan<br />
Rute pemberian cairan pada orang dewasa meliputi oral dan intravena.
Larutan orali dengan komposisi berkisar 29 g glukosa, 3,5 g NaCl, 2,5 g
NaBik dan 1,5 g KCl stiap liternya diberikan per oral pada diare ringan
sebagai upaya pertama dan juga setelah rehidrasi inisial untuk
mempertahankan hidrasi.<br />
<br />
4) Jadual pemberian cairan<br />
Jadual rehidrasi inisial yang dihitung berdasarkan BJ plasma atau sistem
skor diberikan dalam waktu 2 jam dengan tujuan untuk mencapai rehidrasi
optimal secepat mungkin. Jadual pemberian cairan tahap kedua yakni
untuk jam ke-3 didasarkan pada kehilangan cairan selama 2 jam fase
inisial sebelumnya. Dengan demikian, rehidrasi diharapkan lengkap pada
akhir jam ke-3.<br />
<br />
2. Tata kerja terarah untuk mengidentifkasi penyebab infeksi.<br />
Untuk mengetahui penyebab infeksi biasanya dihubungkan dengan dengan
keadaan klinis diare tetapi penyebab pasti dapat diketahui melalui
pemeriksaan biakan tinja disertai dengan pemeriksaan urine lengkap dan
tinja lengkap.<br />
Gangguan keseimbangan cairan, elektrolit dan asam basa diperjelas
melalui pemeriksaan darah lengkap, analisa gas darah, elektrolit, ureum,
kreatinin dan BJ plasma.<br />
Bila ada demam tinggi dan dicurigai adanya infeksi sistemik pemeriksaan
biakan empedu, Widal, preparat malaria serta serologi Helicobacter
jejuni sangat dianjurkan. Pemeriksaan khusus seperti serologi amuba,
jamur dan Rotavirus biasanya menyusul setelah melihat hasil pemeriksaan
penyaring.<br />
Secara klinis diare karena infeksi akut digolongkan sebagai berikut:<br />
1) Koleriform, diare dengan tinja terutama terdiri atas cairan saja.<br />
2) Disentriform, diare dengan tinja bercampur lendir kental dan kadang-kadang darah.<br />
Pemeriksaan penunjang yang telah disinggung di atas dapat diarahkan sesuai manifestasi klnis diare.<br />
<br />
3. Memberikan terapi simtomatik<br />
Terapi simtomatik harus benar-benar dipertimbangkan kerugian dan
keuntungannya. Antimotilitas usus seperti Loperamid akan memperburuk
diare yang diakibatkan oleh bakteri entero-invasif karena memperpanjang
waktu kontak bakteri dengan epitel usus yang seyogyanya cepat
dieliminasi.<br />
<br />
4. Memberikan terapi definitif.<br />
Terapi kausal dapat diberikan pada infeksi:<br />
1) Kolera-eltor: Tetrasiklin atau Kotrimoksasol atau Kloramfenikol.<br />
2) V. parahaemolyticus,<br />
3) E. coli, tidak memerluka terapi spesifik<br />
4) C. perfringens, spesifik<br />
5) A. aureus : Kloramfenikol<br />
6) Salmonellosis: Ampisilin atau Kotrimoksasol atau golongan Quinolon seperti Siprofloksasin<br />
7) Shigellosis: Ampisilin atau Kloramfenikol<br />
8) Helicobacter: Eritromisin<br />
9) Amebiasis: Metronidazol atau Trinidazol atau Secnidazol<br />
10) Giardiasis: Quinacrine atau Chloroquineitiform atau Metronidazol<br />
11) Balantidiasis: Tetrasiklin<br />
12) Candidiasis: Mycostatin<br />
13) Virus: simtomatik dan suportif<br />
G. Konsep Keperawatan<br />
1. Pengkajian (Anak Usia 3 Tahun)<br />
a. Keluhan Utama : Buang air berkali-kali dengan konsistensi encer<br />
<br />
b. Riwayat Kesehatan Sekarang<br />
Pada umumnya anak masuk Rumah Sakit dengan keluhan buang air cair
berkali-kali baik disertai atau tanpa dengan muntah, tinja dpat
bercampur lendir dan atau darah, keluhan lain yang mungkin didapatkan
adalah napsu makan menurun, suhu badan meningkat, volume diuresis
menurun dan gejala penurunan kesadaran<br />
<br />
c. Riwayat Kesehatan Masa Lalu<br />
Meliputi pengkajian riwayat :<br />
1) Prenatal<br />
Kehamilan yang keberapa, tanggal lahir, gestasi (fulterm, prematur, post
matur), abortus atau lahir hidup, kesehatan selama
sebelumnya/kehamilan, dan obat-obat yang dimakan serta imunisasi.<br />
<br />
2) Natal<br />
Lamanya proses persalinan, tempat melahirkan, obat-obatan, orang yang menolong persalinan, penyulit persalinan.<br />
<br />
3) Post natal<br />
Berat badan nomal 2,5 Kg – 4 Kg, Panjang Badan normal 49 -52 cm, kondisi
kesehatan baik, apgar score , ada atau tidak ada kelainan kongenital.<br />
<br />
4) Feeding<br />
Air susu ibu atau formula, umur disapih (2 tahun), jadwal
makan/jumlahnya, pengenalan makanan lunak pada usia 4-6 bulan, peubahan
berat-badan, masalah-masalah feeding (vomiting, colic, diare), dan
penggunaan vitamin dan mineral atau suplemen lain.<br />
<br />
5) Penyakit sebelumnya<br />
Penyebabnya, gejala-gejalanya, perjalanan penyakit, penyembuhan,
kompliksi, insiden penyakit dalam keluarga atau masyarakat, respon emosi
terhadap rawat inap sebelumnya.<br />
<br />
6) Alergi<br />
Apakah pernah menderita hay fever, asthma, eksim. Obat-obatan, binatang, tumbuh-tumbuhan, debu rumah<br />
<br />
7) Obat-obat terakhir yang didapat<br />
Nama, dosis, jadwal, lamanya, alasan pemberian.<br />
<br />
8) Imunisasi<br />
Polio, hepatitis, BCG, DPT, campak, sudah lengkap pada usia 3 tahun,
reaksi yang terjadi adalah biasanya demam, pemberian serum-serum lain,
gamma globulin/transfusi, pemberian tubrkulin test dan reaksinya.<br />
<br />
9) Tumbuh Kembang<br />
Berat waktu lahir 2, 5 Kg – 4 Kg. Berat badan bertambah 150 – 200
gr/minggu, TB bertambah 2,5 cm / bulan, kenaikan ini terjadi sampai 6
bulan. Gigi mulai tumbuh pada usia 6-7 bulan, mulai duduk sendiri pada
usia 8-9 bulan, dan bisa berdiri dan berjalan pada usia 10-12 bulan.<br />
<br />
d. Riwayat Psikososial<br />
Anak sangat menyukai mainannya, anak sangat bergantung kepada kedua
orang tuanya dan sangat histeris jika dipisahkan dengan orang tuanya.
Usia 3 tahun (toddlers) sudah belajar bermain dengan teman sebaya.<br />
<br />
e. Riwayat Spiritual<br />
Anak sudah mengenal beberapa hal yang bersifat ritual misalnya berdoa.<br />
<br />
f. Reaksi Hospitalisasi<br />
1. Kecemasan akan perpisahan : kehilangan interaksi dari keluarga dan
lingkungan yang dikenal, perasaan tidak aman, cemas dan sedih<br />
2. Perubahan pola kegiatan rutin<br />
3. Terbatasnya kemampuan untuk berkomunikasi<br />
4. Kehilangan otonomi<br />
5. Takut keutuhan tubuh<br />
6. Penurunan mobilitas seperti kesempatan untuk mempelajari dunianya dan terbatasnya kesempatan untuk melaksanakan kesenangannya<br />
<br />
g. Aktivitas Sehari-Hari<br />
1. Kebutuhan cairan pada usia 3 tahun adalah 110-120 ml/kg/hari<br />
2. Output cairan :<br />
(a) IWL (Insensible Water Loss)<br />
(1) Anak : 30 cc / Kg BB / 24 jam<br />
(2) Suhu tubuh meningkat : 10 cc / Kg BB + 200 cc (suhu tubuh – 36,8 oC)<br />
(b) SWL (Sensible Water Loss) adalah hilangnya cairan yang dapat diamati, misalnya berupa kencing dan faeces. Yaitu :<br />
(1) Urine : 1 – 2 cc / Kg BB / 24 jam<br />
(2) Faeces : 100 – 200 cc / 24 jam<br />
3. Pada usia 3 tahun sudah diajarkan toilet training.<br />
<br />
h. Pemeriksaan Fisik<br />
a) Tanda-tanda vital<br />
Suhu badan : mengalami peningkatan<br />
Nadi : cepat dan lemah<br />
Pernafasan : frekuensi nafas meningkat<br />
Tekanan darah : menurun<br />
b) Antropometri<br />
Pemeriksaan antropometri meliputi berat badan, Tinggi badan, Lingkaran
kepala, lingkar lengan, dan lingkar perut. Pada anak dengan diare
mengalami penurunan berat badan.<br />
c) Pernafasan<br />
Biasanya pernapasan agak cepat, bentuk dada normal, dan tidak ditemukan bunyi nafas tambahan.<br />
d) Cardiovasculer<br />
Biasanya tidak ditemukan adanya kelainan, denyut nadi cepat dan lemah.<br />
e) Pencernaan<br />
Ditemukan gejala mual dan muntah, mukosa bibir dan mulut kering,
peristaltik usus meningkat, anoreksia, BAB lebih 3 x dengan konsistensi
encer<br />
f) Perkemihan<br />
Volume diuresis menurun.<br />
<br />
g) Muskuloskeletal<br />
Kelemahan fisik akibat output yang berlebihan.<br />
<br />
h) Integumen<br />
lecet pada sekitar anus, kulit teraba hangat, turgor kulit jelek<br />
<br />
i) Endokrin<br />
Tidak ditemukan adanya kelaianan.<br />
<br />
J) Penginderaan<br />
Mata cekung, Hidung, telinga tidak ada kelainan<br />
<br />
k) Reproduksi<br />
Tidak mengalami kelainan.<br />
<br />
l) Neorologis<br />
Dapat terjadi penurunan kesadaran.<br />
<br />
2. Pemeriksaan Tingkat Perkembangan<br />
1) Motorik Kasar<br />
Sudah bisa naik/turun tangga tanpa dibantu, mamakai baju dengan bantuan, mulai bisa bersepeda roda tiga.<br />
<br />
2) Motorik Halus<br />
Menggambat lingkaran, mencuci tangan sendiri dan menggosok gigi<br />
<br />
3) Personal Sosial<br />
Sudah belajar bermain dengan teman sebayanya.<br />
4. Diagnosa Keperawatan<br />
<br />
a. Kekurangan volume cairan b.d kehilangan berlebihan melalui feses dan muntah serta intake terbatas (mual).<br />
b. Perubahan nutrisi kurang dari kebutuhan tubuh b.d gangguan absorbsi nutrien dan peningkatan peristaltik usus.<br />
c. Nyeri (akut) b.d hiperperistaltik, iritasi fisura perirektal.<br />
d. Kecemasan keluarga b.d perubahan status kesehatan anaknya<br />
e. Kurang pengetahuan keluarga tentang kondisi, prognosis dan kebutuhan
terapi b.d pemaparan informasi terbatas, salah interpretasi informasi
dan atau keterbatasan kognitif.<br />
f. Kecemasan anak b.d perpisahan dengan orang tua, lingkungan yang baru<br />
5. Rencana Keperawatan<br />
Dx.1 Kekurangan volume cairan b/d kehilangan berlebihan melalui feses dan muntah serta intake terbatas (mual)<br />
<br />
Tujuan : Kebutuhan cairan akan terpenuhi dengan kriteria tidak ada tanda-tanda dehidrasi
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</style> <![endif]--><div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo1; text-indent: -.25in;"><b><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b>Dasar Pemikiran</b></div><div class="MsoNormal" style="line-height: 115%;">Klien yang dirawat di rumah sakit jiwa atau ruang jiwa umumnya dengan keluhan tidak dapat diatur di rumah, misalnya amuk, diam saja, tidak mandi, keluyuran, mengganggu orang lain dan sebagainya. Setelah berada dan dirawat di rumah sakit, hal yang sama sering terjadi banyak klien diam, menyendiri tanpa ada kegiatan.</div><a name='more'></a> Hari – hari perawatan dilalui dengan makan, minum obat dan tidur. Ada di antara klien yang dengan inisiatif sendiri mencari perubahan situasi dengan jalan – jalan di rumah sakit namun ada diantara mereka yang tidak tahu jalan pulang sehingga jika tertangkap ia dicap sebagai klien<span style="mso-spacerun: yes;"> </span>yang melarikan diri kemudian dimasukan lagi ke dalam ruang isolasi. Apa sebenarnya yang dilakukan klien??<br />
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-indent: .25in;">Terapi aktivitas kelompok merupakan salah satu tindakan keperawatan untuk klien gangguan jiwa. Terapi ini adalah terapi yang pelaksanaannya merupakan tanggung jawab penuh dari seorang perawat. Oleh karena itu seorang perawat khususnya perawaat jiwa haruslah mampu melakukan terapi aktivitas kelompok secara tepat dan benar. </div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-indent: .25in;">Untuk mencapai hal tersebut di atas perlu dibuat suatu pedoman pelaksanaan terapi aktivitas kelompok seperti terapi aktivitas kelompok sosialisasi, penyaluran energi, stimulasi sensori dan orientasi realitas.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-indent: .25in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo1; text-indent: -.25in;"><b><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b>Tujuan</b></div><div class="MsoNormal" style="line-height: 115%; text-indent: .25in;">Terapi aktivitas kelompok adalah suatu upaya untuk memfasilitasi psikoterapis terhadap sejumlah klien pada waktu yang sama untuk memantau dan meningkatkan hubungan interpersonal antar anggota.</div><div class="MsoNormal" style="line-height: 115%; text-indent: .25in;">Secara umum tujuan terapi aktivitas kelompok adalah meningkatkan kemampuan uji realitas melalui komunikasi dan umpan balik dengan atau dari orang lain, melakukan sosialisasi, meningkatkan kesadaran terhadap hubungan reaksi emosi dengan tindakan atau perilaku denfensif, dan meningkatkan motivasi untuk kemajuan fungsi kognitif dan afektif. Secara khusus tujuannya adalah meningkatkan identitas diri, menyalurkan emosi secara konstruktif, meningkatkan ketrampilan hubungan interpersonal atau social.</div><div class="MsoNormal" style="line-height: 115%; text-indent: .25in;">Di samping itu tujuan rehabilitasinya adalah meningkatkan ketrampilan ekspresi diri, social, meningkatkan kepercayaan diri, empati, meningkatkan pengetahuan dan kemampuan pemecahan masalah.</div><div class="MsoNormal" style="line-height: 115%; text-indent: .25in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo1; text-indent: -.25in;"><b><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b>Karakteristik Pasien</b></div><div class="MsoNormal" style="line-height: 115%; text-indent: .25in;">Berdasarkan pengamatan dan kajian status klien maka karakteristik klien yang dilibatkan dalam terapi aktivitas kelompok ini adalah klien dengan masalah keperawatan seperti resiko mencederai diri sendiri, orang lain dan lingkungan, perilaku kekerasan, defisit perawatan diri, isolasi social : menarik diri, dan perubahan persepsi sensori.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo1; text-indent: -.25in;"><b><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b>Landasan Teori</b></div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level2 lfo1; text-indent: -.25in;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span>Model Terapi Aktivitas Kelompok</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l1 level3 lfo1; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Focal conflic model</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Dikembangkan berdasarkan konflik yang tidak disadari dan berfokus pada kelompok individu. Tugas leader adalah membantu kelompok memahami konflik dan membantu penyelesaian masalah. Misal ; adanya perbedaan pendapat antar anggota, bagaimana masalah ditanggapi anggotadan leader mengarahkan alternatif penyelesaian masalah.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l1 level3 lfo1; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Model komunikasi</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Dikembangkan berdasarkan teori dan prinsip komunikasi, bahwa tidak efektifnya komunikasi akan membawa kelompok menjadi tidak puas. Tujuan membantu meningkatkan ketrampilan interpersonal dan social anggota kelompok.<span style="mso-spacerun: yes;"> </span>Tugas leader adalah memfasilitasi komunikasi yang efektif antar anggota dan mengajarkan pada kelompok bahwa perlu adanya komunikasi dalam kelompok, anggota bertanggung jawab terhadap apa yang diucapkan, komunikasi pada semua jenis : verbal, non verbal, terbuka dan tertutup, serta pesan yang disampaikan harus dipahami orang lain. </div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l1 level3 lfo1; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Model interpersonal</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Tingkah laku (pikiran, perasaan dan tindakan) digambarkan melalui hubungan interpersonal dalam kelompok. Pada model ini juga menggambarkan sebab akibat tingkah laku anggota merupakan akibat dari tingkah laku anggota yang lain. Terapist bekerja dengan individu dan kelompok, anggota belajar dari interaksi antar anggota dan terapist. Melalui proses ini, tingkah laku atau kesalahan dapat dikoreksi dan dipelajari.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l1 level3 lfo1; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Model psikodrama</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Dengan model ini dapat memotivasi anggota kelompok untuk berakting sesuai dengan peristiwa yang baru terjadi atau peristiwa yang lalu, sesuai peran yang diperagakan. Anggota diharapkan dapat memainkan peran sesuai peristiwa yang pernah dialami. </div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level2 lfo1; text-indent: -.25in;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span>Metoda</div><div class="MsoNormal" style="line-height: 115%; margin-left: 117.0pt; mso-list: l1 level3 lfo1; text-indent: -99.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Kelompok didaktik</div><div class="MsoNormal" style="line-height: 115%; margin-left: 117.0pt; mso-list: l1 level3 lfo1; text-indent: -99.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Kelompok social terapeutik</div><div class="MsoNormal" style="line-height: 115%; margin-left: 117.0pt; mso-list: l1 level3 lfo1; text-indent: -99.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Kelompok insipirasi represif</div><div class="MsoNormal" style="line-height: 115%; margin-left: 117.0pt; mso-list: l1 level3 lfo1; text-indent: -99.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Psikodrama</div><div class="MsoNormal" style="line-height: 115%; margin-left: 117.0pt; mso-list: l1 level3 lfo1; text-indent: -99.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Kelompok interaksi bebas</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level2 lfo1; text-indent: -.25in;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span>Fokus Terapi Aktivitas Kelompok</div><div class="MsoNormal" style="line-height: 115%; margin-left: 117.0pt; mso-list: l1 level3 lfo1; text-indent: -99.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Orientasi realitas</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Maksudnya adalah memberikan terapi aktivitas kelompok yang mengalami gangguan orientasi terhadap orang, waktu dan tempat. Tujuan adalah klien mampu mengidentifikasi stimulus internal (pikiran, perasaan, sensasi somatic) dan stimulus eksternal (iklim, bunyi, situasi alam sekitar), klien dapat membedakan antara lamunan dan kenyataan, pembicaraan klien sesuai realitas, klien mampu mengenal diri sendiri dan klien mampu mengenal orang lain, waktu dan tempat. Karakteristik klien : gangguan orientasi realita (GOR), halusinasi, waham, ilusi dan depersonalisasi yang sudah dapat berinteraksi dengan orang lain, klien kooperatif, dapat berkomunikasi verbal dengan baik, dan kondisi fisik dalam keadaan sehat.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 117.0pt; mso-list: l1 level3 lfo1; text-indent: -99.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Sosialisasi</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Maksudnya adalah memfasilitasi psikoterapist untuk memantau dan meningkatkan hubungan interpersonal, memberi tanggapan terhadap orang lain, mengekspresikan iden dan tukar persepsi dan menerima stimulus eksternal yang berasal dari lingkungan. Tujuan meningkatkan hubungan interpersonal antar anggota kelompok, berkomunikasi, saling memperhatikan, memberikan tanggapan terhadap orang lain, mengekspresikan ide serta menerima stimulus eksternal. Karakteritistik klien : kurang berminat atau tidak ada inisiatif untuk mengikuti kegiatan ruangan, sering berada di tempat tidur, menarik diri, kontak social kurang, harga diri rendah, gelisah ,curiga, takut dan cemas, tidak ada inisiatif memulai pembicaraan, menjawab seperlunya, jawaban sesuai pertanyaan, dan dapat membina trust, mau berinteraksi dan<span style="mso-spacerun: yes;"> </span>sehat fisik.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 117.0pt; mso-list: l1 level3 lfo1; text-indent: -99.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Stimulasi persepsi</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Maksudnya adalah membantu klien yang mengalami kemunduran orientasi, stimulasi persepsi dalam upaya memotivasi proses berpikir dan afektif serta mengurangi perilaku mal adaptif. Tujuan meningkatkan kemampuan orientasi realita, memusatkan perhatian, intelektual, mengemukakan pendapat dan menerima pendapat orang lain dan mengemukakan perasaannya. Karakteristik klien : gangguan persepsi yang berhubungan dengan nilai – nilai, menarik diri dari realita, inisiati atau ide – ide yang negatif, kondisi fisik sehat, dapat berkomunikasi verbal, kooperatif dan mengikuti kegiatan. </div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 117.0pt; mso-list: l1 level3 lfo1; text-indent: -99.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Stimulasi sensori</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Maksudnya adalah menstimulasi sensori pada klien yang mengalami kemunduran sensoris. Tujuan meningkatkan kemampuan sensori, memusatkan perhatian, kesegaran jasmani, dan mengekspresikan perasaan. </div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 117.0pt; mso-list: l1 level3 lfo1; text-indent: -99.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Penyaluran energi</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Maksudnya adalah untuk menyalurkan energi secara konstruktif. Tujuan menyalurkan energi dari destruktif menjadi konstruktif, mengekspresikan perasaan dan meningkatkan hubungan interpersonal. </div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level2 lfo1; text-indent: -.25in;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span>Tahap – tahap dalam terapi aktivitas kelompok.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">Menurut Yalom yang dikutip oleh Stuart dan Sundeen, 1995, fase – fase dalam terapi aktivitas kelompok adalah sebagai berikut :</div><ol start="1" style="margin-top: 0in;" type="1"><li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Pre kelompok</li>
</ol><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Dimulai dengan membuat tujuan, merencanakan, siapa yang menjadi leader, anggota, dimana, kapan kegiatan kelompok tersebut dilaksanakan, proses evaluasi pada anggota dan kelompok, menjelaskan sumber – sumber yang diperlukan kelompok seperti proyektor dan jika memungkian biaya dan keuangan.</div><ol start="2" style="margin-top: 0in;" type="1"><li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Fase awal</li>
</ol><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Pada fase ini terdapat 3 kemungkinan tahapan yang terjadi yaitu orientasi, konflik atau kebersamaan.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level3 lfo1; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Orientasi.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">Anggota mulai mengembangkan system social masing – masing, dan leader mulai menunjukkan rencana terapi dan mengambil kontrak dengan anggota.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level3 lfo1; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Konflik</div><div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">Merupakan masa sulit dalam proses kelompok, anggota mulai memikirkan siapa yang berkuasa dalam kelompok, bagaimana peran anggota, tugasnya dan saling ketergantungan yang akan terjadi. </div><div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level3 lfo1; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Kebersamaan</div><div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">Anggota mulai bekerja sama untuk mengatasi masalah, anggota mulai menemukan siapa dirinya. </div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><ol start="3" style="margin-top: 0in;" type="1"><li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Fase kerja</li>
</ol><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Pada tahap ini kelompok sudah menjadi tim. Perasaan positif dan engatif dikoreksi dengan hubungan saling percaya yang telah dibina, bekerjasama untuk mencapai tujuan yang telah disepakati, kecemasan menurun, kelompok lebih stabil dan realistic, mengeksplorasikan lebih jauh sesuai dengan tujuan dan tugas kelompok, dan penyelesaian masalah yang kreatif.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;"><br />
</div><ol start="4" style="margin-top: 0in;" type="1"><li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Fase terminasi</li>
</ol><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Ada dua jenis terminasi (akhir dan sementara). Anggota kelompok mungkin mengalami terminasi premature, tidak sukses atau sukses. </div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level2 lfo1; text-indent: -.25in;"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span>Peran Perawat dalam terapi aktivitas kelompok.</div><ol start="1" style="margin-top: 0in;" type="1"><li class="MsoNormal" style="line-height: 115%; mso-list: l0 level1 lfo3; tab-stops: list .5in;">Mempersiapkan program terapi aktivitas kelompok.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l0 level1 lfo3; tab-stops: list .5in;">Sebagai leader dan co leader</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l0 level1 lfo3; tab-stops: list .5in;">Sebagai fasilitator</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l0 level1 lfo3; tab-stops: list .5in;">Sebagai observer</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l0 level1 lfo3; tab-stops: list .5in;">Mengatasi masalah yang timbul pada saat pelaksanaan</li>
</ol><div class="MsoNormal" style="line-height: 115%; margin-left: .25in;"><br />
</div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo1; text-indent: -.25in;"><b><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></b><b>Pelaksanaan</b></div><div class="MsoNormal" style="line-height: 115%;">Pelaksanaan dan uraian kegiatan sesuai macam terapi aktivitas kelompok dapat dilihat pada lampiran – lampiran.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in;"><br />
</div>himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-46355901113104692152012-09-05T06:31:00.000-07:002013-01-30T23:50:53.295-08:00ASUHAN KEPERAWATAN GAWAT DARURAT PADA KLIEN DENGAN NYERI DADA <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF/> <w:LidThemeOther>EN-US</w:LidThemeOther> <w:LidThemeAsian>X-NONE</w:LidThemeAsian> <w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> <w:SplitPgBreakAndParaMark/> <w:DontVertAlignCellWithSp/> <w:DontBreakConstrainedForcedTables/> <w:DontVertAlignInTxbx/> <w:Word11KerningPairs/> <w:CachedColBalance/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> <m:mathPr> <m:mathFont m:val="Cambria Math"/> <m:brkBin m:val="before"/> <m:brkBinSub m:val="--"/> <m:smallFrac m:val="off"/> <m:dispDef/> <m:lMargin m:val="0"/> <m:rMargin m:val="0"/> <m:defJc m:val="centerGroup"/> <m:wrapIndent m:val="1440"/> <m:intLim m:val="subSup"/> <m:naryLim m:val="undOvr"/> </m:mathPr></w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true"
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<span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span>PENGERTIAN <br />
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span>Nyeri dada adalah perasaan nyeri / tidak enak yang mengganggu daerah dada dan seringkali merupakan rasa nyeri yang diproyeksikan pada dinding dada (referred pain)</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span>Nyeri Coroner adalah rasa sakit akibat terjadinya iskemik miokard karena suplai aliran darah koroner yang pada suatu saat tidak mencukupi untuk kebutuhan metabolisme miokard.<br />
<a name='more'></a></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span>Nyeri dada akibat penyakit paru misalnya radang pleura (pleuritis) karena lapisan paru saja yang bisa merupakan sumber rasa sakit, sedang pleura viseralis dan parenkim paru tidak menimbulkan rasa sakit (Himawan, 1996)</div>
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<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span>ETIOLOGI</div>
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Nyeri Dada:</div>
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<span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span>Cardial</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Koroner</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Non Koroner</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level2 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span>Non Cardial</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Pleural</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Gastrointestinal</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Neural</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Psikogenik (Abdurrahman N, 1999)</div>
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<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";"> </span></span>TANDA DAN GEJALA</div>
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Tanda dan gejala yang biasa menyertai nyeri dada adalah :</div>
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<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Nyeri ulu hati</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Sakit kepala</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Nyeri yang diproyeksikan ke lengan, leher, punggung</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Diaforesis / keringat dingin</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Sesak nafas</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Takikardi</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Kulit pucat</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Sulit tidur (insomnia)</div>
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<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Mual, Muntah, Anoreksia</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Cemas, gelisah, fokus pada diri sendiri</div>
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<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Kelemahan</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Wajah tegang, m erintih, menangis</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Perubahan kesadaran</div>
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<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";"> </span></span>PEMERIKSAAN PENUNJANG</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level2 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span>EKG 12 lead selama episode nyeri</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Takhikardi / disritmia</div>
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<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Rekam EKG lengkap : T inverted, ST elevasi / depresi, Q Patologis</div>
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<span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span>Laboratorium</div>
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<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Kadar enzim jantung : CK, CKMB, LDH</div>
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<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Fungsi hati : SGOT, SGPT</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Fungsi Ginjal : Ureum, Creatinin</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l0 level3 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Profil Lipid : LDL, HDL</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level2 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span>Foto Thorax</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level2 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span>Echocardiografi</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level2 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span>Kateterisasi jantung</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-indent: -0.25in;">
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mso-style-qformat:yes;
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</style> <![endif]--><!--[if gte mso 9]><xml> <o:shapedefaults v:ext="edit" spidmax="1027"/> </xml><![endif]--><!--[if gte mso 9]><xml> <o:shapelayout v:ext="edit"> <o:idmap v:ext="edit" data="1"/> </o:shapelayout></xml><![endif]--> </div>
<table cellpadding="0" cellspacing="0"><tbody>
<tr><td bgcolor="white" height="40" style="background: white; vertical-align: top;" width="256"><span style="left: 0pt; mso-ignore: vglayout; position: absolute; z-index: 251651584;"></span><br />
<table cellpadding="0" cellspacing="0" style="width: 100%px;"><tbody>
<tr><td><br /></td> </tr>
</tbody></table>
</td> </tr>
</tbody></table>
PATHWAYS<br />
<br />
<div style="text-align: center;">
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<span style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Suplai O2 dan Nutrisi Jaringan menurun</span></div>
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<span style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Nyeri Dada</span></div>
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<br /></div>
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<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Asam Lactat meningkat</span></div>
<br />
<div style="text-align: left;">
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himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-38588114563422608012012-09-05T06:26:00.001-07:002012-09-05T06:34:02.874-07:00ASUHAN KEPERAWATAN SYOK <div class="Section1"><div class="MsoNormal" style="line-height: 115%;">Syok<span style="mso-spacerun: yes;"> </span>yaitu hambatan di dalam peredaran darah perifer yang menyebabkan perfusi jaringan tak cukup untuk memenuhi kebutuhan sel akan zat makanan dan membuang sisa metabolisme ( Theodore, 93 ),<span style="mso-spacerun: yes;"> </span>atau suatu<span style="mso-spacerun: yes;"> </span>perfusi jaringan yang kurang sempurna.<a name='more'></a></div><div class="MsoNormal" style="line-height: 115%; text-indent: .5in;">Perfusi organ secara langsung berhubungan dengan<span style="mso-spacerun: yes;"> </span>MAP yang ditentukan oleh volume darah, curah jantung dan ukuran vaskuler.</div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="height: 40px; left: 0px; margin-left: 281px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251655168;"><img height="40" src="file:///C:\DOCUME~1\Himz\LOCALS~1\Temp\msohtmlclip1\01\clip_image001.gif" v:shapes="_x0000_s1026" width="12" /></span>MAP<span style="mso-spacerun: yes;"> </span>menurun<span style="mso-spacerun: yes;"> </span>(5 – 10 mmHg )</div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">Aortic arc. dan Carotid sinus ( Baroreseptor )</div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="mso-ignore: vglayout; position: relative; z-index: 251656192;"><span style="height: 39px; left: 0px; left: 281px; position: absolute; top: -1px; width: 12px;"><img height="39" src="file:///C:\DOCUME~1\Himz\LOCALS~1\Temp\msohtmlclip1\01\clip_image002.gif" v:shapes="_x0000_s1027" width="12" /></span></span><o:p> </o:p></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><br />
</div><br clear="ALL" style="mso-ignore: vglayout;" /> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">Otak</div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="height: 39px; left: 0px; margin-left: 281px; margin-top: 16px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251658240;"><img height="39" src="file:///C:\DOCUME~1\Himz\LOCALS~1\Temp\msohtmlclip1\01\clip_image003.gif" v:shapes="_x0000_s1029" width="12" /></span>( Perfusi dan oksigenasi organ vital )</div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">Metabolisme anaerobic</div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="mso-ignore: vglayout;"> <table align="left" cellpadding="0" cellspacing="0"><tbody>
<tr> <td height="2" width="281"></td> </tr>
<tr> <td></td> <td><img height="39" src="file:///C:\DOCUME~1\Himz\LOCALS~1\Temp\msohtmlclip1\01\clip_image004.gif" v:shapes="_x0000_s1030" width="12" /></td> </tr>
</tbody></table></span><o:p> </o:p></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><br />
</div><br clear="ALL" style="mso-ignore: vglayout;" /> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">Asam laktat meningkat</div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">dan zat metabolic lain</div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="mso-ignore: vglayout;"> <table align="left" cellpadding="0" cellspacing="0"><tbody>
<tr> <td height="1" width="281"></td> </tr>
<tr> <td></td> <td><img height="39" src="file:///C:\DOCUME~1\Himz\LOCALS~1\Temp\msohtmlclip1\01\clip_image003.gif" v:shapes="_x0000_s1028" width="12" /></td> </tr>
</tbody></table></span><o:p> </o:p></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><br />
</div><br clear="ALL" style="mso-ignore: vglayout;" /> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">Kerusakan jaringan</div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">Depresi miocardial</div><div align="center" class="MsoNormal" style="line-height: 115%; margin-left: 4.0in; text-align: center;">(Guyton, 1986)</div><div align="center" class="MsoNormal" style="line-height: 115%; margin-left: 4.0in; text-align: center;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 4in; text-align: left;"><br />
