tag:blogger.com,1999:blog-17990999666812671592024-03-12T16:31:11.960-07:00Haris NotesTempatnya E-Book Asuhan KeperawatanElsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.comBlogger80125tag:blogger.com,1999:blog-1799099966681267159.post-2787780315583781942012-12-03T04:55:00.001-08:002012-12-03T04:55:23.176-08:00ASKEP KATARAK<!--[if gte mso 9]><xml>
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<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Asuhan
Keperawatan</span></b></div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Katarak</span></b></div>
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<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 19.85pt; mso-list: l14 level1 lfo1; tab-stops: list 19.85pt; text-align: left; text-indent: -19.85pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Konsep
Katarak</span></b></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pengertian</span></b></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Katarak
adalah : kekeruhan pada lensa tanpa nyeri yang berangsur-angsur, penglihatan
kabur akhirnya tidak dapat menerima cahaya (Barbara )</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; text-align: left;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; mso-list: l14 level2 lfo1; tab-stops: list 38.0pt; text-align: left; text-indent: -18.15pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Etiologi</span></b></div>
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<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Ketuaan,
biasanya dijumpai katarak senilis.</span></div>
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<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Trauma,
terjadi karena pukulan benda tumpul /tajam terpapar oleh sinar X atau
benda-benda radioaktif.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 57.85pt; mso-list: l14 level3 lfo1; tab-stops: list 2.0cm; text-align: left; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Penyakit
mata seperti Uveitis</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 57.85pt; mso-list: l14 level3 lfo1; tab-stops: list 2.0cm; text-align: left; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Penyakit
sistemik seperti DM.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 57.85pt; mso-list: l14 level3 lfo1; tab-stops: list 2.0cm; text-align: left; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Defek
congenital.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.85pt; text-align: left;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; mso-list: l14 level2 lfo1; tab-stops: list 38.0pt; text-align: left; text-indent: -18.15pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Fisiologi
Lensa Mata</span></b></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Fungsi
lensa mata memfokuskan sinar pada retina. Pada saat itu kekuatan refraksi lensa
berubah sesuai dengan kebutuhan sehingga sinar dapat difokuskan pada retina.
Perubahan kekuatan retraksi disebut akomodasi. </span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">2
(dua) faktor yang menentukan dalam akomodasi yaitu:</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 60.7pt; mso-list: l14 level5 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kemampuan lensa untuk berubah bentuk (menjadi lebih cembung)</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 60.7pt; mso-list: l14 level5 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kekuatan
dari muskulus siliaris.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Bila
muskulus siliaris relaks, zonula zinn menjadi tegang, diameter antara posterior
lensa menjadi lebih pendek dan kekuatan refraksi berkurang. Sebaliknya bila
muskulus siliaris kontraksi maka ketegangan zonula zinn berkurang, sehingga
bentuk lensa menjadi lebih cembung dan kekuatan refraksi bertambah.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.85pt; text-align: left;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; mso-list: l14 level2 lfo1; tab-stops: list 38.0pt; text-align: left; text-indent: -18.15pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Patofisiologi</span></b></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Dalam
keadaan normal transfaransi lensa terjadi karena adanya keseimbangan antara
protein yang dapat larut dengan protein yang tidak dapat larut dalam membran
sesemi permeable. Apabila terjadi peningkatan jumlah<span style="mso-spacerun: yes;"> </span>protein yang tidak dapat diserap,
mengakibatkan jumlah protein dalam lensa melebihi jumlah protein pada bagian
lain sehingga membentuk massa transparan ataubbintik kecil di sekitar lensa,
membentuk suatu kapsul yang dikenal dengan katarak.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Terjadinya
penumpukan cairan / degenasi dan desintegrasi pada serabut tersebut menyebabkan
jalannya cahayanya terhambat dan mengakibatkan gangguan penglihatan.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; text-align: left;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; mso-list: l14 level2 lfo1; tab-stops: list 38.0pt; text-align: left; text-indent: -18.15pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pembagian
katarak</span></b></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level6 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Katarak
Congenital</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pada
umumnya bilateral. Banyak disebabkan oleh virus rubella pada trimester I
kehamilan bila pada pemeriksaan positif rubella, maka operasi sebaiknya ditunda
sampai umur 2 tahun karena virus masih aktif di dalam lensa. Kalau di operasi
akan terjadi endoftalmitis dan mata akan menjadi rusak. Bila kekeruhan
bilateral segera lakukan operasi satu mata dulu kurang dari 6 bulan untuk
membentuk visus normal. Sedangkan mata satunya dapat dioperasi setelah umur 2
tahun.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level6 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Katarak
Jevenil</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Katarak
yang terjadi pada anak-anak sesudah lahir. Katarak ini termasuk ke dalam <i>development</i>
<i>cataract, </i><span style="mso-spacerun: yes;"> </span>yaitu kekeruhan lensa
yang terjadi pada saat masih terjadi perkembangan serat – serat lensa sehingga biasanya
konsistensinya lembek seperti bubur dan disebut <i>soft cataract</i>. Biasanya
katarak juvenil merupakan bagian dari suatu kejadian penyakit keturunan lain.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level6 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Katarak
Senil</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Katarak
senile ada hubungannya dengan pertambahan umur dan berkaitan dengan proses ketuaan
yang terjadi di dalam lensa. Perubahan yang tampak adalah bertambah tebalnya
nucleus dengan berkembangnya lapisan kortek lensa.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Secara
klinik / proses ketuaan lensa sudah tampak pada pengurangan kekuatan akomodasi
lensa akibat terjadinya skelerosa lensa yang timbul pada decade 4 yang
dimanifestasi dalam bentuk presbiopia.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; mso-list: l14 level8 lfo1; tab-stops: list 79.4pt; text-align: left; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Katarak
insipien</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Katarak
yang tidak seperti bercak-bercak yang membentuk gerigi dengan dasar perifer dan
daerah jernih diantaranya. Kekeruhan biasanya terletak di korteks nterior atau
posterior. Kekeruhan ini pada permulaan hanya tampak bila pupil dilebarkan.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pada
stadium ini terdapat keluhan polidiopia oleh karena indeks refraksi yang tidak
sama pada semua bagian lensa. Bila dilakukan tes bayangan iris (shadow test)
akan negatif.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; mso-list: l14 level8 lfo1; tab-stops: list 79.4pt; text-align: left; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Katarak
imatur</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pada
stadium yang lebih lanjut maka akan terjadi kekeruhan yang lebih tebal. Tetapi
tidak atau belum mengenal seluruh lensa sehingga masih terdapat bagian-bagian
yang jernih pada lensa. Pada stadium ini terjadi hydras korteks yang
mengakibatkan lensa menjadi bertambah cembung. Pencembungan lensa ini akan
memberikan perubahan indeks refraksi dimana mata akan menjadi myopia.
Kecembungan ini akan mengakibatkan pendorongan iris ke depan sehingga bilik
mata depan dan sudut bilik mata depan akan lebih sempit.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pada
stadium ini akan mudah terjadi <i>glaucoma</i> sebagai penyulit. Stadium imatur
dimana terjadi kecembungan lensa akibat menyerap air disebut <i>stadium
intumesen.</i> Shadow test pada keadaan ini positif.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; mso-list: l14 level8 lfo1; tab-stops: list 79.4pt; text-align: left; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Katarak matur</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Bila
proses degenerasi berjalan terus maka akan terjadi pengeluaran air bersama-sama
hasil desintegrasi melalui kapsul. Lensa kehilangan cairan sehingga mengkerut
lagi dan kamera okuli anterior menjadi normal kembali. Kekeruhan lensa sudah
menyeluruh warna putih keabu-abuan. Pada pemeriksaan iris shadow negatif dan
fundus refleks negatif.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pada
stadium ini saat yang baik untuk operasi dengan tehnik intra kapsuler (Tehnik
Lama).</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; mso-list: l14 level8 lfo1; tab-stops: list 79.4pt; text-align: left; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Katarak
hipermatur</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Merupakan
proses degenerasi lanjut lensa sehingga korteks lensa mencair dan dapat keluar
melalui kapsul lensa.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Dapat
terjadi 2 kemungkinan :</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 97.4pt; mso-list: l15 level1 lfo2; tab-stops: list 97.4pt; text-align: left; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; 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 style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Lensa menjadi kehilangan cairannya terus sehingga mengkerut dan
menipis disebut <i>SHRUNKEN KATARAK</i>.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 97.4pt; mso-list: l15 level1 lfo2; tab-stops: list 97.4pt; text-align: left; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; 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 style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Korteks lensa melunak dan mencair, sedangkan nucleus tidak
mengalami perubahan, akibatnya nucleus jatuh disebut <i>MORGANIAN KATARAK</i>.
Operasi pada saat ini kurang menguntungkan karena lebih mudah terjadi
komplikasi.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; text-align: left;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; text-align: left;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Katarak
senile :</span></b></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Paling sering dijumpai</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; mso-list: l15 level2 lfo2; tab-stops: list 79.4pt; text-align: left; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Biasanya umur lebih dari 50 tahun, tapi kadang-kadang mulai umur
40 tahun</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; mso-list: l15 level2 lfo2; tab-stops: list 79.4pt; text-align: left; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Hampir selalu mengenai kedua mata dengan stadium yang berbeda.
Kekeruhan dapat dimulai dari perifer kortek atau sekitar nucleus.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; mso-list: l15 level2 lfo2; tab-stops: list 79.4pt; text-align: left; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gejala utama adalah penglihatan makin lama makin kabur. Sejak
mulainya terjadi kekeruhan sampai matur dibutuhkan waktu beberapa tahun.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; mso-list: l15 level2 lfo2; tab-stops: list 79.4pt; text-align: left; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Reaksi pupil terhadap cahaya normal.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; text-align: left;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; mso-list: l14 level2 lfo1; tab-stops: list 38.0pt; text-align: left; text-indent: -18.15pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">PEMERIKSAAN</span></b></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level6 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Visus
menurun bergantung pada :</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tak ada
tanda-tanda radang<span style="mso-spacerun: yes;"> </span>(hyperemia tak ada)</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level6 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Iluminasi
oblik tampak kekeruhan yang keabu-abuan atau putih dengan bayangan hitam
disebut <b><i>iris shadow</i></b>.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level6 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pemeriksaan
dengan optalmoskop tampak warna hitam diatas dasar orange disebut <b><i>fundus
reflek</i></b>.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level6 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">5)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pada katarak
yang lebih lanjut, kekeruhan bertambah sehingga iris shadow menghilang dan
fundus reflek menjadi hitam saja (negatif).</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 19.85pt; text-align: left;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; mso-list: l14 level2 lfo1; tab-stops: list 38.0pt; text-align: left; text-indent: -18.15pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">PENGOBATAN
KATARAK</span></b></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Apabila
penderita masih dapat dikoreksi kacamata, maka diberikan dahulu kacamata. Akan
tetapi ukuran kacamata penderita biasanya sangat mudah / cepat berubah.