</div></div><div class="MsoNormal" style="line-height: 115%; margin-left: 28.05pt; mso-list: l0 level1 lfo1; text-indent: -28.05pt;"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span>Stadium Kompensasi.</div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>MAP menurun 10 – 15 mmHg</div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Mekanisme kimia dan ginjal diaktifkan</div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Pelepasan rennin, ADH, aldosteron, katekolamin mengakibatkan GFR menurun dan urine output menurun, reabsorbsi Na meningkat – vasokonstriksi sistemik</div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Hipotensi jaringan organ non vital dan ginjal</div><div class="MsoNormal" style="line-height: 115%; margin-left: 28.05pt; mso-list: l0 level1 lfo1; text-indent: -28.05pt;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span>Stadium intermediate.</div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>MAP menurun lebih dari 20 mmHg</div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Kompensasi tak begitu lama untuk menyuplay oksigen</div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Hipoksia organ vital, organ lain mengalami anoxia, iskemik yang selanjutnya menyebabkan sel – sel jaringan rusak dan mati dan ini mengancam jiwa</div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Koreksi dalam 1 jam (golden hour)</div><div class="MsoNormal" style="line-height: 115%; margin-left: .75in;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 28.05pt; mso-list: l0 level1 lfo1; text-indent: -28.05pt;"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";"> </span></span>Irreversible Stage.</div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Anoxia jaringan dan kematian sel meningkat</div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Sel tersisa metabolisme<span style="mso-spacerun: yes;"> </span>anaerob</div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Terapi tidak efektif </div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoSubtitle" style="line-height: 115%;">ETIOLOGI</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; tab-stops: list .5in; text-indent: -.25in;"><span style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: Tahoma;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Tahoma","sans-serif";">Hipovolemik shock</span></div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>perdarahan</div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>kehilangan volume cairan</div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>perpindahan cairan dari vaskuler ke sel interstisial</div><ol start="2" style="margin-top: 0in;" type="1"><li class="MsoNormal" style="line-height: 115%; mso-list: l3 level1 lfo2; tab-stops: list .5in;"><span style="font-family: "Tahoma","sans-serif";">Cardiogenik shock</span></li>
</ol><div class="MsoNormal" style="line-height: 115%;">Gangguan kemampuan pompa jantung (cardiac arrest, aritmia, kelainan katup, degenerasi miokard, infeksi sistemik obat – obatan.</div><ol start="3" style="margin-top: 0in;" type="1"><li class="MsoNormal" style="line-height: 115%; mso-list: l3 level1 lfo2; tab-stops: list .5in;"><span style="font-family: "Tahoma","sans-serif";">Vasogenic shock</span></li>
</ol><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;"><span style="height: 12px; left: 0px; margin-left: 49px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 40px; z-index: 251660288;"><img height="12" src="file:///C:\DOCUME~1\Himz\LOCALS~1\Temp\msohtmlclip1\01\clip_image001.gif" v:shapes="_x0000_s1026" width="40" /></span>Penurunan tonus simpatic, vasodilatasi, peningkatan permiabilitas<span style="mso-spacerun: yes;"> </span>kapiler</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;"><span style="mso-spacerun: yes;"> </span>neurogenic, atau kimia (anaphylactic), nyeri berat, stress psikologis, kerusakan neurologis, obat kolinergik, agent alpha adrenergic blocker. </div><ol start="4" style="margin-top: 0in;" type="1"><li class="MsoNormal" style="line-height: 115%; mso-list: l3 level1 lfo2; tab-stops: list .5in;"><span style="font-family: "Tahoma","sans-serif";">Septic shock</span></li>
</ol><div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">Organisme penyebab gram negatif (P. aerogenosa, Escherichia coli, Klebseilla pneomoni, Staphylococcus, Streptococcus).</div><div class="MsoNormal" style="line-height: 115%;">Predisiposisi : malnutrisi, luka besar terbuka, iskemia saluran pencernaan (GI), imunosupresi.</div><div class="MsoNormal" style="line-height: 115%;">Interaksi host – toxin merangsang aktivitas komplemen systemic – perubahan organ mikrosirkulaisi, permiabilitas kapiler meningkat, injury sel, peningkatan metabolisme sel </div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%;">Tanda – tanda shock secara umum :</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; tab-stops: list .5in; text-indent: -.25in;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span>Keadaan umum lemah.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; tab-stops: list .5in; text-indent: -.25in;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span>Perfusi : kulit pucat, dingin, basah</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; tab-stops: list .5in; text-indent: -.25in;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span>Takikardi</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; tab-stops: list .5in; text-indent: -.25in;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span>Vena perifer tidak tampak</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; tab-stops: list .5in; text-indent: -.25in;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span>Tekanan darah menurun, sistolik kurang dari 90 mmHg atau turun lebih dari 50 mmHg dari tekanan semula.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; tab-stops: list .5in; text-indent: -.25in;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span>Hiperventilasi.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; tab-stops: list .5in; text-indent: -.25in;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span>Sianosis perifer.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; tab-stops: list .5in; text-indent: -.25in;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span>Gelisah, kesadaran menurun</div><div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l0 level3 lfo1; tab-stops: list .5in; text-indent: -.25in;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";"> </span></span>Produksi urine menurun</div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoSubtitle" style="line-height: 115%;">DIAGNOSA KEPERAWATAN</div><ol start="1" style="margin-top: 0in;" type="1"><li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo3; tab-stops: list .5in;"><span style="font-family: "Tahoma","sans-serif";">Fluid volume deficit <i>related to</i> blood loss.</span></li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo3; tab-stops: list .5in;"><span style="font-family: "Tahoma","sans-serif";">Decrease cardiac output <i>related to</i> decrease venous return</span></li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo3; tab-stops: list .5in;"><span style="font-family: "Tahoma","sans-serif";">Altered thought process <i>related to</i> decrease cerebral perfusion.</span></li>
</ol><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoSubtitle" style="line-height: 115%;">PERENCANAAN</div><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt; mso-list: l4 level1 lfo4; text-indent: -18.7pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span>Fluid volume deficit :</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt; mso-list: l4 level2 lfo4; text-indent: -18.7pt;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span>Terapi intravena (sesuai jenis shock) :</div><div class="MsoNormal" style="line-height: 115%; margin-left: 93.5pt; text-indent: -57.5pt;"><span style="mso-spacerun: yes;"> </span>Kristaloid (untuk mengembalikan cairan elektrolit) : <b><i>RL, ringer Acetat, Normosal</i></b></div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt; mso-list: l4 level2 lfo4; text-indent: -18.7pt;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span>Kolloid (untuk mengembalikan volume plasma dan mengembalikan tekanan osmotic)<span style="mso-spacerun: yes;"> </span>: <b><i>WB, PRC, plasma (plasmanat, dekstran, dll).</i></b></div><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt; mso-list: l4 level1 lfo4; text-indent: -18.7pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span>Decrease Cardiac Output</div><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt;">Tujuan intervensi :</div><ol start="2" style="margin-top: 0in;" type="1"><ol start="1" style="margin-top: 0in;" type="a"><li class="MsoNormal" style="line-height: 115%; mso-list: l4 level2 lfo4; tab-stops: list 1.0in;">Meningkatkan cairan vaskuler.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l4 level2 lfo4; tab-stops: list 1.0in;">Mendukung mekanisme kompensasi klien.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l4 level2 lfo4; tab-stops: list 1.0in;">Mencegah komplikasi iskemia.</li>
</ol></ol><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt;">Therapi obat :</div><ol start="3" style="margin-top: 0in;" type="1"><ol start="1" style="margin-top: 0in;" type="a"><li class="MsoNormal" style="line-height: 115%; mso-list: l1 level2 lfo3; tab-stops: list 1.0in;">Meningkatkan venous return.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level2 lfo3; tab-stops: list 1.0in;">Memperbaiki kontraksi miokard.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level2 lfo3; tab-stops: list 1.0in;">Menjamin perfusi miokard yang adekuat :</li>
</ol></ol><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-bidi-font-style: italic; mso-bidi-font-weight: bold;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span></span>Vasoconstrictor agent : <b><i>Dopamin, Epinephrine, NE, Vasopressin</i></b></div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Agen yang meningkatkan kontraksi mokard : <b><i>Dobutamin, Epinephrine, Iso proterenol.</i></b></div><div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l0 level2 lfo1; tab-stops: list 1.0in; text-indent: -.25in;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span>Agen yang menambah perfusi miokard :<b><i> Nitrogilserin, Nitropruside, Isosorbid dinitrat</i></b></div><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt;">Therapi Oksigen.</div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoSubtitle" style="line-height: 115%;">SHOCK PERDARAHAN DAN THERAPI HEMODILUSI</div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%;">Transportasi oksigen dilakukan dengan 3 (tiga) mekanisme (Preszma 1987, Abram, 1993)</div><div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level1 lfo5; tab-stops: list .75in; text-indent: -.25in;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span>Sistem pernapasan.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level1 lfo5; tab-stops: list .75in; text-indent: -.25in;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span>Sistem sirkulasi.</div><div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level1 lfo5; tab-stops: list .75in; text-indent: -.25in;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span>Sistem Oksihemoglobin (O<span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">2</span>Hb) dalam eritrosit dan transport ke sel jaringan.</div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt; mso-list: l2 level2 lfo5; text-indent: -18.7pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span>Sistem Pernapasan.</div><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt;">Pada perdarahan dan shock terjadi hipoxia stagnant : gangguan hipoxia anemic. Kadar oksigen dalam darah arterial (CaO<span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">2</span> ) mnurut rumus Nunn – Freeman adalah :</div><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt;"><span style="mso-tab-count: 1;"> </span><span style="font-family: "Tahoma","sans-serif";">CaO</span><span style="font-family: "Tahoma","sans-serif"; font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">2<span style="mso-spacerun: yes;"> </span></span><span style="font-family: "Tahoma","sans-serif";">=<span style="mso-spacerun: yes;"> </span>(Hb X saturasi O</span><span style="font-family: "Tahoma","sans-serif"; font-size: 9.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">2</span><span style="font-family: "Tahoma","sans-serif";"><span style="mso-spacerun: yes;"> </span>X<span style="mso-spacerun: yes;"> </span>1,34)<span style="mso-spacerun: yes;"> </span>+<span style="mso-spacerun: yes;"> </span>(PO</span><span style="font-family: "Tahoma","sans-serif"; font-size: 9.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">2</span><span style="font-family: "Tahoma","sans-serif";"> X<span style="mso-spacerun: yes;"> </span>0,003)</span></div><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>dengan harga normal akan didapat :</div><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt;"><span style="mso-tab-count: 1;"> </span><span style="font-family: "Tahoma","sans-serif";"><span style="mso-spacerun: yes;"> </span>=<span style="mso-spacerun: yes;"> </span>(15<span style="mso-spacerun: yes;"> </span>X<span style="mso-spacerun: yes;"> </span>100%<span style="mso-spacerun: yes;"> </span>X<span style="mso-spacerun: yes;"> </span>1,34)<span style="mso-spacerun: yes;"> </span>+<span style="mso-spacerun: yes;"> </span>(100<span style="mso-spacerun: yes;"> </span>X<span style="mso-spacerun: yes;"> </span>0,003)</span></div><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt;"><span style="font-family: "Tahoma","sans-serif";"><span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>=<span style="mso-spacerun: yes;"> </span>20,1<span style="mso-spacerun: yes;"> </span>+<span style="mso-spacerun: yes;"> </span>0,3<span style="mso-spacerun: yes;"> </span>=<span style="mso-spacerun: yes;"> </span><b>20,4 ml/100 ml darah</b></span></div><div class="MsoNormal" style="line-height: 115%; margin-left: 102.85pt; text-indent: -84.15pt;"><span style="mso-spacerun: yes;"> </span>penggunaan klinik unsure (PO<span style="font-size: 9.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">2</span><span style="mso-spacerun: yes;"> </span>X<span style="mso-spacerun: yes;"> </span>0,0003) diabaikan karena relatif kecil.</div><div class="MsoNormal" style="line-height: 115%; margin-left: 102.85pt; text-indent: -84.15pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 102.85pt; text-indent: -84.15pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 18.7pt; mso-list: l2 level2 lfo5; text-indent: -18.7pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span>Sistem Sirkulasi.</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt; mso-list: l2 level3 lfo5; text-indent: -21.75pt;"><span style="font-family: Webdings; mso-bidi-font-family: Webdings; mso-fareast-font-family: Webdings;"><span style="mso-list: Ignore;">–<span style="font: 7.0pt "Times New Roman";"> </span></span></span>Pada EBV yang beredar 65 – 75 ml/Kg</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt; mso-list: l2 level3 lfo5; text-indent: -21.75pt;"><span style="font-family: Webdings; mso-bidi-font-family: Webdings; mso-fareast-font-family: Webdings;"><span style="mso-list: Ignore;">–<span style="font: 7.0pt "Times New Roman";"> </span></span></span>Perdarahan 5 – 15 ml/Kg (20%) terjadi kompensasi : Tachicardi, kekuatan kontraksi miocard, vasokonstriksi di arterial dan vena. Vasokonstriksi berupaya mempertahankan<span style="mso-spacerun: yes;"> </span>tekanan perfusi untuk otak dan jantung sehingga jantung bekerja lebih berat mengatasi SVR</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;">Hubungan antara CO, frekwensi denyut dan stroke Volume (SV)</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;"><span style="mso-tab-count: 1;"> </span><span style="font-family: "Tahoma","sans-serif"; font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">CO = F x SV</span></div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;">SV dipengaruhi oleh EOV – C – SVR.</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;">Available O<sub>2</sub> = CO x C<sub>a</sub>O<sub>2</sub></div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt; mso-list: l2 level3 lfo5; text-indent: -21.75pt;"><span style="font-family: Webdings; mso-bidi-font-family: Webdings; mso-fareast-font-family: Webdings;"><span style="mso-list: Ignore;">–<span style="font: 7.0pt "Times New Roman";"> </span></span></span>Dalam keadaan normal (Hb. 15 g/dl, S<sub>a</sub>O<sub>2</sub> = 100 %, CO = 5 Liter</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;">Oksigen tersedia = 50 x 15 x 1 x 1,34 = 1005 ml/mnt</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt; mso-list: l2 level3 lfo5; text-indent: -21.75pt;"><span style="font-family: Webdings; mso-bidi-font-family: Webdings; mso-fareast-font-family: Webdings;"><span style="mso-list: Ignore;">–<span style="font: 7.0pt "Times New Roman";"> </span></span></span>Perdarahan ( Cardiac Ouput = 3 Liter)</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;">Oksigen tersedia = 30 x 15 x 1 x 1,34<span style="mso-spacerun: yes;"> </span>= 600 ml/mnt</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt; mso-list: l2 level3 lfo5; text-indent: -21.75pt;"><span style="font-family: Webdings; mso-bidi-font-family: Webdings; mso-fareast-font-family: Webdings;"><span style="mso-list: Ignore;">–<span style="font: 7.0pt "Times New Roman";"> </span></span></span>Hemodilusi<span style="mso-spacerun: yes;"> </span>= 50 x 10 x 1,34<span style="mso-spacerun: yes;"> </span>= 670 ml/mnt</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;">Compensasi<span style="mso-spacerun: yes;"> </span>= 75 x 10 x 1,34<span style="mso-spacerun: yes;"> </span>= 1005 ml/mnt</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;">Kompensasi hanya mungkin dalam keadaan normovolemia</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;">Tanda dan gejala :</div><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;"><br />
</div><table border="1" cellpadding="0" cellspacing="3" class="MsoNormalTable" style="border: outset 3.0pt; margin-left: 37.4pt; mso-border-insideh: .75pt outset windowtext; mso-border-insidev: .75pt outset windowtext; mso-cellspacing: 2.0pt; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 191;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 80.65pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">Perfusi</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 81.3pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">Hangat</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 80.2pt;" valign="top" width="107"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">pucat</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 81.15pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">Dingin </div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 67.8pt;" valign="top" width="90"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">Basah</div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 80.65pt;" valign="top" width="108"><div class="MsoNormal" style="line-height: 115%;">EBL</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 81.3pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><br />
</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 80.2pt;" valign="top" width="107"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">15 %</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 81.15pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">30 %</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 67.8pt;" valign="top" width="90"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">40 %</div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 80.65pt;" valign="top" width="108"><div class="MsoNormal" style="line-height: 115%;">Nadi</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 81.3pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">80</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 80.2pt;" valign="top" width="107"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">100</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 81.15pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">>120</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 67.8pt;" valign="top" width="90"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">>140</div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 80.65pt;" valign="top" width="108"><div class="MsoNormal" style="line-height: 115%;">T. Sistol</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 81.3pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">120</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 80.2pt;" valign="top" width="107"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">100</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 81.15pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">< 90</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 67.8pt;" valign="top" width="90"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><70</div></td> </tr>
<tr style="mso-yfti-irow: 4;"> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 80.65pt;" valign="top" width="108"><div class="MsoNormal" style="line-height: 115%;">Hilang</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 81.3pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><br />
</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 80.2pt;" valign="top" width="107"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">600</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 81.15pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">1200</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 67.8pt;" valign="top" width="90"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">2100</div></td> </tr>
<tr style="mso-yfti-irow: 5; mso-yfti-lastrow: yes;"> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 80.65pt;" valign="top" width="108"><div class="MsoNormal" style="line-height: 115%;">Infuse</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 81.3pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><br />
</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 80.2pt;" valign="top" width="107"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">1 – 2 L</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 81.15pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">2 – 4 L</div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 67.8pt;" valign="top" width="90"><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">4-6 L</div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 115%; margin-left: 37.4pt;"><br />
</div><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" /></span>himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-61787804228761089012012-09-05T06:21:00.001-07:002012-09-05T06:21:53.262-07:00KONSEP TEORI ASUHAN KEPERAWATAN GAWAT DARURAT PD PAYAH JANTUNG-ODEM PARU <div class="MsoNormal" style="line-height: 115%; margin-left: -17.0pt; mso-list: l0 level1 lfo1; tab-stops: list -16.0pt; text-indent: -17.0pt;">A.Konsep dasar</div><div class="MsoNormal" style="line-height: 115%;">Gagal nafas yang terjadi pada klien dengan hard heart failure merupakan suatu proses sistematis yang biasanya merupakan peristiwa yang panjang dan berakhir dengan kegagalan fungsi jantung yang memicu terjadinya bendungan pada paru sehingga terjadi "dead space" yang berakibat kegagalan ventilasi alveolar.<a name='more'></a>(Paul L.Marino 1991).<br />
<div class="MsoNormal" style="line-height: 115%;"> <div class="Section1"> <div class="MsoNormal" style="line-height: 115%; margin-left: -17.0pt; mso-list: l0 level1 lfo3; tab-stops: list -16.0pt; text-indent: -17.0pt;"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span>Pengkajian</div><div class="MsoNormal" style="line-height: 115%; margin-left: 0in; mso-list: l1 level1 lfo2; tab-stops: list 1.0pt; text-indent: -17.0pt;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span>Identitas:</div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 0in; mso-list: l1 level1 lfo2; tab-stops: list 1.0pt; text-indent: -17.0pt;"><i style="mso-bidi-font-style: normal;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></i>Keluhan utama<span style="mso-tab-count: 2;"> </span>: <i style="mso-bidi-font-style: normal;">Jantung berdebar-debar dan nafas sesak</i></div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 0in; mso-list: l1 level1 lfo2; tab-stops: list 1.0pt; text-indent: -17.0pt;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span>Riwayat keperawatan :</div><div class="MsoNormal" style="line-height: 115%;"><i style="mso-bidi-font-style: normal;">Klien merasakan jantungnya sering berdebar-debar dan nafas menjadi sesak dan terasa lelah jika beraktivitas.. Riwayat hipertensi, DM, Asthma, Riwayat MRS</i></div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 0in; mso-list: l1 level1 lfo2; tab-stops: list 1.0pt; text-indent: -17.0pt;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span>Data keperawatan</div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l2 level1 lfo1; tab-stops: list .25in; text-indent: -.25in;"><span style="mso-list: Ignore;">(a)<span style="font: 7.0pt "Times New Roman";"> </span></span>Sistem pernafasan</div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 19.6pt; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed; width: 564px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Data</b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Etiologi</b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Diagnose</b></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div class="MsoNormal" style="line-height: 115%; margin-left: 15.85pt; text-indent: -15.85pt;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">S : Sesak nafas sejak, pusing PaO2 < 95 % bertambah sesak jika bergerak atau kepala agak rendah, batuk (+) sekret berbuih, AGD tidak normal</span></div><div class="MsoNormal" style="line-height: 115%; margin-left: 15.85pt; text-indent: -15.85pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 15.85pt; text-indent: -15.85pt;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">O : RR >20 X/mnt, Rh , Wh , Retraksi otot pernafasan, produksi sekret banyak</span></div><div class="MsoNormal" style="line-height: 115%; margin-left: 15.85pt; text-indent: -15.85pt;"><br />
</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Dekompensasi<span style="mso-spacerun: yes;"> </span>ventrikel kiri</span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¯</span></span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Bendungan paru </span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">(odem paru)</span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div class="MsoNormal" style="line-height: 115%;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Resiko tinggi terjadi ketidakefektifan bersihan jalan nafas</span></div><div class="MsoNormal" style="line-height: 115%;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Resiko tinggi gangguan pertukaran gas berhubungan dengan adanya odem paru sekunder dekompensasi ventrikel kiri</span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%;">(b) Sistem kardiovaskuler</div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 19.6pt; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Data</b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Etologi</b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Diagnose</b></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div class="MsoNormal" style="line-height: 115%; margin-left: 15.85pt; text-indent: -15.85pt;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">S : Kepala pusing, jantung berdebar-debar, badan terasa lemah, kaki bengkak s</span></div><div class="MsoNormal" style="line-height: 115%; margin-left: 15.85pt; text-indent: -15.85pt;"><span style="height: 15px; left: 0px; margin-left: 89px; margin-top: 74px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251645440;"><img height="15" src="file:///C:\DOCUME~1\Himz\LOCALS~1\Temp\msohtmlclip1\01\clip_image001.gif" v:shapes="_x0000_s1026" width="2" /></span><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">O : Bendungan vena jugularis (+), S1S2 ireguler S3 (+), Ictus kordis pada pada<span style="mso-spacerun: yes;"> </span>iccs 5-6, bergeeser ke kiri, Acral dingin, keluar keringat dingin, Kap.refill > 1-2dt</span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Dekompensasi kordis</span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¯</span></span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">penurunan kontraktilitas jantung</span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¯</span></span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">penurunan tekanan darah</span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¯</span></span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Syok</span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¯</span></span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Ggn perfusi ke jaringan</span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><br />
</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div class="MsoNormal" style="line-height: 115%;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Ggn perfusi jaringan berhubungan dengan penurunan kotraktilitas jantung </span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%;">(c) Rasa aman</div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 19.6pt; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Data</span></b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Etiologi</span></b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Diagnosis</span></b></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div class="MsoNormal" style="line-height: 115%; margin-left: 14.2pt; text-indent: -14.2pt;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">S : Gelisah, mengeluh nyeri dan rasa tidak enak</span></div><div class="MsoNormal" style="line-height: 115%; margin-left: 14.2pt; text-indent: -14.2pt;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">O : Tidak tenang, ingin mencabut alat yang terpasang, </span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Persaan tidak enak kaena terpasang alat ventilator, </span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¯</span></span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">aktivitas tak terkontrol</span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¯</span></span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Resiko terjadi trauma</span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><br />
</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div class="MsoNormal" style="line-height: 115%;">Resiko terjadi trauma berhubungan dengan kegelisahan sebagai dampak pemasangan alat bantu nafas</div><div class="MsoNormal" style="line-height: 115%;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Cemas berhubungan dengan ancaman terhadap kematian</span></div></td> </tr>
<tr style="mso-yfti-irow: 2; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div class="MsoNormal" style="line-height: 115%; margin-left: 14.2pt; text-indent: -14.2pt;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">S<span style="mso-spacerun: yes;"> </span>: Gelisah, </span></div><div class="MsoNormal" style="line-height: 115%; margin-left: 15.85pt; text-indent: -15.85pt;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">O : Tidak tenang, ingin mencabut alat yang terpasang</span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Ruangan dengan berbagai alat</span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Suara monitor penyakit yg mengancam jiwa</span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¯</span></span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Lingkungan yang asing</span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¯</span></span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">cemas</span></div><div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><br />
</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 141.05pt;" valign="top" width="188"> <div class="MsoNormal" style="line-height: 115%;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Cemas berhubungan dengan ancaman kematian, situasi lingkungan perawatan dan disorientasi tempat.</span></div><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%;"><span style="font-size: 8.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Gangguan komunikasi verbal</span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: -17.0pt; mso-list: l0 level1 lfo3; tab-stops: list -16.0pt; text-indent: -17.0pt;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span>Rencana Tindakan</div><div class="MsoNormal" style="line-height: 115%;"><b style="mso-bidi-font-weight: normal;">Dx: Gangguan perfusi jaringan berhubungan dengan penurunan kontraktilitas otot jantung</b></div><div class="MsoNormal" style="line-height: 115%;"><b style="mso-bidi-font-weight: normal;">Tujuan : </b>Setelah dirawat selama 3X 24 jam T : 120/80, N : 88X/mnt, Urine 40-50 cc/jam, pusing hilang</div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 218.7pt;" valign="top" width="292"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Rencana Tindakan</b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 218.7pt;" valign="top" width="292"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Rasional</b></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 218.7pt;" valign="top" width="292"> <div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;">- Berikan posisi syok</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;">- Observasi vital sign (N : T : S ) dan kapilarri refill setiap jam</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;">- Kolaborasi:</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><span style="mso-spacerun: yes;"> </span>- Pemberian infus RL 28 tts/menit</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><span style="mso-spacerun: yes;"> </span>- Foto thorak</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><span style="mso-spacerun: yes;"> </span>- EKG</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><span style="mso-spacerun: yes;"> </span>- Lanoxin IV 1 ampul</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><span style="mso-spacerun: yes;"> </span>- Lasix 1 ampul</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><span style="mso-spacerun: yes;"> </span>- Observasi produksi urin dan balance cairan</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><span style="mso-spacerun: yes;"> </span>- Periksan DL</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 218.7pt;" valign="top" width="292"> <div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-align: left; text-indent: -9.8pt;">- Memenuhi kebutuhan pefusi otak</div><div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-align: left; text-indent: -9.8pt;">- Untuk mengetahui fungsi jantung dalam upaya mengetahui lebih awal jika terjadi gaguan perfusi</div><div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-align: left; text-indent: -9.8pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%;">- RL untuk memenuhi kebutuhan cairan intra vaskuler, mengatasi jika terjadi asidosis mencegah kolaps vena.</div><div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-align: left; text-indent: -9.8pt;">- Untuk memastikan aanatomi jantung dan melihat adanya edema paru.</div><div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-align: left; text-indent: -9.8pt;">- Untuk melihat gambaran fungai jantung</div><div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-align: left; text-indent: -9.8pt;">- Memperkuat kontraktilitas otot jantung</div><div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-align: left; text-indent: -9.8pt;">- Meningkatkan perfusi ginjal dan mengurangi odem</div><div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-align: left; text-indent: -9.8pt;">- Melihat tingkat perfusi dengan menilai optimalisasi fungsi ginjal.</div><div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-align: left; text-indent: -9.8pt;">- Untuk melihat faktor-faktor predisposisi peningkatan fungsi metabolisme klien sehingga terjadi peningkatan kerja jantung.</div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%;"><b style="mso-bidi-font-weight: normal;">Dx Resiko gangguan pertukaran gas</b></div><div class="MsoNormal" style="line-height: 115%;"><b style="mso-bidi-font-weight: normal;">Tujuan </b>: Setelah dirawat selama 3X24 jam RR : 18 X/mnt, sesak (-), BGA normal paO2 95-100 %</div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 218.7pt;" valign="top" width="292"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Rencana Tindakan</b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 218.7pt;" valign="top" width="292"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Rasionalisasi</b></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 218.7pt;" valign="top" width="292"> <div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;">- Lapangkan jalan nafas dengan mengektensikan kepala</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;">- Lakukan auskultasi paru</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;">- Lakukan<span style="mso-spacerun: yes;"> </span>suction jika ada sekret</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;">- Berikan O2 per kanul 6-10lt/mnt atau bantuan nafas dengan ventilator sesuai mode dan dosis yang telah ditetapkan.</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;">- Kolaborasi pemeriksaan</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><span style="mso-spacerun: yes;"> </span>- BGA dan SaO2</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.8pt; text-indent: -8.8pt;">- Orbservasi pernafasan observasi seting ventilator</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 218.7pt;" valign="top" width="292"> <div class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-indent: -9.8pt;">- Untuk meningkatkan aliran udara sehingga suply O2 optimal</div><div class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-indent: -9.8pt;">- Untuk mengetahui adanya sekret</div><div class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-indent: -9.8pt;">- Meningkatkan bersihan jalan nafas</div><div class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-indent: -9.8pt;">- Untuk meningkatkan saturasi O2 jaringan </div><div class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-indent: -9.8pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-indent: -9.8pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-indent: -9.8pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-indent: -9.8pt;">- Untuk mengetahui optimalisasi fungsi pertukaran gas pada paru</div><div class="MsoNormal" style="line-height: 115%; margin-left: 9.8pt; text-indent: -9.8pt;">- Untuk membantu fungsi pernafasan yang terganggu</div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 28.35pt; text-indent: -28.35pt;"><b style="mso-bidi-font-weight: normal;">Dx : Resiko terjadi ketidak efektifan bersihan jalan nafas berhubungan dengan<span style="mso-spacerun: yes;"> </span>tidak adanya reflek batuk dan produksi sekret yang banyak</b></div><div class="MsoNormal" style="line-height: 115%; margin-left: 28.35pt; text-indent: -28.35pt;"><b style="mso-bidi-font-weight: normal;">Tujuan <span style="mso-tab-count: 1;"> </span>: </b>Setelah dirawat tidak terjadi sumbatan jalan nafas, stridor (-), dyspnoe (-), sekret bersih</div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed; width: 590px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 189.7pt;" valign="top" width="253"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Tindakan</b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 253.1pt;" valign="top" width="337"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Rasionalisasi</b></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 189.7pt;" valign="top" width="253"> <div class="MsoNormal" style="line-height: 115%;">- Auskultasi bunyi nafas tiap 2 - jam</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Lakukan<span style="mso-spacerun: yes;"> </span>suction jika terdengar stridor/ ronchi sampai bersih.</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Pertahankan suhu humidifier 35-37,5 derajat</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Monitor status hidrasi klien</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Lakukan fisiotherapi nafas</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Kaji tanda-tanda vital sebelum dan setelah tindakan</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 253.1pt;" valign="top" width="337"> <div class="MsoNormal" style="line-height: 115%;">- Memantau keefektifan jalan nafas</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -8.75pt;">- Jalan nafas bersih, sehingga mencegah hipoksia, dan tidak terjadi infeksi nasokomial.</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -8.75pt;">- Membantu mengencerkan sekret</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -8.75pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -8.75pt;">- Mencegah sekret mengental</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -8.75pt;">- Memudahkan pelepasan sekret</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -8.75pt;">- Deteksi dini adanya kelainan</div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 115%; margin-left: 28.35pt; text-indent: -28.35pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 28.35pt; text-indent: -28.35pt;"><b style="mso-bidi-font-weight: normal;">Dx : Ketidakefektifan pola nafas berhubungan dengan dengan kelelahan, pengesetan ventilator yang tidak tepat, obstruksi ETT</b></div><div class="MsoNormal" style="line-height: 115%; margin-left: 56.7pt; text-indent: -56.7pt;"><b style="mso-bidi-font-weight: normal;">Tujuan<span style="mso-tab-count: 1;"> </span>: </b>Setelah dirawat nafas sesuai dengan irama ventilator, volume nafas adekuat, alarm tidak berbunyi</div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 196.8pt;" valign="top" width="262"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Rencana Tindakan</b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 246.0pt;" valign="top" width="328"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Rasionalisasi</b></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 196.8pt;" valign="top" width="262"> <div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Lakukan pemeriksaan ventilator tiap 1-2 jam</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Evaluasi semua ventilator dan tentukan penyebabnya</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Pertahankan alat resusitasi bag & mask pada posisi TT sepanjang waktu</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Evaluasi tekanan<span style="mso-spacerun: yes;"> </span>atau kebocoran balon cuff</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Masukka penahan gigi</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Amankan selang ETT dengan fiksasi yg baik</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Monitor suara nafas dan pergerakan dada</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 246.0pt;" valign="top" width="328"> <div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -7.1pt;">- Deteksi dini adanya kelainan pada vntilator</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -7.1pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -7.1pt;">- Bunyi alarm pertanda ggn fungsi ventilator</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -7.1pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -7.1pt;">-Mempermudah melakukan pertolongan jika sewaktu[waktu ada gangguan fungsi ventilator.</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -7.1pt;">- Mencegah berkurangnya aliran udara nafas</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -7.1pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -7.1pt;">- Mencegah tergigitnya selang ETT</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -7.1pt;">- Mencegah selang ETT tercabut</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -7.1pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -7.1pt;">- Evaluasi keefektifan pola nafas</div><div class="MsoNormal" style="line-height: 115%; margin-left: 8.75pt; text-indent: -7.1pt;"><br />
</div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 115%; margin-left: 28.35pt; text-indent: -28.35pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%;"><b style="mso-bidi-font-weight: normal;">Dx : Resiko terjadi trauma berhubungan dengan kegelisahan sebagai efek pemasangan alat bantu nafas</b></div><div class="MsoNormal" style="line-height: 115%; margin-left: 35.45pt; text-indent: -35.45pt;">Tujuan : </div><div class="MsoNormal" style="line-height: 115%; margin-left: 35.45pt;">Setelah dirawat klien tidak mengalami iritasi pd jalan nafas, tidak terjadi barotrauma, tidak terjadi keracunan O2, tidak terjadi infeksi saluran nafas, suhu tubuh 36,5-37 derajat celcius</div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Tindakan</b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Rasionalisasi</b></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"> <div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Orientasikan klien tentang alat perawatan yang digunakan</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Jika perlu lakukan fiksasi</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Rubah posisi setiap 2 jam</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Yakinkan nafas klien sesuai dengan irama vetilator</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Obsevasi tanda dan gejala barotrauma</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Kolaborasi penggunaan sedasi</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Evaluasi warna dan bau sputum</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Lakukan<span style="mso-spacerun: yes;"> </span>oral hygiene setiap hari</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Ganti slang tubing setiap 24-72 jam</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Kolaborasi pemberian antibiotika</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"> <div class="MsoNormal" style="line-height: 115%;">- Agar klien memahami peran dan fungsi serta sikap yang harus dilakukan<span style="mso-spacerun: yes;"> </span>klien</div><div class="MsoNormal" style="line-height: 115%; margin-left: 5.4pt; text-indent: -5.4pt;">- Untuk mencegah trauma</div><div class="MsoNormal" style="line-height: 115%; margin-left: 5.4pt; text-indent: -5.4pt;">- Untuk mencegah timbulnya trauma akibat penekanan yang terus menerus pada satu tempat.</div><div class="MsoNormal" style="line-height: 115%; margin-left: 5.4pt; text-indent: -5.4pt;">- Mencegah fighting sehingga trauma bisa dicegah</div><div class="MsoNormal" style="line-height: 115%; margin-left: 5.4pt; text-indent: -5.4pt;">- Untuk deteksi dini</div><div class="MsoNormal" style="line-height: 115%; margin-left: 5.4pt; text-indent: -5.4pt;">- Untuk mencegah<span style="mso-spacerun: yes;"> </span>fighting</div><div class="MsoNormal" style="line-height: 115%; margin-left: 5.4pt; text-indent: -5.4pt;">- Monitor dini terjadini infeksi skunder</div><div class="MsoNormal" style="line-height: 115%; margin-left: 5.4pt; text-indent: -5.4pt;">- Mencegah infeksi skunder</div><div class="MsoNormal" style="line-height: 115%; margin-left: 5.4pt; text-indent: -5.4pt;">- Menjamin selang ventilator steril</div><div class="MsoNormal" style="line-height: 115%; margin-left: 5.4pt; text-indent: -5.4pt;">- Sebagai profilaksis</div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%;"><b style="mso-bidi-font-weight: normal;">Dx : Cemas berhubungan dengan disorientasi ruangan dan ancaman akan kematian</b></div><div class="MsoNormal" style="line-height: 115%;"><b style="mso-bidi-font-weight: normal;">Tujuan : </b>Setelah dirawat kien kooperatif, tidak gelisah dan tenang</div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border-bottom: none; border: solid windowtext 1.0pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Tindakan</b></div></td> <td style="border-bottom: none; border-left: none; border-right: solid windowtext 1.0pt; border-top: solid windowtext 1.0pt; mso-border-left-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"> <div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;"><b style="mso-bidi-font-weight: normal;">Rasional</b></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"> <div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Lakukan komunikasi terapeutik</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Berikan orientasi ruangan</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Dorong klien agar mengepresikan perasaannya</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Berikan suport mental</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Berikan keluarga mengunjungi pada saat-saat tertentu</div><div class="MsoNormal" style="line-height: 115%; margin-left: 7.1pt; text-indent: -7.1pt;">- Berikan informasi realistis sesuai dengan tingkat pemahaman klien</div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"> <div class="MsoNormal" style="line-height: 115%; margin-left: 12.5pt; text-indent: -12.5pt;">- Membinan hubungan saling percaya</div><div class="MsoNormal" style="line-height: 115%; margin-left: 12.5pt; text-indent: -12.5pt;">- Mengurangi stress adaptasi</div><div class="MsoNormal" style="line-height: 115%; margin-left: 12.5pt; text-indent: -12.5pt;">- Menggali perasaan dan masalah klien</div><div class="MsoNormal" style="line-height: 115%; margin-left: 12.5pt; text-indent: -12.5pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-left: 12.5pt; text-indent: -12.5pt;">- Mengurangi cemas dan meningkatkan daya tahan klien</div><div class="MsoNormal" style="line-height: 115%; margin-left: 12.5pt; text-indent: -12.5pt;">- Untuk meningkatkan semangat dan motivasi</div><div class="MsoNormal" style="line-height: 115%; margin-left: 12.5pt; text-indent: -12.5pt;">- Agar klien memahami<span style="mso-spacerun: yes;"> </span>tujuan perawatan yang dilakukan.</div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 115%;"><br />
</div><div class="MsoNormal" style="line-height: 115%;">Daftar pustaka :</div><div class="MsoNormal" style="line-height: 115%;">Marini L. Paul (1991) <i style="mso-bidi-font-style: normal;">ICU Book</i>, Lea & Febriger, Philadelpia</div><div class="MsoNormal" style="line-height: 115%;">Tabrani (1998), <i style="mso-bidi-font-style: normal;">Agenda Gawat Darurat</i>, Pembina Ilmu, Bandung</div><div class="MsoNormal" style="line-height: 115%;">Carpenitto (1997) <i style="mso-bidi-font-style: normal;">Nursing Diagnosis</i>, J.B Lippincott, Philadelpia</div><div class="MsoNormal" style="line-height: 115%;">Hudack & Galo (1996), <i style="mso-bidi-font-style: normal;">Perawatan Kritis</i>; Pendekatan Holistik, EGC , <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city></div></div><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" /></span></b> <div class="MsoNormal" style="line-height: 115%;"><span style="mso-ignore: vglayout;"> <table align="left" cellpadding="0" cellspacing="0"><tbody>
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</div></div>himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-21304342138854668562012-09-05T03:36:00.003-07:002012-12-12T20:50:12.635-08:00LAPORAN PENDAHULUAN ANGINA PECTORIS<!--[if gte mso 9]><xml>
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<br />
<div align="center" class="MsoNormal" style="tab-stops: dotted 396.9pt blank 423.0pt right 425.25pt; text-align: center;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">BAB I</span></b><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 115%;"></span></div>
<div align="center" class="MsoNormal" style="mso-margin-bottom-alt: auto; text-align: center;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">PENDAHULUAN</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.5pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; mso-list: l12 level2 lfo1; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: -19.5pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">1.1<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Latar Belakang </span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.5pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-spacerun: yes;"> </span>Dewasanya suatu pola hidup yang tidak
sehat tentunya akan menimbulkan berbagai macam permasalahan kesehatan. Utamanya
bagi sistem kardiovaskuler. Keluhan utama yang sering terjadi pada gangguan
sistem kardiovaskuler ialah nyeri dada, berdebar-debar dan sesak napas. Keluhan
tambahan</span><br />
<a name='more'></a>lainnya yang mungkin menyertai keluhan utama, ialah perasaan cepat
lelah, kemampuan fisik menurun dan badan sering terasa lemas, perasaan seperti
mau pingsan (fainting) atau sinkope, kaki rasa berat atau membengkak, perut
kembung atau membuncit disertai kencing yang berkurang, kadang-kadang terlihat
kebiruan <span style="mso-spacerun: yes;"> </span>( cyanotic spells ), batuk atau
hemoptisis dengan dahak yang kemerahan, sering berkeringat dingin dan lemas
dengan perasaan tidak enak pada perut bagian atas.</div>
<br />
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-spacerun: yes;"> </span>Salah satu jenis gangguan pada sistem
kardiovaskuler yang dibahas dalam makalah ini yakni angina pectoris. Angina
pectoris ialah suatu sindrom klinis dimana terjadi sakit dada yang khas, yaitu
seperti tertekan atau terasa berat di dada yang sering menjalar ke lengan kiri.
Sakit dada tersebut biasanya timbul pada waktu melakukan aktivitas dan segera
menghilang bila pasien beristirahat.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: 22.5pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-spacerun: yes;"> </span>Oleh karena
itu sebagai calon seorang perawat professional diharapkan mampu mengerti serta
melaksanakan asuhan keperawatan yang tepat pada pasien dengan berdasarkan
etiologi atau faktor-faktor yang berkaitan dengan penyakit tersebut. Sesuai
dengan konsep yang sudah ada yakni pengkajian, diagnosa, perencanaan,
pelaksanaan, dan evaluasi.</span></div>
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<br /></div>
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<br /></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.5pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; mso-list: l12 level2 lfo1; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: -19.5pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">1.2<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Rumusan Masalah</span></b></div>
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<br /></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Adapun
rumusan masalahnya adalah sebagai berikut :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">1.Apakah
pengertian dari Angina Pektoris ?</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">1.
Ada berapakah jenis Angina Pektoris?</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">3.
Apa etiologi dari Angina Pektoris?</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">4.
Bagaimanakah manifestasi klinis dari Angina Pektoris ?</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">5.
Apa saja pemeriksaan penunjang dari Angina Pektoris ?</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">6.
Bagaimanakah asuhan keperawatan dari Angina Pektoris ?</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">1.3<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Tujuan</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">1
Mengerti Pengertian dari Angina Pektoris</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2
Menjelaskan Jenis dari Angina Pektoris</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">3
Menjelaskan Etiologi dari Angina Pektoris</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">4
Menjelaskan Manifestasi Klinis dari Angina Pektoris</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">5
Menjelaskan Pemeriksaan Penunjang dari Angina Pektoris</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">6
Menjelaskan Asuhan Keperawatan dari Angina Pektoris</span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">BAB
II</span></b><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman";"></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">PEMBAHASAN</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2.1 Pengertian</span></b></div>
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<span style="color: red; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Angina pektoris adalah suatu sindroma
kronis dimana klien mendapat serangan sakit dada di daerah sternum atau di
bawah sternum (substernal) atau dada sebelah kiri yang khas, yaitu seperti
ditekan, atau terasa berat di dada yang seringkali menjalar ke lengan kiri,
kadang-kadang dapat menjalar ke punggung, rahang, leher atau ke lengan kanan</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">.
Sakit dada tersebut biasanya timbul pada waktu pasien melakukan aktivitas dan
segera hilang bila pasien menghentikan aktivitasnya. (Prof. Dr.H.M.Sjaifoellah
Noer,1996).</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Sakit dada pada angina pektoris disebabkan karena timbulnya
iskemia miokard, karena suplai darah dan oksigen ke miokard berkurang. Serangan
sakit dada biasanya berlangsung 1 sampai 5 menit, bila sakit dada terus
berlangsung lebih dari 20 menit, mungkin pasien mendapat serangan infark
miokard akut dan bukan disebabkan angina pektoris biasa. Pada pasien angina
pektoris dapat pula timbul keluhan lain seperti <span style="color: red;">sesak
napas</span>, <span style="color: #1f497d;">perasaan kadang-kadang sakit dada
disertai keringat dingin</span></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Angina pektoris adalah suatu istilah yang digunakan
untuk menggambarkan jenis rasa tidak nyaman yang biasanya terletak dalam daerah
retrosternum. (Penuntun Praktik Kardiovaskuler)</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2.2 ETIOLOGI</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Faktor
penyebab Angina Pektoris antara lain:</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">1.
Ateriosklerosis</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2.
Spasmearterikoroner</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">3.
Anemia berat</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">4.
Artritis</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">5.
Aorta Insufisiensi</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2.3 MANIFESTASI <span style="mso-spacerun: yes;"> </span>KLINIS</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Iskemia otot jantung akan memberi nyeri dengan
derajat yang bervariasi, mulai dari rasa tertekan pada dada sampai nyeri hebat
yang disertai dengan rasa takut atau rasa akan menjelang ajal. Nyeri sangat
terasa pada di daerah belakang sternum atas atau sternum ketiga tengah
(retrosentral). Meskipun rasa nyeri biasanya terlokalisasi, namun nyeri
tersebut dapat menyebar ke leher, dagu, bahu, dan aspek dalam ekstremitas atas.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Pasien biasanya memperlihatkan rasa sesak, tercekik,
dengan kualitas yang terus menerus. Rasa lemah atau baal di lengan atas,
pergelangan tangan, dan tangan akan menyertai rasa nyeri. Selama terjadi nyeri
fisik, pasien mungkin akan merasa akan meninggal. Karakteristik utama nyeri
tersebut akan berkurang apabila faktor presipitasinya dihilangkan.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2.4 PATOFISIOLOGI</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Mekanisme timbulnya angina pektoris didasarkan pada
ketidakadekuatan suplay oksigen ke sel-sel miokardium yang diakibatkan karena <span style="color: red;">kekauan arteri</span> dan <span style="color: #00b050;">penyempitan
lumen arteri koroner (ateriosklerosis koroner).</span> Tidak diketahui secara
pasti apa penyebab ateriosklerosis, namun jelas bahwa tidak ada faktor tunggal
yang bertanggungjawab atas perkembangan ateriosklerosis. Ateriosklerosis
merupakan penyakit arteri koroner yang paling sering ditemukan. Sewaktu beban
kerja suatu jaringan meningkat, maka kebutuhan oksigen juga meningkat. <span style="color: #7030a0;">Apabila kebutuhan meningkat pada jantung yang sehat maka
artei koroner berdilatasi dan megalirkan lebih banyak darah dan oksigen ke otot
jantung</span>. Namun apabila arteri koroner mengalami kekauan atau menyempit
akibat ateriosklerosis dan tidak dapat berdilatasi sebagai respon terhadap
peningkatan kebutuhan akan oksigen, maka terjadi iskemik (kekurangan suplai
darah) miokardium.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Adanya endotel yang cedera mengakibatkan hilangnya
produksi No (nitrat Oksido yang berfungsi untuk menghambat berbagai zat yang
reaktif. Dengan tidak adanya fungsi ini dapat menyababkan otot polos
berkontraksi dan timbul spasmus koroner yang memperberat penyempitan lumen
karena suplai oksigen ke miokard berkurang. Penyempitan atau blok ini belum
menimbulkan gejala yang begitu nampak bila belum mencapai 75 %. Bila
penyempitan lebih dari 75 % serta dipicu dengan aktifitas berlebihan maka
suplai darah ke koroner akan berkurang. Sel-sel miokardium menggunakan <span style="color: #7030a0;">glikogen anaerob</span> untuk memenuhi kebutuhan energi
mereka. Metabolisme ini menghasilkan asam laktat yang menurunkan pH miokardium
dan menimbulkan nyeri. Apabila kebutuhan energi sel-sel jantung berkurang, maka
suplai oksigen menjadi adekuat dan sel-sel otot kembali fosforilasi oksidatif
untuk membentuk energi. Proses ini tidak menghasilkan asam laktat. Dengan
hilangnya asam laktat nyeri akan reda.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Sejumlah
faktor yang dapat menimbulkan nyeri angina:</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">1.
Latihan fisik dapat memicu serangan dengan cara meningkatkan kebutuhan oksigen
jantung.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2.
Pajanan terhadap dingin dapat mengakibatkan vasokontriksi dan peningkatan
tekanan darah, disertai peningkatan kebutuhan oksigen.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">3.
Makan makanan berat akan meningkatkan aliran darah ke daerah mesentrik untuk
pencernaan, sehingga menurunkan ketersediaan darah unuk supai jantung.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">4.
Stress atau berbagai emosi akibat situasi yang menegangkan, menyebabkan
frekuensi jantung meningkat, akibat pelepasan adrenalin dan meningkatnya
tekanan darah dengan demikian beban kerja jantung juga meningkat.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2.5 TIPE ANGINA</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">1.
Angina Pektoris Stabil</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Disebut
juga angina klasik, terjadi jika arteri koroner yang arterosklerotik tidak
dapat berdilatasi untuk meningkatkan alirannya sewaktu kebutuhan oksigen
meningkat. Peningkatan kerja jantung dapat menyertai aktivitas misalnya berolah
raga atau naik tangga.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-spacerun: yes;"> </span>Berkaitan dengan latihan atau aktifitas yang
meningkatkan kebutuhan oksigen niokard.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Nyeri
segera hilang dengan istirahat atau penghentian aktifitas.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Durasi
nyeri 3 – 15 menit.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2.
Angina Pektoris Tidak Stabil (Angina pra infark; Angina kresendo)</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Adalah
kombinasi angina stabil dengan angina prinzmetal, dijumpai pada individu dengan
perburukan penyakit arteri koroner. Angina ini biasanya menyertai peningkatan
beban kerja jantung. Hal ini tampaknya terjadi akibat arterosklerosis koroner,
yang ditandai oleh trombus yang tumbuh dan mudah mengalami spasme.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Durasi
serangan dapat timbul lebih lama dari angina pektoris stabil.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Pencetus
dapat terjadi pada keadaan istirahat atau pada tigkat aktifitas ringan.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Kurang
responsif terhadap nitrat.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Lebih
sering ditemukan depresisegmen ST.</span></div>
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disebabkan oleh ruptur plak aterosklerosis, spasmus, trombus atau trombosit
yang beragregasi.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">3.
Angina Prinzmental (Angina Varian: Istrahat)</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Angina
yang terjadi karena spasme arteri koronaria. Berhubungan dengan risiko tinggi
terjadinya infark.</span></div>
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dada atau nyeri timbul pada waktu istirahat, seringkali pagi hari.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Nyeri
disebabkan karena spasmus pembuluh koroneraterosklerotik.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">EKG
menunjukkan elevasi segmen ST.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Cenderung
berkembang menjadi infark miokard akut.</span></div>
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terjadi aritmia.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">4.
Angina Nokturnal</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Nyeri
terjadi saat malam hari,biasanya saat tidur dan dapat dikurangi dengan duduk
tegak. Biasanya akibat gagal ventrikel kiri.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">5.
Angina Refrakter atau Intraktabel</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Angina yang sangat berat sampai tidak tertahankan.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">6.
Angina Dekubitus</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Angina saat berbaring.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">7.
Iskemia tersamar</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Terdapat
bukti obyektif iskemia (seperti tes pada stress) tetapi pasien tidak
menunjukkan gejala.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2.6 PEMERIKSAAN PENUNJANG</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">•
Elektrokardiogram</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Gambaran
elektrokardiogram (EKG) yang dibuat pada waktu istirahat dan bukan pada waktu
serangan angina seringkali masih normal. Gambaran EKG kadang-kadang menunjukkan
bahwa pasien pernah mendapat infark miokard pada masa lampau. Kadang-kadang EKG
menunjukkan pembesaran ventrikel kiri pada pasien hipertensi dan angina.
Kadang-kadang EKG menunjukkan perubahan segmen ST dan gelombang T yang tidak
khas. Pada waktu serangan angina, EKG akan menunjukkan adanya depresi segmen ST
dan gelombang T menjadi negatif.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">•
Foto Rontgen Dada</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Foto
rontgen dada seringkali menunjukkan bentuk jantung yang normal, tetapi pada
pasien hipertensi dapat terlihat jantung yang membesar dan kadang-kadang tampak
adanya kalsifikasi arkus aorta.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">•
Pemeriksaan Laboratorium</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Pemeriksaan
laboratorium tidak begitu penting dalam diagnosis angina pectoris. Walaupun
demikian untuk menyingkirkan diagnosis infark miokard jantung akut maka sering
dilakukan pemeriksaan enzim CPK, SGOT, atau LDH. Enzim tersebut akan meninggi
pada infark jantung akut sedangkan pada angina kadarnya masih normal.
Pemeriksaan lipid darah seperti kadar kolesterol, HDL, LDL, dan trigliserida
perlu dilakukan untuk menemukan faktor resiko seperti hiperlipidemia dan
pemeriksaan gula darah perlu dilakukan untuk menemukan diabetes mellitus yang
juga merupakan faktor risiko bagi pasien angina pectoris.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">•
Uji Latihan Jasmani</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Karena
pada angina pectoris gambaran EKG seringkali masih normal, maka seringkali
perlu dibuat suatu ujian jasmani. Pada uji jasmani tersebut dibuat EKG pada
waktu istirahat lalu pasien disuruh melakukan latihan dengan alat treadmill
atau sepeda ergometer sampai pasien mencapai kecepatan jantung maksimal atau
submaksimal dan selama latihan EKG di monitor demikian pula setelah selesai EKG
terus di monitor. Tes dianggap positif bila didapatkan depresi segmen ST
sebesar 1 mm atau lebih pada waktu latihan atau sesudahnya. Lebih-lebih bila
disamping depresi segmen ST juga timbul rasa sakit dada seperti pada waktu
serangan, maka kemungkinan besar pasien memang menderita angina pectoris.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Di
tempat yang tidak memiliki treadmill, test latihan jasmani dapat dilakukan
dengan cara Master, yaitu latihan dengan naik turun tangga dan dilakukan
pemeriksaan EKG sebelum dan sesudah melakukan latihan tersebut.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">•
Thallium Exercise Myocardial Imaging</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Pemeriksaan
ini dilakukan bersama-sama ujian latihan jasmani dan dapat menambah sensifitas
dan spesifitas uji latihan.thallium 201 disuntikkan secara intravena pada
puncak latihan, kemudian dilakukan pemeriksaan scanning jantung segera setelah
latihan dihentikan dan diulang kembali setelah pasien sehat dan kembali normal.
Bila ada iskemia maka akan tampak cold spot pada daerah yang yang menderita
iskemia pada waktu latihan dan menjadi normal setelah pasien istirahat.
Pemeriksaan ini juga menunjukkan bagian otot jantung yang menderita iskemia.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2.7 TERAPI FARMAKOLOGI</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Nitrogliserin.
Senyawa nitrat masih merupakan obat utama untuk menangani angina pektoris.
Nitrogengliserin diberikan untuk menurunkan konsumsi jantung yang akan
mengurangi iskemia dan mengurangi nyeri angina.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Nitrogliserin
adalah bahan vasoaktif yang berfungsi melebarkan baik vena maupun arteria
sehingga mempengaruhi sirkulasi parifer dengan pelebaran vena terjadi
penggumpalan darah vena di seluruh tubuh. Akibatnya hanya sedikit darah yang
kembali ke jantung dan terjadilah penurunan tekanan pengisian (preload). Nitrat
juga melepaskan arteriol sistemik dan menyebabkan penurunan tekanan darah
(penurunan afterload). Semua itu berakibat pada penurunan oksigen pada jantung,
menciptakan suatu keadaan yang lebih seimbang antara suplay dan kebutuhan.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Efek
samping nitrogliserin meliputi sakit kepala berdenyut, hipertensi, dan
takikardi. Penggunaan preparat nitrat long-acting masih diperdebatkan. Isrobid
dinitrat (isordil) tampaknya efeksamping 2 jam bila digunakan di bawah lidah,
tapi efeknya tidak jelas bila diminum peroral.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Salep
Nitrogliserin Topikal. Nitrogliserin juga tersedia dalam bentuk
Lnilin-petrolatum. Bentuk ini dioleskan di kulit sebagai perlindungan terhadap
nyeri angina dan mengurangi nyeri. Bentuk ini sangat berguna bila digunakan
pada pasien yang mengalami angina pada malam hari atau yang menjalankan
aktivitas dalam waktu yang cukup lama (misal main golf) karena mempunyai efek
jangka panjang sampai 24 jam. Biasanya dosis ditingkatkan sampai sakit kepala
atau efek berat terhadap tekanan darah atau tekanan jantung, kemudian diturunka
sampai dosis tertinggi yang tidak menimbulkan efek samping tersebut. Cara
pemakaian salep biasanya dilampirkan pada kemasan. Pasien diingatkan untuk
mengganti tempat yang akan dioleskan salep untuk mencegah iritasi kulit.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2.8 PENATALAKSANAAN</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Tujuan
penatalaksanaan medis angina adalah untuk menurunkan kebutuhan oksigen jantung
dan untuk meningkatkan suplai oksigen. Secara medis tujuan ini dicapai melalui
terapi farmakologi dan kontrol terhadap faktor risiko. Secara bedah tujuan ini
dapat dicapai melalui revaskularisasi suplai darah jantung melalui bedah pintas
arteri koroner atau angiosplasti koroner transluminar perkutan (PCTA =
percutaneous transluminal coronary angioplasty). Biasanya diterapkan kombinasi
antara terapi medis dan pembedahan.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Tiga
teknik utama yang menawarkan penyembuhan bagi klien dengan penyakit arteri
koroner mencakup penggunaan alat intrakoroner untuk meningkatkan aliran darah,
penggunaan laser untuk menguapkan plak dan endarterektomi koroner perkutan
untuk mengangkat obstruksi. Penelitian yang bertujuan untuk membandingkan hasil
akhir yang dicapai oleh salah satu atau seluruh teknik di atas, melalui bedah
pintas koroner dan PTCA sedang dilakukan. Ilmu pengetahuan terus dikembangkan
untuk mengurangi gejala dan kemunduran proses angina yang diderita pasien.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">BAB III</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">PROSES KEPERAWATAN</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Asuhan
Keperawatan pada Pasien dengan Angina Pektoris</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">3.1 Pengkajian</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Perawat
mengumpulkan informasi tentang seluruh segi aktivitas pasien, terutama mereka
yang ditemukan beresiko mengalami serangan jantung atau nyeri angina.
Pertanyaan yang sesuai mencakup:</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Kapan
cenderung terjadi serangan? Setelah makan? Setelah melakukan aktivitas tertentu?