Pengobatan yang paling baik dan tepat saat ini adalah <b><i>operasi</i></b>.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Indikasi
operasi yaitu :</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level6 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Visus yang
menurun yang tak dapat dikoreksi dengan kacamata dan mengganggu aktifitas.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level6 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Dahulu
penderita dioperasi bila visusnya 1/300 s/d tak terhingga (LP+).</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Akan
tetapi dengan kemajuan tehnologi saat ini katarak dapat dioperasi pada stadium
apapun, bila penderita sudah terganggu aktivitasnya.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.85pt; text-align: left;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.85pt; text-align: left;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Macam
operasi :</span></b></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 58.7pt; mso-list: l2 level1 lfo3; tab-stops: list 58.7pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Intra
Capsular :</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 58.7pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Intra
catarax extraction (ICCE) mengeluarkan lensa secara utuh.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 58.7pt; mso-list: l2 level1 lfo3; tab-stops: list 58.7pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Ekstra
Capsular :</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 58.7pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Extra
capsular catarax extraction (ECCE) : mengeluarkan lensa dengan merobek kapsul
bagian anterior dan meninggalkan kapsul bagian posterior.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pada
saat ini dimana kemajuan tehnologi yang sudah tinggi, tehnik ECCE lebih disukai
karena komplikasinya lebih kecil dan dapat disertai pemasangan lensa implant
intra okuler (IOL = intra okuler lens). Sehingga hasil setelah operasi menjadi
lebih baik.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; text-align: left;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Afakia
:</span></b></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level7 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -21.55pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mata yang lensanya tidak ada (dioperasi atau sebab lain).</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level7 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -21.55pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Visus 1/60</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level7 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -21.55pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Menjadi hipermetrop (kira-kira + 10.00 D)</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level7 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -21.55pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kehilangan daya akomodasi</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level7 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -21.55pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Untuk membaca memerlukan tambahan + 3.00 D</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pseudofkia
:</span></b></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mata
yang lensanya sudah diambil dan dipasang IOL</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Visus
lebih baik, bisa sampai 6/6</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kehilangan
daya akomodasi</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Untuk
membaca memerlukan tambahan + 3.00 D</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Evaluasi
sesudah operasi katarak :</span></b></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Hari
1 sesudah operasi harus sudah dievaluasi yaitu :</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Perdarahan
dibilik mata depan (hifema).</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 58.7pt; mso-list: l6 level1 lfo4; tab-stops: list 58.7pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kamera okuli
anterior jernih/keruh :</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 58.7pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Bila
mata depan keruh (flare/sel positif)</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Bilik mata depan keruh (flare /sel positif)</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; mso-list: l15 level2 lfo2; tab-stops: list 79.4pt; text-align: left; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mungkin sampai terjadi pengendapan pus di bilik mata depan
(hipopion).</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Iris miossi disertai sinekia postrior</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Perhatikan
pupil<span style="mso-spacerun: yes;"> </span>miosis/midriasis/normal :</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; mso-list: l15 level2 lfo2; tab-stops: list 79.4pt; text-align: left; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Miosis : biasanya dipergunakan miotikum pada waktu operasi
sehingga hari berikutnya pupil menjadi miosis. Miosis ini dapat terjadi bila
terjadi uveitis anterior, dan biasanya disertai adanya sinekia posterior.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Midirasis : dapat terjadi bila ada peningkatan tekanan intra
okuler (glaucoma)</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pupil tidak bulat : terjadi bila pada waktu operasi terjadi
korpukasi (korpus viterius keluar).</span></div>
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<br /></div>
<div align="left" class="MsoListParagraph" style="line-height: 115%; margin-left: 38.0pt; mso-add-space: auto; mso-list: l14 level2 lfo1; tab-stops: list 38.0pt; text-align: left; text-indent: -18.15pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">PENGOBATAN SESUDAH OPERASI KATARAK :</span></b></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Setelah
operasi dapat diberi :</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kacamata, diberikan bila tanda-tanda iritasi sudah hilang (kurang
lebih sesudah 1,5 bulan post op), sudah tidak ada perubahan refraksi (3 x
refraksi tiap minggu).</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l1 level1 lfo5; tab-stops: list 59.55pt; text-align: left; text-indent: -21.55pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Lensa Kontak :</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Penglihatan
lebih baik daripada kacamata, dan dipakai pada operasi katarak unilateral (satu
mata).</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l1 level1 lfo5; tab-stops: list 59.55pt; text-align: left; text-indent: -21.55pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Inolan Lensa Intra Okuli (IOL) :</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 77.55pt; mso-list: l1 level2 lfo5; tab-stops: list 77.55pt; text-align: left; text-indent: -18.0pt;">
<span style="font-size: 14.0pt; line-height: 115%;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Implan ini memasukkan ke dalam mata pada saat operasi,
menggantikan lensa yang diambil (ECCE).</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 77.55pt; mso-list: l1 level2 lfo5; tab-stops: list 77.55pt; text-align: left; text-indent: -18.0pt;">
<span style="font-size: 14.0pt; line-height: 115%;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Letaknya permanen</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 77.55pt; mso-list: l1 level2 lfo5; tab-stops: list 77.55pt; text-align: left; text-indent: -18.0pt;">
<span style="font-size: 14.0pt; line-height: 115%;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tidak memerlukan perawatan.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 77.55pt; mso-list: l1 level2 lfo5; tab-stops: list 77.55pt; text-align: left; text-indent: -18.0pt;">
<span style="font-size: 14.0pt; line-height: 115%;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Visus lebih baik daripada kacamata / lensa kontak.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; text-align: left;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kerugian
:</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l19 level1 lfo6; tab-stops: list 59.55pt; text-align: left; text-indent: -21.55pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Merupakan benda asing, kemungkinan bereaksi / ditolak oleh tubuh.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l19 level1 lfo6; tab-stops: list 59.55pt; text-align: left; text-indent: -21.55pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tehnik operasi lebih sukar/canggih.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; text-align: left;">
<br /></div>
<h2 align="left" style="line-height: 115%; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">KONSEP
ASUHAN KEPERAWATAN</span></h2>
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<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">PENGKAJIAN
PRE OPERATIF</span></b></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Subyektif</span></b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> : keluhan
penglihatan</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kabur secara total</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Hanya melihat baik pada tempat yang redup</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Hanya dapat melihat rangsangan cahaya saja</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Ganda / majemuk pada satu mata.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Indikator
verbal dan non verbal dari ansietas.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pemahaman
tentang pembedahan katarak termasuk :</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Sifat prosedur</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Resiko dan keuntungan</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Obat anestesi</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pilihan untuk rehabilitasi visual setelah pembedahan, seperti
implan lensa intraokuler, kontak lensa dan kacamata katarak (kacamata afakia).</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Jumlah
informasi yang dicari klien.</span></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Obyektif
:</span></b></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tidak terdapat tanda-tanda peradangan kecuali pada katarak
komplikata yang penyakit intra okulernya masih aktif.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pada pemeriksaan penyinaran lensa tampak kelabu atau kekeruhan
yang memutih.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pada pemeriksaan optalmoskop pada jarak tertentu didapatkan
kekeruhan yang berwarna hitam dengan latar belakang berwarna merah.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pada pemeriksaan refraksi meningkat. Pada penderita yang tadinya
menderita presbiopia kemudian menderita katarak, pada stadium awal dapat
membaca tanpa menggunakan kacamata baca.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Observasi terjadinya tanda-tanda glaucoma karena komplikasi
katarak, tersering adalah glaucoma seperti adanya rasa nyeri karena peningkatan
TIO, kelainan lapang pandang.</span></div>
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<br /></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">10.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">PENGKAJIAN POST OPERASI</span></b></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Data Subyektif</span></b></div>
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<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Nyeri</span></div>
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<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mual</span></div>
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<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Diaporesis</span></div>
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<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Riwayat
jatuh sebelumnya</span></div>
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<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Sistem
pendukung, lingkungan rumah.</span></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Data Obyektif</span></b></div>
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<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Perubahan
tanda-tanda vital</span></div>
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<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Respon yang
lazim terhadap nyeri.</span></div>
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<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tanda-tanda
infeksi</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kemerahan</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 102.1pt; mso-list: l4 level1 lfo10; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Oedema</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 102.1pt; mso-list: l4 level1 lfo10; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Infeksi
kojunctiva (pembuluh darah konjunctiva menonjol).</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 102.1pt; mso-list: l4 level1 lfo10; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Drainase
pada kelopak mata dan bulu mata.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 102.1pt; mso-list: l4 level1 lfo10; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">5)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Zat purulen</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 102.1pt; mso-list: l4 level1 lfo10; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">6)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Peningkatan
suhu</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 102.1pt; mso-list: l4 level1 lfo10; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">7)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Nilai lab;
peningkatan leukosit, perubahan leukosit, hasil pemeriksaan kultur sensitifitas
abnormal.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; mso-list: l14 level9 lfo1; tab-stops: list 79.4pt; text-align: left; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Ketajaman
penglihatan masing-masing mata</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 79.4pt; mso-list: l14 level9 lfo1; tab-stops: list 79.4pt; text-align: left; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kesiapan dan
kemampuan untuk belajar dan menyerap informasi</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; text-align: left;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 38.0pt; mso-list: l14 level2 lfo1; tab-stops: list 38.0pt; text-align: left; text-indent: -18.15pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">11.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">DIAGNOSA KEPERAWATAN</span></b></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level5 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -22.7pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">PRE OPERATIF</span></b></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; mso-list: l14 level6 lfo1; tab-stops: list 82.25pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gangguan
persepsi sensori visual / penglihatan berhubungan dengan penurunan ketajaman
penglihatan, penglihatan ganda.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tujuan
: gangguan persepsi sensori teratasi.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kriteria
hasil :</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 103.8pt; mso-list: l16 level1 lfo12; tab-stops: list 103.8pt; text-align: left; text-indent: -21.55pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Dengan penglihatan yang terbatas klien mampu melihat lingkungan
semaksimal mungkin.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 103.8pt; mso-list: l16 level1 lfo12; tab-stops: list 103.8pt; text-align: left; text-indent: -21.55pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mengenal perubahan stimulus yang positif dan negatif</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 103.8pt; mso-list: l16 level1 lfo12; tab-stops: list 103.8pt; text-align: left; text-indent: -21.55pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mengidentifikasi kebiasaan lingkungan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 103.8pt; tab-stops: list 103.8pt;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 36.0pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 166.8pt;" valign="top" width="222">
<div class="MsoTitle">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">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: 0cm 5.4pt 0cm 5.4pt; width: 175.4pt;" valign="top" width="234">
<div class="MsoTitle">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Rasional</span></div>
</td>
</tr>
<tr style="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: 0cm 5.4pt 0cm 5.4pt; width: 166.8pt;" valign="top" width="222">
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level2 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Orientasikan
pasien terhadap lingkungan aktifitas.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level2 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Bedakan
kemampuan lapang pandang diantara kedua mata</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level2 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Observasi
tanda disorientasi dengan tetap berada di sisi pasien.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level2 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Dorong
klien untuk melakukan aktivitas sederhana seperti menonton TV, radio, dll</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level2 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Anjurkan
pasien menggunakan kacamata katarak, cegah lapang pandang perifer dan catat
terjadinya bintik buta.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level2 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Posisi
pintu harus tertutup terbuka, jauhkan rintangan.</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: 0cm 5.4pt 0cm 5.4pt; width: 175.4pt;" valign="top" width="234">
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Memperkenalkan pada pasien tentang
lingkungan dam aktifitas sehingga dapat meninggalkan stimulus penglihatan.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Menentukan kemampuan lapang pandang tiap
mata</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mengurangi ketakutan pasien dan meningkatkan
stimulus.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Meningkatkan input sensori, dan
mempertahankan perasaan normal, tanpa meningkatkan stress.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Menurunkan penglihatan perifer dan gerakan.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Menurunkan penglihatan perifer dan gerakan.</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; mso-list: l14 level6 lfo1; tab-stops: list 82.25pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Cemas
berhubungan dengan pembedahan yang akan dijalani dan kemungkinan kegagalan
untuk memperoleh penglihatan kembali.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tujuan
: kecemasan teratasi</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kriteria
hasil :</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mengungkapkan
kekhawatirannya dan ketakutan mengenai pembedahan yang akan dijalani.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mengungkapkan
pemahaman tindakan rutin perioperasi dan perawatan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 36.0pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 169.35pt;" valign="top" width="226">
<div class="MsoTitle">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">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: 0cm 5.4pt 0cm 5.4pt; width: 172.85pt;" valign="top" width="230">
<div class="MsoTitle">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Rasional</span></div>
</td>
</tr>
<tr style="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: 0cm 5.4pt 0cm 5.4pt; width: 169.35pt;" valign="top" width="226">
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l21 level1 lfo13; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Ciptakan
lingkungan yang tenang dan relaks, berikan dorongan untuk verbalisasi dan
mendengarkan dengan penuh perhatian.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l21 level1 lfo13; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Yakinkan
klien bahwa ansietas mempunyai respon normal dan diperkirakan terjadi pada
pembedahan katarak yang akan dijalani.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l21 level1 lfo13; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tunjukkan
kesalahpahaman yang diekspresikan klien, berikan informasi yang akurat.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l21 level1 lfo13; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Sajikan
informasi menggunakan metode dan media instruksional.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l21 level1 lfo13; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Jelaskan
kepada klien aktivitas premedikasi yang diperlukan.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l21 level1 lfo13; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Diskusikan
tindakan keperawatan pra operatif yang diharapkan.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l21 level1 lfo13; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Berikan
informasi tentang aktivitas penglihatan dan suara yang berkaitan dengan
periode intra operatif</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: 0cm 5.4pt 0cm 5.4pt; width: 172.85pt;" valign="top" width="230">
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Membantu mengidentifikasi sumber ansietas.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Meningkatkan keyakinan klien</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Meningkatkan keyakinan klien</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Meningkatkan proses belajar dan informasi
tertulis mempunyai sumber rujukan setelah pulang.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pengetahuan yang meningkat akan menambah
kooperatif klien dan menurunkan kecemasan.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">S d a</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Menjelaskan pilihan memungkinkan klien
membuat keputusan secara benar.</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 59.55pt; mso-list: l14 level5 lfo1; tab-stops: list 59.55pt; text-align: left; text-indent: -22.7pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">POST OPERATIF</span></b></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; mso-list: l14 level6 lfo1; tab-stops: list 82.25pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gangguan
rasa nyaman (nyeri akut) berhubungan dengan prosedur invasive.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tujuan<span style="mso-spacerun: yes;"> </span>: nyeri teratasi</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kriteria<span style="mso-spacerun: yes;"> </span>hasil<span style="mso-spacerun: yes;">
</span>:<span style="mso-spacerun: yes;"> </span>klien melaporkan penurunan
nyeri secara progresif dan nyeri terkontrol setelah intervensi. </span></div>
<div class="MsoNormal" style="margin-left: 82.25pt;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 36.0pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 172.2pt;" valign="top" width="230">
<div class="MsoTitle">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">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: 0cm 5.4pt 0cm 5.4pt; width: 170.0pt;" valign="top" width="227">
<div class="MsoTitle">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Rasional</span></div>
</td>
</tr>
<tr style="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: 0cm 5.4pt 0cm 5.4pt; width: 172.2pt;" valign="top" width="230">
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l17 level1 lfo17; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Bantu
klien dalam mengidentifikasi tindakan penghilangan nyeri yang efektif.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l17 level1 lfo17; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Jelaskan
bahwa nyeri dapat terjadi sampai beberapa jam setelah pembedahan.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l17 level1 lfo17; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Lakukan
tindakan mengurangi nyeri dengan cara:</span></div>
<div class="MsoNormal" style="margin-left: 38.0pt; mso-list: l8 level2 lfo18; tab-stops: list 38.0pt; text-indent: -18.15pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Posisi :
tinggikan bagian kepala tempat tidur, ganti posisi dan tidur, ganti posisi
dan tidur pada sisi yang tidak dioperasi</span></div>
<div class="MsoNormal" style="margin-left: 38.0pt; mso-list: l8 level2 lfo18; tab-stops: list 38.0pt; text-indent: -18.15pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Distraksi</span></div>
<div class="MsoNormal" style="margin-left: 38.0pt; mso-list: l8 level2 lfo18; tab-stops: list 38.0pt; text-indent: -18.15pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Latihan
relaksasi</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l17 level1 lfo17; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Berikan
obat analgetik sesuai program</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l17 level1 lfo17; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Lapor
dokter jika nyeri tidak hilang setelah ½ jam pemberian obat, jika nyeri
disertai mual.</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: 0cm 5.4pt 0cm 5.4pt; width: 170.0pt;" valign="top" width="227">
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l13 level1 lfo19; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Membantu
pasien menemukan tindakan yang dapat menghilangkan atau mengurangi nyeri yang
efektif.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l13 level1 lfo19; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Nyeri
dapat terjadi sampai anestesi local habis, memahami hal ini dapat membantu
mengurangi kecemasan yang berhubungan dengan yang tidak diperkirakan.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l13 level1 lfo19; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Latihan
nyeri dengan menggunakan tindakan yang non farmakologi memungkinkan klien
untuk memperoleh rasa kontrol terhadap nyeri.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l13 level1 lfo19; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Analgesik
dapat menghambat reseptor nyeri.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l13 level1 lfo19; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tanda ini
menunjukkan peningkatan tekanan intra ocular atau komplikasi lain.</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 82.25pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; mso-list: l14 level6 lfo1; tab-stops: list 82.25pt; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Resiko
tinggi terjadinya infeksi berhubungan dengan prosedur invasif (bedah
pengangkatan).</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tujuan<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;">
</span>infeksi tidak terjadi<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kriteria
hasil :<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 99.25pt; mso-list: l5 level3 lfo14; tab-stops: list 100.2pt; text-indent: -17.05pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tanda-tanda
infeksi tidak terjadi</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 99.25pt; mso-list: l5 level3 lfo14; tab-stops: list 100.2pt; text-indent: -17.05pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Penyembuhan
luka tepat waktu</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 99.25pt; mso-list: l5 level3 lfo14; tab-stops: list 100.2pt; text-indent: -17.05pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Bebas
drainase purulen , eritema, dan demam</span></div>
<div class="MsoNormal" style="margin-left: 82.2pt;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 36.0pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 178.35pt;" valign="top" width="238">
<div class="MsoTitle">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">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: 0cm 5.4pt 0cm 5.4pt; width: 163.85pt;" valign="top" width="218">
<div class="MsoTitle">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Rasional</span></div>
</td>
</tr>
<tr style="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: 0cm 5.4pt 0cm 5.4pt; width: 178.35pt;" valign="top" width="238">
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l12 level1 lfo20; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tingkatkan
penyembuhan luka dengan :</span></div>
<div class="MsoNormal" style="margin-left: 38.0pt; mso-list: l8 level2 lfo18; tab-stops: list 38.0pt; text-indent: -18.15pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Beri dorongan
untuk mengikuti diet seimbang dan asupan cairan yang adekuat</span></div>
<div class="MsoNormal" style="margin-left: 38.0pt; mso-list: l8 level2 lfo18; tab-stops: list 38.0pt; text-indent: -18.15pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Instruksikan
klien untuk tetap menutup mata sampai hari pertama setelah operasi atau
sampai diberitahukan.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l12 level1 lfo20; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gunakan
tehnik aseptic untuk meneteskan tetes mata :</span></div>
<div class="MsoNormal" style="margin-left: 38.0pt; mso-list: l8 level2 lfo18; tab-stops: list 38.0pt; text-indent: -18.15pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Cuci
tangan sebelum memulai</span></div>
<div class="MsoNormal" style="margin-left: 38.0pt; mso-list: l8 level2 lfo18; tab-stops: list 38.0pt; text-indent: -18.15pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pegang
alat penetes agak jauh dari mata.</span></div>
<div class="MsoNormal" style="margin-left: 38.0pt; mso-list: l8 level2 lfo18; tab-stops: list 38.0pt; text-indent: -18.15pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Ketika
meneteskan hindari kontk antara mata dengan tetesan dan alat penetes.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l12 level1 lfo20; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gunakan
tehnik aseptic untuk membersihkan mata dari dalam ke luar dengan tisu basah /
bola kapas untuk tiap usapan, ganti balutan dan memasukkan lensa bila
menggunakan.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l12 level1 lfo20; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tekankan
pentingnya tidak menyentuh / menggaruk mata yang dioperasi.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l12 level1 lfo20; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Observasi
tanda dan gejala infeksi seperti : kemerahan, kelopak mata bengkak, drainase
purulen, injeksi konjunctiva (pembuluh darah menonjol), peningkatan suhu.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l12 level1 lfo20; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Anjurkan
untuk mencegah ketegangan pada jahitan dengan cara : menggunakan kacamata
protektif dan pelindung mata pada malam hari.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l12 level1 lfo20; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kolaborasi
obat sesuai indikasi :</span></div>
<div class="MsoNormal" style="margin-left: 38.0pt; mso-list: l8 level2 lfo18; tab-stops: list 38.0pt; text-indent: -18.15pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Antibiotika
(topical, parental atau sub conjunctiva)</span></div>
<div class="MsoNormal" style="margin-left: 38.0pt; mso-list: l8 level2 lfo18; tab-stops: list 38.0pt; text-indent: -18.15pt;">
<span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Steroid</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: 0cm 5.4pt 0cm 5.4pt; width: 163.85pt;" valign="top" width="218">
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Nutrisi dan hidrasi yang optimal
meningkatkan kesehatan secara keseluruhan, meningkatkan penyembuhan luka
pembedahan.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Memakai pelindung mata meingkatkan
penyembuhan dan menurunkan kekuatan iritasi kelopak mata terhadap jahitan
luka.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tehnik aseptic menimalkan masuknya
mikroorganisme dan mengurangi infeksi.</span></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" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tehnik aseptic menurunkan resiko penyebaran
infeksi/.bakteri dan kontaminasi silang.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mencegah kontaminasi dan kerusakan sisi
operasi.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Deteksi dini infeksi memungkinkan
penanganan yang cepat untuk meminimalkan keseriusan infeksi.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Ketegangan pada jahitan dapat menimbulkan
interupsi, menciptakan jala masuk untuk mirkoorganisme</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Sediaan topical digunakan secara
profilaksis, dimana terapi lebih agresif diperlukan bila terjadi infeksi</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l4 level3 lfo10; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: Wingdings; font-size: 8.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">£<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Menurunkan inflamasi</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 82.2pt;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; mso-list: l14 level6 lfo1; tab-stops: list 82.25pt; text-align: left; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gangguan
sensori – perceptual : penglihatan berhubungan dengan gangguan penerimaan
sensori/ status organ indera, lingkugan secara terapeutik dibatasi, ditandai
dengan :</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 99.25pt; mso-list: l22 level3 lfo15; tab-stops: list 100.2pt; text-align: left; text-indent: -17.05pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Menurunnya
ketajaman, gangguan penglihatan.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 99.25pt; mso-list: l22 level3 lfo15; tab-stops: list 100.2pt; text-align: left; text-indent: -17.05pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Perubahan
respo biasanya terhadap rangsang.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 82.2pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Hasilnya
yang diharapkan<span style="mso-spacerun: yes;"> </span>:</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 99.25pt; mso-list: l22 level3 lfo15; tab-stops: list 100.2pt; text-align: left; text-indent: -17.05pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Meningkatkan
ketajaman penglihatn dalam batas situasi individu</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 99.25pt; mso-list: l22 level3 lfo15; tab-stops: list 100.2pt; text-align: left; text-indent: -17.05pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mengenal
gangguan sensori dan berkompensasi terhadap perubahan</span></div>
</div>
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-hansi-theme-font: major-latin;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 36.0pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 167.95pt;" valign="top" width="224">
<div class="MsoTitle">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">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: 0cm 5.4pt 0cm 5.4pt; width: 174.25pt;" valign="top" width="232">
<div class="MsoTitle">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Rasional</span></div>
</td>
</tr>
<tr style="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: 0cm 5.4pt 0cm 5.4pt; width: 167.95pt;" valign="top" width="224">
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l9 level1 lfo21; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">tentukan
ketajaman penglihatan, catat apakah satu atau kedua mata terlibat</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l9 level1 lfo21; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">orientasi
pasien terhadap lingkungan, staf/ orang lain di area</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l9 level1 lfo21; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">observasi
tanda-tanda dan gejala-gejala disorientasi, pertahankan pengamanan tempat
tidur sampai benar-benar sembuh dari anesthesia.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l9 level1 lfo21; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">ingatkan
klien menggunakan kacamata katarak yang tujuannya memperbesar ± 25%, penglihatan
perifer hilang.</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: 0cm 5.4pt 0cm 5.4pt; width: 174.25pt;" valign="top" width="232">
<div class="MsoNormal" style="margin-left: 17.0pt; mso-list: l3 level3 lfo23; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<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><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kebutuhan
individu dan pilihan intervensi dan pilihan intervensi bervariasi sebab
kehilangan penglihatan terjadi lambat dan progresif.</span></div>
<div class="MsoNormal" style="margin-left: 17.0pt; mso-list: l3 level3 lfo23; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<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><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Memberikan
peningkatan kenyamanan dan kekeluargaaan, menurunkan cemas dan disorientasi
pasca operasi.</span></div>
<div class="MsoNormal" style="margin-left: 17.0pt; mso-list: l3 level3 lfo23; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<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><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Terbangun
dalam lingkungan yang tak dikenal dan mengalami keterbatasan penglihatan
dapat mengakibatkan bingung pada orangtua.</span></div>
<div class="MsoNormal" style="margin-left: 17.0pt; mso-list: l3 level3 lfo23; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<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><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Perubahan
ketajaman dan kedalaman persepsi dapat menyebabkan bingung / meningkatkan
resiko cedera sampai pasien belajar untuk mengkompensasi.</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 82.2pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt; mso-list: l14 level6 lfo1; tab-stops: list 82.25pt; text-indent: -22.7pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kurang
pengetahuan tentang kondisi prognosis pengobatan berhubungan dengan tidak
mengenal sumber informasi, ditandai dengan klien kurang mengikuti instruksi,
sering bertanya terjadi komplikasi yang dapat dicegah.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tujuan<span style="mso-spacerun: yes;"> </span>:</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Setelah
diberikan tindakan keperawatan berupa HE diharapkan klien mengerti dengan
kondisi, prognosis,dan pengobatan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 82.25pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kriteria
hasil :</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 99.25pt; mso-list: l11 level3 lfo16; tab-stops: list 100.2pt; text-indent: -17.05pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Dapat
melakukan perawatan dengan prosedur yang benar</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 99.25pt; mso-list: l11 level3 lfo16; tab-stops: list 100.2pt; text-indent: -17.05pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Dapat
menyembuhkan kembali apa yang telah dijelasakan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 99.25pt;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 36.0pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 168.5pt;" valign="top" width="225">
<div class="MsoTitle">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">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: 0cm 5.4pt 0cm 5.4pt; width: 173.7pt;" valign="top" width="232">
<div class="MsoTitle">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Rasional</span></div>
</td>
</tr>
<tr style="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: 0cm 5.4pt 0cm 5.4pt; width: 168.5pt;" valign="top" width="225">
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l10 level1 lfo22; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kaji informasi
tentang kondisi individu prognosis tipe prosedur, tipe prosedur lensa.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l10 level1 lfo22; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tekankan
pentingnya evaluasi perawatan. Beritahu untuk melaporkan penglihatan berawan.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l10 level1 lfo22; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Informasikan
kepada klien untuk menghindari tetes mata yang dijual bebas.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l10 level1 lfo22; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Dorong
pemasukan cairan yang adekuat, makan terserat.</span></div>
<div class="MsoNormal" style="margin-left: 19.85pt; mso-list: l10 level1 lfo22; tab-stops: list 19.85pt; text-indent: -19.85pt;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Anjurkan
klien untuk menghindari membaca, berkedip, mengangkat yang berat, mengejar
saat defekasi, membongkok pada panggul, meniup hidung penggunaan spray, bedak
bubuk, merokok.</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: 0cm 5.4pt 0cm 5.4pt; width: 173.7pt;" valign="top" width="232">
<div class="MsoNormal" style="margin-left: 17.0pt; mso-list: l10 level2 lfo22; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<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><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Meningkatkan
pemahaman dan kerjasama dengan program pasca operasi</span></div>
<div class="MsoNormal" style="margin-left: 17.0pt; mso-list: l10 level2 lfo22; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<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><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pengawasan
periodic menurun kan resiko komplikasi serius.</span></div>
<div class="MsoNormal" style="margin-left: 17.0pt; mso-list: l10 level2 lfo22; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<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><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Dapat
bereaksi silang / campur dengan obat yang diberikan.</span></div>
<div class="MsoNormal" style="margin-left: 17.0pt; mso-list: l10 level2 lfo22; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<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><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Memertahankan
konsistensi faeces untuk menghindari mengejan</span></div>
<div class="MsoNormal" style="margin-left: 17.0pt; mso-list: l10 level2 lfo22; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<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><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Aktifitas
yang menyebabkan mata lelah tegang, manuver valsava atau meningkatkan TID
dapat mempengaruhi hasil operasi dan mencetuskan perdarahan.</span></div>
<div class="MsoNormal" style="margin-left: 17.0pt; mso-list: l10 level2 lfo22; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<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><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Catatan :
iritasi pernapasan yang menyebabkan batuk / bersih dapat meningkatkan TID.</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoTitle" style="line-height: normal; text-align: center;">
<br /></div>
<div class="MsoTitle" style="line-height: normal; text-align: center;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">DAFTAR PUSTAKA</span></div>
<div align="left" class="MsoTitle" style="line-height: normal; text-align: left;">
<br /></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; text-align: left; text-indent: -36.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Carpenito, Lynda Juall, (1999), Rencana Asuhan dan Dokumentasi Keperawatan,
Edisi 6, EGC, Jakarta.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; text-align: left; text-indent: -36.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Doengoes, Mariyln E., (2000) Rencana Asuhan Keperawatan Pedoman
Untuk Perencanaan dan Pendokumentasian Perawatan Pasien, Edisi 3, EGC, Jakarta.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; text-align: left; text-indent: -36.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Sidarta Ilyas, (1997), Katarak, Balai Penerbit FKUI, Jakarta.</span></div>
<div align="left" class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; text-align: left; text-indent: -36.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tamim Radjamin RK, Dkk, (1993), Ilmu Penyakit Mata, Airlangga
University Press, Surabaya.</span></div>
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com1tag:blogger.com,1999:blog-1799099966681267159.post-73175299110417823972012-12-03T04:20:00.000-08:002012-12-03T04:29:51.207-08:00ASKEP COMBOSTIO<!--[if gte mso 9]><xml>
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<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Asuhan
Keperawatan Luka Bakar</span></b></div>
<div align="center" class="MsoNormal" style="line-height: 115%; text-align: center;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">( Combostio
)</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt; mso-list: l4 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">PENGERTIAN.</span></b></div>
<div align="left" class="MsoBodyTextIndent" style="line-height: 115%; tab-stops: 0cm; text-align: left;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Luka Bakar</span></b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;"> adalah luka yang disebabkan
oleh kontak dengan suhu tinggi seperti api, air panas, listrik, bahan kimia dan
radiasi, juga kontak dengan suhu rendah (frost bite).</span></div>
<div align="left" class="MsoBodyTextIndent" style="line-height: 115%; mso-list: l4 level2 lfo1; text-align: left; text-indent: 0cm;">
<span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">à<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Kematian
dan akibat lain<span style="mso-spacerun: yes;"> </span>berkaitan dengan problem
fungsi maupun estetik.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 115%; margin-left: 18.0pt; mso-add-space: auto; mso-list: l4 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="SV" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">ETIOLOGI</span></b><span lang="SV" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Hampir semua luka bakar yang menimpa anak-anak terjadi di rumah pada waktu
kita tidur. </span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Vektor-vektor
utama energi panas yang bersangkutan adalah cairan serta bahan padat yang
panas, bahan-bahan seperti kain yang mudah terbakar, cairan yang mudah menguap
dan terbakar serta rumah tempat tinggal. Bahan-bahan yang dapat terbakar,
paling lazim kebakarannya ditimbulkan oleh korek api, alat-alat pemanas ruangan
yang tidak dijaga dengan baik, kompor di dapur atau alat-alat pemanas/ memasak
air.</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt; mso-list: l4 level1 lfo1; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">PATOFISIOLOGI</span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;"></span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Cedera
termis menyebabkan gangguan keseimbangan cairan dan elektrolit sampai shock,
dapat menimbulkan asidosis, nekrosis tubular akut dan disfungsi cerebral.