Setelah melakukan aktivitas secara umum? Setelah mengunjungi anggota keluarga
atau teman-teman?</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Bagaimana
pasien menggambarkan nyerinya?</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Apakah
awitan nyeri mendadak atau bertahap?</span></div>
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hal itu terjadi dalam berapa detik? Menit? Jam?</span></div>
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kualitas nyeri menetap atau terus-menerus?</span></div>
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rasa nyaman disertai dengan gejala seperti perspirasi yang berlebihan, sedikit
sakit kepala, mual, palpitasi dan napas pendek?</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Berapa
menit nyeri berlangsung setelah minum notrogliserin?</span></div>
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nyeri berkurang ?</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">3.2 Diagnosa Keperawatan</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Berdasarkan
pada data pengkajian, diagnosa keperawatan utama untuk klien ini mencakup yang
berikut:</span></div>
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berhubungan dengan iskemia miokardium</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Cemas
berhubungan dengan rasa takut akan kematian</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Kurang
pengetahuan tentang sifat dasar penyakit dan metode untuk menghindari
komplikasi</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Potensial
terjadi ketidakpatuhan terhadap terapuitik berhubuangan dengan tidak mau
menerima perubahan pola hidup yang sesuai.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Intoleransi
aktifitas berhubungan dengan berkurangnya curah jantung.</span></div>
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<br /></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">3.3 Intervensi dan Implementasi</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Tujuan
utama mencakup mencegah nyeri, mengurangi cemas, menghindari salah paham
terhadap sifat dasar penyakit dan perawatan yang diberika, mematuhi program
perawatan diri dan mencegah komplikasi.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Nyeri berhubungan dengan iskemia
miokardium</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Intervensi :</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Kaji
gambaran dan faktor-faktor yang memperburuk nyeri.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Letakkan
klien pada istirahat total selama episode angina (24-30 jam pertama) dengan
posisi semi fowler.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Observasi
tanda vital tiap 5 menit setiap serangan angina.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Ciptakanlingkunan
yang tenang, batasi pengunjung bila perlu.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Berikan
makanan lembut dan biarkan klien istirahat 1 jam setelah makan.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Tinggal
dengan klien yang mengalami nyeri atau tampak cemas.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Ajarkan
tehnik distraksi dan relaksasi.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Kolaborasi
pengobatan.</span></div>
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<br /></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Cemas berhubungan dengan rasa takut akan
kematian</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Intervensi :</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Jelaskan
semua prosedur tindakan.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Tingkatkan
ekspresi perasaan dan takut.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Dorong
keluarga dan teman utnuk menganggap klien seperti sebelumnya.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Beritahu
klien program medis yang telah dibuat untuk menurunkan/membatasi serangan akan
datang dan meningkatkan stabilitas jantung.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Kolaborasi.</span></div>
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<br /></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Kurang pengetahuan tentang sifat dasar
penyakit dan metode untuk menghindari komplikasi</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Intervensi :</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Tekankan
perlunya mencegah serangan angina.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Dorong
untuk menghindari faktor/situasi yang sebagai pencetus episode angina.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Kaji
pentingnya kontrol berat badan, menghentikan kebiasaan merokok, perubahan diet
dan olah raga.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Tunjukkan/
dorong klien untuk memantau nadi sendiri selama aktifitas, hindari tegangan.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Diskusikan
langkah yang diambil bila terjadi serangan angina.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Dorong
klien untuk mengikuti program yang telah ditentukan.</span></div>
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<br /></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Intoleransi aktifitas berhubungan dengan
berkurangnya curah jantung.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Intervensi :</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Pertahankan
tirah baring pada posisi yang nyaman.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Berikan
periode istirahat adekuat, bantu dalam pemenuhan aktifitas perawatan diri
sesuai indikasi.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Catat
warna kulit dan kualittas nadi.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Tingkatkan
katifitas klien secara teratur.</span></div>
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<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Pantau
EKG dengan sering.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Intervensi
keperawatan</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Pencegahan Nyeri. Pasien harus memahami gejala
kompleks dan harus menghindrari aktivitas yang diketahui akan menyebabkan nyeri
angina seperti latihan mendadak, pajanan terhadap dingin, dan kegembiraan
emosional.belajar untuk merubah, menyesuaikan dan beradaptasi terhadap stres
tersebut amatlah penting.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Bagi pasien yang serangannya terutama terjadi pada
pagi hari, perlu dilakukan pembuatan jadwal kegiatan sehari-hari. Idealnya
kegiatan tidak dilakukan terburu-buru in dilakukan sepanjang hari, sehingga
semua tugas dan perjanjian yang direncanakan dapat dijalankan tanpa rasa
tertekan dan terburu-buru.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Mengurangi Kecemasan. Pasien-pasien ini biasanya
mempunyai rasa takut akan kematian. Untuk pasien rawat inap, asuhan keperawatan
direncanakan sedemikian rupa sehingga waktu dimana ia jauh dari tempat tidur
diusahakan seminimal mungkin, karena perasaan takut akan meninggal tersebut
sering dapat dikurangi dengan adanya kehadiran fisik orang lain.pasien rawat
jalan harus diberikan informasi mengenai penyakitnya dan penjelasan mengenai
pentingnya mematuhi petunjuk yang telah diberikan.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Penyuluhan Pasien dan Pendekatan Asuhan di Rumah.
Program penyuluhan untuk pasien dengan angina dirancang untuk menjelaskan sifat
dasar penyakit dan menunjukan data yang diperlukan untuk mengatur kembali
kebiasaan hidup untuk mencapai tujuan sebagai berikut: mengurangi frekuensi dan
beratnya serangan angina, memperlambat perkembangan penyakit yang mendasarinya,
bila mungkin memberikan perlindungan dari komplikasi lain.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">3.4 Evaluasi</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Hasil
yang diharapkan :</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">1.
Bebas dari nyeri.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2.
Menunjukkan penurunan kecemasan</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">a. Memahami
penyakit dan tujuan perawatannya.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">b. Mematuhi semua aturan medis.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">c.
Mengetahui kapan harus meminta bantuan medis bila nyeri menetap atau sifatnya
berubah.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">d. Menghindari tinggal sendiri saat terjadinya episode
nyeri.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">3.
Memahami cara mencegah komplikasi dan menunjukkan tanda-tanda bebas dari
komplikasi</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">a. Menjelaskan proses terjadinya angina</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">b. Menjelaskan alasan tindakan pencegahan komplikasi</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">c. EKG dan kadar enzim jantung normal</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">d. Bebas dari tanda dan gejala infark miokardium
akut</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">4.
Mematuhi program perawatan diri</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">a. Menunjukkan pemahaman mengenai terapi farmakologi</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">b. Kebiasaan sehari-hari mencerminkan penyesuaian
gaya hidup.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">BAB IV</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">PENUTUP</span></b></div>
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<br /></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">4.1<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">KESIMPULAN</span></b></div>
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<br /></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-list: l4 level1 lfo12; mso-pagination: none; text-align: justify; text-autospace: none;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Angina pektoris adalah suatu
sindroma kronis dimana klien mendapat serangan sakit dadadi dearah sternum
atau di bawah sternum (substernal) atau dada sebelah kiri yang khas, yaitu
seperti ditekan, atau terasa berat di dada yang seringkali menjalar ke
lengan kiri, kadang-kadang dapat menjalar ke punggung, rahang, leher atau
ke lengan kanan. Sakit dada tersebut biasanya timbul pada waktu pasien
melakukan aktivitas dan segera hilang bila pasien menghentikan
aktivitasnya. (Prof. Dr.H.M.Sjaifoellah Noer,1996).</span></li>
</ol>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">2. Faktor penyebab Angina Pektoris antara lain:</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">a.
Ateriosklerosis</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">b. Spasmearterikoroner</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">c. Anemia berat</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">d. Artritis</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">e. Aorta Insufisiensi</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">3. Tipe Angina</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">a. Angina pektoris stabil</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">b. Angina Pektoris Tidak Stabil (Angina pra infark;
Angina kresendo)</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">c. Angina Prinzmental (Angina Varian: Istrahat)</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">d. Angina Nokturnal</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">e. Angina Refrakter atau Intraktabel</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: 31.5pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">f. Angina Dekubitus</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: 31.5pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">g. Iskemia tersamar</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: 31.5pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: .25in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">4. Pemeriksaan Penunjang</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: 31.5pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">a. Elektrokardiogram</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: 31.5pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">b. Foto Rontgen Dada</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: 31.5pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">c. Pemeriksaan Laboratorium</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: 31.5pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">d. Uji Latihan Jasmani</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: 31.5pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">e. Thallium Exercise Myocardial Imaging</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: 31.5pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: .25in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">5. Diagnosa yang dapat ditemukan, antara lain:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.5pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; mso-list: l1 level1 lfo13; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: -9.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Nyeri berhubungan dengan iskemia
miokardium</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; mso-list: l1 level1 lfo13; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: -13.5pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Cemas berhubungan dengan rasa takut akan
kematian</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; mso-list: l1 level1 lfo13; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: -13.5pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Kurang pengetahuan tentang sifat dasar
penyakit dan metode untuk menghindari komplikasi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; mso-list: l1 level1 lfo13; mso-pagination: none; text-align: justify; text-autospace: none; text-indent: -13.5pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Potensial terjadi ketidakpatuhan
terhadap terapuitik berhubuangan dengan tidak mau menerima perubahan pola hidup
yang sesuai.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Intoleransi aktifitas berhubungan dengan
berkurangnya curah jantung.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
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<br /></div>
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<br /></div>
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<br /></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">DAFTAR
PUSTAKA</span></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Noer,
H.M Sjaifoellah.1996. <i style="mso-bidi-font-style: normal;">Buku Ajar Ilmu Penyakit
Dalam</i>. Balai Penerbit FKUI: Jakarta.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">http://id.wikipedia.org/wiki/Angina_pektoris</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">http://blog.<i style="mso-bidi-font-style: normal;">ilmukeperawatan.com/mengenal-angina-pektoris</i>.html</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">http://id.shvoong.com/medicine-and-health/radiology/1936688-angina-pektoris/</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">http://www.kalbe.co.id/files/cdk/files/147_05PenyakitJantungKoroner.pdf/147_05PenyakitJantungKoroner.html</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">http://oktavie.wordpress.com/2010/02/14/angina-pektoris/</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">http://ifan050285.wordpress.com/2010/03/16/angina-pektoris-tidak-stabil/</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; mso-pagination: none; tab-stops: 9.0pt; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">smeltear
,C.suzanne dan Brenda G.Bare.2002.<i style="mso-bidi-font-style: normal;">Buku <span style="mso-spacerun: yes;"> </span>Ajar Keperawatan Medikal Bedah</i>.
Jakarta:EGC</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-88794382492217864642012-09-03T21:41:00.001-07:002012-09-03T21:41:15.104-07:00ASUHAN KEPERAWATAN PADA PASIEN DENGAN PEMASANGAN CVP<!--[if gte mso 9]><xml>
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<br />
<span style="mso-list: Ignore;"><span style="font: 7.0pt "Times New Roman";"> <span style="font-size: x-large;">I.</span></span></span><span style="font-size: x-large;">Pengertian
</span><div class="MsoNormal" style="line-height: 115%;">
Tekanan vena central (central
venous pressure) adalah tekanan darah di AKa atau vena kava. Ini memberikan
informasi tentang tiga parameter volume darah, keefektifan jantung sebagai pompa,
dan tonus vaskular. Tekanan vena central dibedakan dari tekanan vena perifer,
yang dapat merefleksikan hanya tekanan lokal.</div>
<a name='more'></a><br />
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<h1 style="line-height: 115%;">
<span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";">
</span></span>Lokasi Pemantauan</h1>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l5 level1 lfo5; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Vena Jugularis interna kanan atau kiri (lebih
umum pada kanan)</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l5 level1 lfo5; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Vena subklavia kanan atau kiri, tetapi duktus toraks
rendah pada kanan</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l5 level1 lfo5; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Vena brakialis, yang mungkin tertekuk dan
berkembang menjadi phlebitis</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l5 level1 lfo5; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Lumen proksimal kateter arteri pulmonalis, di
atrium kanan atau tepat di atas vena kava superior</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<h1 style="line-height: 115%;">
<span style="mso-list: Ignore;">II.<span style="font: 7.0pt "Times New Roman";"> </span></span>Indikasi<span style="mso-spacerun: yes;"> </span>dan<span style="mso-spacerun: yes;">
</span>Penggunaan</h1>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Pengukuran tekanan vena sentral (CVP).</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Pengambilan darah untuk pemeriksaan
laboratorium.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Pengukuran oksigenasi vena sentral.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Nutrisi parenteral dan pemberian cairan
hipertonik atau cairan yang mengiritasi yang perlu pengenceran segera dalam
sistem sirkulasi.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Pemberian obat vasoaktif per drip (tetesan) dan
obat inotropik.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Sebagai jalan masuk vena bila semua tempat IV
lainnya telah lemah.</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<h1 style="line-height: 115%; margin-left: 0in; mso-list: none; tab-stops: 21.85pt; text-indent: 0in;">
III.<span style="mso-tab-count: 1;"> </span>Komplikasi</h1>
<div class="MsoNormal" style="line-height: 115%;">
Adapun komplikasi dari pemasangan
kanulasi CVP antara lain :</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Nyeri dan inflamasi pada lokasi penusukan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Bekuan darah karena tertekuknya kateter.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Perdarahan : ekimosis atau perdarahan besar bila
jarum terlepas.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Tromboplebitis (emboli thrombus,emboli udara,
sepsis).</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Microshock.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Disritmia jantung</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<h1 style="line-height: 115%;">
<span style="mso-list: Ignore;">III.<span style="font: 7.0pt "Times New Roman";"> </span></span>Pengkajian</h1>
<div class="MsoNormal" style="line-height: 115%;">
Yang perlu dikaji pada pasien yang
terpasang CVP adalah tanda-tanda komplikasi yang ditimbulkan oleh pemasangan
alat.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo3; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Keluhan nyeri, napas sesak, rasa tidak nyaman.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo3; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Keluhan verbal adanya kelelahan atau kelemahan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo3; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Frekuensi napas, suara napas</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo3; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Tanda kemerahan / pus pada lokasi pemasangan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo3; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Adanya gumpalan darah / gelembung udara pada
cateter</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo3; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Kesesuaian posisi jalur infus set</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo3; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Tanda-tanda vital, perfusi</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo3; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Tekanan CVP</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo3; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Intake dan out put</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l1 level1 lfo3; tab-stops: list .25in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>ECG Monitor</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<h1 style="line-height: 115%;">
<span style="mso-list: Ignore;">IV.<span style="font: 7.0pt "Times New Roman";"> </span></span>Diagnosa
Keperawatan</h1>
<h3 style="line-height: 115%;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Gangguan aktivitas berhubungan dengan<span style="mso-spacerun: yes;"> </span>pemasangan kateter vena central </h3>
<div class="MsoNormal" style="line-height: 115%;">
Kriteria pengkajian<span style="mso-spacerun: yes;"> </span>focus :</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l3 level1 lfo2; tab-stops: list .75in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Kelemahan, kelelahan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l3 level1 lfo2; tab-stops: list .75in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Perubahan tanda vital, adanya disritmia.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l3 level1 lfo2; tab-stops: list .75in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Dispnea.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l3 level1 lfo2; tab-stops: list .75in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Pucat</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l3 level1 lfo2; tab-stops: list .75in; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Berkeringat.</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<h1 style="line-height: 115%;">
<span style="mso-list: Ignore;">V.<span style="font: 7.0pt "Times New Roman";"> </span></span>Tujuan
Asuhan Keperawatan</h1>
<div class="MsoNormal" style="line-height: 115%;">
<span style="mso-spacerun: yes;"> </span>Pasien akan mencapai peningkatan toleransi
aktivitas yang dapat diukur, dibuktikan oleh menurunnya kelemahan dan kelelahan
dan tanda vital DBN selama aktivitas.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 42.55pt; text-indent: -42.55pt;">
<br /></div>
<h1 style="line-height: 115%;">
<span style="mso-list: Ignore;">VI.<span style="font: 7.0pt "Times New Roman";"> </span></span>Intervensi
</h1>
<div class="MsoNormal" style="line-height: 115%; margin-left: 17.85pt; mso-list: l9 level1 lfo6; tab-stops: list .25in left 21.3pt; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-weight: bold;">Periksa tanda vital sebelum dan segera
setelah aktivitas.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; tab-stops: 21.3pt;">
Rasionalisasi
: Hipotensi ortostatik dapat terjadi dengan aktivitas.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 17.85pt; mso-list: l9 level1 lfo6; tab-stops: list .25in left 21.3pt; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Catat respons kardiopulmonal terhadap aktivitas,
catat takikardi, disritmia, dispnea, berkeringat, pucat.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 17.85pt; tab-stops: 21.3pt;">
Rasionalisasi
: penurunan/ketidakmampuan miokardium untuk meningkatkan volume sekuncup selama
aktivitas, dapat menyebabkan peningkatan segera pada frekuensi jantung dan
kebutuhan oksigen, juga peningkatan kelelahan dan kelemahan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 17.85pt; mso-list: l2 level1 lfo7; tab-stops: list .25in left 21.3pt; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Kaji presipitator/penyebab kelemahan contoh nyeri.
</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 17.85pt;">
Rasionalisasi :
Nyeri dan program penuh stres jugas memerlukan energi dan menyebabkan
kelemahan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 17.85pt; mso-list: l4 level1 lfo8; tab-stops: list .25in left 21.3pt; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Anjurkan latihan ROM aktif atau bila pasien
tidak dapat memenuhinya lakukan ROM pasif setiap 6 jam.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 17.85pt;">
Rasionalisasi :
ROM dapat meningkatkan kekuatan otot, memperbaiki sirkulasi dan mengurangi rasa
tidak nyaman.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 17.85pt; mso-list: l11 level1 lfo9; tab-stops: list .25in left 21.3pt; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Jelaskan bahwa gangguan aktivitas adalah kondisi
sementara yang diharuskan hanya selama waktu pemantauan sementara.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 17.85pt;">
Rasionalisasi :
Penjelasan dapat mengurangi anxietas karena rasa takut terhadap pemasangan<span style="mso-spacerun: yes;"> </span>CVP.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 17.85pt; mso-list: l0 level1 lfo10; tab-stops: list .25in left 21.3pt; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Berikan bantuan dalam aktivitas perawatan diri
sesuai indikasi.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 17.85pt; mso-list: l0 level1 lfo10; tab-stops: list .25in left 21.3pt; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Rasionalisasi : Pemenuhan kebutuhan perawatan
diri pasien tanpa mempengaruhi pemasangan CVP.</div>
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; text-transform: uppercase;"><br clear="all" style="page-break-before: always;" />
</span></b>
<div class="MsoTitle" style="line-height: 115%;">
DAFTER PUSTAKA</div>
<div class="MsoTitle" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
Anna Owen, 1997. <i style="mso-bidi-font-style: normal;">Pemantauan Perawatan Kritis</i>. EGC.
Jakarta.</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
Carpenito, Lynda Juall, 2000. <i style="mso-bidi-font-style: normal;">Diagnosa Keperawatan</i> .EGC. Jakarta.</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
Doenges M.E.<span style="mso-spacerun: yes;"> </span>at all, 1993. <i style="mso-bidi-font-style: normal;">Rencana Asuhan Keperwatan</i>. Edisi 3. EGC. Jakarta</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
Hudak & Gallo, 1997. <i style="mso-bidi-font-style: normal;">Keperawatan Kritis Edisi VI Volume I</i>.
EGC. Jakarta.</div>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-61348202006119402212012-09-03T21:38:00.002-07:002012-09-03T21:38:39.884-07:00ASUHAN KEPERAWATAN PASIEN DENGAN INTOKSIKASI INSEKTISIDA <!--[if gte mso 9]><xml>
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<br />
<div class="Section1">
A. Pengertian.
<div class="MsoNormal" style="line-height: 115%; text-indent: .5in;">
Intoksikasi atau
keracunan adalah masuknya zat atau senyawa kimia dalam tubuh manusia yang </div>
<div class="MsoNormal" style="line-height: 115%; text-indent: 0.5in;">
menimbulkan efek merugikan pada yang menggunakannya.</div>
<a name='more'></a><br />
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">
Istilah peptisida
pada umumnya dipakai untuk semua bahan yang dipakai manusia untuk membasmi hama yang merugikan
manusia.Termasuk peptisida ini adalah insektisida. Ada 2 macam insektisuda yang paling benyak
digunakan dalam pertanian :</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l0 level1 lfo2; tab-stops: list .75in; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Insektisida hidrokarbon khorin ( IHK=Chlorinated
Hydrocarbon )</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l0 level1 lfo2; tab-stops: list .75in; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>Isektida fosfat organic ( IFO =Organo Phosphatase<span style="mso-spacerun: yes;"> </span>insectisida )</div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="mso-spacerun: yes;"> </span>Yang paling sering digunakan
adalah<span style="mso-spacerun: yes;"> </span>IFO yang pemakaiannya terus
menerus meningkat. Sifat dari </div>
<div class="MsoNormal" style="line-height: 115%;">
IFO adalah insektisida poten yang paling banyak
digunakan dalam pertanian dengan toksisitas yang </div>
<div class="MsoNormal" style="line-height: 115%;">
tinggi. Salah satu derivatnya
adalah<span style="mso-spacerun: yes;"> </span>Tabun dan Sarin. Bahan ini dapat
menembusi kulit yang normal </div>
<div class="MsoNormal" style="line-height: 115%;">
(intact) juga dapaat diserap diparu dan saluran
makanan,namun tidak berakumulasi dalam jaringan </div>
<div class="MsoNormal" style="line-height: 115%;">
tubuh seperti golongan IHK. </div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="mso-tab-count: 1;"> </span>Macam-macam
IFO adalah malathion ( Tolly ) Paraathion,diazinon,Basudin,Paraoxon dan
lain-lain. IFO ada 2 macam adalah IFO Murni dan golongan carbamate.Salah satu
contoh gol.carbamate adalah baygon.</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<ol start="2" style="margin-top: 0in;" type="A">
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo1; tab-stops: list .5in;">Patogenesis.</li>
</ol>
<div class="MsoNormal" style="line-height: 115%; text-indent: .5in;">
IFO bekerja<span style="mso-spacerun: yes;"> </span>dengan cara menghabat ( inaktivasi ) enzim
asetikolinesterase<span style="mso-spacerun: yes;"> </span>tubuh ( KhE).Dalam
keadaan normal enzim KhE bekerja untuk menghidrolisis arakhnoid( AKH ) dengan
jalan mengikat Akh –KhE yang bersifat inaktif.Bila konsentrasi<span style="mso-spacerun: yes;"> </span>racun lebih tinggi dengan ikatan IFO- KhE
lebih banyak terjadi. Akibatnya akan terjadi<span style="mso-spacerun: yes;">
</span>penumpukan Akh ditempat-tempat tertentu, sehingga timbul gejala gejal;a
ransangan Akh yang berlebihan ,yang akan menimbulkan efek muscarinik, nikotinik
dan SSP ( menimbulkan stimulasi kemudian depresi SSP )</div>
<div class="MsoNormal" style="line-height: 115%; text-indent: .5in;">
Pada keracunan IFO
,ikatan Ikatan IFO – KhE bersifat menetap (ireversibel ) ,sedangkan keracunan
carbamate<span style="mso-spacerun: yes;"> </span>ikatan ini bersifat sementara
(reversible ).Secara farmakologis efek Akh<span style="mso-spacerun: yes;">
</span>dapat dibagi 3 golongan :</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l3 level1 lfo3; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span>Muskarini,terutama
pada saluran pencernaan,kelenjar ludah dan keringat,pupil,bronkus dan jantung.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l3 level1 lfo3; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span>Nikotinik,terutama
pada otot-otot skeletal,bola mata,lidah,kelopak mata dan otot pernafasan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l3 level1 lfo3; text-indent: -.25in;">
<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span>SSP,
menimbulkan nyeri kepala,perubahan emosi,kejang-kejang(Konvulsi ) sampai koma.<span style="mso-tab-count: 1;"> </span></div>
<ol start="3" style="margin-top: 0in;" type="A">
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo1; tab-stops: list .5in;">Gambaran Klinik.</li>
</ol>
<div class="MsoNormal" style="line-height: 115%;">
Yang paling menonjol adalah
kelainan visus,hiperaktifitas kelenjar ludah,keringat<span style="mso-spacerun: yes;"> </span>dan ggn saluran pencernaan,serta kesukaran
bernafas.</div>
<div class="MsoNormal" style="line-height: 115%;">
Gejala ringan meliputi : Anoreksia,
nyeri kepala, rasa lemah,rasa takut, tremor pada lidah,kelopak mata,pupil
miosis.</div>
<div class="MsoNormal" style="line-height: 115%;">
Keracunan sedang : nausea,
muntah-muntah, kejang atau kram perut, hipersaliva, hiperhidrosis,fasikulasi
otot dan bradikardi.</div>
<div class="MsoNormal" style="line-height: 115%;">
Keracunan berat<span style="mso-spacerun: yes;"> </span>: diare, pupil pi- poin, reaksi cahaya
negatif ,sesak nafas, sianosis, edema paru .inkontenesia urine dan feces,
kovulsi,koma, blokade jantung akhirnya meningal.</div>
<div class="MsoNormal" style="line-height: 115%; text-indent: -.25in;">
<br /></div>
<ol start="4" style="margin-top: 0in;" type="A">
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo1; tab-stops: list .5in;">Pemeriksaan.</li>
</ol>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level2 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span>Laboratorik.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
Pengukuran kadar
KhE dengan sel darah merah dan plasma, penting untuk memastikan diagnosis
keracunan IFO akut maupun kronik (Menurun sekian %<span style="mso-spacerun: yes;"> </span>dari harga normal ).</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
Kercunan akut
:<span style="mso-spacerun: yes;"> </span>Ringan<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>40<span style="mso-spacerun: yes;"> </span>-<span style="mso-spacerun: yes;"> </span>70 %</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
<span style="mso-tab-count: 3;"> </span>Sedang<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>20<span style="mso-spacerun: yes;">
</span>-<span style="mso-spacerun: yes;"> </span>40 %</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
<span style="mso-tab-count: 3;"> </span>Berat<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span><<span style="mso-spacerun: yes;">
</span>20 %</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; text-indent: -.25in;">
<span style="mso-tab-count: 1;"> </span>Keracunan kronik bila kadar
KhE menurun sampai 25<span style="mso-spacerun: yes;"> </span>-<span style="mso-spacerun: yes;"> </span>50 % setiap individu yang berhubungan dengan
insektisida ini harus segara disingkirkan dan baru diizinkan bekerja kemballi kadar
KhE telah meningkat<span style="mso-spacerun: yes;"> </span>> 75 % N</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level2 lfo1; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span>Patologi
Anatomi ( PA ).</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
Pada keracunan
acut,hasil pemeriksaan patologi biasanya tidak khas.sering hanya ditemukan
edema paru,dilatsi kapiler,hiperemi paru,otak dan organ-oragan lainnya.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
<br /></div>
<ol start="5" style="margin-top: 0in;" type="A">
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo1; tab-stops: list .5in;">Penatalaksanaan.</li>
</ol>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level2 lfo4; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span>Resusitasi.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
Setelah jalan
nafas dibebaskan dan dibersihkan,periksa pernafasan dan nadi.Infus dextrose 5 %
kec.<span style="mso-spacerun: yes;"> </span>15-<span style="mso-spacerun: yes;">
</span>20 tts/menit .,nafas buatan,oksigen,hisap lendir dalam saluran
pernafasan,hindari obat-obatan depresan saluran nafas,kalu perlu respirator
pada kegagalan nafas berat.Hindari pernafasan buatan dari mulut kemulut, sebab
racun organo fhosfat akan meracuni lewat mlut penolong.Pernafasan buatan hanya
dilakukan dengan meniup face mask atau menggunakan alat bag – valve – mask.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level1 lfo4; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span>Eliminasi.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
Emesis,
merangsang penderita supaya muntah pada penderita yang sadar atau dengan pemeberian
sirup ipecac<span style="mso-spacerun: yes;"> </span>15<span style="mso-spacerun: yes;"> </span>-<span style="mso-spacerun: yes;"> </span>30
ml. Dapat diulang setelah 20 menit bila tidak berhasil.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
Katarsis,(
intestinal lavage ), dengan pemberian laksan bila diduga racun telah sampai
diusus halus dan besar.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
Kumbah lambung
atau gastric lavage, pada penderita yang kesadarannya menurun,atau pada
penderita yang tidak kooperatif.Hasil paling efektif bila kumbah lambung
dikerjakan dalam 4 jam setelah keracunan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
Keramas
rambut<span style="mso-spacerun: yes;"> </span>dan memandikan seluruh tubuh
dengan sabun.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
Emesis,katarsis
dan kumbah lambung sebaiknya hanya dilakukan bila keracunan terjadi kurang dari
4 – 6 jam . pada koma derajat sedang hingga berat tindakan kumbah lambung
sebaiknya dukerjakan dengan bantuan pemasangan pipa endotrakeal berbalon,untuk
mencegah aspirasi pnemonia.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
<span style="mso-tab-count: 2;"> </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level1 lfo4; text-indent: -.25in;">
<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span>Anti
dotum.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in;">
Atropin sulfat ( SA
)<span style="mso-spacerun: yes;"> </span>bekerja dengan menghambat efek
akumulasi Akh pada tempat penumpukan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 153.0pt; mso-list: l2 level3 lfo4; tab-stops: list 1.0in; text-indent: -99.0pt;">
<span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span>Mula-mula diberikan bolus IV<span style="mso-spacerun: yes;"> </span>1<span style="mso-spacerun: yes;">
</span>-<span style="mso-spacerun: yes;"> </span>2,5 mg</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l2 level3 lfo4; tab-stops: list 1.0in; text-indent: -.25in;">
<span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span>Dilanjutkan dengan<span style="mso-spacerun: yes;">
</span>0,5 – 1 mg setiap 5<span style="mso-spacerun: yes;"> </span>-<span style="mso-spacerun: yes;"> </span>10<span style="mso-spacerun: yes;">
</span>-<span style="mso-spacerun: yes;"> </span>15<span style="mso-spacerun: yes;"> </span>menitsamapi timbulk gejala-gejala
atropinisasi ( muka merah,mulut kering,takikardi,midriasis,febris dan
psikosis).</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l2 level3 lfo4; tab-stops: list 1.0in; text-indent: -.25in;">
<span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span>Kemudian interval diperpanjang setiap 15 – 30 -<span style="mso-spacerun: yes;"> </span>60 menit selanjutnya setiap 2 – 4 –6 – 8 dan
12 jam.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.0in; mso-list: l2 level3 lfo4; text-indent: -.25in;">
<span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span>Pemberian
SA dihentikan minimal setelaj 2 x 24 jam. Penghentian yang mendadak dapat
menimbulkan rebound effect berupa edema paru dan kegagalan pernafasan akut yang
sering fatal.</div>
<div class="MsoNormal" style="line-height: 115%; text-indent: -27.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-indent: -27.0pt;">
ASUHAN
KEPERAWATAN.</div>
<div class="MsoNormal" style="line-height: 115%; text-indent: -27.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45.0pt; mso-list: l2 level4 lfo4; text-indent: -.5in;">
<span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span>Pengkajian.</div>
<div class="MsoNormal" style="line-height: 115%;">
Pengkajian difokusakan padfa
masalah yang mendesak seperti jalan nafas dan sirkulasi yang mengancam
jiwa,adanya gangguan asam basa,keadaan status jantung,status kesadran.</div>
<div class="MsoNormal" style="line-height: 115%;">
Riwayat kesadaran : riwayat
keracunan,bahan racun yang digunakan,berapa lama diketahui setelah
keracunan,ada masalah lain sebagi pencetus keracunan dan sindroma toksis yang
ditimbulkan dan kapan terjadinya.</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 189.0pt; mso-list: l2 level4 lfo4; text-indent: -2.5in;">
<span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";">
</span></span>Masalah keperawatan. Yang mungkin timbul adalah :</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level5 lfo4; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Tidak efektifnya pola nafas</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level5 lfo4; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Resiko tinggi kekurangan cairan tubuh.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level5 lfo4; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Gangguan kesadaran</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level5 lfo4; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Tidak efektifnya koping individu. </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 69.0pt;">
<br /></div>
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<span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";">
</span></span>Intervensi.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level5 lfo4; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Pertolongan pertama yang dilakukan meliputi :
tindakan umum yang bertujuan untuk keselamatan hidup,mencegah penyerapan dan
penawar racun ( antidotum ) yan meliputi resusitasi, : Air way, breathing,
circulasi eliminasi untuk menghambat absorsi melalui pencernaaan dengan cara
kumbah lambung,emesis, ata katarsis dan kerammas rambut.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level5 lfo4; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Berikan anti dotum sesuai advis dokter minimal 2
x 24 jam<span style="mso-spacerun: yes;"> </span>yaitu pemberian SA.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level5 lfo4; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Perawatan suportif; meliputi mempertahankan<span style="mso-spacerun: yes;"> </span>agar pasien tidak samapi demamatau
mengigil,monitor perubahan-perubahan fisik seperti perubahan nadi yang
cepat,distress pernafasan, sianosis, diaphoresis, dan tanda-tanda lain kolaps
pembuluh darah dan kemungkinan fatal atau kematian.Monitir vital sign setiap 15
menit untuk bebrapa jam dan laporkan<span style="mso-spacerun: yes;">
</span>perubahan segera kepada dokter.Catat tanda-tanda seperti muntah,mual,dan
nyeri abdomen serta monotor semua muntah<span style="mso-spacerun: yes;">
</span>akan adanya darah. Observasi fese dan urine serta pertahankan cairan
intravenous sesuai pesanan dokter.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level5 lfo4; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Jika pernafasan depresi ,berikan oksigen dan
lakukan suction. Ventilator mungkin bisa diperlukan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l2 level5 lfo4; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Jika keracunan sebagai uasaha untuk mebunuh diri
maka lakukan safety precautions . Konsultasi psikiatri atau perawat psikiatri
klinis. Pertimbangkan juga masalah kelainan kepribadian,reaksi depresi,psikosis
.neurosis, mental retardasi dan lain-lain. </div>
</div>
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
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<div class="MsoTitle" style="line-height: 115%;">
SUMBER.</div>
<div class="MsoTitle" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; text-indent: -.75in;">
Emerton, D M ( 1989 <b><i>) Principle And Practise Of nursing </i></b>, University<span style="mso-spacerun: yes;">
</span>of Quennsland Press, Australia.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; text-indent: -.75in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; text-indent: -.75in;">
Departemen kesehatan RI, ( 2000 ) <b><i>Resusitasi jantung, paru otak
Bantuan hidup lanjut ( Advanced Life Support )</i></b> Jakarta.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; text-indent: -.75in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; text-indent: -.75in;">
La/UPF Ilmu Penyakit Dalam RSUD Dr.Soetomo Surabaya,( 1994 ) <b><i>Pedoman
Diagnosis dan Terapi</i>,</b> Surabaya.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; text-indent: -.75in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; text-indent: -.75in;">
Phipps , ect,<span style="mso-spacerun: yes;"> </span>( 1999<b> ) <i>Medikal
Surgical Nursing : Consept dan Clinical Pratise, Mosby </i></b>Year Book, Toronto. </div>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-66858634312943579562012-09-03T21:34:00.002-07:002012-09-03T21:34:46.280-07:00LAPORAN PENDAHULUAN HIPOGLIKEMIA<!--[if gte mso 9]><xml>
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<br />
<span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span>Pengertian
<br />
<div class="MsoNormal">
Hipoglikemi adalah suatu keadaan, dimana kadar gula darah
plasma puasa kurang dari 50 mg/%. </div>
<div class="MsoNormal" style="margin-left: .25in;">
Populasi yang memiliki resiko
tinggi mengalami hipoglikemi adalah:</div>
<a name='more'></a><br />