Kondisi ini dijumpai pada fase awal yang berlangsung sampai 72 jam I.<span style="mso-spacerun: yes;"> </span>Dengan kehilangan kulit yang memiliki fungsi
sebagai barier, maka sangat mudah terinfeksi dan mudah terjadi penguapan cairan
tubuh yang berlebihan disertai pengeluaran protein dan energi sehingga terjadi
gangguan metabolisme.<span style="mso-spacerun: yes;"> </span>Jaringan nekrosis
yang ada melepas toksin yang dapat menimbulkan sepsis dan kegagalan fungsi
organ tubuh. Reaksi inflamasi yang berlanjut akan menyebabkan kerapuhan
jaringan dan struktur-strukturnya.<span style="mso-spacerun: yes;">
</span>Kondisi ini menimbulkan parut yang tidak beraturan, kontraktur dan deformitas
sendi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Sel-sel
dapat menahan temperatur sampai 44 <sup>0</sup>C tanpa kerusakan permanen.<span style="mso-spacerun: yes;"> </span>Antara 44 dan 51 <sup>0</sup>C<span style="mso-spacerun: yes;"> </span></span><span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-ascii-font-family: Cambria; mso-char-type: symbol; mso-hansi-font-family: Cambria; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">à</span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;"><span style="mso-spacerun: yes;"> </span>kecepatan kerusakan jaringan berlipat ganda
untuk tiap derajat kenaikan temperatur.<span style="mso-spacerun: yes;">
</span>Lebih dari 51 <sup>0</sup>C protein terdenaturasi dan kerusakan protein
sangat hebat.<span style="mso-spacerun: yes;"> </span>Diatas 71 <sup>0</sup>C
: kerusakan seluler sangat cepat.</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 115%; margin-left: 18.0pt; mso-add-space: auto; mso-list: l4 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">MANISFESTASI</span></b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> <b>KLINIS</b></span></div>
<div class="MsoBodyText" style="line-height: 115%; text-indent: 18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Berikut ini
adalah manisfestasi awal untuk luka bakar sedang sampai berat:</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l14 level1 lfo2; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Takikardia</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l14 level1 lfo2; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tekanan darah turun</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l14 level1 lfo2; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Ekstremitas dingin</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l14 level1 lfo2; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Perubahan tingkat kesadaran</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l14 level1 lfo2; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Dehidrasi ( Penurunan turgor kulit, penurunan jumlah urin yang
keluar, lidah dan kulit kering)</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l14 level1 lfo2; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Peningkatan frekuensi napas</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-hyphenate: none; mso-list: l14 level1 lfo2; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pucat (tidak
ada pada luka bakar derajat kedua dan ketiga)<br style="mso-special-character: line-break;" />
<br style="mso-special-character: line-break;" />
</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt; mso-list: l4 level1 lfo1; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">DERAJAT
LUKA BAKAR.</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt;">
<i><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Secara
klasik luka bakar terbagi 3 macam, yaitu :</span></i></div>
<div align="left" class="MsoBodyTextIndent" style="line-height: 115%; tab-stops: 36.0pt; text-align: left;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">1). Derajat<span style="mso-spacerun: yes;"> </span>I<span style="mso-spacerun: yes;"> </span>( Luka Bakar Superfisial ).</span></b></div>
<div align="left" class="MsoBodyTextIndent" style="line-height: 115%; margin-left: 36.0pt; tab-stops: 36.0pt; text-align: left; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;"><span style="mso-tab-count: 1;"> </span>Terbatas pada lapisan epdermis ditandai
dengan kemerahan yang akan sembuh tanpa jaringan parut dalam waktu 5 – 7 hari.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; tab-stops: 36.0pt; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">2).<span style="mso-tab-count: 1;"> </span>Derajat<span style="mso-spacerun: yes;"> </span>II<span style="mso-spacerun: yes;"> </span>(
Luka Bakar Dermis ).</span></b></div>
<div class="MsoBodyTextIndent2" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Mencapai kedalaman
dermis, tetapi<span style="mso-spacerun: yes;"> </span>masih ada elemen epitel
yang tersisa.<span style="mso-spacerun: yes;"> </span>Dengan adanya sel epitel
yang sehat ini luka dapat sembuh dalam<span style="mso-spacerun: yes;"> </span>10
- 21 hari.<span style="mso-spacerun: yes;"> </span>Karena kerusakan kapiler
dan<span style="mso-spacerun: yes;"> </span>ujung saraf di dermis maka luka
tampak pucat dan lebih nyeri karena ada iritasi ujung syaraf sensorik.<span style="mso-spacerun: yes;"> </span>Timbul bula berisi cairan eksudat yang keluar
dari pembuluh darah. karena permeabilitas dindingnya meninggi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt;">
<i><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Derajat
II dibedakan menjadi<span style="mso-spacerun: yes;"> </span>:</span></i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l16 level1 lfo3; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Derajat<span style="mso-spacerun: yes;">
</span>II<span style="mso-spacerun: yes;"> </span>Dangkal;</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Kerusakan
mengenai bagian siperfisial dari dermis dan sembuh spontan<span style="mso-spacerun: yes;"> </span>14<span style="mso-spacerun: yes;">
</span>– 15<span style="mso-spacerun: yes;"> </span>hari.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l16 level1 lfo3; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Derajat<span style="mso-spacerun: yes;">
</span>II<span style="mso-spacerun: yes;"> </span>Dalam ;</span></b></div>
<div class="MsoBodyTextIndent3" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Kerusakan mengenai
hampir seluruh bagian dermis dan dirasakan nyeri.<span style="mso-spacerun: yes;"> </span>Sembuh lebih lama tergantung dari sel epitel
sehat yang masih tersisa. Penyembuhan lebih dari satu bulan.<span style="mso-tab-count: 2;"> </span></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; tab-stops: 36.0pt; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">3).<span style="mso-tab-count: 1;"> </span>Derajat<span style="mso-spacerun: yes;"> </span>III.</span></b></div>
<div class="MsoBodyTextIndent2" style="line-height: 115%; tab-stops: 36.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Meliputi
seluruh kedalaman kulit, subkutis atau organ yang lebih dlm.<span style="mso-spacerun: yes;"> </span>Karena elemen epitel rusak semuanya maka
kesembuhan dilakukan dengan cangkok kulit. Karena koagulasi protein yang
terjadi maka gambaran kulit putih,<span style="mso-spacerun: yes;"> </span>tidak<span style="mso-spacerun: yes;"> </span>ada bula, tidak nyeri.</span></div>
<div align="left" class="MsoBodyTextIndent" style="line-height: 115%; text-align: left;">
<i><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Derajat
luka bakar berhubungan dengan beberapa faktor, yaitu </span></i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; mso-list: l11 level1 lfo4; tab-stops: 18.0pt list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Kondisi jaringan yang terkena.</span></div>
<div class="MsoBodyTextIndent2" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Syaraf dan pembuluh
darah merupakan struktur yang kurang tahan terhadap konduksi panas, sedangkan
tulang paling tahan.<span style="mso-spacerun: yes;"> </span>Jaringan lain
memiliki konduksi sedang.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; mso-list: l11 level1 lfo4; tab-stops: 18.0pt list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Waktu kontak.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; mso-list: l11 level1 lfo4; tab-stops: 18.0pt list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Pigmentasi kulit.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt; tab-stops: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt; mso-list: l4 level1 lfo1; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">F.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">KLASIFIKASI
LUKA BAKAR.</span></b></div>
<div align="left" class="MsoBodyTextIndent" style="line-height: 115%; tab-stops: 36.0pt 99.0pt; text-align: left;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">1<b>.<span style="mso-spacerun: yes;">
</span>Berat,</b><span style="mso-tab-count: 1;"> </span><i>bila :</i></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l3 level1 lfo5; tab-stops: list 54.0pt left 99.0pt; text-indent: -18.0pt;">
<span style="font-family: Wingdings; line-height: 115%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Derajat<span style="mso-spacerun: yes;"> </span>II<span style="mso-spacerun: yes;">
</span>dengan luas lebih dari 25 %.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l3 level1 lfo5; tab-stops: list 54.0pt left 99.0pt; text-indent: -18.0pt;">
<span style="font-family: Wingdings; line-height: 115%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Derajat<span style="mso-spacerun: yes;"> </span>III<span style="mso-spacerun: yes;">
</span>dengan luas lebih dari<span style="mso-spacerun: yes;"> </span>10 %.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l3 level1 lfo5; tab-stops: list 54.0pt left 99.0pt; text-indent: -18.0pt;">
<span style="font-family: Wingdings; line-height: 115%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Disertai
trauma jalan nafas, jaringan lunak luas, fraktur.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l3 level1 lfo5; tab-stops: list 54.0pt left 99.0pt; text-indent: -18.0pt;">
<span style="font-family: Wingdings; line-height: 115%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Akibat
listrik.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt; tab-stops: 36.0pt 99.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">2<b>.<span style="mso-spacerun: yes;"> </span>Sedang,</b><span style="mso-tab-count: 1;"> </span><i>bila
:</i></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l7 level1 lfo6; tab-stops: 36.0pt list 54.0pt left 99.0pt; text-indent: -18.0pt;">
<span style="font-family: Wingdings; line-height: 115%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Derajat<span style="mso-spacerun: yes;"> </span>II<span style="mso-spacerun: yes;">
</span>dengan luas 15 – 25 %.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l7 level1 lfo6; tab-stops: 36.0pt list 54.0pt left 99.0pt; text-indent: -18.0pt;">
<span style="font-family: Wingdings; line-height: 115%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Derajat<span style="mso-spacerun: yes;"> </span>III<span style="mso-spacerun: yes;">
</span>dengan luas kurang dari 10 %, kecuali muka, kaki dan tangan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt; tab-stops: 36.0pt 99.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">3<b>.<span style="mso-spacerun: yes;"> </span>Ringan,</b><span style="mso-tab-count: 1;"> </span><i>bila
:</i></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l15 level1 lfo7; tab-stops: 36.0pt list 54.0pt left 99.0pt; text-indent: -18.0pt;">
<span style="font-family: Wingdings; line-height: 115%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Derajat<span style="mso-spacerun: yes;"> </span>II<span style="mso-spacerun: yes;">
</span>dengan luas kurang dari 15 %.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l15 level1 lfo7; tab-stops: 36.0pt list 54.0pt left 99.0pt; text-indent: -18.0pt;">
<span style="font-family: Wingdings; line-height: 115%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Derajat<span style="mso-spacerun: yes;"> </span>III<span style="mso-spacerun: yes;">
</span>kurang dari<span style="mso-spacerun: yes;"> </span>2 %.</span></div>
<div class="MsoNormal" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt; mso-list: l4 level1 lfo1; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">G.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">LUAS
LUKA BAKAR.</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt;">
<b><i><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Perhitungan
luas luka bakar menurut Role of Nine<span style="mso-spacerun: yes;">
</span>dari Walace.</span></i></b></div>
<ul style="margin-top: 0cm;" type="square">
<li class="MsoNormal" style="line-height: 115%; mso-list: l12 level1 lfo8; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Kepala dan leher<span style="mso-tab-count: 1;"> </span>: 9 %.</span></li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l12 level1 lfo8; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Ekstremitas atas<span style="mso-tab-count: 1;"> </span>: 2 x 9 %.</span></li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l12 level1 lfo8; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Paha dan kaki<span style="mso-tab-count: 2;"> </span>: 4 x 9 %.</span></li>
<li class="MsoNormal" style="line-height: 115%; mso-list: l12 level1 lfo8; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Perineum dan genital<span style="mso-tab-count: 1;"> </span>: 1 %.</span></li>
</ul>
<div class="MsoBodyText" style="line-height: 115%;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 115%; margin-left: 18.0pt; mso-add-space: auto; mso-list: l4 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">H.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">PEMERIKSAAN
DIAGNOSTIK</span></b></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 39.0pt; mso-hyphenate: none; mso-list: l9 level1 lfo9; mso-pagination: none; tab-stops: list 39.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Hitung darah lengkap (CBC)-menurun</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 39.0pt; mso-hyphenate: none; mso-list: l9 level1 lfo9; mso-pagination: none; tab-stops: list 39.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Nilai analisis gas darah arteri-asidosis metabolic (pH turun,
tekanan parsial karbon dioksida [Po2] turun)</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 39.0pt; mso-hyphenate: none; mso-list: l9 level1 lfo9; mso-pagination: none; tab-stops: list 39.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Elektrolit serum-menurun karena menghilang ke daerah trauma dan
ruang interstisial</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 39.0pt; mso-hyphenate: none; mso-list: l9 level1 lfo9; mso-pagination: none; tab-stops: list 39.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Glukosa serum-meningkat karena glkoneogenesis akibat stress</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 39.0pt; mso-hyphenate: none; mso-list: l9 level1 lfo9; mso-pagination: none; tab-stops: list 39.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Nitrogen urea darah (BUN)-meningkat karena kerusakan jaringan dan
oliguria</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 39.0pt; mso-hyphenate: none; mso-list: l9 level1 lfo9; mso-pagination: none; tab-stops: list 39.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kreatinin-meningkat karena kerusakan jaringan dan oliguria </span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 39.0pt; mso-hyphenate: none; mso-list: l9 level1 lfo9; mso-pagination: none; tab-stops: list 39.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kadar protein serum-menurun karena pemecahan protein karena
kebutuhan energi yang meningkat</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 39.0pt; margin-right: 0cm; margin-top: 0cm; mso-hyphenate: none; mso-list: l9 level1 lfo9; mso-pagination: none; tab-stops: list 39.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Foto toraks<br style="mso-special-character: line-break;" />
<br style="mso-special-character: line-break;" />
</span></div>
<div class="MsoListParagraph" style="line-height: 115%; margin-left: 18.0pt; mso-add-space: auto; mso-list: l4 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">KOMPLIKASI</span></b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-hyphenate: none; mso-list: l8 level1 lfo10; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gagal ginjal</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-hyphenate: none; mso-list: l8 level1 lfo10; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Asidosis
metabolic</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-hyphenate: none; mso-list: l8 level1 lfo10; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Hiperkalemia</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-hyphenate: none; mso-list: l8 level1 lfo10; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Hiponatremia</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l8 level1 lfo10; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Hipokalsemia</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l8 level1 lfo10; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Masalah paru, yang terdiri dari :</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 72.0pt; mso-hyphenate: none; mso-list: l8 level2 lfo10; mso-pagination: none; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Edema paru</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 72.0pt; mso-hyphenate: none; mso-list: l8 level2 lfo10; mso-pagination: none; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Insufisiensi paru</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 72.0pt; mso-hyphenate: none; mso-list: l8 level2 lfo10; mso-pagination: none; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Embolus paru</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 72.0pt; mso-hyphenate: none; mso-list: l8 level2 lfo10; mso-pagination: none; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pneumonia bacterial</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; mso-list: l8 level1 lfo10; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Infeksi</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; mso-list: l8 level1 lfo10; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Ulkus