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Diabetes melitus</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Parenteral nutrition</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Sepsis</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Enteral feeding</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Corticosteroid therapi</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Bayi dengan ibu dengan diabetik</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Bayi dengan<span style="mso-spacerun: yes;">
</span>kecil masa kehamilan</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Bayi dengan ibu yang ketergantungan narkotika</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Luka bakar</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Kanker pankreas</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Penyakit Addison’s</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Hiperfungsi kelenjar adrenal</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Penyakit hati</div>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in;">
Type hipoglikemi digolongkan
menjadi beberapa jenis yakni:</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span><i>Transisi dini neonatus</i> ( early transitional
neonatal ) : ukuran bayi yang besar ataupun normal yang mengalami
kerusakan<span style="mso-spacerun: yes;"> </span>sistem produksi pankreas
sehingga terjadi hiperinsulin.</div>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span><span style="mso-spacerun: yes;"> </span><i>Hipoglikemi
klasik sementara (</i>Classic transient neonatal) : tarjadi jika bayi mengalami
<i>malnutrisi </i>sehingga mengalami kekurangan cadangan lemak dan glikogen.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-bidi-font-style: italic;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><i>Sekunder (</i>Scondary) : sebagai suatu
respon stress dari neonatus<span style="mso-spacerun: yes;"> </span>sehingga
terjadi peningkatan metabolisme<span style="mso-spacerun: yes;"> </span>yang
memerlukan banyak cadangan glikogen.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-bidi-font-style: italic;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><i>Berulang </i><span style="mso-spacerun: yes;"> </span>( Recurrent) : disebabkan oleh adanya
kerusakan enzimatis, atau metabolisme insulin terganggu.</div>
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font-size:10.0pt;
font-family:"Times New Roman","serif";}
</style>
<![endif]-->
</div>
<div class="Section1">
<div class="MsoNormal" style="margin-left: .25in; mso-list: l1 level1 lfo2; text-indent: -.25in;">
<span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span>Fokus Pengkajian</div>
<div class="MsoNormal" style="margin-left: .25in;">
Data dasar yang perlu dikaji
adalah :</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level2 lfo2; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Keluhan utama : sering tidak jelas tetapi bisanya
simptomatis, dan lebih sering hipoglikemi merupakan diagnose sekunder yang
menyertai keluhan lain sebelumnya seperti asfiksia, kejang, sepsis.</div>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level2 lfo2; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>Riwayat :</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>ANC</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Perinatal</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Post natal</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Imunisasi</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Diabetes melitus pada orang tua/ keluarga</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Pemakaian parenteral nutrition</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Sepsis</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Enteral feeding</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Pemakaian Corticosteroid therapi</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Ibu yang memakai atau ketergantungan narkotika</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Kanker </div>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level2 lfo2; text-indent: -.25in;">
<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>Data fokus</div>
<div class="MsoNormal" style="margin-left: .5in;">
<span style="mso-spacerun: yes;">
</span>Data Subyektif:</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list blank 28.35pt blank .5in left 63.0pt; text-indent: 9.0pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Sering masuk dengan keluhan yang tidak jelas</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list blank 28.35pt blank .5in left 63.0pt; text-indent: 9.0pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Keluarga mengeluh bayinya keluar banyaj keringat dingin</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list blank 28.35pt blank .5in left 63.0pt; text-indent: 9.0pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Rasa lapar (bayi sering nangis)</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list blank 28.35pt blank .5in left 63.0pt; text-indent: 9.0pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Nyeri kepala</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list blank 28.35pt blank .5in left 63.0pt; text-indent: 9.0pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Sering menguap</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list blank 28.35pt blank .5in left 63.0pt; text-indent: 9.0pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Irritabel</div>
<div class="MsoNormal" style="margin-left: .5in; tab-stops: list .5in left 63.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; tab-stops: list .5in left 63.0pt; text-indent: 9.0pt;">
Data
obyektif:</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left 63.0pt; text-indent: 9.0pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Parestisia pada bibir dan jari, gelisah, gugup, tremor,
kejang, kaku, </div>
<div class="MsoNormal" style="margin-left: 63.0pt; mso-list: l2 level1 lfo3; tab-stops: list .5in 63.0pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Hight—pitched cry, lemas, apatis, bingung, cyanosis,
apnea, nafas cepat irreguler, keringat dingin, mata berputar-putar, menolak
makan dan koma</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left 63.0pt; text-indent: 9.0pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Plasma glukosa < 50 gr/%</div>
<div class="MsoNormal" style="margin-left: .5in; tab-stops: list .5in left 63.0pt; text-indent: 9.0pt;">
<br /></div>
</div>
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<br />
<div class="Section2">
<div class="MsoNormal" style="margin-left: .25in; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span>Diagnose
dan Rencana Keperawatan</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level2 lfo2; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Resiko<span style="mso-spacerun: yes;">
</span>komplikasi berhubungan dengan kadar glukosa plasma yang rendah seperti,
gangguan mental, gangguan perkembangan otak, gangguan fungsi saraf otonom, koma
hipoglikemi</div>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoNormal">
Rencana tindakan:</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in 63.0pt; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Cek serum glukosa sebelum dan setelah makan</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in 63.0pt; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Monitor : kadar glukosa, pucat, keringat dingin, kulit
yang lembab</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in 63.0pt; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Monitor vital sign</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in 63.0pt; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Monitor kesadaran</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in 63.0pt; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Monitor <span style="mso-spacerun: yes;"> </span>tanda
gugup, irritabilitas</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in 63.0pt; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Lakukan pemberian susu manis<span style="mso-spacerun: yes;"> </span>peroral 20 cc X 12</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in 63.0pt; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Analisis kondisi lingkungan yang berpotensi menimbulkan
hipoglikemi.</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in 63.0pt; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Cek BB setiap hari</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in 63.0pt; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Cek tanda-tanda infeksi</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in 63.0pt; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Hindari terjadinya hipotermi</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in 63.0pt; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Lakukan kolaborasi pemberian Dex 15 % <span style="mso-spacerun: yes;"> </span>IV</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in left .75in 63.0pt; text-indent: 0in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Lakukan kolaborasi pemberian O2 1 lt – 2 lt /menit</div>
<div class="MsoNormal" style="tab-stops: .75in 63.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level2 lfo2; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>Resiko<span style="mso-spacerun: yes;"> </span>terjadi
infeksi berhubungan dengan<span style="mso-spacerun: yes;"> </span>penurunan
daya tahan tubuh</div>
<div class="MsoNormal">
Rencana tindakan:</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Lakukan prosedur perawatan tangan sebelum dan setelah
tindakan</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Pastikan setiap benda yang dipakai kontak dengan bayi
dalam keadaan bersih atau steril</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Cegah kontak dengan petugas atau pihak lain yang
menderita infeksi saluran nafas.</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Perhatikan kondisi feces bayi</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Anjurkan keluarga agar mengikuti prosedur septik
aseptik.</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Berikan antibiotik sebagai profolaksis sesuai dengan
order.</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Lakukan pemeriksaan DL, UL, FL secara teratur.</div>
<div class="MsoNormal" style="margin-left: .75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level2 lfo2; text-indent: -.25in;">
<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>Resiko<span style="mso-spacerun: yes;"> </span>Ggn
Keseimbangan cairan dan elektrolit berhubungan dengan<span style="mso-spacerun: yes;"> </span>peningkatan pengeluaran keringat </div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Cek intake dan output</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Berikan cairan<span style="mso-spacerun: yes;">
</span>sesuai dengan<span style="mso-spacerun: yes;"> </span>kebutuhan bayi /kg
BB/24 jam</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Cek turgor kulit bayi</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Kaji intoleransi minum bayi</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Jika mengisap sudah baik anjurkan pemberian ASI</div>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l1 level2 lfo2; text-indent: -.25in;">
<span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span>Keterbatasan gerak dan aktivitas berhubungan
dengan<span style="mso-spacerun: yes;"> </span>hipoglikemi pada otot</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Bantu pemenihan kebutuhan sehari-hari</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Lakukan fisiotherapi</div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span>Ganti pakaian bayi secara teratur dan atau jika kotor
dan basah.</div>
</div>
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-size: 10.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span></i></b>
<br />
<div class="MsoTitle">
DAFTAR PUSTAKA</div>
<div class="MsoTitle">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: .75in; text-indent: -.75in;">
Carpenito (1997), L.J <i>Nursing Diagnosis, </i><span style="mso-spacerun: yes;"> </span>Lippincott , New York</div>
<div class="MsoNormal" style="line-height: 200%; margin-left: .75in; text-indent: -.75in;">
Marino (1991), <i>ICU Book, </i>Lea & Febiger, London</div>
<div class="MsoNormal" style="margin-left: 0.5in; text-indent: -0.25in;">
<br /></div>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-33585858493606186052012-09-03T21:29:00.002-07:002012-09-03T21:56:59.165-07:00ASUHAN KEPERAWATAN PADA BAYI BBLR DAN PREMATUR<!--[if gte mso 9]><xml>
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<br />
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<span style="font-size: small;"><b><span style="line-height: 115%;">A.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></b><b><span style="line-height: 115%;">KONSEP DASAR PENYAKIT</span></b></span>
</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small;"><b><span style="line-height: 115%;">1.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></b><b><span style="line-height: 115%;">Definisi </span></b></span></div>
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<span style="font-size: small; line-height: 115%;">Bayi Berat Lahir Rendah
(BBLR) adalah bayi dengan berat lahir < 2500 gr (berat lahir adalah berat
bayi yang ditimbang dalam 1 jam setelah lahir). WHO pada tahun 1961 mengatakan
bahwa semua bayi baru lahir yang berat badannya < 2500 gr atau sama dengan
2500 gr disebut <i>Low Birth Weight Infant </i>(Bayi
dengan berat badan lahir rendah, BBLR).</span></div>
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<span style="font-size: small;"><i><span style="line-height: 115%;">Bayi Prematur</span></i></span></div>
<a name='more'></a><span style="font-size: small;"><br /></span>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45pt; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Menurut WHO, bayi
prematur adalah bayi lahir hidup sebelum usia kehamilan minggu ke 37 (dihitung
dari hari pertama haid terakhir), BB < 2500 gr.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small;"><b><span style="line-height: 115%;">2.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></b><b><span style="line-height: 115%;">Macam BBLR</span></b></span></div>
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<span style="font-size: small; line-height: 115%;">a.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Prematur murni</span></div>
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<span style="font-size: small; line-height: 115%;">Yaitu bayi dengan masa
kehamilan kurang dari 37 minggu dan berat badan lahir sesuai untuk usia
kehamilan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">b.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Dismatur</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Yaitu bayi dengan berat
badan lahir kurang dengan berat badan yang seharusnya untuk usia kehamilan. Ini
menunjukkan bayi mengalami retardasi pertumbuhan intra uterin.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small;"><b><span style="line-height: 115%;">3.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></b><b><span style="line-height: 115%;">Klasifikasi BBLR</span></b></span></div>
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<span style="font-size: small; line-height: 115%;">BBLR dapat
diklasifikasikan sebagai berikut:</span></div>
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<span style="font-size: small; line-height: 115%;">Berdasarkan BB lahir:</span></div>
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<span style="font-family: Wingdings; font-size: small; line-height: 115%;">Ø<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">BBLR: BB lahir < 2500 gram</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-family: Wingdings; font-size: small; line-height: 115%;">Ø<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">BBLSR: BB lahir 1000 – 1500 gram</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-family: Wingdings; font-size: small; line-height: 115%;">Ø<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">BBLASR: BB lahir < 1000 gram</span></div>
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<span style="font-size: small;"><br /></span></div>
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<span style="font-size: small; line-height: 115%;">Berdasarkan umur
kehamilan:</span></div>
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<span style="font-family: Wingdings; font-size: small; line-height: 115%;">Ø<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kurang bulan/Preterm/Prematur</span></div>
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<span style="font-family: Symbol; font-size: small; line-height: 115%;">®</span><span style="font-size: small; line-height: 115%;"> UK < 37 minggu</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-family: Wingdings; font-size: small; line-height: 115%;">Ø<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Cukup bulan/Fullterm/Aterm</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify;">
<span style="font-family: Symbol; font-size: small; line-height: 115%;">®</span><span style="font-size: small; line-height: 115%;"> UK 37 – 42 minggu</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-family: Wingdings; font-size: small; line-height: 115%;">Ø<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Lebih bulan/Postterm/Serotinus</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify;">
<span style="font-family: Symbol; font-size: small; line-height: 115%;">®</span><span style="font-size: small; line-height: 115%;"> UK > 42 minggu</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small;"><b><span style="line-height: 115%;">4.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></b><b><span style="line-height: 115%;">Etiologi BBLR</span></b></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">a.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Faktor ibu</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Umur
ibu pada waktu hamil < dari 20 tahun/> 35 tahun.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Toksemia
gravidakum yaitu preeklampsi & eklampsi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Kelainan
bentuk uterus.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Tumor
(misal: mioma uteri, sistoma).</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Ibu
yang menderita penyakit:</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Acut: Panas tinggi
(Tyfus, malaria)</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Cronis (TBC, penyakit
jantung, grumerulo nefritis kronis).</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Trauma
pada masa kehamilan</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Fisik (misal: jatuh)</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Psikologis (misal: stres)</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Plasenta:
plasenta previa, sulusio plasenta.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">b.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Faktor janin</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Kehamilan
ganda.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Hidramnion.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Kebutuhan
pecah dini.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Cacat
bawaan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Infeksi:
Rubeolla, sifilis, tokso plasmosis.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Infusiensi
plasenta.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Inkompatibilitas
darah ibu dan janin (faktor rhesus, golongan darah ABO).</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">c.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Faktor plasenta</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Plasenta
previa</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Solusio
plasenta</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">d.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Tidak diketahui</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small;"><b><span style="line-height: 115%;">5.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></b><b><span style="line-height: 115%;">Gejala dan Tanda</span></b></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45pt; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Tanda klinis atau
penampilan yang tampak sangat bervariasi, bergantung pada usia kehamilan saat
bayi dilahirkan. Makin prematur atau makin kecil umur kehamilan saat dilahirkan
makin besar pula perbedaannya dengan bayi yang lahir cukup bulan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">a.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Prematur murni</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">1.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">BB
< 2500 gram, PB < 45 cm, LK < 33 cm, LD < 30 cm.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">2.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Masa
gestasi < 37 minggu.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">3.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Kepala
lebih besar dari badan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">4.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Kulit
tipis transparan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">5.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Lanugo
(bulu-bulu halus) banyak terutama pada dahi, pelipis, telinga dan lengan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">6.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Lemak
sub cutan kurang.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">7.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Ubun-ubun
dan sutura lebar.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span lang="PT-BR" style="font-size: small; line-height: 115%;">8.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span lang="PT-BR" style="font-size: small; line-height: 115%;">Genitalia belum sempurna, labia
minora belum tertutup labia mayora (pada wanita) , pada laki-laki testis belum
turun.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">9.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Pembuluh
darah kulit banyak terlihat, peristaltik usus dapat terlihat.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">10.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Rambut tipis dan halus.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">11.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Tulang rawan dan daun telinga
imatur/elastis, daun telinga masih kurang sempurna.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">12.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Puting susu belum terbentuk dengan
baik.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">13.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Bayi kecil, posisi masih posisi
fetal.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">14.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Pergerakan kurang dan lemah.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">15.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Banyak tidur, tangis lemah,
pernafasan belum teratur dan sering mengalami serangan apnea.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">16.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Otot masih hipotonik.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">17.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Reflek tonus leher lemah, reflek
mengisap dan menelan serta reflek batuk belum sempurna.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">18.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kulit tampak mengkilat dan licin.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">b.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Dismaturitas</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">1.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Preterm:
sama dengan bayi prematuritas murni.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.25in; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">2.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Term
dan post term </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.5in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Kulit
berselubung verniks kaseosa tipis/tidak ada.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.5in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Kulit
pucat bernoda meconium, kering, keriput, tipis.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.5in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Jaringan
lemak di bawah kulit tipis.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.5in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Bayi
tampak gesit, aktif dan kuat.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1.5in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Tali
pusat berwarna kuning kehijauan. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small;"><b><span style="line-height: 115%;">6.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></b><b><span style="line-height: 115%;">Penyulit Yang Dapat Terjadi</span></b></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">a.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Hipotermi</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Kemampuan untuk
mempertahankan dan kesanggupan menambah produksi panas sangat terbatas karena
pertumbuhan otot-otot yang belum cukup memadai.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Lemak sub cutan sedikit,
belum matangnya sistem saraf pengatur suhu tubuh, luas permukaan tubuh relatif
lebih besar dibandingkan dengan berat badan sehingga mudah kehilangan panas.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">b.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Sindrom gawat panas</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-family: "Courier New"; font-size: small; line-height: 115%;">o<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Dapat
disebabkan belum sempurnanya pembentukan membran hialin surfaktan paru yang
merupakan suatu zat yang dapat menurunkan tegangan dinding alveoli paru.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;"> Pertumbuhan
surfaktan paru mencapai maksimum pada minggu ke 35 kehamilan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -0.25in;">
<span style="font-family: "Courier New"; font-size: small; line-height: 115%;">o<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Defisiensi
surfaktan menyebabkan gangguan kemampuan paru untuk mempertahankan
stabilitasnya, alveoli akan kembali kolaps setiap akhir ekspirasi sehingga
untuk pernafasan berikutnya dibutuhkan tekanan negatif intra toraks yang lebih
besar yang disertai usaha inspirasi yang kuat. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">c.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Hipoglikemia</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Bayi BBLR dapat
mempertahankan kadar gula darah dalam kadar 40 mg/dl,hal ini disebabkan
cadangan glikoden yang belum mencukupi. </span><span lang="PT-BR" style="font-size: small; line-height: 115%;">Hipoglikemia bila
kadar gula darah sama dengan atau < dari 20 mg/dl.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">d.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Perdarahan intra kranial</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify;">
<span lang="PT-BR" style="font-size: small; line-height: 115%;">Pada bayi prematur pembuluh darah sangat rapuh hingga mudah pecah.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify;">
<span lang="PT-BR" style="font-size: small; line-height: 115%;">Perdarahan intra kranial dapat terjadi karena trauma lahir, atau
Trombositopenia Idiopatik.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">e.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Rentan terhadap infeksi</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Pemindahan substansi
kekebalan dari ibu ke janin terjadi pada minggu terakhir masa kehamilan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Bayi prematur mudah
menderita infeksi karena imunitas humoral dan seluler masih kurang hingga bayi
mudah menderita infeksi. Selain itu karena kulit & selaput lendir membran
tidak memiliki perlindungan seperti bayi cukup bulan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">f.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Hiperbillirubinemia</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify;">
<span lang="PT-BR" style="font-size: small; line-height: 115%;">Hal ini dapat terjadi karena belum maturnya fungsi hepar. Kurangnya
enzym glukorinil transferase sehingga konyugasi billirubin indirek menjadi
billirubin direk belum sempurna dan kadar albumin darah yang berperan dalam
transportasi billirubin dari jaringan ke hepar kurang.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify;">
<span style="font-size: small;"><br /></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">g.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kerusakan integritas kulit</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Lemak subkutan kurang
atau sedikit, struktur kulit yang belum matang dan rapuh. Sensitivitas yang
kurang akan memudahkan terjadinya kerusakan integritas kulit, terutama pada
daerah yang sering tertekan dalam waktu lama. Pemakaian plester dapat
mengakibatkan kulit bayi lecet atau bahkan lapisan atas ikut terangkat.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 45pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small;"><b><span style="line-height: 115%;">7.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></b><b><span style="line-height: 115%;">Penatalaksanaan</span></b></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">a.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Mengupayakan dan mempertahankan nafas
spontan dengan resusitasi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">b.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Mengupayakan dan mempertahankan suhu
dalam batas normal dengan cara: mengeringkan dan membungkus bayi, rawat bayi
dalam inkubator, metode kanguru.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">c.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Pemberian nutrisi/cairan terutama
ASI.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 63pt; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">d.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Mencegah/mengatasi infeksi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><br /></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.25in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small;"><b><span style="line-height: 115%;">B.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></b><b><span style="line-height: 115%;">KONSEP DASAR PENYAKIT</span></b></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small;"><b><span style="line-height: 115%;">1.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></b><b><span style="line-height: 115%;">Pengkajian</span></b></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">a.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Masalah yang berkaitan dengan ibu</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">1.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Penyakit seperti: hipertensi,
toksemia, plasenta previa, abrupsio plasenta, inkompeten servikal, kehamilan
kembar, mal nutrisi dan DM.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">2.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Status sosial ekonomi yang rendah.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">3.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Tiadanya perawatan sebelum kelahiran
(prenatal care).</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">4.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Riwayat kelahiran prematur atau
aborsi, kelahiran kembar.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">5.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Penggunaan obat-obatan, alkohol,
rokok, kafein.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">6.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Riwayat ibu, umur < 16 tahun atau
diatas 35 tahun.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">7.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Latar belakang pendidikan rendah.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">8.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kurang gizi, konsultasi genetik yang
pernah dilakukan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">9.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Jarak kehamilan yang berdekatan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">10.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Infeksi, troch atau penyakit hubungan
seksual lain.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 81pt; text-align: justify; text-indent: -27pt;">
<span style="font-size: small; line-height: 115%;">11.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Golongan darah dan faktor Rh. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">b.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Bayi pada saat kelahiran</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">1.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Umur kehamilan biasanya antara 24-37
minggu.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">2.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Rendahnya BB pada saat kelahiran, SGA
atau terlalu besar dibanding umur kehamilan. BB biasanya < 2500 gram.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">3.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kurus, lapisan lemak subkutan sedikit
atau tidak ada.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">4.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kepala relatif lebih besar dibanding
badan, 3 cm > dibanding lebar dada.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">5.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kelainan fisik yang mungkin terlihat,
nilai apgar pada 1 sampai 5 menit, 0 sampai 3 menunjukkan kegawatan yang parah,
4-6 kegawatan sedang, dan 7-10 normal. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">c.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kardiovaskular</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify;">
<span lang="PT-BR" style="font-size: small; line-height: 115%;">Denyut jantung rata-rata 120 sampai 160 x/mnt.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">d.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Gastro intestinal</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">1.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Penonjolan abdomen, pengeluaran
mekonium, biasanya terjadi dalam waktu 12 jam.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">2.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Reflek menelan dan mengisap lemah.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">3.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Ada atau tidak ada anus.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">4.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Ketidaknormalan konginital lain. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">e.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Integumen</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">1.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kulit yang berwarna merah muda atau
merah kekuning-kuningan, sianosis atau campuran bermacam warna.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">2.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Vernik kaserosa sedikit, dengan
rambut lanugo diseluruh tubuh.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">3.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kurus dan kulit tampak transparan,
halus dan mengkilap.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">4.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Edema yang menyeluruh atau di bagian
tertentu yang terjadi pada saat kelahiran.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">5.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kuku pendek belum melewati ujung
jari.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">6.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Rambut jarang atau mungkin tidak ada
sama sekali.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">7.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Petekie atau ekimosis.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">f.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Muskulo skeletal</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">1.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Tulang kartilago telingan belum
tumbuh dengan sempurna, lembut dan lunak.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">2.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Tulang tengkorak dan rusuk lunak.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">3.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Gerakan lemah dan tidak aktif atau
letargik.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">g.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Neurologis</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">1.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Reflek dan gerakan TD tes neurologis
tampak tidak resisten, gerak reflek hanya berkembang sebagian.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">2.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Menelan, mengisap dan batuk sangat
lemah atau tidak efektif.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span lang="PT-BR" style="font-size: small; line-height: 115%;">3.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span lang="PT-BR" style="font-size: small; line-height: 115%;">Tidak ada atau menurunnya tanda
neurologis: mata mungkin tertutup atau mengatup apa bila umur kehamilan belum
mencapai 25 sampai 26 minggu.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">4.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Suhu tubuh tidak stabil, biasanya
hipotermia, gemetar, kejang dan mata berputar-putar. Biasanya bersifat sementara,
tetapi mungkin juga ini mengindikasikan adanya kelainan neurologis.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">h.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Paru</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Jumlah pernafasan
biasanya antara 40-60 per menit diselingi dengan periode apnea, pernafasan yang
tidak teratur, dengkuran, retraksi (intercostal, suprasternal, substernal) terdengar
suaran gemerisik.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">i.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Ginjal</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Berkemih terjadi setelah
8 jam kelahiran, ketidakmampuan untuk melarutkan ekskresi ke dalam urine.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">j.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Reproduksi</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Bayi
perempuan: klitoris yang menonjol dengan labium mayora yang belum berkembang.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Bayi
laki-laki: Scrotum yang belum berkembang sempurna dengan rugae yang kecil,
testis tidak turun kedalam skrotum.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify;">
<span style="font-size: small;"><br /></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small;"><b><span style="line-height: 115%;">2.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></b><b><span style="line-height: 115%;">Diagnosa Dan Rencana Asuhan
Keperawatan</span></b></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><b><span style="line-height: 115%;">Diagnosa Keperawatan:</span></b></span><span style="font-size: small; line-height: 115%;"> Resiko tinggi gawat nafas yang berhubungan dengan ketidak matangan paru
karena kurang produksi surfactan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><i><u><span style="line-height: 115%;">Tujuan:</span></u></i></span><span style="font-size: small; line-height: 115%;">
Menjaga dan memaksimalkan fungsi paru.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><i><u><span style="line-height: 115%;">Intervensi:</span></u></i></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">a.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kumpulkan data penilaian yang
berkaitan dengan kegawatan pernafasan:</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Riwayat
ibu atas penggunaan obat-obat atau kondisi tidak normal selama kehamilan dan
proses kelahiran.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Kondisi
bayi saat kelahiran, nilai apgar, resusitasi (dilakukan atau tidak).</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Pernafasan:
frekuensi, kedalaman, kemudahan, takipnea, dengan frekuensi > 60 kali per
menit.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Dengkuran
ekspirasi, pernafasan cuping hidung atau retraksi dengan penggunaan otot-otot
eksesoris (interkostal, suprasternal, atau substernal).</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Sianosis
ketika menghirup udara kamar, penurunan suara nafas. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">b.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Waspada episode apnea yang
berlangsung > 20 detik</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Catat hal-hal:</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Letargi,
posisi dan aktivitas sebelum dan sesudah periode apnea (sambil tiduran atau
menyuap), berbaring miring, telungkup atau posisi terlentang, sumbatan jalan
nafas disebabkan oleh masker di atas hidung.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Distensi
abdomen.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Suhu
dan sianosis.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Lamanya
periode apnea.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Penyebab
apnea, seperti: stress, demam, sepsis, kegagalan pernafasan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span lang="PT-BR" style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span lang="PT-BR" style="font-size: small; line-height: 115%;">Hasil hitung sel darah, kultur darah,
sinar x dada, dan kajian analisa gas darah jika ada.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify;">
<span style="font-size: small;"><br /></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify;">
<span style="font-size: small;"><br /></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">c.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Memberi dan memantau bantuan
pernafasan sebagai berikut:</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Berikan
oksigen yang hangat dan sudah diatur kelembabannya. Periksa oksigen setiap 1
jam. Rubah posisi setiap 1 jam.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Isap
lendir dengan hati-hati dari mulut selama < 5 menit.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Jaga
suhu lingkungan yang netral.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Posisikan
bayi tengkurap atau terlentang dengan bantalan kecil di bawah bahu atau posisi
berbaring miring dengan kepala sedikit
diangkat.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 1in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">-<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span style="font-size: small; line-height: 115%;">Rangsang
bayi dengan cara tepukan lembut pada telapak kaki, tangan dan punggung,
kemudian tubuh, wajah, lengan dan tungkai.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">d.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Pantau kajian analisa gas darah untuk
mengetahui asidosis pernafasan dan metabolis.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">e.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Persiapkan dan lakukan terapi
farmacologi, seperti teofilim IV, awasi tingkat darah setiap 1 sampai 2 hari
untuk deteksi adanya keracunan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><b><span style="line-height: 115%;">Diagnosa Keperawatan: </span></b></span><span style="font-size: small; line-height: 115%;">Resiko tinggi hipotermi atau hipertermia yang berhubungan
dengan prematuritas atau perubahan suhu lingkungan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><i><u><span style="line-height: 115%;">Tujuan:</span></u></i></span><span style="font-size: small; line-height: 115%;">
Menjaga suhu lingkungan netral.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><i><u><span style="line-height: 115%;">Intervensi:</span></u></i></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">a.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Jaga temperatur ruangan perawatan 25<sup>0</sup>C.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">b.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Ukur suhu rectal bayi terlebih
dahulu, baru kemudian suhu axila setiap 2 jam atau setiap kali diperlukan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">c.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Lakukan prosedur penghangatan setelah
bayi lahir.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">d.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Tempatkan bayi di bawah penghangatan
radian warmar atau inkubator jika diperlukan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">e.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Tempatkan kontrol temperatur
(servo-control) diatas abdomen.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify;">
<span lang="PT-BR" style="font-size: small; line-height: 115%;">Atur suhunya 37-37,5<sup>0</sup>C, juga jaga suhu kulit 36-36,5<sup>0</sup>C.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">f.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Hindari menempatkan bayi kontak
dengan sumber panas atau sumber dingin, hindari juga udara panas dan udara
dingin, lakukan juga perlindungan untuk menjaga panas tubuh, seperti menjaga
agar kulit bayi tetap kering, dan menjaga agar kepala bayi tertutup.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">g.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Awasi bayi terhadap perubahan yang
mengindikasikan adanya stress dingin.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><b><span style="line-height: 115%;">Diagnosa Keperawatan:</span></b></span><span style="font-size: small; line-height: 115%;"> Gangguan nutrisi, kurang dari kebutuhan tubuh yang berhubungan dengan
simpanan glikogen, zat besi dan kalsium yang tidak cukup dan penipisan
persedian karena metabolik yang tinggi, tingginya kebutuhan, asupan kalori yang
tidak mencukupi dan hilangnya kalori.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><i><u><span style="line-height: 115%;">Tujuan:</span></u></i></span><span style="font-size: small; line-height: 115%;">
Meningkatan dan menjaga asupan kalori dan status gizi bayi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><i><u><span style="line-height: 115%;">Intervensi:</span></u></i></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">a.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Awasi reflek mengisap dan kemampuan
menelan bayi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify;">
<span style="font-size: small; line-height: 115%;">Pemberian makanan melalui
mulut dimulai ketika bayi sudah dalam keadaan stabil dan pernafasan terkendali
dengan baik.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">b.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Awasi dan hitung kebutuhan kalori
bayi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">c.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Mulai pemberian ASI atau susu dengan
botol 2-6 jam setelah kelahiran, mulai dengan 3-5 ml, setiap pemberian dengan
interval 3 jari, pemberian bisa ditambah bila bayi menunjukkan toleransi yang
baik.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">d.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Timbang bayi setiap hari, bandingkan
berat badan dengan asupan kalori yang diberikan. Ini dilakukan untuk menentukan
jumlah asupan yang tepat atau kebutuhan peningkatan asupan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">e.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Sediakan Dexrosa 10%.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">f.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Beri minum ASI langsung ke ibunya
jika reflek mengisap dan menelan kuat.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">g.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Gunakan makanan melalui orifaring
jika bayi lelah mengisap. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><b><span style="line-height: 115%;">Diagnosa Keperawatan :</span></b></span><span style="font-size: small; line-height: 115%;"> Kekurangan volume cairan yang berhubungan dengan pengeluaran
yang disebabkan oleh immaturitas, pemanas radian (pancaran) atau pengeluaran
melalui kulit/paru.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><i><u><span style="line-height: 115%;">Tujuan:</span></u></i></span><span style="font-size: small; line-height: 115%;">
Menjaga keseimbangan cairan dan elektrolit.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><i><u><span style="line-height: 115%;">Intervensi :</span></u></i></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">a.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Awasi dan hitunglah kebutuhan cairan
bayi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">b.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Berikan cairan 150-180 ml/kg jika
diperlukan dapat dinaikkan sampai 200 ml/kg.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">c.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Timbang bayi setiap hari.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">d.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Pantau dan catat asupan dan
pengeluaran cairan bayi setiap jam.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify; text-indent: 0.25in;">
<span style="font-size: small; line-height: 115%;">Bandingkan
jumlahnya untuk mengetahui bila terjadi ketidak seimbangan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">e.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Periksa berat jenis urine dan
glikosuria.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">f.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kaji bayi dari tanda yang
mengindikasikan meningkatnya kebutuhan cairan, seperti kenaikkan suhu tubuh,
syok hipovolemik dengan peningkatan tekanan darah dan meningkatnya detak
jantung, penurunan denyut nadi kaki dan tangan yang dingin, pengerutan kulit,
sepsis, asfeksia dan hipoksia. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><b><span style="line-height: 115%;">Diagnosa Keperawatan : </span></b></span><span style="font-size: small; line-height: 115%;">Kurang pengetahuan yang berhubungan dengan perawatan bayi
yang sakit di rumah.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><i><u><span style="line-height: 115%;">Tujuan</span></u></i></span><span style="font-size: small; line-height: 115%;"> :
Orang tua dan keluarga mengetahui tentang penyakit bayi dan perawatan
selanjutnya.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><i><u><span style="line-height: 115%;">Intervensi:</span></u></i></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">a.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Informasikan pada orang tua dan
keluarga tentang proses penyakit, prosedur perawatan, tanda dan gejala masalah
pernafasan, perawatan lanjut.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">b.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Ajari orang tua dan keluarga tentang
perawatan yang dibutuhkan seperti terapi oksigen di rumah, ventilasi mekanis,
fisioterapi dada, terapi obat, terapi gizi dan cairan, pemantauan khusus
seperti pemantauan apnea dan gula darah.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">c.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Meminta orang tua dan keluarga
mendemonstrasikan kembali prosedur yang harus diajarkan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">d.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Mendorong orang tua dan keluarga
untuk berpartisipasi dalam perawatan bayi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">e.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Mengajarkan orang tua dan keluarga
bagaimana menyeimbangkan antara aktivitas dan istirahat dan bagaimana
mengevaluasi toleransi bayi terhadap aktivitas.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">f.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Susun perawatan kesehatan lanjutan di
rumah. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><b><span style="line-height: 115%;">Diagnosa Keperawatan :</span></b></span><span style="font-size: small; line-height: 115%;"> Resiko tinggi infeksi yang berhubungan dengan kurang
kekebalan tubuh dan kemungkinan infeksi silang dari ibu atau staf kesehatan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><i><u><span style="line-height: 115%;">Tujuan :</span></u></i></span><span style="font-size: small; line-height: 115%;">
Tidak terjadi infeksi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.5in; text-align: justify;">
<span style="font-size: small;"><i><u><span style="line-height: 115%;">Intervensi:</span></u></i></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">a.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kaji adanya kenaikan suhu tubuh,
letargi, apnea, malas minum, gelisah dan ikterus.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">b.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Kaji riwayat ibu, kondisi bayi selama
kehamilan, dan epidemi infeksi di ruang perawatan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">c.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Ambil sampel darah.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">d.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Pantau ulang hasil penelitian
eritrosit.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<span style="font-size: small; line-height: 115%;">e.<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: "Times New Roman"; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-size: small; line-height: 115%;">Upayakan pencegahan infeksi dari
lingkungan, cuci tangan sebelum dan sesudah memegang bayi, isolasi bayi bila
perlu, lakukan prosedur tindakan secara steril, cegah kontak dengan orang tua
yang menderita infeksi, ajar orang tua untuk melakukan tindakan pencegahan
infeksi silang atau perpindahan microorganisme.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0.25in; text-align: justify;">
<span style="font-size: small;"><br /></span></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<span style="font-size: small;"><br /></span></div>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-7630949553145627542012-09-03T21:24:00.001-07:002012-09-03T21:24:09.964-07:00TIPS BIAR LANCAR MENYUSUN PROPOSAL MAUPUN KTI<br />
<a name='more'></a>assalamu'alaikum broo...<br />
buat temen2 yang senasip sepenanggungan sama Q...yang lagi pusing mikirin proposal dan KT I , aku punya cara jitu loh,,,, biar gk stres n berjalan dengan enjoy....<br />caranya simple banget hanya memerlukan sedikit dana n tentunya keikhlasan yg paling penting...<br />mua tau,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,!!!!!!!!!!<br />kasi tau gk ya?kasih dagh.......<br />caranya tugh.....<br />catat tanggal lahir , hobi,makanan kesukaan,permaenan kesukaan,siaran tv kesukaan,pokoknya semua yang disukai n juga yang disukai ma pembimbing kamu....<br />
tinggal lakuin yang disukai n g ush lakuin yang g' disukai n jngan lupa sering2 like status pembimbingmu...<br />
heheh selmat mencoba n pasti berhasil...<br />
wassalam..himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-82818641176300977632012-09-03T09:01:00.001-07:002012-09-03T09:17:59.256-07:00LAPORAN PENDAHULUAN ASUHAN KEPERAWATAN KLIEN DENGAN GAGAL NAFAS (BANTUAN VENTILASI MEKANIK)<!--[if !mso]>
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<br />
<h2 style="tab-stops: list .25in;">
<span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span>Pengertian</h2>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Kegagalan
pernafasan adalah pertukaran gas yang tidak adekuat sehingga terjadi hipoksia,
hiperkapnia (peningkatan konsentrasi karbon dioksida arteri), dan asidosis.</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Ventilator adalah
suatu alat yang digunakan untuk membantu sebagian atau seluruh proses ventilasi
untuk mempetahankan oksigenasi.</span><br />
<a name='more'></a></div>
<div class="MsoNormal">
<br /></div>
<h2 style="tab-stops: list .25in;">
<span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span>Penyebab
gagal nafas</h2>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="mso-list: l0 level1 lfo3; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Penyebab sentral</span></li>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal" style="mso-list: l0 level2 lfo3; tab-stops: list 1.0in;"><span lang="IN" style="mso-ansi-language: IN;">Trauma kepala : contusio cerebri</span></li>
<li class="MsoNormal" style="mso-list: l0 level2 lfo3; tab-stops: list 1.0in;"><span lang="IN" style="mso-ansi-language: IN;">Radang otak : encephalitis</span></li>
<li class="MsoNormal" style="mso-list: l0 level2 lfo3; tab-stops: list 1.0in;"><span lang="IN" style="mso-ansi-language: IN;">Gangguan vaskuler : perdarahan otak
, infark otak</span></li>
<li class="MsoNormal" style="mso-list: l0 level2 lfo3; tab-stops: list 1.0in;"><span lang="IN" style="mso-ansi-language: IN;">Obat-obatan : narkotika, anestesi</span></li>
</ol>
<li class="MsoNormal" style="mso-list: l0 level1 lfo3; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Penyebab perifer</span></li>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal" style="mso-list: l0 level2 lfo3; tab-stops: list 1.0in;"><span lang="IN" style="mso-ansi-language: IN;">Kelainan neuromuskuler : GBS,
tetanus, trauma cervical, muscle relaxans</span></li>
<li class="MsoNormal" style="mso-list: l0 level2 lfo3; tab-stops: list 1.0in;"><span lang="IN" style="mso-ansi-language: IN;">Kelainan jalan nafas : obstruksi
jalan nafas, asma bronchiale</span></li>
<li class="MsoNormal" style="mso-list: l0 level2 lfo3; tab-stops: list 1.0in;"><span lang="IN" style="mso-ansi-language: IN;">Kelainan di paru : edema paru, atelektasis,
ARDS</span></li>
<li class="MsoNormal" style="mso-list: l0 level2 lfo3; tab-stops: list 1.0in;"><span lang="IN" style="mso-ansi-language: IN;">Kelainan tulang iga/thoraks: fraktur
costae, pneumo thorax, haematothoraks</span></li>
<li class="MsoNormal" style="mso-list: l0 level2 lfo3; tab-stops: list 1.0in;"><span lang="IN" style="mso-ansi-language: IN;">Kelainan jantung : kegagalan jantung
kiri</span></li>
</ol>
</ol>
<h2 style="tab-stops: list .25in;">
<span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";"> </span></span>Patofisiologi</h2>
<div class="MsoNormal" style="text-indent: .5in;">
<span lang="IN" style="mso-ansi-language: IN;">Pada pernafasan spontan inspirasi terjadi karena diafragma dan otot
intercostalis berkontraksi, rongga dada mengembang dan terjadi tekanan negatif
sehingga aliran udara masuk ke paru, sedangkan fase ekspirasi berjalan secara
pasif .</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Pada pernafasan
dengan ventilasi mekanik, ventilator mengirimkan udara dengan memompakan ke
paru pasien, sehingga tekanan selama inspirasi adalah positif dan menyebabkan
tekanan intra thorakal meningkat. Pada akhir inspirasi tekanan dalam rongga
thoraks paling positif. </span></div>
<div class="MsoNormal">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="IN" style="mso-ansi-language: IN;">Ventilator</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="mso-ignore: vglayout;">
</span></div>
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="5" width="282"><br /></td>
</tr>
<tr>
<td><br /></td>
<td><img height="27" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /></td>
</tr>
</tbody></table>
<span lang="IN" style="mso-ansi-language: IN;"> </span>
<br />
<div class="MsoHeader">
<br /></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div class="MsoNormal" style="margin-right: -45.0pt;">
<span style="height: 27px; left: 0px; margin-left: 558px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251664384;"><img height="27" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /></span><span style="height: 27px; left: 0px; margin-left: 414px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251662336;"><img height="27" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /></span><span style="height: 2px; left: 0px; margin-left: 383px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 182px; z-index: 251661312;"><img height="2" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image002.gif" width="182" /></span><span style="height: 27px; left: 0px; margin-left: 282px; margin-top: 16px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251645952;"><img height="27" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /></span><span lang="IN" style="mso-ansi-language: IN;"><span style="mso-spacerun: yes;">
</span>Tekanan positif inspirasi</span></div>
<div class="MsoHeader">
<br /></div>
<div class="MsoHeader" style="margin-right: -.25in;">
<span style="height: 38px; left: 0px; margin-left: 59px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251650048;"><img height="38" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image003.gif" width="2" /></span><span style="height: 2px; left: 0px; margin-left: 59px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 158px; z-index: 251649024;"><img height="2" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image004.gif" width="158" /></span><span lang="IN" style="mso-ansi-language: IN;"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Darah
ke jantung<span style="mso-spacerun: yes;"> </span>suplai ke otak<span style="mso-spacerun: yes;"> </span>vol tidal</span></div>
<div class="MsoNormal" style="margin-left: 171.0pt;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-spacerun: yes;"> </span>Terhambat<span style="mso-spacerun: yes;"> </span>kurang<span style="mso-spacerun: yes;"> </span>tinggi</span></div>
<div class="MsoNormal">
<span style="mso-ignore: vglayout;">
</span></div>
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="2" width="282"><br /></td>
<td width="12"><br /></td>
<td width="120"><br /></td>
<td width="12"><br /></td>
<td width="132"><br /></td>
<td width="12"><br /></td>
</tr>
<tr>
<td height="27"><br /></td>
<td align="left" valign="top"><img height="27" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /></td>
<td><br /></td>
<td align="left" valign="top"><img height="27" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /></td>
<td><br /></td>
<td align="left" valign="top"><img height="27" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /></td>
</tr>
</tbody></table>
<span lang="IN" style="mso-ansi-language: IN;"> </span>
<br />
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Darah ke atrium
kiri<span style="mso-spacerun: yes;"> </span>Venous return
b(-)</span></div>
<div class="MsoNormal" style="margin-right: -.25in;">
<span style="height: 27px; left: 0px; margin-left: 282px; margin-top: 1px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251648000;"><img height="27" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image005.gif" width="12" /></span><span lang="IN" style="mso-ansi-language: IN;"><span style="mso-spacerun: yes;"> </span>Berkurang<span style="mso-spacerun: yes;">
</span>TIK meningkat<span style="mso-spacerun: yes;">
</span>resiko </span></div>
<div class="MsoNormal" style="margin-right: -.25in;">
<span style="height: 63px; left: 0px; margin-left: 54px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251652096;"><img height="63" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image006.gif" width="12" /></span><span lang="IN" style="mso-ansi-language: IN;"><span style="mso-spacerun: yes;">
</span>pneumotorak</span></div>
<div class="MsoNormal">
<span style="height: 12px; left: 0px; margin-left: 70px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 135px; z-index: 251653120;"><img height="12" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image007.gif" width="135" /></span><span style="height: 2px; left: 0px; margin-left: 59px; margin-top: 1px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251651072;"><img height="2" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image008.gif" width="2" /></span><span lang="IN" style="mso-ansi-language: IN;"><span style="mso-spacerun: yes;">
</span>cardiac output menurun</span></div>
<div class="MsoNormal">
<span style="height: 12px; left: 0px; margin-left: 383px; margin-top: 1px; mso-ignore: vglayout; position: absolute; width: 51px; z-index: 251659264;"><img height="12" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image009.gif" width="51" /></span><span style="height: 14px; left: 0px; margin-left: 287px; margin-top: 6px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251657216;"><img height="14" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image010.gif" width="2" /></span><span style="height: 2px; left: 0px; margin-left: 287px; margin-top: 6px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251656192;"><img height="2" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image008.gif" width="2" /></span><span lang="IN" style="mso-ansi-language: IN;"><span style="mso-spacerun: yes;">
</span>Hipotensi<span style="mso-spacerun: yes;"> </span>Ggn
perfusi jaringan</span></div>
<div class="MsoNormal">
<span style="mso-ignore: vglayout; position: relative; z-index: 251658240;"><span style="height: 43px; left: 0px; left: 287px; position: absolute; top: -5px; width: 230px;">
</span></span></div>
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="0" width="0"><br /></td>
<td width="27"><br /></td>
<td width="177"><br /></td>
<td width="26"><br /></td>
</tr>
<tr>
<td height="5"><br /></td>
<td align="left" rowspan="2" valign="top"><img height="12" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image011.gif" width="27" /></td>
</tr>
<tr>
<td height="7"><br /></td>
<td><br /></td>
<td align="left" rowspan="2" valign="top"><img height="38" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image012.gif" width="26" /></td>
</tr>
<tr>
<td height="31"><br /></td>
</tr>
</tbody></table>
<span lang="IN" style="mso-ansi-language: IN;"> </span>
<br />
<div class="MsoNormal">
<span style="height: 12px; left: 0px; margin-left: 503px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 27px; z-index: 251669504;"><img height="12" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image013.gif" width="27" /></span><span style="height: 15px; left: 0px; margin-left: 234px; margin-top: 5px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251655168;"><img height="15" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image014.gif" width="12" /></span><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 5px; mso-ignore: vglayout; position: absolute; width: 74px; z-index: 251654144;"><img height="2" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image015.gif" width="74" /></span><span lang="IN" style="mso-ansi-language: IN;">Kompresi mikro vaskuler<span style="mso-spacerun: yes;">
</span><span style="mso-spacerun: yes;"> </span>Kecemasan</span></div>
<div class="MsoHeader">
<span style="mso-ignore: vglayout; position: relative; z-index: 251668480;"><span style="height: 14px; left: 0px; left: 503px; position: absolute; top: -1px; width: 2px;"><img height="14" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image010.gif" width="2" /></span></span><span style="height: 2px; left: 0px; margin-left: 491px; margin-top: 11px; mso-ignore: vglayout; position: absolute; width: 14px; z-index: 251667456;"><img height="2" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image016.gif" width="14" /></span><span style="height: 12px; left: 0px; margin-left: 335px; margin-top: 6px; mso-ignore: vglayout; position: absolute; width: 39px; z-index: 251660288;"><img height="12" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image017.gif" width="39" /></span><span lang="IN" style="mso-ansi-language: IN;"><span style="mso-spacerun: yes;">
</span>Suplai darah ke paru b(-)<span style="mso-spacerun: yes;">
</span>Ggn oksigenasi</span></div>
<div class="MsoNormal">
<br /></div>
<h2 style="tab-stops: list .25in;">
<span style="font-weight: normal; mso-bidi-font-weight: bold;"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";"> </span></span></span>Pemeriksaan
Fisik<span style="font-weight: normal; mso-bidi-font-weight: bold;"></span></h2>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">( Menurut
pengumpulan data dasar oleh Doengoes)</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo7; tab-stops: list .5in; text-indent: -.5in;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">Sirkulasi</span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN" style="mso-ansi-language: IN;">Tanda : Takikardia, irama ireguler</span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN" style="mso-ansi-language: IN;">S3S4/Irama gallop </span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN" style="mso-ansi-language: IN;">Daerah PMI bergeser ke daerah mediastinal</span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN" style="mso-ansi-language: IN;">Hamman’s sign (bynui udara beriringan dengan denyut jantung menandakan
udara di mediastinum)</span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN" style="mso-ansi-language: IN;">TD : hipertensi/hipotensi</span></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l6 level1 lfo7; tab-stops: list .5in; text-indent: -.25in;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">Nyeri/Kenyamanan</span></div>
<div class="MsoBodyTextIndent2">
Gejala :<span style="mso-spacerun: yes;">
</span>nyeri pada satu sisi, nyeri tajam saat napas dalam, dapat menjalar ke
leher, bahu dan<span style="mso-spacerun: yes;"> </span>abdomen, serangan
tiba-tiba saat batuk</div>
<div class="MsoHeader">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-spacerun: yes;"> </span>Tanda<span style="mso-spacerun: yes;">
</span>:<span style="mso-spacerun: yes;"> </span>Melindungi bagian nyeri,
perilaku distraksi, ekspresi meringis</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo7; tab-stops: list .5in; text-indent: -.5in;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">Pernapasan</span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -45.0pt;">
<span lang="IN" style="mso-ansi-language: IN;">Gejala<span style="mso-spacerun: yes;">
</span>:<span style="mso-spacerun: yes;"> </span>riwayat trauma dada, penyakit
paru kronis, inflamasi paru , keganasan, “lapar udara”, batuk</span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -45.0pt;">
<span lang="IN" style="mso-ansi-language: IN;">Tanda :<span style="mso-spacerun: yes;">
</span>takipnea, peningkatan kerja pernapasan, penggunaan otot asesori,
penurunan bunyi napas, penurunan fremitus vokal, perkusi : hiperesonan di atas
area berisi udara (pneumotorak), dullnes di area berisi cairan (hemotorak);
perkusi : pergerakan dada tidak seimbang, reduksi ekskursi thorak. Kulit :
cyanosis, pucat, krepitasi sub kutan; mental: cemas, gelisah, bingung, stupor</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo7; tab-stops: list .5in; text-indent: -.5in;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">Keamanan</span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN" style="mso-ansi-language: IN;">Gejala :<span style="mso-spacerun: yes;"> </span>riwayat terjadi fraktur,
keganasan paru, riwayat radiasi/kemoterapi</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">5.<span style="mso-spacerun: yes;"> </span>Penyuluhan/pembelajaran</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-spacerun: yes;"> </span>Gejala : riwayat faktor resiko keluarga
dengan tuberkulosis, kanker<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -45.0pt;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-spacerun: yes;"> </span></span></div>
<h2 style="tab-stops: list .25in;">
<span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";"> </span></span>Pemeriksaan
Diagnostik</h2>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">- Hb<span style="mso-spacerun: yes;"> </span>: dibawah 12 gr %</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">- Analisa gas
darah : </span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo4; tab-stops: list 1.25in 117.0pt; text-indent: -81.0pt;">
<span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">pH
dibawah 7,35 atau di atas<span style="mso-spacerun: yes;"> </span>7,45</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo4; tab-stops: list 1.25in 117.0pt; text-indent: -81.0pt;">
<span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">paO2
di bawah 80 atau di atas <span style="mso-spacerun: yes;"> </span>100 mmHg</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo4; tab-stops: list 1.25in 117.0pt; text-indent: -81.0pt;">
<span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">pCO2
di bawah 35 atau di atas<span style="mso-spacerun: yes;"> </span>45 mmHg</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo4; tab-stops: list 1.25in 117.0pt; text-indent: -81.0pt;">
<span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">BE di
bawah -2 atau di atas<span style="mso-spacerun: yes;"> </span>+2</span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo4; tab-stops: list .75in 1.0in; text-indent: -1.0in;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">Saturasi
O2 kurang dari 90 %</span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo4; tab-stops: list .75in 1.0in; text-indent: -1.0in;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">Ro” :
terdapat gambaran akumulasi udara/cairan , dapat terlihat perpindahan letak
mediastinum</span></div>
<div class="MsoNormal">
<br /></div>
<h2 style="tab-stops: list .25in;">
<span style="mso-list: Ignore;">F.<span style="font: 7.0pt "Times New Roman";"> </span></span>Diagnosa
Keperawatan</h2>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Diagnosa
Keperawatan yang mungkin muncul pada klien dengan pernafasan ventilator mekanik
adalah :</span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN" style="mso-ansi-language: IN;">1.Ketidak efektifan bersihan jalan nafas berhubungan dengan peningkatan
produksi sekret</span></div>
<ol start="2" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="mso-list: l2 level1 lfo4; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Gangguan pertukaran gas berhubungan
dengan sekresi tertahan, proses<span style="mso-spacerun: yes;">
</span>penyakit</span></li>
<li class="MsoNormal" style="mso-list: l2 level1 lfo4; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Ketidakefektifan pola nafas
berhubungandengan kelelahan, pengesetan ventilator yang tidak tepat,
obstruksi selang ETT</span></li>
<li class="MsoNormal" style="mso-list: l2 level1 lfo4; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Cemas berhubungan dengan penyakti
kritis, takut terhadap kematian</span></li>
<li class="MsoNormal" style="mso-list: l2 level1 lfo4; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Gangguan komunikasi verbal
berhubungan dengan pemasangan selang ETT</span></li>
<li class="MsoNormal" style="mso-list: l2 level1 lfo4; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Resiko tinggi komplikasi infeksi
saluran nafas berhubungan dengan pemasangan selang ETT</span></li>
<li class="MsoNormal" style="mso-list: l2 level1 lfo4; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Resiko tinggi sedera berhubungan
dengan penggunaan ventilasi mekanik, selang ETT, ansietas, stress</span></li>
<li class="MsoNormal" style="mso-list: l2 level1 lfo4; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Nyeri berhubungan dengan penggunaan
ventilasi mekanik, letak selang ETT</span></li>
</ol>
<div class="MsoNormal">
<br /></div>
<h2 style="tab-stops: list .25in;">
<span style="mso-list: Ignore;">G.<span style="font: 7.0pt "Times New Roman";"> </span></span>Rencana
Keperawatan</h2>
<div class="MsoNormal">
<br /></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="mso-list: l3 level1 lfo5; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Ketidak efektifan bersihan jalan
nafas berhubungan dengan peningkatan produksi sekret</span></li>
</ol>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoBodyTextIndent2">
Tujuan : Klien akan memperlihatkan kemampuan
meningkatkan dan mempertahankan keefektifan<span style="mso-spacerun: yes;">
</span>jalan nafas</div>
<div class="MsoBodyTextIndent2">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN" style="mso-ansi-language: IN;">Kriteria hasil :</span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo4; tab-stops: list 1.0in; text-indent: -.25in;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">Bunyi
nafas bersih</span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo4; tab-stops: list 1.0in; text-indent: -.25in;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">Ronchi
(-)</span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo4; tab-stops: list 1.0in; text-indent: -.25in;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">Tracheal
tube bebas sumbatan</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Intervensi</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Rasional</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">1.Auskultasi
bunyi nafas tiap 2-4 jam atau bila diperlukan</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">2.Lakukan
penghisapan bila terdengar ronchi dengan cara :</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">a.Jelaskan pada
klien tentang tujuan dari tindakan penghisapan</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">b.Berikan
oksigenasi dengan O2 100 % sebelum dilakukan penghisapan, minimal<span style="mso-spacerun: yes;"> </span>4 – 5 x pernafasan</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">c.Perhatikan
teknik aseptik, gunakan sarung tangan steril, kateter penghisap steril</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">d.Masukkan
kateter ke dalam selang ETT dalam keadaan tidak menghisap, lama penghisapan
tidak lebih 10 detik</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">e.Atur tekana
penghisap tidak lebih 100-120 mmHg </span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">f.Lakukan
oksigenasi lagi dengan O2 100% sebelum melakukan penghisapan berikutnya</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">g.Lakukan
penghisapan berulang-ulang sampai suara nafas bersih</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">3.Pertahankan
suhu humidifier tetap hangat ( 35 – 37,8 C)</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Mengevaluasi
keefektifan bersihan jalan nafas</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Meningkatkan
pengertian sehingga memudahkan klien berpartisipasi</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Memberi
cadangan oksigen untuk menghindari hypoxia</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Mencegah
infeksi nosokomial</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Aspirasi lama
dapat menyebabkan hypoksiakarena tindakan penghisapan akan mengeluarkan
sekret dan oksigen</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Tekana negatif
yang berlebihan dapat merusak mukosa jalan nafas</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Memberikan
cadangan oksigen dalam paru</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Menjamin
kefektifan jalan nafas</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Membantu
mengencerkan sekret</span></div>
<div class="MsoNormal">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l3 level1 lfo5; tab-stops: list .5in; text-indent: -.25in;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">Gangguan
pertukaran gas berhubungan dengan sekresi tertahan,proses penyakit, pengesetan
ventilator yang tidak tepat</span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN" style="mso-ansi-language: IN;">Tujuan : Klien akan memperlihatkan kemampuan pertukaran gas yang kembali
normal</span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN" style="mso-ansi-language: IN;">Kriteria hasil :</span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo4; tab-stops: list 1.0in; text-indent: -.25in;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">Hasil
analisa gas darah normal :</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo4; tab-stops: list 117.0pt; text-indent: -.25in;">
<span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">PH
(7,35 – 7,45)</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo4; tab-stops: list 117.0pt; text-indent: -.25in;">
<span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">PO2
(80 – 100 mmHg)</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo4; tab-stops: list 117.0pt; text-indent: -.25in;">
<span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">PCO2
( 35 – 45 mmHg)</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo4; tab-stops: list 117.0pt; text-indent: -.25in;">
<span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">BE (
-2 - +2)</span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo4; tab-stops: list 1.0in; text-indent: -.25in;">
<span lang="IN" style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN;">Tidak
cyanosis</span></div>
<div class="MsoNormal">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Intervensi</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Rasional</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">1.Cek analisa
gas darah setiap 10 –30 mnt setelah perubahan setting ventilator</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">2.Monitor hasil
analisa gas darah atau oksimetri selama periode penyapihan</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">3.Pertahankan
jalan nafas bebas dari sekresi</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">4.Monitpr tanda
dan gejala hipoksia</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Evaluasi
keefektifan setting ventilator yang diberikan</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Evaluasi
kemampuan bernafas klien</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Sekresi
menghambat kelancaran udara nafas</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Deteksi dini
adanya kelainan</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<ol start="3" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="mso-list: l3 level1 lfo5; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Ketidakefektifan pola nafas
berhubungan dengan kelelahan, pengesetan ventilator yang tidak tepat,
peningkatan sekresi, obstruksi ETT</span></li>
</ol>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Tujuan : Klien
akan mempertahankan pola nafas yang efektif</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Kriteria hasil : </span></div>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal" style="mso-list: l1 level1 lfo6; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Nafas sesuai dengan irama ventilator</span></li>
<li class="MsoNormal" style="mso-list: l1 level1 lfo6; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Volume nafas adekuat</span></li>
<li class="MsoNormal" style="mso-list: l1 level1 lfo6; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;">Alarm tidak berbunyi</span></li>
<li class="MsoNormal" style="mso-list: l1 level1 lfo6; tab-stops: list .5in;"><span lang="IN" style="mso-ansi-language: IN;"> </span></li>
</ol>
<div class="MsoNormal">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Intervensi</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Rasional</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">1.Lakukan
pemeriksaan ventilator tiap 1-2 jam </span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">2.Evaluasi
semua alarm dan tentukan penyebabnya</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">3.Pertahankan
alat resusitasi manual (bag & mask) pada posisi tempat tidur sepanjang
waktu</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">4.Monitor
slang/cubbing ventilator dari terlepas, terlipat, bocor atau tersumbat</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">5.Evaluasi
tekanan atau kebocoran balon cuff</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">6.Masukkan
penahan gigi (pada pemasangan ETT lewat oral)</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">7.Amankan slang
ETT dengan fiksasi yang baik</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">8.Monitor suara
nafas dan pergerakan ada secara teratur</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Deteksi dini
adanya kelainan atau gangguan fungsi ventilator</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Bunyi alarm
menunjukkan adanya gangguan fungsi ventilator</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Mempermudah
melakukan pertolongan bila sewaktu-waktu ada gangguan fungsi ventilator</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Mencegah
berkurangnya aliran udara nafas</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Mencegah
berkurangnya aliran udara nafas</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Mencegah
tergigitnya slang ETT</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Mencegah
terlepasnya.tercabutnya slang ETT</span></div>
<div class="MsoNormal">
<span lang="IN" style="mso-ansi-language: IN;">Evaluasi
keefektifan pola nafas</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<h1 style="text-indent: -.75in;">
<span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";">
</span></span>Daftar Pustaka</h1>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-right: -27.0pt;">
Carpenito, Lynda Juall (2000), <i style="mso-bidi-font-style: normal;">Buku saku Diagnosa Keperawatan</i>,<span style="mso-spacerun: yes;"> </span>Edisi 8, EGC, Jakarta</div>
<div class="MsoNormal" style="margin-right: -27.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-right: -27.0pt;">
Corwin, Elizabeth J, (2001<i style="mso-bidi-font-style: normal;">), Buku saku Patofisiologi</i>, Edisi bahasa
Indonesia,
EGC, Jakarta</div>
<div class="MsoNormal" style="margin-right: -27.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-right: -27.0pt;">
Doengoes, E. Marilyn (1989), <i style="mso-bidi-font-style: normal;">Nursing Care Plans,</i> Second Edition, FA
Davis, Philadelphia</div>
<div class="MsoNormal" style="margin-right: -27.0pt;">
<br /></div>
<div class="MsoBodyTextIndent">
Suprihatin, Titin (2000), <i style="mso-bidi-font-style: normal;">Bahan Kuliah Keperawatan Gawat Darurat PSIK Angkatan I,</i> Universitas
Airlangga, Surabaya</div>
<div class="MsoNormal" style="margin-left: .75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .75in;">
<br /></div>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-91130907068577643652012-09-03T06:53:00.001-07:002012-09-03T08:02:40.658-07:00LANGKAH-LANGKAH MENYUSUN PROPOSAL<br />
<a name='more'></a>buat temen-temen mahasiswa sekalian yang lgi senasip sama saya,..<br />
lgi pusing menyusun proposal..sekarang saya kasih langkah-langkahnya.temen2 tenang aja ini langkah bukan dari saya tapi dari ahlinya jadi dijamin kebenarannya.<br />
silahkan download file dalam bentuk pdf nya <a href="http://www.ziddu.com/download/20264350/langkah-langkah-penyusunan-proposal.pdf.html">disini</a><br />
oyaa yg mw download buat buka file pdf yg fiturnya lengkap + bisa copy paste file pdf dngan mudah silahkan download <a href="http://himztips.blogspot.com/2012/09/free-download-foxit-reader-514-aplikasi.html">disini </a><br />
semoga dapat membantu thanks and don't forget post your comment okee :)himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-34414887702993312732012-09-03T05:13:00.001-07:002012-09-03T05:15:31.718-07:00CEDERA KEPALA <!--[if gte mso 9]><xml>
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<br />
<div class="Section1">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">A. PENGERTIAN</span></b>
<br />
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Cidera
kepala yaitu adanya deformasi berupa penyimpangan bentuk atau penyimpangan
garis pada tulang tengkorak, percepatan dan perlambatan (accelerasi -
decelerasi ) yang merupakan perubahan bentuk dipengaruhi oleh perubahan peningkatan
pada percepatan faktor dan penurunan kecepatan, serta notasi yaitu pergerakan
pada kepala dirasakan juga oleh otak sebagai akibat perputaran pada tindakan
pencegahan.</span><br />
<a name='more'></a></div>
<div class="MsoNormal" style="line-height: 115%; margin-right: 1.9in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-right: 1.9in;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">B. PATOFISIOLOGI</span></b></div>
<div class="MsoNormal" style="line-height: 115%; text-indent: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Otak dapat berfungsi dengan baik bila kebutuhan oksigen
dan glukosa dapat terpenuhi. Energi yang dihasilkan didalam sel-sel saraf
hampir seluruhnya melalui proses oksidasi. Otak tidak mempunyai cadangan
oksigen, jadi kekurangan aliran darah ke otak walaupun sebentar akan
menyebabkan gangguan fungsi. Demikian pula dengan kebutuhan oksigen sebagai
bahan bakar metabolisme otak tidak boleh kurang dari 20 mg %, karena akan
menimbulkan koma. Kebutuhan glukosa sebanyak 25 % dari seluruh kebutuhan
glukosa tubuh, sehingga bila kadar glukosa plasma turun sampai 70 % akan terjadi
gejala-gejala permulaan disfungsi cerebral.</span></div>
<div class="MsoNormal" style="line-height: 115%; text-indent: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pada saat otak mengalami hipoksia, tubuh berusaha
memenuhi kebutuhan oksigen melalui proses metabolik anaerob yang dapat
menyebabkan dilatasi pembuluh darah. Pada kontusio berat, hipoksia atau
kerusakan otak akan terjadi penimbunan asam laktat akibat metabolisme anaerob.