Curling</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 18.0pt; mso-list: l4 level1 lfo1; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">J.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">PENATAL</span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">AKSANAAN</span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;"></span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; mso-list: l4 level4 lfo1; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Prinsip
Penanganan Luka Bakar.</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level5 lfo1; text-indent: -18.0pt;">
<span style="font-size: 14.0pt; line-height: 115%;"><span style="mso-list: Ignore;">õ<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Penutupan lesi sesegera mungkin.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level5 lfo1; text-indent: -18.0pt;">
<span style="font-size: 14.0pt; line-height: 115%;"><span style="mso-list: Ignore;">õ<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Pencegahan infeksi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level5 lfo1; text-indent: -18.0pt;">
<span style="font-size: 14.0pt; line-height: 115%;"><span style="mso-list: Ignore;">õ<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Mengurangi rasa nyeri.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level5 lfo1; text-indent: -18.0pt;">
<span style="font-size: 14.0pt; line-height: 115%;"><span style="mso-list: Ignore;">õ<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Pencegahan trauma mekanik pada kulit.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level5 lfo1; text-indent: -18.0pt;">
<span style="font-size: 14.0pt; line-height: 115%;"><span style="mso-list: Ignore;">õ<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Pembatasan jaringan parut.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; mso-list: l4 level4 lfo1; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Pada
Saat Kejadian.</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level5 lfo1; text-indent: -18.0pt;">
<span style="font-size: 14.0pt; line-height: 115%;"><span style="mso-list: Ignore;">õ<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Jauhkan korban dari sumber trauma.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level5 lfo1; text-indent: -18.0pt;">
<span style="font-size: 14.0pt; line-height: 115%;"><span style="mso-list: Ignore;">õ<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Padamkan api dan siram kulit yang panas dengan
air.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level5 lfo1; text-indent: -18.0pt;">
<span style="font-size: 14.0pt; line-height: 115%;"><span style="mso-list: Ignore;">õ<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Kalau trauma bahan kimia<span style="mso-spacerun: yes;"> </span></span><span style="font-family: Wingdings; font-size: 14.0pt; line-height: 115%; mso-ascii-font-family: Cambria; mso-char-type: symbol; mso-hansi-font-family: Cambria; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">à</span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;"> siram
kulit dengan air mengalir.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 36.0pt; mso-list: l4 level4 lfo1; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Tindakan
Selanjutnya.</span></b></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level6 lfo1; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Lakukan
resusitasi dengan memperhatikan jalan nafas dan sirkulasi.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level6 lfo1; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Periksa
cedera diseluruh tubuh secara sistematis.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level6 lfo1; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Untuk
memenuhi kebutuhan<span style="mso-spacerun: yes;"> </span>cairan maka memakai
perhitungan :</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 72.0pt; tab-stops: 72.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">1).<span style="mso-tab-count: 1;"> </span>Berat
badan (kg)<span style="mso-spacerun: yes;"> </span>x<span style="mso-spacerun: yes;"> </span>% luka bakar<span style="mso-spacerun: yes;"> </span>x<span style="mso-spacerun: yes;">
</span>1 cc Nacl.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 72.0pt; tab-stops: 72.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">2).<span style="mso-tab-count: 1;"> </span>Berat
badan<span style="mso-spacerun: yes;"> </span>(kg)<span style="mso-spacerun: yes;"> </span>x<span style="mso-spacerun: yes;"> </span>%
luka bakar<span style="mso-spacerun: yes;"> </span>x<span style="mso-spacerun: yes;"> </span>1 cc larutan koloid.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 72.0pt; tab-stops: 72.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">3).<span style="mso-tab-count: 1;"> </span>2000
cc<span style="mso-spacerun: yes;"> </span>glukosa<span style="mso-spacerun: yes;"> </span>5 %.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 72.0pt; tab-stops: 72.0pt; text-indent: -18.0pt;">
<i><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Keterangan<span style="mso-tab-count: 1;"> </span>:</span></i></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 72.0pt; mso-list: l4 level7 lfo1; tab-stops: 72.0pt; text-indent: -18.0pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; 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: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Terapi
cairan di atas diindikasikan pada luka bakar derajat II / III dengan luas lebih
dari 25 % atau pasien yang tidak dapat minum.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 72.0pt; mso-list: l4 level7 lfo1; tab-stops: 72.0pt; text-indent: -18.0pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; 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: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Terapi
dihentikan bila masukan oral dapat diberikan.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 72.0pt; mso-list: l4 level7 lfo1; tab-stops: 72.0pt; text-indent: -18.0pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; 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: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Separo
dari jumlah 1,2 dan 3<span style="mso-spacerun: yes;"> </span>diberi pada 8 jam
I, sisanya diberikan dalam 16 jam berikutnya.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 72.0pt; mso-list: l4 level7 lfo1; tab-stops: 72.0pt; text-indent: -18.0pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; 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: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Pada
hari ke 2 diberikan ½ dari jumlah cairan hari I.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 72.0pt; mso-list: l4 level7 lfo1; tab-stops: 72.0pt; text-indent: -18.0pt;">
<span style="font-family: Wingdings; font-size: 14.0pt; 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: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Hari ke
3 diberikan ½<span style="mso-spacerun: yes;"> </span>dari jumlah cairan hari
ke<span style="mso-spacerun: yes;"> </span>2..</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level6 lfo1; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Berikan
analgetik.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level6 lfo1; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Lakukan
pencucian luka setelah sirkulasi stabil, bila perlu lakukan debredement.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level6 lfo1; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">f.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Berikan
antibiotika topical sesudah pencucian luka.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 54.0pt; mso-list: l4 level6 lfo1; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">g.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Berikan
antitetanus / toxoid yaitu ATS 3.000 Unit pada orang dewasa dan separuh untuk
anak.</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 115%; margin-left: 18.0pt; mso-add-space: auto; mso-list: l4 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">K.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">KONSEP
ASUHAN KEPERAWATAN</span></b></div>
<div class="MsoBodyText" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-hyphenate: none; mso-list: l13 level1 lfo12; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; 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 style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Aktifitas/istirahat: </span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 35.35pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tanda:
Penurunan kekuatan, tahanan; keterbatasan rentang gerak pada area yang sakit;
gangguan massa otot, perubahan tonus.</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 35.35pt;">
<br /></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l2 level1 lfo11; mso-pagination: none; tab-stops: 9.0pt list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-style: italic; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><em><span style="font-family: "Cambria","serif"; font-size: 14.0pt; font-style: normal; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Sirkulasi:</span></em><i><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> </span></i></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 35.35pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tanda
(dengan cedera luka bakar lebih dari 20% APTT): hipotensi (syok); penurunan
nadi perifer distal pada ekstremitas yang cedera; vasokontriksi perifer umum
dengan kehilangan nadi, kulit putih dan dingin (syok listrik); takikardia
(syok/ansietas/nyeri); disritmia (syok listrik); pembentukan oedema jaringan
(semua luka bakar).</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 35.35pt;">
<br /></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l2 level1 lfo11; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-style: italic; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><em><span style="font-family: "Cambria","serif"; font-size: 14.0pt; font-style: normal; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Integritas ego:</span></em><i><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> </span></i></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 35.35pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gejala:
masalah tentang keluarga, pekerjaan, keuangan, kecacatan.</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 35.35pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tanda:
ansietas, menangis, ketergantungan, menyangkal, menarik diri, marah.</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 35.35pt;">
<br /></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l2 level1 lfo11; mso-pagination: none; tab-stops: 18.0pt 27.0pt list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-style: italic; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><em><span style="font-family: "Cambria","serif"; font-size: 14.0pt; font-style: normal; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Eliminasi:</span></em><i><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> </span></i></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 35.35pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tanda: haluaran
urine menurun/tak ada selama fase darurat; warna mungkin hitam kemerahan bila
terjadi mioglobin, mengindikasikan kerusakan otot dalam; diuresis (setelah
kebocoran kapiler dan mobilisasi cairan ke dalam sirkulasi); penurunan bising
usus/tak ada; khususnya pada luka bakar kutaneus lebih besar dari 20% sebagai
stres penurunan motilitas/peristaltik gastrik.</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 35.35pt;">
<br /></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l2 level1 lfo11; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-style: italic; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><em><span style="font-family: "Cambria","serif"; font-size: 14.0pt; font-style: normal; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Makanan/cairan:</span></em><i><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> </span></i></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 35.35pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tanda:
oedema jaringan umum; anoreksia; mual/muntah.</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 35.35pt;">
<br /></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l2 level1 lfo11; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-style: italic; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><em><span style="font-family: "Cambria","serif"; font-size: 14.0pt; font-style: normal; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Neurosensori:</span></em><i><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> </span></i></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 35.35pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gejala: area
batas; kesemutan.</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 35.35pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tanda:
perubahan orientasi; afek, perilaku; penurunan refleks tendon dalam (RTD) pada
cedera ekstremitas; aktifitas kejang (syok listrik); laserasi korneal;
kerusakan retinal; penurunan ketajaman penglihatan (syok listrik); ruptur
membran timpanik (syok listrik); paralisis (cedera listrik pada aliran saraf).</span></div>
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<br /></div>
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<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-style: italic; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><em><span style="font-family: "Cambria","serif"; font-size: 14.0pt; font-style: normal; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Nyeri/kenyamanan:</span></em><i><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> </span></i></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gejala:
Berbagai nyeri; contoh luka bakar derajat pertama secara eksteren sensitif
untuk disentuh; ditekan; gerakan udara dan perubahan suhu; luka bakar ketebalan
sedang derajat kedua sangat nyeri; smentara respon pada luka bakar ketebalan
derajat kedua tergantung pada keutuhan ujung saraf; luka bakar derajat tiga
tidak nyeri.</span></div>
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<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-style: italic; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><em><span style="font-family: "Cambria","serif"; font-size: 14.0pt; font-style: normal; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pernafasan:</span></em><i><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> </span></i></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gejala:
terkurung dalam ruang tertutup; terpajan lama (kemungkinan cedera inhalasi). </span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tanda: serak;
batuk mengii; partikel karbon dalam sputum; ketidakmampuan menelan sekresi oral
dan sianosis; indikasi cedera inhalasi.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pengembangan
torak mungkin terbatas pada adanya luka bakar lingkar dada; jalan nafas atau
stridor/mengii (obstruksi sehubungan dengan laringospasme, oedema laringeal);
bunyi nafas: gemericik (oedema paru); stridor (oedema laringeal); sekret jalan
nafas dalam (ronkhi).</span></div>
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<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Symbol; mso-bidi-font-style: italic; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><em><span style="font-family: "Cambria","serif"; font-size: 14.0pt; font-style: normal; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Keamanan:</span></em><i><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> </span></i></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tanda:</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kulit umum:
destruksi jaringan dalam mungkin tidak terbukti selama 3-5 hari sehubungan
dengan proses trobus mikrovaskuler pada beberapa luka.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Area kulit
tak terbakar mungkin dingin/lembab, pucat, dengan pengisian kapiler lambat pada
adanya penurunan curah jantung sehubungan dengan kehilangan cairan/status syok.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Cedera api:
terdapat area cedera campuran dalam sehubunagn dengan variase intensitas panas
yang dihasilkan bekuan terbakar. Bulu hidung gosong; mukosa hidung dan mulut
kering; merah; lepuh pada faring posterior;oedema lingkar mulut dan atau
lingkar nasal.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Cedera
kimia: tampak luka bervariasi sesuai agen penyebab.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kulit
mungkin coklat kekuningan dengan tekstur seprti kulit samak halus; lepuh;
ulkus; nekrosis; atau jarinagn parut tebal. Cedera secara mum ebih dalam dari
tampaknya secara perkutan dan kerusakan jaringan dapat berlanjut sampai 72 jam setelah
cedera.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Cedera
listrik: cedera kutaneus eksternal biasanya lebih sedikit di bawah nekrosis.
Penampilan luka bervariasi dapat meliputi luka aliran masuk/keluar (eksplosif),
luka bakar dari gerakan aliran pada proksimal tubuh tertutup dan luka bakar termal
sehubungan dengan pakaian terbakar.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Adanya
fraktur/dislokasi (jatuh, kecelakaan sepeda motor, kontraksi otot tetanik
sehubungan dengan syok listrik).</span></div>
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<br /></div>
<div class="MsoBodyText" style="line-height: 115%;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">L. DIAGNOSA KEPERAWATAN</span></b></div>
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<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">1. </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tidak
efektifnya pertukaran gas/oksigen b.d kerusakan jalan nafas</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">2. </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gangguan
keseimbangan cairan dan elektrolit b.d banyaknya penguapan/cairan tubuh yang
keluar</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">3. </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Nyeri b.d
kerusakan kulit dan tindakan pencucian .</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">4. Perubahan
nutrisi kurang dari kebutuhan tubuh b.d peningkatan metabolik(BMR)</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">5. </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Risti
infeksi b.d kerusakan integritas kulit</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">6. </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gangguan
mobilisasi b.d keruskan jaringan dan kontraktur</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">7. </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kurang
pengetahuan tentang kondisi luka bakar, prognosis dan perawatan luka bakar b.d
kurangnya informasi</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
<b><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">M. RENCANA KEPERAWATAN</span></b></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">1. Tidak
efektifnya pertukaran gas/oksigen b.d kerusakan jalan nafas</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>Tujuan
: </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Oksigenasi jaringan adekuat</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>Kriteria Hasil :<span style="mso-spacerun: yes;"> </span>- Tidak ada tanda-tanda sianosis</span></div>
<div class="MsoBodyText" style="line-height: 115%; text-indent: 72.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Frekuensi nafas 12 - 24
x/mnt</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>Intervensi
:</span></div>
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<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kaji tanda-tanda
distress nafas, bunyi, frekuensi, irama, kedalaman nafas</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l5 level1 lfo13; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Monitor tanda-tanda hipoksia
(agitsi,takhipnea, stupor,sianosis)</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l5 level1 lfo13; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kolabolarasi dengan tim
medis untuk pemasangan ventilator bila diperlukan</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l5 level1 lfo13; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kolaborasi dengan tim
medis untuik pemberian inhalasi terapi bila diperlukan</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: -18.0pt;">
<br /></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">2. </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Gangguan
keseimbangan cairan dan elektrolit b.d banyaknya penguapan/cairan tubuh yang
keluar</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tujuan : </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pemulihan cairan optimal dan keseimbangan elektrolit serta perfusi organ vital
tercapai </span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kriteria Hasil : - BP 100-140/60 –90 mmHg</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: 45.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Turgor elastis</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: 54.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Mukosa lembab</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: 54.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Akral hangat</span></div>
<div class="MsoBodyText" style="line-height: 115%; text-indent: 72.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Rasa haus tidak ada</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Intervensi :</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l17 level1 lfo14; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Berikan banyak minum
kalau kondisi lambung memungkinkan baik secara langsung maupun melalui NGT</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l17 level1 lfo14; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Monitor dan catat
intake, output (urine 0,5 – 1 cc/kg.bb/jam)</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l17 level1 lfo14; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Beri cairan infus yang
mengandung elektrolit (pada 24 jam ke I), sesuai dengan rumus formula yang
dipakai</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l17 level1 lfo14; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Monitor vital sign</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l17 level1 lfo14; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Monitor kadar Hb, Ht,
elektrolit, minimal setiap 12 jam</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt;">
<br /></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">3. </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Nyeri b.d
kerusakan kulit dan tindakan pencucian .</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tujuan : </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Nyeri berkurang</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kriteria Hasil : - Skala 1-2</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: 54.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Expresi wajah tenang</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: 54.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Nadi 60-100 x/mnt</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: 54.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Klien tidak gelisah</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Intervensi :</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l6 level1 lfo15; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kaji rasa nyeri</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l6 level1 lfo15; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Atur posisi tidur
senyaman mungkin</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l6 level1 lfo15; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Anjurkan klien untuk
teknik rileksasi</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l6 level1 lfo15; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Lakukan prosedur
pencucian luka dengan hati-hati </span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l6 level1 lfo15; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Lakukan prosedur
pencucian luka dengan hati-hati </span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l6 level1 lfo15; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Anjurkan klien untuk
mengekspresikan rasa nyeri yang dirasakan</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l6 level1 lfo15; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Beri tahu klien tentang
penyebab rasa sakit pada luka bakar</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l6 level1 lfo15; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kolaborasi dengan tinm
medis untuik pemberian analgetik</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: -18.0pt;">
<br /></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">4. Perubahan
nutrisi kurang dari kebutuhan tubuh b.d peningkatan metabolik(BMR)</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tujuan : </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Intake nutrisi adekuat dengan mempertahankan 85-90% BB </span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kriteria Hasil : - Intake kalori 1600 -2000 kkal</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: 54.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Intake protein +- 40 gr /hari</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: 54.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Makanan yang disajikan habis
dimakan</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Intervensi :</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l0 level1 lfo16; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kaji sejauh mana
kurangnya nutrisi</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l0 level1 lfo16; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Lakukan penimbangan
berat badan klien setiap hari (bila mungkin)</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l0 level1 lfo16; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pertahankan keseimbangan
intake dan output</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l0 level1 lfo16; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Jelaskan kepada klien
tentang pentingnya nutrisi sebagai penghasil kalori yang sangat dibutuhkan
tubuh dalam kondisi luka bakar.</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l0 level1 lfo16; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kolaborasi dengan tim
medis untuk pemberian nutrisi parenteral</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l0 level1 lfo16; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kolaborsi dengan tim
ahli gizi untuk pemberian nutrisi yang adekuat.</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<br /></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">5. </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Risti
infeksi b.d kerusakan integritas kulit</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tujuan : </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Infeksi tidak terjadi </span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kriteria Hasil : - Suhu 36 – 37 C </span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 12.6pt; text-indent: 59.4pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- TD 100-140/60 –90 mmHg</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: 54.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Leukosit 5000 -10.000.ul</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> </span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: 54.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span><span lang="IN">- Tidak ada kemerahan,
pembengkakan, dan kelainan fungsi</span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Intervensi :</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l1 level1 lfo17; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Beritahu klien tentang
tindakan yang akan dilakukan</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l1 level1 lfo17; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kaji sampai dimana luas
dan kedalaman luka klien, kalau memungkinkan beritahu klien tentang kondisinya</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l1 level1 lfo17; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kaji tanda-tanda infeksi
(dolor, kolor, rubor, tumor dan fungsiolesa)</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l1 level1 lfo17; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Lakukan ganti balutan
dengan tehnik steril, gunakan obat luka (topical)yang sesuai dengan kondisi
luka dan sesuai dengan program medis</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l1 level1 lfo17; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Monitor vital sign</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l1 level1 lfo17; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pertahankan personal
hygiene</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<br /></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">6. Gangguan
mobilisasi b.d keruskan jaringan dan kontraktur</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tujuan : </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mobilitas fisik optimal</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kriteria Hasil : - OS mampu melakukan ROM aktif</span></div>
<div class="MsoBodyText" style="line-height: 115%; text-indent: 72.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Tidak ada tanda-tanda kontraktur
daerah luka bakar</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: 54.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Kebutuhan sehari-hari terpenuhiA</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Intervensi :</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l18 level1 lfo18; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kaji kemampuan ROM
(Range Of Motion)</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l18 level1 lfo18; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Ajarkan dan anjurkan
klien untuk berlatih menggerakan persendian pada eksteremitas secara bertahap.</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l18 level1 lfo18; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Beri support mental</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l18 level1 lfo18; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kolaborasi dengan tim
fisioterapi</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l18 level1 lfo18; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Untuk program latihan
selanjutnya</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<br /></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: -18.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">7. </span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kurang pengetahuan tentang kondisi luka bakar, prognosis dan perawatan luka
bakar b.d kurangnya informasi</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Tujuan : </span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Klien
mengetahui tentang kondisi luka bakar, prognosis dan perawatan luka bakar </span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kriteria
Hasil : - Klien terlihat tenang</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 18.0pt; text-indent: 54.0pt;">
<span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Klien mengerti tentang kondisinya</span></div>
<div class="MsoBodyText" style="line-height: 115%;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Intervensi :</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l10 level1 lfo19; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Kaji sejauh mana
pengetahuan klien tentang kondisi, prognosis dan harapan masa depan</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l10 level1 lfo19; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Diskusikan harapan klien
untuk kembali kerumah, bekerja dan kembali melakukan aktifitras secara normal</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l10 level1 lfo19; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Anjurkan klien untuk
menentukan program latihan dan waktu untuk istirahat</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-list: l10 level1 lfo19; mso-pagination: none; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="IN" style="font-family: Symbol; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; 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="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Beri kesempatan pada
klien untuk bertanya mengenai hal-hal yang tidak diketahuiny</span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">a.</span><span lang="IN" style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span></div>
<h1 style="line-height: 115%; text-align: center;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">DAFTAR<span style="mso-spacerun: yes;">
</span>PUSTAKA</span></h1>
<div class="MsoBodyText" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l19 level3 lfo20; tab-stops: 18.0pt; text-indent: -72.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Susan Martin Tucker.<span style="mso-spacerun: yes;"> </span>1998.<span style="mso-spacerun: yes;">
</span><b>Standar Perawatan Pasien</b> . Volume 3. Penerbit : EGC, Jakarta.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 72.0pt; mso-list: l19 level3 lfo20; tab-stops: 18.0pt; text-indent: -72.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;"><span style="mso-spacerun: yes;"> </span>Arif
Mansjoer etc. 2000. <b>Kapita Selekta Kedokteran</b>.<span style="mso-spacerun: yes;"> </span>Edisi 3. Jilid 2. penerbit : Media
Aesculapius, Jakarta.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-left: 72.0pt; mso-list: l19 level3 lfo20; tab-stops: 18.0pt; text-indent: -72.0pt;">
<span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Cambria; mso-fareast-font-family: Cambria;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Cambria","serif"; font-size: 14.0pt; line-height: 115%;">Sabiston.<span style="mso-spacerun: yes;">
</span>1992.<span style="mso-spacerun: yes;"> </span><b>Buku Ajar Bedah</b>.<span style="mso-spacerun: yes;"> </span>Bagian<span style="mso-spacerun: yes;">
</span>I.<span style="mso-spacerun: yes;"> </span>Penerbit : EGC, Jakarta.</span></div>
<div class="MsoBodyText" style="line-height: 115%; margin-left: 36.0pt; mso-hyphenate: none; mso-pagination: none;">
<br /></div>
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</o:shapelayout></xml><![endif]-->Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-32758452518019296572012-12-03T03:42:00.001-08:002012-12-03T03:42:10.930-08:00DAFTAR ISI<script style="text/javascript" src="http://sites.google.com/site/barajajs/listofcontent/contents.js"></script><script src="http://hariskumpulanaskep.blogspot.com/feeds/posts/default?max-results=9999&alt=json-in-script&callback=loadtoc"></script>Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-63718953312067893922012-11-11T02:20:00.001-08:002012-11-11T02:20:53.728-08:00ASKEP JANTUNG KORONER<!--[if gte mso 9]><xml>
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<div align="center" class="MsoNormalCxSpFirst" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: center; text-indent: -21.3pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">Asuhan
Keperawatan PJK</span></b></div>
<div align="center" class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: center; text-indent: -21.3pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">(Penyakit
Jantung Koroner)</span></b></div>
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<br /></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -21.3pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">I. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">KONSEP DASAR MEDIS </span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">A. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pengertian</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: 32.7pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Penyakit Jantung
Koroner adalah salah satu akibat utama arteriosklerosis (pengerasan pembuluh
darah nadi) yang dikenal sebagai atherosklerosis. Pada keadaan ini pembuluh
darah nadi menyempit karena terjadi endapan-endapan lemak (atheroma dan
plaques) pada didindingnya. Pembuluh darah koroner merupakan penyalur aliran
darah (membawa 02 dan makanan yang dibutuhkan miokard agar dapat berfusi dengan
baik.</span></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">B. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Etiologi</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">1.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">98
% karena proses arterio skelosis pada arteri koronaria.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">2.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">2
% karena kelainan arteri koronaria yang lain.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Adanya aterosklerosis koroner dimana
terjadi kelainan pada intima bermula berupa bercak fibrosa (fibrous plaque) dan
selanjutnya terjadi ulserasi, pendarahan, kalsifikasi dan trombosis. Perjalanan
dalam kejadian aterosklerosis tidak hanya disebabkan oleh faktor tunggal, akan
tetapi diberati juga banyak faktor lain seperti : hipertensi, kadar lipid, rokok,
kadar gula darah yang abnormal.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: 18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Penyakit jantung
koroner (PJK) dapat juga disebabkan antara lain:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">1.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Hipertensi
</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">2.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kolesterol
darah </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">3.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Merokok
</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">4.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Diet<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">5.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Usia
</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">6.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Sex
</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">7.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kurang
latihan </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">8.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Turunan</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">C. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Patofisiologi</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">1.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Iskemia</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Iskemia adalah suatu keadaan
kekurangan oksigen yang bersifat sementara dan reversibel. Penurunan suplai
oksigen akan meningkatkan mekanisme metabolisme anaerobik. Iskemia yang lama
dapat menyebabkan kematian otot atau nekrosis. Keadaan nekrosis yang berlanjut
dapat menyebabkan kematian otot jantung (infark miokard). Ventriekel kiri
merupakan ruang jantung yang paling rentan mengalami iskemia dan infark, hal
ini disebabkan kebutuhan oksigen ventrikel kiri lebih besar untuk berkontraksi.
Metabolisme anaerobik sangat tidak efektif selain energi yang dihasilkan tidak
cukup besar juga meningkatkan pembentukan asam laktat yang dapat menurunkan PH
sel (asidosis). Iskemia secara khas ditandai perubahan EKG: T inversi, dan
depresi segmen ST. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Gabungan efek hipoksia, menurunnya
suplai energi, serta asidosis dapat dengan cepat mengganggu fungsi ventrikel
kiri. Kekuatan kontraksi pada daerah yang terserang mengalami gangguan, serabut
ototnya memendek, serta daya kecepatannya menurun. Perubahan kontraksi ini dapat
menyebakan penurunan curah jantung. Iskemia dapat menyebabkan nyeri sebagai
akibat penimbunan asam laktat yang berlebihan. Angina pektoris merupakan nyeri
dada yang menyertai iskemia miokardium.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">2.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Angina</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Angina pektoris dapat dibagi: angina
pektoris stabil (stable angina), angina pektoris tidak stabil (unstable
angina), angina variant (angina prinzmetal).</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">a.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Angina
Pectoris Stabil</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Nyeri dada yang tergolong angina
stabil adalah nyeri yang timbul saat melakukan aktifitas. Rasa nyeri tidak
lebih dari 15 menit dan hilang dengan istirahat</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">b.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Angina
Pectoris tidak Stabil</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pada UAP nyeri dada timbul pada saat
istirahat, nyeri berlangsung lebih dari 15 menit dan terjadi peningkatan rasa
nyeri</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">c.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Angina
Varian</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: 18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Merupakan angina
tidak stabil yang disebabkan oleh spasme arteri koroner</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">3.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Infark</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Iskemia yang berlangsung lebih dari 30
menit dapat menyebabkan kerusakan sel yang ireversibel dan kematian otot
(nekrosis). Bagian miokardium yang mengalami nekrosis atau infark akan berhenti
berkontraksi secara permanen.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">D. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Manifestasi
Klinis</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: 18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Manifestasi
klinis dapat berupa :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">1.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Tanpa
gejala</span></div>
<div class="MsoNormal" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">2. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Angina pektoris</span></div>
<div class="MsoNormal" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">3. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Infark miokard
akut</span></div>
<div class="MsoNormal" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">4. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Aritmia</span></div>
<div class="MsoNormal" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">5. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Payah jantung</span></div>
<div class="MsoNormal" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">6. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kematian mendadak</span></div>
<div class="MsoNormal" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">E. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pemeriksaan
Penunjang Diagnostik</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">1.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pemeriksaan
fisik EKG istirahat yang menunjujkkan depresi ST atau inversi T. penelitian
menunujukkan bahwa banyak terdapat hasil yang popsitif palsu maupun negatif
palsu</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">2.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Dalam
hal – hal tertentu dapat dilakukan pemeriksaan dengan bahan – bahan radio aktif</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">3.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Echocardiografi
dapat membantu evaluasi miokard yang iskemik atau nekrotik pada penyakit
jantung kotoner</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">4.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pemeriksaan
rekaman EKG selama 24 jam atau lebih, yaitu holter monitorig, sangat berguna
untuk menemukan angina variant atau iskemik miokard tenang</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">5.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Angigrafi
koroner dianggap sebagai acuan dasar untuk diagnmostik PJK.</span></div>
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<br /></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">F. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Penatalaksanaan</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: 18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pada dasarnya
pengobatan penyakit jantung koroner adalah sbb:</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">1.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Menghentikan,
atau mengurangi atau regresi dari proses aterosklerosis dengan cara
menegndalikan faktor – faktor resiko</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Tidak merokok</span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Latihan fisik sesuai demngan kemampuan jantung penderita</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Diet untuk mencapai profil lemak yang baik dan berat badan yang ideal.</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Mengendalikan rtekanan darah tinggi, DM, dan sterss mental</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Pemakaian obat – oabatan untk mengatasi iskemia miokard</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Latihan fisik sesuai demngan kemampuan jantung penderita</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Diet untuk mencapai profil lemak yang baik dan berat badan yang ideal.</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Mengendalikan tekanan darah tinggi, DM, dan sterss mental</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">2.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pemakaian
obat – oabatan untk mengatasi iskemia miokard</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">3.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pengobatan
terhadap akibat –akibat dari iskemia miokard, misalnya :</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Aritmia</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Gagal jantung</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">4.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pengobatan
revaskularisasi</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Apabila dengan pengobatan dengan obat
– obatan keluhan penderita tak dapat diiatasi sehingga mengganggu kualitas
hidupnya, maka harus dipertimbangkan pengobatan revaskularisasi, yang bisa
terdiri dari:</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Angioplasti koroner</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Bedah pintas koroner</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">5.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Penanggulangan
infark miokard akut, yang memerlukan penatalaksanaan khusus.</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -21.3pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">II. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">KONSEP
DASAR KEPERAWATAN</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">A. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Diagnosa
Keperawatan</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Diagnosa keperawatan yang lazim muncul
pada penderita penyakit jantung koroner antara lain:</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">1.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Penurunan curah jantung berhubungan dengan p</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">erubahan
kontraktilitas miokardial/perubahan inotropik, perubahan frekuensi, irama dan
konduksi listrik, perubahan structural</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<i><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">2.