Hal ini akan menyebabkan asidosis metabolik.</span></div>
<div class="MsoNormal" style="line-height: 115%; text-indent: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Dalam keadaan normal cerebral blood flow (CBF) adalah 50
- 60 ml / menit / 100 gr. jaringan otak, yang merupakan 15 % dari cardiac
output.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Trauma
kepala meyebabkan perubahan fungsi jantung sekuncup aktivitas
atypical-myocardial, perubahan tekanan vaskuler dan udem paru. Perubahan otonom
pada fungsi ventrikel adalah perubahan gelombang T dan P dan disritmia,
fibrilasi atrium dan vebtrikel, takikardia.</span></div>
<div class="MsoNormal" style="line-height: 115%; text-indent: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Akibat adanya perdarahan otak akan mempengaruhi tekanan
vaskuler, dimana penurunan tekanan vaskuler menyebabkan pembuluh darah arteriol
akan berkontraksi . Pengaruh persarafan simpatik dan parasimpatik pada pembuluh
darah arteri dan arteriol otak tidak begitu besar.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
</div>
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-font-size: 12.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span></b>
<br />
<div class="Section2">
<div class="MsoNormal" style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Cedera kepala menurut patofisiologi
dibagi menjadi dua :</span></b></div>
<div class="MsoNormal" style="line-height: 115%; text-indent: .5in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">1. Cedera kepala primer</span></b></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Akibat
langsung pada mekanisme dinamik (acelerasi - decelerasi rotasi ) yang
menyebabkan gangguan pada jaringan.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pada
cedera primer dapat terjadi :</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Gegar kepala ringan</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Memar otak</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Laserasi<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">2. Cedera kepala sekunder</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l4 level1 lfo1; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pada cedera kepala sekunder akan timbul gejala, seperti :</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l4 level1 lfo2; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Hipotensi sistemik</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l4 level1 lfo2; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Hipoksia</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l4 level1 lfo2; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Hiperkapnea</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l4 level1 lfo2; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Udema otak</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l4 level1 lfo2; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Komplikasi pernapasan </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l4 level1 lfo2; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">infeksi / komplikasi pada organ tubuh yang lain</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">C. PERDARAHAN YANG SERING DITEMUKAN </span></b></div>
<div class="MsoNormal" style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">1. Epidural Hematoma</span></b></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Terdapat
pengumpulan darah di antara tulang tengkorak dan duramater akibat pecahnya
pembuluh darah / cabang - cabang arteri meningeal media yang terdapat di
duramater, pembuluh darah ini tidak dapat menutup sendiri<span style="mso-spacerun: yes;"> </span>karena itu sangat berbahaya. Dapat terjadi
dalam beberapa jam sampai 1-2 hari. Lokasi yang paling sering yaitu di lobus
temporalis dan parietalis.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Gejala-gejala
yang terjadi :</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Penurunan tingkat kesadaran, Nyeri kepala, Muntah,
Hemiparesis, Dilatasi pupil ipsilateral, Pernapasan dalam cepat kemudian
dangkal irreguler, Penurunan nadi, Peningkatan suhu</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">2. Subdural Hematoma</span></b><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;"></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Terkumpulnya
darah antara duramater dan jaringan otak, dapat terjadi akut dan kronik.
Terjadi akibat pecahnya pembuluh darah vena / jembatan vena yang biasanya
terdapat diantara duramater, perdarahan lambat dan sedikit. Periode akut
terjadi dalam 48 jam - 2 hari atau 2 minggu dan kronik dapat terjadi dalam 2
minggu atau beberapa bulan.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tanda-tanda
dan gejalanya adalah : nyeri kepala, bingung, mengantuk, menarik diri, berfikir
lambat, kejang dan udem pupil</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Perdarahan
intracerebral berupa perdarahan di jaringan otak karena pecahnya pembuluh darah
arteri; kapiler; vena.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tanda
dan gejalanya :</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Nyeri kepala, penurunan kesadaran, komplikasi pernapasan,
hemiplegia kontra lateral, dilatasi pupil, perubahan tanda-tanda vital</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">3. Perdarahan Subarachnoid</span></b></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Perdarahan
di dalam rongga subarachnoid akibat robeknya pembuluh darah<span style="mso-spacerun: yes;"> </span>dan permukaan otak, hampir selalu ada pad
cedera kepala yang hebat.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tanda
dan gejala :</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Nyeri kepala, penurunan kesadaran, hemiparese, dilatasi
pupil ipsilateral dan kaku kuduk</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">ASUHAN KEPERAWATAN</span></b></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">A. PENGKAJIAN</span></b></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pengumpulan
data klien baik subyektif atau obyektif pada gangguan sistem persarafan
sehubungan dengan cedera kepala tergantung pada bentuk, lokasi, jenis injuri
dan adanya komplikasi pada organ vital lainnya. Data yang perlu didapati adalah
sebagai berikut :</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip; text-indent: -.25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Identitas klien dan keluarga (penanggung jawab): nama,
umur, jenis kelamin, agama, suku bangsa, status perkawinan, alamat, golongan
darah, pengahasilan, hubungan klien dengan penanggung jawab.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip; text-indent: -.25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Riwayat kesehatan :</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-indent: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tingkat kesadaran/GCS (< 15), konvulsi, muntah,
dispnea / takipnea, sakit kepala, wajah simetris / tidak, lemah, luka di
kepala, paralise, akumulasi sekret pada saluran napas, adanya liquor dari
hidung dan telinga dan kejang</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip; text-indent: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Riwayat penyakit dahulu
haruslah diketahui baik yang berhubungan dengan sistem persarafan maupun
penyakit sistem sistemik lainnya. demikian pula riwayat penyakit keluarga
terutama yang mempunyai penyakit menular.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip; text-indent: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Riwayat kesehatan tersebut
dapat dikaji dari klien atau keluarga sebagai data subyektif. Data-data ini
sangat berarti karena dapat mempengaruhi prognosa klien.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip; text-indent: -.25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pemeriksaan Fisik</span></div>
<div class="MsoNormal" style="line-height: 115%; text-indent: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Aspek neurologis yang dikaji adalah tingkat kesadaran,
biasanya GCS < 15, disorientasi orang, tempat dan waktu. Adanya refleks
babinski yang positif, perubahan nilai tanda-tanda vital kaku kuduk,
hemiparese.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Nervus
cranialis dapat terganggu bila cedera kepala meluas sampai batang otak karena
udema otak atau perdarahan otak juga mengkaji nervus I, II, III, V, VII, IX,
XII.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip; text-indent: -.25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l6 level1 lfo4; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pemeriksaan Penujang</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">CT-Scan (dengan atau
tanpa kontras) : mengidentifikasi luasnya lesi, perdarahan, determinan
ventrikuler, dan perubahan jaringan otak. Catatan : Untuk mengetahui adanya
infark / iskemia jangan dilekukan pada 24 - 72 jam setelah injuri.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">MRI : Digunakan sama
seperti CT-Scan dengan atau tanpa kontras radioaktif.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Cerebral Angiography:
Menunjukan anomali sirkulasi cerebral, seperti : perubahan jaringan otak
sekunder menjadi udema, perdarahan dan trauma.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Serial EEG: Dapat
melihat perkembangan gelombang yang patologis</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">X-Ray: Mendeteksi
perubahan struktur tulang (fraktur), perubahan struktur
garis(perdarahan/edema), fragmen tulang.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">BAER: Mengoreksi
batas fungsi corteks dan otak kecil</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">PET: Mendeteksi
perubahan aktivitas<span style="mso-spacerun: yes;"> </span>metabolisme otak</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">CSF, Lumbal Punksi
:Dapat dilakukan jika diduga terjadi perdarahan subarachnoid.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">ABGs: Mendeteksi
keberadaan ventilasi atau masalah<span style="mso-spacerun: yes;">
</span>pernapasan (oksigenisasi) jika terjadi peningkatan tekanan intrakranial</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kadar Elektrolit :
Untuk mengkoreksi keseimbangan elektrolit sebagai akibat peningkatan tekanan
intrkranial</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Screen Toxicologi:
Untuk mendeteksi pengaruh obat sehingga menyebabkan penurunan kesadaran.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Penatalaksanaan</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Konservatif:</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: .25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Bedrest total</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: .25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pemberian obat-obatan</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: .25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Observasi tanda-tanda
vital (GCS dan tingkat kesadaran)</span></div>
<div class="MsoNormal" style="line-height: 115%; text-indent: .25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Prioritas Perawatan:</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l3 level1 lfo5; text-indent: .25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Maksimalkan perfusi / fungsi otak</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l3 level1 lfo6; text-indent: .25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Mencegah komplikasi</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l3 level1 lfo6; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pengaturan fungsi secara optimal / mengembalikan ke
fungsi normal</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l3 level1 lfo6; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Mendukung proses pemulihan koping klien / keluarga</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l3 level1 lfo6; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pemberian informasi tentang proses penyakit, prognosis,
rencana pengobatan, dan rehabilitasi.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tujuan:</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l5 level1 lfo7; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Fungsi otak membaik : defisit neurologis berkurang/tetap</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l5 level1 lfo8; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Komplikasi tidak terjadi</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l5 level1 lfo8; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kebutuhan sehari-hari dapat dipenuhi sendiri atau dibantu
orang lain</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l5 level1 lfo8; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Keluarga dapat menerima kenyataan dan berpartisipasi
dalam perawatan</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l5 level1 lfo8; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Proses penyakit, prognosis, program pengobatan dapat
dimengerti oleh keluarga sebagai sumber informasi.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">B. DIAGNOSA KEPERAWATAN</span></b></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Diagnosa
Keperawatan yang biasanya muncul adalah:</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l2 level1 lfo9; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tidak efektifnya pola napas sehubungan dengan depresi
pada pusat napas di otak.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l2 level1 lfo10; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tidakefektifnya kebersihan jalan napas sehubungan dengan
penumpukan sputum.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l2 level1 lfo10; text-indent: -.25in;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></i><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Gangguan perfusi
jaringan otak sehubungan dengan udem otak</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l2 level1 lfo10; text-indent: -.25in;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></i><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Keterbatasan
aktifitas sehubungan dengan penurunan kesadaran (soporos - coma)<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l2 level1 lfo10; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Resiko tinggi gangguan integritas kulit sehubungan dengan
immobilisasi, tidak adekuatnya sirkulasi perifer.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">C. INTERVENSI</span></b></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<b><i><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tidak efektifnya pola napas sehubungan dengan depresi
pada pusat napas di otak</span></i></b><i><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">.</span></i></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tujuan : </span></i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Mempertahankan pola napas yang efektif melalui
ventilator.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kriteria evaluasi :</span></i></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip; text-indent: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Penggunaan otot bantu napas tidak ada, sianosis tidak ada
atau tanda-tanda hipoksia tidak ada dan gas darah dalam batas-batas normal.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Rencana tindakan :</span></i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Hitung pernapasan
pasien dalam satu menit.<span style="mso-spacerun: yes;"> </span>pernapasan yang
cepat dari pasien dapat menimbulkan alkalosis respiratori dan pernapasan lambat
meningkatkan tekanan Pa Co2 dan menyebabkan asidosis respiratorik.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Cek pemasangan tube,
untuk memberikan ventilasi yang adekuat dalam pemberian tidal volume.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Observasi ratio
inspirasi dan ekspirasi pada fase ekspirasi biasanya 2 x lebih panjang dari
inspirasi, tapi dapat lebih panjang sebagai kompensasi terperangkapnya udara
terhadap gangguan pertukaran gas.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Perhatikan kelembaban
dan suhu pasien keadaan dehidrasi dapat mengeringkan sekresi / cairan paru
sehingga menjadi kental dan meningkatkan resiko infeksi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Cek selang ventilator
setiap waktu (15 menit), adanya obstruksi dapat menimbulkan tidak adekuatnya
pengaliran volume dan menimbulkan penyebaran udara yang tidak adekuat.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Siapkan ambu bag
tetap berada di dekat pasien, membantu membarikan ventilasi yang adekuat bila
ada gangguan pada ventilator. </span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="mso-bidi-font-style: italic;">Tidak efektifnya kebersihan jalan napas sehubungan dengan penumpukan
sputum.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tujuan :</span></i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Mempertahankan jalan napas dan mencegah aspirasi</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kriteria Evaluasi :</span></i></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip; text-indent: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Suara napas bersih, tidak terdapat suara sekret pada
selang dan bunyi alarm karena peninggian suara mesin, sianosis tidak ada.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Rencana tindakan :</span></i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kaji dengan ketat
(tiap 15 menit) kelancaran jalan napas. Obstruksi dapat disebabkan pengumpulan
sputum, perdarahan, bronchospasme atau masalah terhadap tube.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Evaluasi pergerakan
dada dan auskultasi dada (tiap 1 jam ). Pergerakan yang simetris dan suara
napas yang bersih indikasi pemasangan tube yang tepat dan tidak adanya
penumpukan sputum.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Lakukan pengisapan
lendir dengan waktu kurang dari 15 detik bila sputum banyak. Pengisapan lendir
tidak selalu rutin dan waktu harus dibatasi untuk mencegah hipoksia.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Lakukan fisioterapi
dada setiap 2 jam. Meningkatkan ventilasi untuk semua bagian paru dan
memberikan kelancaran aliran serta pelepasan sputum.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<b><i>Gangguan perfusi jaringan
otak sehubungan dengan udem otak</i></b></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tujuan :</span></i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Mempertahankan dan memperbaiki tingkat kesadaran fungsi
motorik.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kriteria hasil :</span></i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tanda-tanda vital stabil, tidak ada peningkatan
intrakranial.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Rencana tindakan :</span></i></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Monitor
dan catat status neurologis dengan menggunakan metode GCS.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Refleks membuka mata menentukan pemulihan tingkat
kesadaran. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Respon motorik menentukan kemampuan berespon terhadap
stimulus eksternal dan indikasi keadaan kesadaran yang baik.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Reaksi pupil digerakan oleh saraf kranial oculus motorius
dan untuk menentukan refleks batang otak.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pergerakan mata membantu menentukan area cedera dan tanda
awal peningkatan tekanan intracranial adalah terganggunya abduksi mata.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Monitor
tanda-tanda<span style="mso-spacerun: yes;"> </span>vital tiap 30 menit.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Peningkatan sistolik dan penurunan diastolik serta
penurunan tingkat kesadaran dan tanda-tanda peningkatan tekanan intrakranial.
Adanya pernapasan yang irreguler indikasi terhadap adanya peningkatan
metabolisme sebagai reaksi terhadap infeksi. Untuk mengetahui tanda-tanda
keadaan syok akibat perdarahan.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pertahankan
posisi kepala yang sejajar dan tidak menekan. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Perubahan kepala pada satu sisi dapat menimbulkan
penekanan pada vena jugularis dan menghambat aliran darah otak, untuk itu dapat
meningkatkan tekanan intrakranial.</span></div>
<div class="MsoNormal" style="line-height: 115%; tab-stops: 35.45pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; tab-stops: 35.45pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Hindari batuk yang berlebihan, muntah, mengedan,
pertahankan pengukuran urin dan hindari<span style="mso-spacerun: yes;">
</span>konstipasi yang berkepanjangan. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: skip; text-indent: -.5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Dapat mencetuskan respon
otomatik penngkatan intrakranial.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Observasi
kejang dan lindungi pasien dari cedera akibat kejang.<span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;"><span style="mso-spacerun: yes;"> </span></i></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kejang terjadi akibat iritasi otak, hipoksia, dan kejang
dapat meningkatkan tekanan intrakrania.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Berikan
oksigen sesuai dengan kondisi pasien. </span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip; text-indent: .25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Dapat menurunkan hipoksia otak. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Berikan
obat-obatan yang diindikasikan dengan tepat dan benar (kolaborasi). </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Membantu menurunkan tekanan intrakranial secara biologi /
kimia seperti osmotik diuritik untuk<span style="mso-spacerun: yes;">
</span>menarik air dari sel-sel otak sehingga dapat menurunkan udem otak,
steroid (dexametason) untuk menurunkan inflamasi,<span style="mso-spacerun: yes;"> </span>menurunkan edema jaringan. Obat anti kejang
untuk menurunkan kejang, analgetik untuk menurunkan rasa nyeri efek negatif
dari peningkatan tekanan intrakranial. Antipiretik untuk menurunkan panas yang
dapat meningkatkan pemakaian oksigen otak.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<b><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Keterbatasan aktifitas sehubungan dengan
penurunan kesadaran (soporos - coma ) </span></i></b></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tujuan :</span></i></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip; text-indent: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kebutuhan dasar pasien dapat terpenuhi secara adekuat.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kriteria hasil :</span></i></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip; text-indent: .5in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kebersihan terjaga, kebersihan lingkungan terjaga,
nutrisi terpenuhi sesuai dengan kebutuhan, oksigen adekuat.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Rencana Tindakan :</span></i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>Berikan penjelasan tiap kali melakukan
tindakan pada pasien. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Penjelasan dapat mengurangi kecemasan dan meningkatkan
kerja sama yang dilakukan pada pasien dengan kesadaran penuh atau menurun.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Beri bantuan untuk memenuhi kebersihan diri.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kebersihan perorangan, eliminasi, berpakaian, mandi,
membersihkan mata dan kuku, mulut, telinga, merupakan kebutuhan dasar akan
kenyamanan yang harus dijaga oleh perawat untuk meningkatkan rasa nyaman, mencegah
infeksi dan keindahan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Berikan bantuan untuk memenuhi kebutuhan nutrisi dan
cairan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Makanan dan minuman merupakan kebutuhan sehari-hari yang
harus dipenuhi untuk menjaga kelangsungan perolehan energi. Diberikan sesuai
dengan kebutuhan pasien baik jumlah, kalori, dan waktu.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Jelaskan pada keluarga tindakan yang dapat dilakukan
untuk menjaga lingkungan yang aman dan bersih.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Keikutsertaan keluarga diperlukan untuk menjaga hubungan
klien - keluarga. Penjelasan perlu agar keluarga dapat memahami peraturan yang
ada di ruangan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Berikan bantuan untuk memenuhi kebersihan dan keamanan
lingkungan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Lingkungan yang bersih dapat mencegah infeksi dan
kecelakaan.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<b><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kecemasan keluarga
sehubungan keadaan yang kritis pada pasien.</span></i></b></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tujuan :</span></i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kecemasan keluarga dapat berkurang</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kriteri evaluasi :</span></i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Ekspresi wajah tidak menunjang adanya kecemasan</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Keluarga mengerti cara berhubungan dengan pasien</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pengetahuan keluarga mengenai keadaan, pengobatan dan
tindakan meningkat.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Rencana tindakan :</span></i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0in; mso-list: l1 level1 lfo3; text-indent: 0in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Bina hubungan saling
percaya.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip; text-indent: .25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Untuk membina hubungan terpiutik perawat - keluarga.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip; text-indent: .25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Dengarkan dengan aktif dan empati, keluarga akan merasa
diperhatikan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Beri penjelasan
tentang semua prosedur dan tindakan yang akan dilakukan pada pasien.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip; text-indent: .25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Penjelasan akan mengurangi kecemasan akibat ketidak
tahuan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Berikan kesempatan
pada keluarga untuk bertemu dengan klien. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Mempertahankan hubungan pasien dan keluarga.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0in; mso-list: l1 level1 lfo3; text-indent: 0in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Berikan dorongan
spiritual untuk keluarga.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; text-indent: -.25in;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;">
</span>Semangat keagamaan dapat mengurangi rasa cemas dan meningkatkan keimanan
dan<span style="mso-spacerun: yes;"> </span>ketabahan dalam
menghadapi krisis.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<br /></div>
<div class="MsoBodyText" style="line-height: 115%;">
Resiko tinggi gangguan integritas
kulit sehubungan dengan immobilisasi, tidak adekuatnya sirkulasi perifer.</div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Tujuan :</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Gangguan integritas kulit tidak terjadi</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Rencana tindakan :</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; tab-stops: .5in; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kaji fungsi motorik
dan sensorik pasien dan sirkulasi perifer untuk menetapkan kemungkinan
terjadinya lecet pada kulit.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0in; mso-list: l1 level1 lfo3; text-indent: 0in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kaji kulit pasien
setiap 8 jam : palpasi pada daerah yang tertekan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; tab-stops: 0in; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Berikan posisi dalam
sikap anatomi dan gunakan tempat kaki untuk daerah yang menonjol.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 0in; mso-list: l1 level1 lfo3; text-indent: 0in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Ganti posisi pasien
setiap 2 jam</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pertahankan
kebersihan dan kekeringan pasien : keadaan lembab akan memudahkan terjadinya
kerusakan kulit.</span></div>
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</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Massage dengan lembut
di atas daerah yang menonjol setiap 2 jam sekali.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Pertahankan alat-alat
tenun tetap bersih dan tegang.</span></div>
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<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Kaji daerah kulit
yang lecet untuk adanya eritema, keluar cairan setiap 8 jam.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .75in; mso-list: l1 level1 lfo3; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Berikan perawatan
kulit pada daerah yang rusak / lecet setiap 4 - 8 jam dengan menggunakan H2O2.</span></div>
</div>
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-font-size: 10.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-font-kerning: 14.0pt;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span></b>
<br />
<div class="MsoTitle" style="line-height: 115%;">
DAFTAR KEPUSTAKAAN</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Doenges</span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;"> M.E.</span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;"> (1989) <u>Nursing Care Plan</u>, Guidlines for Planning
Patient Care (2 nd ed ). Philadelpia, F.A. Davis Company.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Long; BC and Phipps WJ (1985) <u>Essential of Medical
Surgical Nursing : A Nursing Process Approach<span style="text-decoration: none; text-underline: none;"> St. Louis</span><span style="text-decoration: none; text-underline: none;">. Cv. Mosby Company.</span></u></span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt;">Asikin Z (1991) <u>Simposium Keperawatan Penderita Cedera
Kepala</u>.<span style="mso-spacerun: yes;"> </span>Panatalaksanaan Penderita dengan
Alat Bantu Napas, Jakarta.</span></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; mso-list: skip;">
<span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-bidi-font-size: 12.0pt; mso-bidi-font-weight: bold;">Harsono (1993)<u> Kapita
Selekta Neurologi, </u>Gadjah
Mada University
Press</span></div>
<div class="MsoTitle" style="line-height: 115%;">
<br /></div>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-28378468518300655922012-09-03T05:10:00.002-07:002012-09-03T05:18:50.088-07:00ASUHAN KEPERAWATAN PADA PASIEN DENGAN FRAKTUR CERVICALIS<!--[if !mso]>
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mso-para-margin-bottom:.0001pt;
mso-pagination:widow-orphan;
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<br />
<div class="Section1">
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l3 level1 lfo1; tab-stops: list .25in; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Pengertian</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Cedera tulang
belakang adalah cedera mengenai cervicalis, vertebralis dan lumbalis akibat
trauma ; jatuh dari ketinggian, kecelakakan lalu lintas, kecelakakan olah raga
dsb ( Sjamsuhidayat, 1997).<br />
<a name='more'></a></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l3 level1 lfo1; tab-stops: list .25in; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>Patofisiologis dikaitkan dengan KDM</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
Akibat
suatu trauma mengenai tulang belakang</div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<span style="height: 69px; left: 0px; margin-left: 276px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251651072;"></span>Jatuh dari ketinggian, kecelakakan
lalu lintas, kecelakakan olah raga</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="69" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /></a></div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<span style="height: 69px; left: 0px; margin-left: 275px; margin-top: 22px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251652096;"><img height="69" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /></span>Mengakibatkan patah tulang belakang;
paling banyak cervicalis dan lumbalis</div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
Fraktur
dapat berupa patah tulang sederhana, kompresi, kominutif</div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
Dan
dislokasi, sedangkan sumsum tulang belakang dapat berupa memar,</div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
Kontusio,
kerusakan melintang, laserasi dengan atau tanpa gangguan</div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<span style="height: 69px; left: 0px; margin-left: 266px; margin-top: 21px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251653120;"><img height="69" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image003.gif" width="12" /></span>Peredaran darah</div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<span style="mso-ignore: vglayout;">
</span></div>
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="3" width="68"><br /></td>
<td width="12"><br /></td>
<td width="389"><br /></td>
<td width="12"><br /></td>
</tr>
<tr>
<td height="1"><br /></td>
<td colspan="2"><br /></td>
<td align="left" rowspan="2" valign="top"><img height="32" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image004.gif" width="12" /></td>
</tr>
<tr>
<td height="31"><br /></td>
<td align="left" rowspan="2" valign="top"><img height="32" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image005.gif" width="12" /></td>
</tr>
<tr>
<td height="1"><br /></td>
</tr>
</tbody></table>
<br />
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<br /></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div class="MsoNormal" style="line-height: 115%;">
<span style="height: 32px; left: 0px; margin-left: 470px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251658240;"><img height="32" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image006.gif" width="12" /></span><span style="height: 32px; left: 0px; margin-left: 267px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251657216;"><img height="32" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image007.gif" width="12" /></span><span style="height: 32px; left: 0px; margin-left: 67px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251656192;"><img height="32" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image008.gif" width="12" /></span>Blok syaraf parasimpatis<span style="mso-tab-count: 1;"> </span>pelepasan mediator kimia<span style="mso-tab-count: 2;"> </span>kelumpuhan</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="height: 32px; left: 0px; margin-left: 468px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251661312;"><img height="32" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image009.gif" width="12" /></span><span style="height: 32px; left: 0px; margin-left: 266px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251660288;"><img height="32" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image010.gif" width="12" /></span><span style="height: 32px; left: 0px; margin-left: 67px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251659264;"><img height="32" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image008.gif" width="12" /></span>Kelumpuhan otot pernapasan<span style="mso-tab-count: 2;"> </span>respon nyeri hebat dan akut<span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>anestesi</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoBodyTextIndent" style="line-height: 115%;">
<span style="height: 47px; left: 0px; margin-left: 265px; margin-top: 31px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251663360;"><img height="47" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image011.gif" width="12" /></span><span style="height: 53px; left: 0px; margin-left: 67px; margin-top: 31px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251662336;"><img height="53" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image012.gif" width="12" /></span>Iskemia dan hipoksemia<span style="mso-tab-count: 1;"> </span>syok spinal<span style="mso-tab-count: 1;"> </span>gangguan fungsi rektum,
kandung kemih</div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="mso-ignore: vglayout; position: relative; z-index: 251664384;"><span style="height: 32px; left: 0px; left: 465px; position: absolute; top: -1px; width: 12px;"><img height="32" src="file:///C:/DOCUME%7E1/Himz/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image013.gif" width="12" /></span></span> </div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div class="MsoHeader" style="line-height: 115%;">
Gangguan kebutuhan<span style="mso-tab-count: 2;"> </span>gangguan rasa nyaman nyeri<span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;">
</span>gangguan eliminasi</div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="mso-spacerun: yes;"> </span>oksigen<span style="mso-spacerun: yes;">
</span><span style="mso-spacerun: yes;"> </span>nyeri
terus, </div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="mso-tab-count: 3;"> </span><span style="mso-spacerun: yes;"> </span>Dan potensial komplikasi </div>
<div class="MsoHeader" style="line-height: 115%;">
<span style="mso-tab-count: 4;"> </span>Hipotensi,
bradikardia<span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l3 level1 lfo1; tab-stops: list .25in; text-indent: -.25in;">
<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>Data fokus. </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Aktifitas dan
istirahat : kelumpuhan otot terjadi kelemahan selama syok spinal</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Sirkulasi :
berdebar-debar, pusing saat melakukan perubahan posisi, hipotensi, bradikardia
ekstremitas dingin atau pucat</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Eliminasi :
inkontenensia defekasi dan berkemih, retensi urine, distensi perut, peristaltik
usus hilang</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Integritas ego :
menyangkal, tidak percaya, sedih dan marah, takut cemas, gelisah dan menarik
diri.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Pola makan :
mengalami distensi perut, peristaltik usus hilang</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Pola kebersihan
diri : sangat ketergantungan dalam melakukan ADL</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Neurosensori :
kesemutan, rasa terbakar pada lengan atau kaki, paralisis flasid, hilangnya
sensai dan hilangnya tonus otot, hilangnya reflek, perubahan reaksi pupil,
ptosis.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Nyeri/kenyamanan
: nyeri tekan otot, hiperestesi tepat diatas daerah trauma, dan mengalami
deformitas pada derah trauma.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Pernapasan :
napas pendek, ada ronkhi, pucat, sianosis</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Keamanan : suhu
yang naik turun</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l3 level1 lfo1; tab-stops: list .25in; text-indent: -.25in;">
<span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span>Pemeriksaan diagnostik</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Sinar x spinal :
menentukan lokasi dan jenis cedera tulang (fraktur atau dislok)</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
CT scan : untuk
menentukan tempat luka/jejas</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
MRI : untuk
mengidentifikasi kerusakan syaraf spinal</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Foto rongent
thorak : mengetahui keadaan paru</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
AGD : menunjukkan
keefektifan pertukaran gas dan upaya ventilasi</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l3 level1 lfo1; tab-stops: list .25in; text-indent: -.25in;">
<span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span>Diagnosa keperawatan</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l3 level2 lfo1; tab-stops: list .25in; text-indent: -.25in;">
<span style="mso-list: Ignore;">5.1<span style="font: 7.0pt "Times New Roman";"> </span></span>Pola
napas tidak efektif berhubungan dengan kelumpuhan otot diafragma</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Tujuan perawatan
: pola nafas efektif setelah diberikan oksigen</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Kriteria hasil :
ventilasi adekuat, PaO2 > 80, PaCo2 < 45, rr = 16-20 x/mt, tanda sianosis
–</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Intervensi
keperawatan :</div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Pertahankan jalan nafas; posisi kepala tanpa gerak.