</span></i><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Aktivitas intoleran
berhubungan dengan k</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">etidak seimbangan antar suplai okigen,
kelemahan umum, tirah baring lama/immobilisasi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">3. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kelebihan volume cairan berhubungan
dengan<span style="mso-spacerun: yes;"> </span>menurunnya laju filtrasi
glomerulus (menurunnya curah jantung)/meningkatnya produksi ADH dan retensi
natrium/air</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">4. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Resiko tinggi gangguan pertukaran gas
berhubungan dengan : perubahan menbran kapiler-alveolus. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">5. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Resiko tinggi terhadap kerusakan integritas
kulit berhubungan dengan tirah baring lama, edema dan penurunan perfusi
jaringan.</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">6. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kurang pengetahuan (kebutuhan belajar)
mengenai kondisi dan program pengobatan berhubungan dengan<span style="mso-spacerun: yes;"> </span>kurang pemahaman/kesalahan persepsi tentang
hubungan fungsi jantung/penyakit/gagal.</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">B. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">1. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Penurunan curah jantung berhubungan dengan p</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">erubahan
kontraktilitas miokardial/perubahan inotropik, perubahan frekuensi, irama dan
konduksi listrik, perubahan structural.</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; tab-stops: 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kriteria hasil
:<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 5.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Menunjukkan tanda vital dalam batas yang dapat diterima (disritmia<span style="mso-spacerun: yes;"> </span>terkontrol atau
hilang) dan bebas gejala gagal jantung </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Melaporkan penurunan epiode dispnea, angina</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Ikut serta dalam aktivitas yang mengurangi beban kerja jantung.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Auskultasi nadi apical ; kaji frekuensi, iram jantung </span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Catat bunyi jantung</span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Palpasi nadi perifer</span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Pantau TD</span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Kaji kulit terhadp pucat dan sianosis </span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Berikan oksigen tambahan dengan kanula nasal/masker dan obat<span style="mso-spacerun: yes;"> </span>sesuai indikasi<span style="mso-spacerun: yes;"> </span>(kolaborasi)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<i><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">2. </span></i><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Aktivitas intoleran berhubungan dengan k</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">etidak seimbangan
antar suplai okigen, kelemahan umum, tirah baring lama/immobilisasi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kriteria hasil:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Berpartisipasi pada aktivitas yang diinginkan, memenuhi perawatan diri sendiri.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">- </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Mencapai
peningkatan toleransi aktivitas yang dapat diukur, dibuktikan oelh menurunnya
kelemahan dan kelelahan.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Periksa tanda vital sebelum dan segera setelah aktivitas, khususnya bila klien
menggunakan vasodilator,diuretic dan penyekat beta.</span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Catat respons kardiopulmonal terhadap aktivitas, catat takikardi, diritmia,
dispnea berkeringat dan pucat.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Evaluasi peningkatan intoleran aktivitas.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Implementasi program rehabilitasi jantung/aktivitas (kolaborasi)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">3. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kelebihan volume cairan berhubungan dengan<span style="mso-spacerun: yes;"> </span>menurunnya laju filtrasi glomerulus
(menurunnya curah jantung)/meningkatnya produksi ADH dan retensi natrium/air.</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kriteria hasil :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Mendemonstrasikan volume cairan stabil dengan keseimbangan masukan
danpengeluaran, bunyi nafas bersih/jelas, tanda vital dalam rentang yang dapat
diterima, berat badan stabil dan tidak ada edema.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Menyatakan pemahaman tentang pembatasan cairan individual.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Pantau pengeluaran urine, catat jumlah dan warna saat dimana diuresis terjadi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Pantau/hitung keseimbangan pemasukan dan pengeluaran selama 24 jam</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Pertahakan duduk atau tirah baring dengan posisi semifowler selama fase akut.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Pantau TD </span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Kaji bisisng usus. Catat keluhan anoreksia, mual, distensi abdomen dan
konstipasi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Pemberian obat sesuai indikasi (kolaborasi)</span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Konsul dengan ahli diet.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">4.
</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Resiko tinggi gangguan
pertukaran gas berhubungan dengan : perubahan menbran kapiler-alveolus.</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kriteria hasil :</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Mendemonstrasikan ventilasi dan oksigenisasi dekuat pada jaringan ditunjukkan
oleh oksimetri dalam rentang normal dan bebas gejala distress pernapasan.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Berpartisipasi dalam program pengobatan dalam btas kemampuan/situasi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Pantau bunyi nafas, catat krekles</span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Ajarkan/anjurkan klien batuk efektif, nafas dalam.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Dorong perubahan posisi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Pantau/gambarkan seri GDA, nadi oksimetri.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Berikan obat/oksigen tambahan sesuai indikasi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">5. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Resiko tinggi terhadap kerusakan integritas kulit berhubungan dengan tirah
baring lama, edema dan penurunan perfusi jaringan.</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kriteria hasil:</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Mempertahankan integritas kulit</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Mendemonstrasikan perilaku/teknik mencegah kerusakan kulit.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt 135.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi:</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Pantau kulit, adanya edema, area sirkulasinya terganggu/pigmentasi atau
kegemukan/kurus.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Pijat area kemerahan atau yang memutih</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Ubah posisi sering ditempat tidur/kursi, bantu latihan rentang gerak
pasif/aktif.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Berikan perawtan kulit, minimalkan dengan kelembaban/ekskresi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Hindari obat intramuskuler</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial;">6. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kurang pengetahuan (kebutuhan belajar) mengenai kondisi dan program
pengobatan berhubungan dengan<span style="mso-spacerun: yes;"> </span>kurang
pemahaman/kesalahan persepsi tentang hubungan fungsi jantung/penyakit/gagal.</span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kriteria hasil :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Mengidentifikasi hubungan terapi untuk menurunkan episode berulang dan mencegah
komplikasi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Mengidentifikasi stress pribadi/faktor resiko dan beberapa teknik untuk
menangani.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Melakukan perubahan pola hidup/perilaku yang perlu.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Diskusikan fungsi jantung normal</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Kuatkan rasional pengobatan.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Anjurkan makanan diet pada pagi hari.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 54.0pt; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">-
Rujuk pada sumber di masyarakat/kelompok pendukung suatu indikasi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">DAFTAR PUSTAKA</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 70.9pt; text-indent: -70.9pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><span style="mso-tab-count: 1;"> </span>Marilynn E Doenges,
dkk., 2000, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Rencana Asuhan Keperawatan</i></b>, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="mso-spacerun: yes;"> </span></i></b>Penerbit Buku Kedokteran, EGC,
Jakarta.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 42.0pt; text-indent: -42.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><span style="mso-tab-count: 1;"> </span>Ngastiyah, 1997, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Perawatan
Anak Sakit</i></b>,<b style="mso-bidi-font-weight: normal;"> </b>Penerbit Buku
Kedokteran, EGC, Jakarta.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 70.9pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Sylvia & Lorraine,
1994, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Patofisiologi</i></b>,<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"> </i></b><i style="mso-bidi-font-style: normal;">Konsep
Klinis Proses Penyakit<b style="mso-bidi-font-weight: normal;">.</b></i><b style="mso-bidi-font-weight: normal;"> </b>Penerbit Buku Kedokteran, EGC,
Jakarta.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 42.0pt; text-indent: -42.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><span style="mso-tab-count: 1;"> </span>Staf Pengajar Kesehatan Anak FKUI,
1985, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Ilmu Kesehatan Anak</i></b>, FKUI Jakarta.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 42.0pt; text-indent: -42.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><span style="mso-tab-count: 1;"> </span>Staf Pengajar Patologi Anatomi FKU
Airlangga, 1995, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Buku Ajar Patologi II, </i><span style="mso-spacerun: yes;"> </span></b>FKU
Airlangga,<span style="mso-spacerun: yes;"> </span>Jakarta.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 42.0pt; text-indent: -42.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><span style="mso-tab-count: 1;"> </span>Staf Pengajar FKUI, 1986, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="mso-spacerun: yes;"> </span></i></b>Patologi, FKUI, Jakarta.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 42.0pt; text-indent: -42.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><span style="mso-tab-count: 1;"> </span>Suriadi & Rita Yuliani, 2001, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Asuhan
Keperawatan Pada Anak,</i> </b>Penerbit Fajar Interpratama, Jakarta.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 42.0pt; text-indent: -42.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><span style="mso-tab-count: 1;"> </span>Tierney, dkk., 2002, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Diagnosis
dan Terapi Kedokteran</i></b>, Penerbit Salemba Medika, Jakarta.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 42.0pt; text-indent: -42.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><span style="mso-tab-count: 1;"> </span>Underwood, 1997,<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">
Patologi Umum & Sistematik</i>, </b>Penerbit Buku Kedokteran EGC, Jakarta.</span></div>
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<br />
<div align="center" class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;">
<b><span style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Asuhan Keperawatan</span></b></div>
<div align="center" class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;">
<b><span style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Aritmia</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">A. Definisi</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Gangguan irama
jantung</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
atau<b> aritmia</b> merupakan komplikasi yang sering terjadi pada <b>infark
miokardium</b>. <b>Aritmia atau disritmia</b> adalah perubahan pada frekuensi
dan irama jantung yang disebabkan oleh konduksi elektrolit abnormal atau
otomatis (Doenges, 1999). Aritmia timbul akibat perubahan elektrofisiologi
sel-sel miokardium. Perubahan elektrofisiologi ini bermanifestasi sebagai
perubahan bentuk potensial aksi yaitu rekaman grafik aktivitas listrik sel
(Price, 1994). Gangguan irama jantung tidak hanya terbatas pada iregularitas
denyut jantung tapi juga termasuk gangguan kecepatan denyut dan konduksi
(Hanafi, 1996).</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><br />
<b>B. Etiologi</b><br />
Etiologi <b>aritmia jantung</b> dalam garis besarnya dapat disebabkan oleh :<br />
1. Peradangan jantung, misalnya demam reumatik, peradangan miokard (miokarditis
karena infeksi)<br />
2. Gangguan sirkulasi koroner (aterosklerosis koroner atau spasme arteri
koroner), misalnya iskemia miokard, infark miokard.<br />
3. Karena obat (intoksikasi) antara lain oleh digitalis, quinidin dan obat-obat
anti aritmia lainnya<br />
4. Gangguan keseimbangan elektrolit (hiperkalemia, hipokalemia)<br />
5. Gangguan pada pengaturan susunan saraf autonom yang mempengaruhi kerja dan
irama jantung<br />
6. Ganggguan psikoneurotik dan susunan saraf pusat.<br />
7. Gangguan metabolik (asidosis, alkalosis)<br />
8. Gangguan endokrin (hipertiroidisme, hipotiroidisme)<br />
9. Gangguan irama jantung karena kardiomiopati atau tumor jantung<br />