Rasional : pasien dengan cedera cervicalis akan membutuhkan bantuan untuk
mencegah aspirasi/ mempertahankan jalan nafas.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Lakukan penghisapan lendir bila perlu, catat jumlah,
jenis dan karakteristik sekret. Rasional : jika batuk tidak efektif,
penghisapan dibutuhkan untuk mengeluarkan sekret, dan mengurangi resiko
infeksi pernapasan.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Kaji fungsi pernapasan. Rasional : trauma pada C5-6
menyebabkan hilangnya fungsi pernapasan secara partial, karena otot
pernapasan mengalami kelumpuhan.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Auskultasi suara napas. Rasional : hipoventilasi
biasanya terjadi atau menyebabkan akumulasi sekret yang berakibat pnemonia.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Observasi warna kulit. Rasional : menggambarkan
adanya kegagalan pernapasan yang memerlukan tindakan segera</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Kaji distensi perut dan spasme otot. Rasional :
kelainan penuh pada perut disebabkan karena kelumpuhan diafragma</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Anjurkan pasien untuk minum minimal 2000 cc/hari.
Rasional : membantu mengencerkan sekret, meningkatkan mobilisasi sekret
sebagai ekspektoran.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Lakukan pengukuran kapasitas vital, volume tidal dan
kekuatan pernapasan. Rasional : menentukan fungsi otot-otot pernapasan.
Pengkajian terus menerus untuk mendeteksi adanya kegagalan pernapasan.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Pantau analisa gas darah. Rasional : untuk mengetahui
adanya kelainan fungsi pertukaran gas sebagai contoh : hiperventilasi PaO2
rendah dan PaCO2 meningkat.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Berikan oksigen dengan cara yang tepat : metode dipilih
sesuai dengan keadaan isufisiensi pernapasan.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l2 level1 lfo2; tab-stops: list .5in;">Lakukan fisioterapi nafas. Rasional : mencegah sekret
tertahan</li>
</ol>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l3 level2 lfo1; tab-stops: list .25in; text-indent: -.25in;">
<span style="mso-list: Ignore;">5.2<span style="font: 7.0pt "Times New Roman";"> </span></span>Diagnosa
keperawatan : kerusakan mobilitas fisik berhubungan dng kelumpuhan</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Tujuan perawatan
: selama perawatan gangguan mobilisasi bisa diminimalisasi sampai cedera
diatasi dengan pembedahan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Kriteria hasil :
tidak ada kontrakstur, kekuatan otot meningkat, pasien mampu beraktifitas
kembali secara bertahap.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Intervensi
keperawatan :</div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 115%; mso-list: l5 level1 lfo3; tab-stops: list .5in;">Kaji secara teratur fungsi motorik. Rasional :
mengevaluasi keadaan secara umum</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l5 level1 lfo3; tab-stops: list .5in;">Instruksikan pasien untuk memanggil bila minta
pertolongan. Rasional memberikan rasa aman</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l5 level1 lfo3; tab-stops: list .5in;">Lakukan log rolling. Rasional : membantu ROM secara
pasif</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l5 level1 lfo3; tab-stops: list .5in;">Pertahankan sendi 90 derajad terhadap papan kaki.
Rasional mencegah footdrop</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l5 level1 lfo3; tab-stops: list .5in;">Ukur tekanan darah sebelum dan sesudah log rolling.
Rasional : mengetahui adanya hipotensi ortostatik</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l5 level1 lfo3; tab-stops: list .5in;">Inspeksi kulit setiap hari. Rasional : gangguan
sirkulasi dan hilangnya sensai resiko tinggi kerusakan integritas kulit.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l5 level1 lfo3; tab-stops: list .5in;">Berikan relaksan otot sesuai pesanan seperti
diazepam. Rasional : berguna untuk membatasi dan mengurangi nyeri yang
berhubungan dengan spastisitas.</li>
</ol>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in; mso-list: l3 level2 lfo1; tab-stops: list .25in; text-indent: -.25in;">
<span style="mso-list: Ignore;">5.3<span style="font: 7.0pt "Times New Roman";"> </span></span>Diagnosa
keperawatan : gangguan rasa nyaman nyeri berhubungan dengan adanya cedera</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Tujuan
keperawatan : rasa nyaman terpenuhi setelah diberikan perawatan dan pengobatan</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Kriteria hasil :
melaporkan rasa nyerinya berkurang</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .25in;">
Intervensi
keperawatan :</div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo4; tab-stops: list .5in;">Kaji terhadap nyeri dengan skala 0-5. Rasional :
pasien melaporkan nyeri biasanya diatas tingkat cedera.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo4; tab-stops: list .5in;">Bantu pasien dalam identifikasi faktor pencetus.
Rasional : nyeri dipengaruhi oleh; kecemasan, ketegangan, suhu, distensi
kandung kemih dan berbaring lama.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo4; tab-stops: list .5in;">Berikan tindakan kenyamanan. Rasional : memberikan
rasa nayaman dengan cara membantu mengontrol nyeri.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo4; tab-stops: list .5in;">Dorong pasien menggunakan tehnik relaksasi. Rasional
: memfokuskan kembali perhatian, meningkatkan rasa kontrol.</li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l1 level1 lfo4; tab-stops: list .5in;">Berikan obat antinyeri sesuai pesanan. Rasional :
untuk menghilangkan nyeri otot atau untuk menghilangkan kecemasan dan
meningkatkan istirahat.</li>
</ol>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 21.3pt; mso-list: l1 level2 lfo4; text-indent: -21.3pt;">
<span style="mso-list: Ignore;">5.4<span style="font: 7.0pt "Times New Roman";"> </span></span>Diagnosa
keperawatan : gangguan eliminasi alvi /konstipasi berhubungan dengan gangguan
persarafan pada usus dan rektum.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 21.3pt;">
Tujuan perawatan
: pasien tidak menunjukkan adanya gangguan eliminasi alvi/konstipasi </div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 21.3pt;">
Kriteria hasil :
pasien bisa b.a.b secara teratur sehari 1 kali</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 21.3pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 21.3pt;">
Intervensi
keperawatan :</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.3pt; mso-list: l6 level1 lfo5; tab-stops: list 39.3pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Auskultasi bising usus, catat lokasi dan
karakteristiknya.Rasional : bising usus mungkin tidak ada selama syok spinal.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.3pt; mso-list: l6 level1 lfo5; tab-stops: list 39.3pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>Observasi adanya distensi perut.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.3pt; mso-list: l6 level1 lfo5; tab-stops: list 39.3pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>Catat adanya keluhan mual dan ingin muntah, pasang NGT.
Rasional : pendarahan gantrointentinal dan lambung mungkin terjadi akibat
trauma dan stress.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.3pt; mso-list: l6 level1 lfo5; tab-stops: list 39.3pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span>Berikan diet seimbang TKTP cair : meningkatkan
konsistensi feces</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.3pt; mso-list: l6 level1 lfo5; tab-stops: list 39.3pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span>Berikan obat pencahar sesuai pesanan. Rasional:
merangsang kerja usus</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 21.3pt; mso-list: l6 level2 lfo5; text-indent: -21.3pt;">
<span style="mso-list: Ignore;">5.5<span style="font: 7.0pt "Times New Roman";"> </span></span>Diagnosa
keperawatan : perubahan pola eliminasi urine berhubungan dengan kelumpuhan syarat
perkemihan.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 21.3pt;">
Tujuan perawatan
: pola eliminasi kembali normal selama perawatan</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 21.3pt;">
Kriteria hasil :
produksi urine 50 cc/jam, keluhan eliminasi uirine tidak ada</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 21.3pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 21.3pt;">
Intervensi
keperawatan:</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.3pt; mso-list: l4 level1 lfo6; tab-stops: list 39.3pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Kaji pola berkemih, dan catat produksi urine tiap jam.
Rasional : mengetahui fungsi ginjal</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.3pt; mso-list: l4 level1 lfo6; tab-stops: list 39.3pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>Palpasi kemungkinan adanya distensi kandung kemih.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.3pt; mso-list: l4 level1 lfo6; tab-stops: list 39.3pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>Anjurkan pasien untuk minum 2000 cc/hari. Rasional :
membantu mempertahankan fungsi ginjal.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.3pt; mso-list: l4 level1 lfo6; tab-stops: list 39.3pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span>Pasang dower kateter. Rasional membantu proses
pengeluaran urine</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 21.3pt; text-indent: -21.3pt;">
5.6<span style="mso-spacerun: yes;"> </span>Diagnosa keperawatan :
gangguan integritas kulit berhubungan dengan tirah baring lama</div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="mso-spacerun: yes;"> </span>Tujuan keperawatan : tidak terjadi
gangguan integritas kulit selama perawatan</div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="mso-spacerun: yes;"> </span>Kriteria hasil : tidak ada dekibitus,
kulit kering</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 21.3pt; text-indent: -21.3pt;">
<span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 21.3pt; text-indent: -21.3pt;">
<span style="mso-tab-count: 1;"> </span>Intervensi keperawatan :</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.0pt; mso-list: l0 level1 lfo7; tab-stops: list 39.0pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span>Inspeksi seluruh lapisan kulit. Rasional : kulit
cenderung rusak karena perubahan sirkulasi perifer.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.0pt; mso-list: l0 level1 lfo7; tab-stops: list 39.0pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>Lakukan perubahan posisi sesuai pesanan: untuk
mengurangi penekanan kulit</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.0pt; mso-list: l0 level1 lfo7; tab-stops: list 39.0pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span>Bersihkan dan keringkan kulit. Rasional: meningkatkan
integritas kulit</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.0pt; mso-list: l0 level1 lfo7; tab-stops: list 39.0pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span>Jagalah tenun tetap kering. Rasional: mengurangi resiko
kelembaban kulit</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 39.0pt; mso-list: l0 level1 lfo7; tab-stops: list 39.0pt; text-indent: -.25in;">
<span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span>Berikan terapi kinetik sesuai kebutuhan : Rasional :
meningkatkan sirkulasi sistemik dan perifer dan menurunkan tekanan pada kulit
serta mengurangi kerusakan kulit.</div>
</div>
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<br />
<div class="MsoTitle" style="line-height: 115%;">
Daftar kepustakaan :</div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 56.7pt; text-indent: -56.7pt;">
Hudak and Gallo, (1994), <i style="mso-bidi-font-style: normal;">Critical
Care Nursing, A Holistic Approach</i>, JB Lippincott company, Philadelpia.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 56.7pt; text-indent: -56.7pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 56.7pt; text-indent: -56.7pt;">
Marilynn E Doengoes, et all, alih bahasa Kariasa IM, (2000), <i style="mso-bidi-font-style: normal;">Rencana Asuhan Keperawatan, pedoman untuk
perencanaan dan pendokumentasian perawatan pasien,</i> EGC, Jakarta.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 56.7pt; text-indent: -56.7pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 56.7pt; text-indent: -56.7pt;">
Reksoprodjo Soelarto, (1995),<span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">Kumpulan Kuliah Ilmu Bedah</i>,<span style="mso-spacerun: yes;"> </span>Binarupa Aksara, Jakarta.</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 56.7pt; text-indent: -56.7pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 56.7pt; text-indent: -56.7pt;">
Suddarth Doris Smith, (1991), <i style="mso-bidi-font-style: normal;">The
lippincott Manual of Nursing Practice, </i>fifth edition, JB Lippincott
Company, Philadelphia.
</div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 56.7pt; text-indent: -56.7pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 56.7pt; text-indent: -56.7pt;">
Sjamsuhidajat. R (1997), <i style="mso-bidi-font-style: normal;">Buku ajar
Ilmu Bedah, </i>EGC, Jakarta</div>
<div class="MsoHeader" style="line-height: 115%;">
<br /></div>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0tag:blogger.com,1999:blog-9162758075501499629.post-88744636510825902012012-09-03T04:53:00.000-07:002012-09-03T08:03:07.298-07:00SATUAN PENYULUHAN ANEMIA PADA IBU HAMIL <br />
<h5 style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l4 level1 lfo18; page-break-after: avoid; tab-stops: list .5in; text-align: justify; text-indent: -.5in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Arial, sans-serif; font-size: 11pt; line-height: 115%;">I.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="font-family: Arial, sans-serif; font-size: 11pt; line-height: 115%;">DASAR PEMIKIRAN <o:p></o:p></span></h5>
<h1 style="line-height: 115%; mso-list: none; tab-stops: .5in; text-align: justify; text-indent: 0in;">
<span lang="IN" style="font-size: 11.0pt; font-weight: normal; line-height: 115%; mso-bidi-font-weight: bold;">Anemia atau kurang darah adalah
suatu keadaan dimana kadar haemoglobin (hB) dalam darah kurang dari normal yang
berbeda untuk tiap kelompok umur dan jenis kelamin. Anemia yang paling sering
adalah defisiensi besi dan asam folat adalah anemia yang disebabkan oleh
kekurangan satu atau beberapa bahan yang diperlukan untuk pematangan eritrosit.
Hampir semua jenis anemia ditandai dengan keadaan klinik pucat atau anemi.<a name='more'></a><o:p></o:p></span></h1>
<h1 style="line-height: 115%; mso-list: none; tab-stops: .5in; text-align: justify; text-indent: 0in;">
<span lang="IN" style="font-size: 11.0pt; font-weight: normal; line-height: 115%; mso-bidi-font-weight: bold;">Anemia ini menyebabkan gejala
lelah, lesu, pusing, yang bisa terjadi pada
anak sekolah akan mengurangi kapasitas dan kemampuan belajar. Sedangkan
pada orang tua akan menurunkan produktivitas kerja, untuk itu harus segera
ditangani. Anemia pada masyarakat dikenal sebagai penyakit kurang darah.
Sehingga tablet besi yang diberikan disebut sebagai tablet tambah darah dalam
upaya menurunkan prevalensi anemia. <o:p></o:p></span></h1>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; text-align: justify;">
<br /></div>
<h1 style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<!--[if !supportLists]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">I.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%;">TUJUAN <o:p></o:p></span></h1>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: .75in; mso-list: l17 level1 lfo8; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">a.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Tujuan Umum<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: .75in; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Setelah dilakukan
penyuluhan dapat mengenal masalah anemia dan pencegahannya. <o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: .75in; text-align: justify;">
<br /></div>
<div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: .75in; mso-list: l17 level1 lfo8; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">b.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Tujuan Khusus<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: 1.0in; mso-list: l16 level1 lfo10; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Ibu Hamil dapat menjelaskan tentang pengertian anemia. <o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: 1.0in; mso-list: l16 level1 lfo10; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Ibu Hamil dapat menjelaskan tentang akibat anemia. <o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: 1.0in; mso-list: l16 level1 lfo10; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Ibu Hamil dapat menjelaskan tentang penyebab anemia <o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: 1.0in; mso-list: l16 level1 lfo10; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Ibu Hamil dapat menjelaskan tentang pencegahan anemia <o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: 1.0in; text-align: justify;">
<br /></div>
<h1 style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<!--[if !supportLists]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">II.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%;">SASARAN<o:p></o:p></span></h1>
<div class="MsoBodyTextIndent" style="line-height: 115%; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Adapun sasaran dari kegiatan penyuluhan ini adalah Ibu
Hamil<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 115%; text-align: justify;">
<br /></div>
<h1 style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<!--[if !supportLists]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">III.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%;">TEMPAT DAN WAKTU <o:p></o:p></span></h1>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 135.0pt; mso-list: l3 level3 lfo1; tab-stops: list .75in left 113.4pt 135.0pt; text-align: justify; text-indent: -99.0pt;">
<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">1.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%;">Hari
/ Tanggal : Selasa / 19 Oktober 2004 <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">2.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%;">Tempat
: Poli Kebidanan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">3.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%;">Waktu
: 10.00 s/d 10.30 WIB<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">IV.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%;">METODE<o:p></o:p></span></h1>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%;">Metode
yang digunakan:<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">1.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%;">Ceramah
<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">2.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%;">Tanya
Jawab<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">V.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%;">MEDIA <o:p></o:p></span></h1>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%;">Peralatan
yang digunakan : <o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%;">Leafleat<o:p></o:p></span></div>
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<span lang="IN" style="font-size: 11.0pt; line-height: 115%;"> </span></h1>
<h1 style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<!--[if !supportLists]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">VI.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%;">STRATEGI <o:p></o:p></span></h1>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">a.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Persiapan <o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">1). Penyuluh<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Pembuatan satuan penyuluhan dengan materi anemia ibu
hamil <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Pembuatan leaflet <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Persiapan alat <o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">2). Sasaran <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Menentukan tempat dan waktu. <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Melakukan kontrak dengan Ibu hamil<o:p></o:p></span></div>
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<div class="MsoBodyTextIndent2" style="line-height: 115%; margin-left: .75in; mso-list: l12 level1 lfo11; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">b.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Pelaksanaan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Pembukaan.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Melakukan caramah.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Melakukan tanya jawab. <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">Penutup. <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">VII.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%;">EVALUASI <o:p></o:p></span></h1>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">a.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%;">Evaluasi
pelaksanaan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">ibu hamil dapat mengikuti penyuluhan dari awal sampai
akhir penyuluhan sampai selesai.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">ibu hamil terlihat antusias dalam mengikuti penyuluhan
dengan melakukan tanya jawab. <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">b.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%;">Evaluasi
materi <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">ibu hamil dapat menjelaskan tentang pengertian anemia
pada ibu hamil <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">ibu hamil dapat menjelaskan tentang akibat anemia pada
ibu hamil<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">ibu hamil dapat menjelaskan tentang penyebab anemia pada
ibu hamil<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN; mso-fareast-font-family: Arial;">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: IN;">ibu hamil dapat menjelaskan tentang pencegahan anemia
pada ibu hamil<o:p></o:p></span></div>
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<b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">LAMPIRAN
MATERI<o:p></o:p></span></b></div>
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<b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">ANEMIA
PADA IBU HAMIL<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">I.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">PENGERTIAN PENYAKIT ANEMIA<o:p></o:p></span></b></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Anemia adalah suatu keadaan dimana
terjadi penurunan konsentrasi Hb dalam darah sampai kadar di bawah 11 g/l
(buimil). Hb ( Hemoglobin) merupakan zat berwarna merah yang terdapat dalam
bentuk larutan dalam sel darah merah, yang mempunyai fingsi uintuk mengangkut
oksigen ke semua bagian tubuh. Sedangkan kandungan yang terdapat dalam hb
diantaranya adalah zat besi, asam folat, vitamin dan unsur mineral
lainnya.Kandungan tersebut diperlukan untuk pembentukan Hb yang dibentuk dalam
sumsum tulang.<o:p></o:p></span></div>
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<br /></div>
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<!--[if !supportLists]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">II.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">BATAS NORMAL KADAR HB MENURUT
KELOMPOK UMUR<o:p></o:p></span></b></div>
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<tbody>
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<b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">KELOMPOK<o:p></o:p></span></b></div>
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<b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">UMUR<o:p></o:p></span></b></div>
</td>
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<b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Hb (g/<o:p></o:p></span></b></div>
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<b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">100 ml<o:p></o:p></span></b></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Anak<o:p></o:p></span></div>
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<br /></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Dewasa<o:p></o:p></span></div>
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<br /></div>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 132.0pt;" valign="top" width="176"><div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">6 bulan – 6 tahun<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">6 tahun –14 tahuh<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Laki-laki<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Wanita<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Bumil<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 84.0pt;" valign="top" width="112"><div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">11<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">12<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">13<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">12<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">11<o:p></o:p></span></div>
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</tbody></table>
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<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 35.0pt; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Secara marfologis, anemia dapat
diklasifikasikan menurut ukuran sel dan Hb yang dikandung sebagai berikut :<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; mso-list: l8 level1 lfo3; tab-stops: list 53.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Makrositik<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Pada anemia makrositik ukuran sel
darah merah bertambah besar dan jumlah Hb tiap sel juga bertambah. Anemia
makrositik dibagi menjadi dua yaitu anemia megaloblastik dan anemia non-megaloblastik.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; mso-list: l2 level1 lfo4; tab-stops: list 53.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Mikrositik<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Mengecilnya ukuran sel darah merah.
<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; mso-list: l2 level1 lfo4; tab-stops: list 53.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Normositik<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Ukuran sel darah merahnya tidak
berubah,tetapi terjadi peningkatan volume plasma secara berlebihan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; mso-list: l11 level2 lfo7; tab-stops: list .5in; text-align: justify; text-indent: -.5in;">
<!--[if !supportLists]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">III.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">PENYEBAB TERJADINYA PENYAKIT ANEMIA<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; mso-list: l13 level1 lfo5; tab-stops: list 53.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Anemia makrositik<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 71.0pt; mso-list: l1 level1 lfo6; tab-stops: list 71.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial Unicode MS","sans-serif"; font-size: 11.0pt; line-height: 115%;">a)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Megaloblastik
disebabkan oleh kekurangan vitamin B12, asam folat, atau gangguan sintesis DNA.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 71.0pt; mso-list: l1 level1 lfo6; tab-stops: list 71.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial Unicode MS","sans-serif"; font-size: 11.0pt; line-height: 115%;">b)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Non-Megaloblastik
disebabkan oleh eritropoiesis yang dipercepat dan peningkatan luas permukaan
membran.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; mso-list: l13 level1 lfo5; tab-stops: list 53.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Anemia mikrositik<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Disebabkan oleh defisiensi besi,
gangguan sintesis globin, porfirin, dan heme serta gangguan metabolisme besi
lainnya.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; mso-list: l13 level1 lfo5; tab-stops: list 53.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Symbol; font-size: 11.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Anemia normositik<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Disebabkan oleh kehilangan darah yang parah,
penyakit-penyakit hemolitik, gangguan endokrin, ginjal dan hati.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 35.0pt; text-align: justify;">
<br /></div>
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<!--[if !supportLists]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">IV.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">TANDA-TANDA PENYAKIT ANEMIA<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: .5in; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Stadium awal anemia kehamilan
umumnya tanpa gejala, walaupun demikian dengan menurunnya konsentrasi Hb ,
pasokan oksigen keorgan-organ vital menurun. Bumil mulai mengeluh tentang
kelemahan umum, mudah lelah, pusing dan nyeri kepala. Kulit dan selaput lendir
pucat, dasar kuku dan lidah akan menjadi jelas jika konsentrasi Hb turun
menjadi 7 g/l.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 17.0pt; text-align: justify;">
<br /></div>
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<b><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-fareast-font-family: "Arial Unicode MS";">V.</span></b><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">AKIBAT DARI PENYAKIT ANEMIA BAGI
IBU HAMIL<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 35.0pt; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Ibu hamil yang mengalami anemia
sangat beresiko terjadi:<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">4.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Gangguan pertumbuhan janin<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; mso-list: l3 level1 lfo1; tab-stops: list 53.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">5.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Resiko melahirkan prematur atau
BBLR<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; mso-list: l3 level1 lfo1; tab-stops: list 53.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">6.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Perdarahan sebelum dan pada saat
persalinan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; mso-list: l3 level1 lfo1; tab-stops: list 53.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">7.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Kematian ibu dan bayi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 35.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<b><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-fareast-font-family: "Arial Unicode MS";">VI.</span></b><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">CARA PENANGGULANGAN ANEMIA<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">1.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Meningkatkan konsumsi zat besi dari
makanan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 53.0pt; text-align: justify;">
<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Mengkonsumsi pangan hewani, seperti
daging, ikan, hati, dan telur dalam jumlah cukup sebernanya dapat mencegah
anemia, namun bagi maysarakat harga pangan hewani sulit terjangkau karena
harganya mahal. Untuk itu diperlukan variasi dengan pemberian pangan dari
sumber nabati yang banyak mengandung zat besi yaitu sayuran hijau, buah-buahan,
kacang-kacangan, padi-padian.<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Vitamin C diperlukan untuk
meningkatkan penyerapan zat besi dalam tubuh. Sumber-sumber vitamin C yaitu
buah-buahan segar dan sayuran, jika perlu diberikan tablet vitamin C. <o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Konsumsi bahan pangan yang
mengandung zat-zat penghambat absorbsi besi harus dikurangi. Teh mengandung
tanin, jika dikonsumsi bersama pada saat makan akan mengurangi absorbsi zat
besi sampai 50 %. Bahan makanan lain yang mengandung zat penghambat absorbsi
besi antara lain kopi,fosvitin dalam kuning telur, protein kedelai, fitat dan
fsfat yang banyak terkandung pada serealia, kalsium dan serat dalam bahan
makanan.<o:p></o:p></span></div>
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<b><i><u><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Kebutuhan zat besi tiap trimester
sebagai berikut :<o:p></o:p></span></u></i></b></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Trimester I : <u>+</u> 1 mg/hr,
(kehilangan basal 0,8 mg/hr) ditambah 30-40 mg untuk kebutuhan janin dan sel
darah merah.<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Trimester II : <u>+</u>
5 mg/hr, (kehilangan basal 0,8 mg/hr) ditambah kebutuhan sel darah merah 300 mg
dan conceptus 115 mg.<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Trimester III : <u>+</u>
5 mg/hr, (kehilangan basal 0,8 mg/hr) ditambah
kebutuhan sel darah merah 150 mg dan conceptus 223 mg.<o:p></o:p></span></div>
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<!--[if !supportLists]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">2.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Suplementasi zat besi (Pemberian
tablet tambah darah)<o:p></o:p></span></b></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Pemberian suplement besi
menguntungkan karena dapat memperbaaiki status Hb dalam waktu yang relatif
singkat. Pil besi yang umum digunakan dalam suplementasi zat besi ini adalah
Ferrosos sulfat, senyawa ini dapat diabsorbsi sampai 20 %. Dosis umum yang
biasa digunakan 1 x 1 tablet/hari, minimal 90 tablet selama kehamilan.<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Kendala utama dalam suplamantasi
zat besi ini adalah akibat efek samping
yang dihasilkan dan kesulitan mematuhi meminum pil karena kurangnya kesadaran akan
pentingnya masalah anemia. Efek samping pemberian pil besi pada saluran
pencernaan adalah mual, muntah, konstipasi, dan diare. Semakin tinggi dosis
yang diberikan maka kemungkinan efek samping akan semakin besar. <o:p></o:p></span></div>
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<b><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-fareast-font-family: "Arial Unicode MS";">3.</span></b><b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Cara Mengolah dan penyajian makanan
<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%;">a.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Cara mengolah makanan:<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Sayuran, buah dicuci dahulu baru
dipotong-potong<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Sayuran dimasak, jangan terlalu
lama<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Alat-alat masak bersih <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">4)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Cuci tangan sebelum memasak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%;">b.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Cara menyajikan makanan:<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Bervariasi jenis makanannya <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Kombinasi makanan hewani dan nabati<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: Arial;">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Perhatikan jadwal menu</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 71.0pt; mso-list: l11 level3 lfo7; tab-stops: list 71.0pt 1.25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-size: 11.0pt; line-height: 115%;">c.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-fareast-font-family: "Arial Unicode MS";">Jumlah makanan sesuai dengan
kebutuhan<o:p></o:p></span></div>
himz_uchihahttp://www.blogger.com/profile/18056503866353951626noreply@blogger.com0