10. Gangguan irama jantung karena penyakit degenerasi (fibrosis sistem konduksi
jantung)<br />
<br />
<b>C. Macam – macam aritmia</b><br />
1. Sinus Takikardi<br />
Meningkatnya aktifitas nodus sinus, gambaran yang penting pada ECG adalah :
laju gelombang lebih dari 100 X per menit, irama teratur dan ada gelombang P
tegak disandapan I,II dan aVF.<br />
2. Sinus bradikardi<br />
Penurunan laju depolarisasi atrim. Gambaran yang terpenting pada ECG adalah
laju kurang dari 60 permenit, irama teratur, gelombang p tgak disandapan I,II
dan aVF.<br />
3. Komplek atrium prematur<br />
Impul listrik yang berasal di atrium tetapi di luar nodus sinus menyebabkan
kompleks atrium prematur, timbulnya sebelu denyut sinus berikutnya. Gambaran
ECG menunjukan irama tidak teratur, terlihat gelombang P yang berbeda bentuknya
dengan gelombang P berikutnya.<br />
4. Takikardi Atrium<br />
Suatu episode takikardi atrium biasanya diawali oleh suatu kompleks atrium
prematur sehingga terjadi reentri pada tingkat nodus AV.<br />
5. Fluter atrium.<br />
Kelainan ini karena reentri pada tingkat atrium. Depolarisasi atrium cept dan
teratur, dan gambarannya terlihat terbalik disandapan II,III dan atau aVF
seperti gambaran gigi gergaji<br />
6. Fibrilasi atrium<br />
Fibrilasi atrium bisa tibul dari fokus ektopik ganda dan atau daerah reentri
multipel. Aktifitas atrium sangat cepat.sindrom sinus sakit<br />
7. Komplek jungsional prematur<br />
8. Irama jungsional<br />
9. Takikardi ventrikuler<br />
<br />
<b>D. Manifestasi klinis</b><br />
a. Perubahan TD ( hipertensi atau hipotensi ); nadi mungkin tidak teratur;
defisit nadi; bunyi jantung irama tak teratur, bunyi ekstra, denyut menurun;
kulit pucat, sianosis, berkeringat; edema; haluaran urin menurun bila curah
jantung menurun berat.<br />
b. Sinkop, pusing, berdenyut, sakit kepala, disorientasi, bingung, letargi,
perubahan pupil.<br />
c. Nyeri dada ringan sampai berat, dapat hilang atau tidak dengan obat
antiangina, gelisah<br />
d. Nafas pendek, batuk, perubahan kecepatan/kedalaman pernafasan; bunyi nafas
tambahan (krekels, ronki, mengi) mungkin ada menunjukkan komplikasi pernafasan
seperti pada gagal jantung kiri (edema paru) atau fenomena tromboembolitik
pulmonal; hemoptisis.<br />
e. demam; kemerahan kulit (reaksi obat); inflamasi, eritema, edema (trombosis
siperfisial); kehilangan tonus otot/kekuatan<br />
<br />
<b>E. Pemeriksaan Penunjang</b><br />
1. EKG : menunjukkan pola cedera iskemik dan gangguan konduksi. Menyatakan
tipe/sumber disritmia dan efek ketidakseimbangan elektrolit dan obat jantung.<br />
2. Monitor Holter : Gambaran EKG (24 jam) mungkin diperlukan untuk menentukan
dimana disritmia disebabkan oleh gejala khusus bila pasien aktif (di
rumah/kerja). Juga dapat digunakan untuk mengevaluasi fungsi pacu jantung/efek
obat antidisritmia.<br />
3. Foto dada : Dapat menunjukkanpembesaran bayangan jantung sehubungan dengan
disfungsi ventrikel atau katup<br />
4. Skan pencitraan miokardia : dapat menunjukkan aea iskemik/kerusakan miokard
yang dapat mempengaruhi konduksi normal atau mengganggu gerakan dinding dan
kemampuan pompa.<br />
5. Tes stres latihan : dapat dilakukan utnnuk mendemonstrasikan latihan yang
menyebabkan disritmia.<br />
6. Elektrolit : Peningkatan atau penurunan kalium, kalsium dan magnesium dapat
mnenyebabkan disritmia.<br />
7. Pemeriksaan obat : Dapat menyatakan toksisitas obat jantung, adanya obat
jalanan atau dugaan interaksi obat contoh digitalis, quinidin.<br />
8. Pemeriksaan tiroid : peningkatan atau penururnan kadar tiroid serum dapat
menyebabkan.meningkatkan disritmia.<br />
9. Laju sedimentasi : Penignggian dapat menunukkan proses inflamasi akut contoh
endokarditis sebagai faktor pencetus disritmia.<br />
10. GDA/nadi oksimetri : Hipoksemia dapat menyebabkan/mengeksaserbasi
disritmia.<br />
<br />
<b>F. Penatalaksanaan Medis</b><br />
1. Terapi medis<br />
Obat-obat antiaritmia dibagi 4 kelas yaitu :<br />
a. Anti aritmia Kelas 1 : sodium channel blocker<br />
<span style="mso-spacerun: yes;"> </span>Kelas 1 A</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; 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: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><br />
Quinidine adalah obat yang digunakan dalam terapi pemeliharaan untuk mencegah
berulangnya atrial fibrilasi atau flutter.<br />
Procainamide untuk ventrikel ekstra sistol atrial fibrilasi dan aritmi yang
menyertai anestesi.<br />
Dysopiramide untuk SVT akut dan berulang<br />
<span style="mso-spacerun: yes;"> </span>Kelas 1 B</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; 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: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><br />
Lignocain untuk aritmia ventrikel akibat iskemia miokard, ventrikel takikardia.<br />
Mexiletine untuk aritmia entrikel dan VT<br />
<span style="mso-spacerun: yes;"> </span>Kelas 1 C</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; 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: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><br />
Flecainide untuk ventrikel ektopik dan takikardi<br />
b. Anti aritmia Kelas 2 (Beta adrenergik blokade)<br />
Atenolol, Metoprolol, Propanolol : indikasi aritmi jantung, angina pektoris dan
hipertensi<br />
c. Anti aritmia kelas 3 (Prolong repolarisation)<br />
Amiodarone, indikasi VT, SVT berulang<br />
d. Anti aritmia kelas 4 (calcium channel blocker)<br />
Verapamil, indikasi supraventrikular aritmia<br />
2. Terapi mekanis<br />
a. Kardioversi : mencakup pemakaian arus listrik untuk menghentikan disritmia
yang memiliki kompleks GRS, biasanya merupakan prosedur elektif.<br />
b. Defibrilasi : kardioversi asinkronis yang digunakan pada keadaan gawat
darurat.<br />
c. Defibrilator kardioverter implantabel : suatu alat untuk mendeteksi dan
mengakhiri episode takikardi ventrikel yang mengancam jiwa atau pada pasien
yang resiko mengalami fibrilasi ventrikel.<br />
d. Terapi pacemaker : alat listrik yang mampu menghasilkan stimulus listrik
berulang ke otot jantung untuk mengontrol frekuensi jantung.</span></div>
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<b>G. Pengkajian</b> <b>Keperawatan</b><br />
Pengkajian primer :<br />
1. Airway<br />
• Apakah ada peningkatan sekret ?<br />
• Adakah suara nafas : krekels ?<br />
2. Breathing<br />
• Adakah distress pernafasan ?<br />
• Adakah hipoksemia berat ?<br />
• Adakah retraksi otot interkosta, dispnea, sesak nafas ?<br />
• Apakah ada bunyi whezing ?<br />
3. Circulation<br />
• Bagaimanakan perubahan tingkat kesadaran ?<br />
• Apakah ada takikardi ?<br />
• Apakah ada takipnoe ?<br />
• Apakah haluaran urin menurun ?<br />
• Apakah terjadi penurunan TD ?<br />
• Bagaimana kapilery refill ?<br />
• Apakah ada sianosis ?<br />
Pengkajian sekunder<br />
1. Riwayat penyakit<br />
<span style="mso-spacerun: yes;"> </span>Faktor resiko keluarga contoh penyakit
jantung, stroke, hipertensi</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; 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: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><br />
<span style="mso-spacerun: yes;"> </span>Riwayat IM sebelumnya (disritmia),
kardiomiopati, GJK,</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; 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: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> penyakit katup
jantung, hipertensi<br />
<span style="mso-spacerun: yes;"> </span>Penggunaan obat digitalis, quinidin dan
obat anti aritmia lainnya kemungkinan untuk terjadinya intoksikasi</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; 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: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><br />
<span style="mso-spacerun: yes;"> </span>Kondisi psikososial</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; 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: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><br />
<br />
2. Pengkajian fisik<br />
a. Aktivitas : kelelahan umum<br />
b. Sirkulasi : perubahan TD ( hipertensi atau hipotensi ); nadi mungkin tidak
teratur; defisit nadi; bunyi jantung irama tak teratur, bunyi ekstra, denyut
menurun; kulit warna dan kelembaban berubah misal pucat, sianosis, berkeringat;
edema; haluaran urin menruun bila curah jantung menurun berat.<br />
c. Integritas ego : perasaan gugup, perasaan terancam, cemas, takut,
menolak,marah, gelisah, menangis.<br />
d. Makanan/cairan : hilang nafsu makan, anoreksia, tidak toleran terhadap
makanan, mual muntah, peryubahan berat badan, perubahan kelembaban kulit<br />
e. Neurosensori : pusing, berdenyut, sakit kepala, disorientasi, bingung,
letargi, perubahan pupil.<br />
f. Nyeri/ketidaknyamanan : nyeri dada ringan sampai berat, dapat hilang atau
tidak dengan obat antiangina, gelisah<br />
g. Pernafasan : penyakit paru kronis, nafas pendek, batuk, perubahan
kecepatan/kedalaman pernafasan; bunyi nafas tambahan (krekels, ronki, mengi)
mungkin ada menunjukkan komplikasi pernafasan seperti pada gagal jantung kiri
(edema paru) atau fenomena tromboembolitik pulmonal; hemoptisis.<br />
h. Keamanan : demam; kemerahan kulit (reaksi obat); inflamasi, eritema, edema
(trombosis siperfisial); kehilangan tonus otot/kekuatan<br />
<br />
<b>H. Diagnosa keperawatan dan Intervensi</b><br />
<br />
1. Resiko tinggi penurunan curah jantung berhubungan dengan gangguan konduksi
elektrikal, penurunan kontraktilitas miokardia.<br />
Kriteria hasil :<br />
a. Mempertahankan/meningkatkan curah jantung adekuat yang dibuktikan oleh
TD/nadi dalam rentang normal, haluaran urin adekuat, nadi teraba sama, status
mental biasa<br />
b. Menunjukkan penurunan frekuensi/tak adanya disritmia<br />
c. Berpartisipasi dalam aktivitas yang menurunkan kerja miokardia.<br />
Intervensi :<br />
1. Raba nadi (radial, femoral, dorsalis pedis) catat frekuensi, keteraturan,
amplitudo dan simetris.<br />
2. Auskultasi bunyi jantung, catat frekuensi, irama. Catat adanya denyut
jantung ekstra, penurunan nadi.<br />
3. Pantau tanda vital dan kaji keadekuatan curah jantung/perfusi jaringan.<br />
4. Tentukan tipe disritmia dan catat irama : takikardi; bradikardi; disritmia
atrial; disritmia ventrikel; blok jantung<br />
5. Berikan lingkungan tenang. Kaji alasan untuk membatasi aktivitas selama fase
akut.<br />
6. Demonstrasikan/dorong penggunaan perilaku pengaturan stres misal relaksasi
nafas dalam, bimbingan imajinasi<br />
7. Selidiki laporan nyeri, catat lokasi, lamanya, intensitas dan faktor
penghilang/pemberat. Catat petunjuk nyeri non-verbal contoh wajah mengkerut,
menangis, perubahan TD<br />
8. Siapkan/lakukan resusitasi jantung paru sesuai indikasi<br />
Kolaborasi :<br />
1. Pantau pemeriksaan laboratorium, contoh elektrolit<br />
2. Berikan oksigen tambahan sesuai indikasi<br />
3. Berikan obat sesuai indikasi : kalium, antidisritmi<br />
4. Siapkan untuk bantu kardioversi elektif<br />
5. Bantu pemasangan/mempertahankan fungsi pacu jantung<br />
6. Masukkan/pertahankan masukan IV<br />
7. Siapkan untuk prosedur diagnostik invasif<br />
8. Siapkan untuk pemasangan otomatik kardioverter atau defibrilator<br />
<br />
2. Kurang pengetahuan tentang penyebab atau kondisi pengobatan berhubungan
dengan kurang informasi/salah pengertian kondisi medis/kebutuhan terapi.<br />
Kriteria hasil :<br />
a. menyatakan pemahaman tentang kondisi, program pengobatan<br />
b. Menyatakan tindakan yang diperlukan dan kemungkinan efek samping obat<br />
Intervensi :<br />
1. Kaji ulang fungsi jantung normal/konduksi elektrikal<br />
2. Jelakan/tekankan masalah aritmia khusus dan tindakan terapeutik pada
pasien/keluarga<br />
3. Identifikasi efek merugikan/komplikasiaritmia khusus contoh kelemahan,
perubahan mental, vertigo.<br />
4. Anjurkan/catat pendidikan tentang obat. Termasuk mengapa obat diperlukan;
bagaimana dan kapan minum obat; apa yang dilakukan bila dosis terlupakan<br />
5. Dorong pengembangan latihan rutin, menghindari latihan berlebihan<br />
6. Kaji ulang kebutuhan diet contoh kalium dan kafein<br />
7. Memberikan informasi dalam bentuk tulisan bagi pasien untuk dibawa pulang<br />
8. Anjurkan psien melakukan pengukuran nadi dengan tepat<br />
9. Kaji ulang kewaspadaan keamanan, teknik mengevaluasi pacu jantung dan gejala
yang memerlukan intervensi medis<br />
10.Kaji ulang prosedur untuk menghilangkan PAT contoh pijatan karotis/sinus,
manuver Valsava bila perlu<br />
<br />
`</span></div>
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<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">DAFTAR PUSTAKA</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><br />
1. Hudak, C.M, Gallo B.M.<b> Keperawatan Kritis</b> : Pendekatan Holistik.
Jakarta : EGC.1997<br />
2. Price, Sylvia Anderson. Patofisiologi :<b> konsep klinis proses-proses
penyakit</b>. Alih bahasa Peter Anugrah. Editor Caroline Wijaya. Ed. 4. Jakarta
: EGC ; 1994.<br />
3. Santoso Karo karo. Buku Ajar Kardiologi. Jakarta : Balai Penerbit FKUI ;
1996<br />
4. Smeltzer Suzanne C. Buku Ajar Keperawatan Medikal Bedah Brunner &
Suddarth. Alih bahasa Agung Waluyo, dkk. Editor Monica Ester, dkk. Ed. 8.
Jakarta : EGC; 2001.<br />
5. Doenges, Marilynn E. <b>Rencana Asuhan Keperawatan </b>: Pedoman untuk
Perencanaan dan pendokumentasian Perawatan Pasien. Alih bahasa I Made Kariasa.
Ed. 3. Jakarta : EGC;1999<br />
6. Hanafi B. Trisnohadi. Buku Ajar Ilmu Penyakit Dalam. Jilid I. Ed. 3. Jakarta
: Balai Penerbit FKUI ; 2001</span></div>
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<br /></div>
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mso-style-noshow:yes;
mso-style-priority:99;
mso-style-qformat:yes;
mso-style-parent:"";
mso-padding-alt:0cm 5.4pt 0cm 5.4pt;
mso-para-margin-top:0cm;
mso-para-margin-right:0cm;
mso-para-margin-bottom:10.0pt;
mso-para-margin-left:0cm;
line-height:115%;
mso-pagination:widow-orphan;
font-size:11.0pt;
font-family:"Calibri","sans-serif";
mso-ascii-font-family:Calibri;
mso-ascii-theme-font:minor-latin;
mso-hansi-font-family:Calibri;
mso-hansi-theme-font:minor-latin;
mso-bidi-font-family:"Times New Roman";
mso-bidi-theme-font:minor-bidi;}
</style>
<![endif]-->
<div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">ASKEP
FLAIL CHEST</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Definisi</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Flail chest
adalah area toraks yang “melayang” (flail) oleh sebab adanya fraktur iga
multipel berturutan = 3 iga , dan memiliki garis fraktur = 2 (segmented) pada
tiap iganya. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Akibatnya adalah: terbentuk area “flail” yang akan bergerak
paradoksal (kebalikan) dari gerakan mekanik pernapasan dinding dada. Area
tersebut akan bergerak masuk saat inspirasi dan bergerak keluar pada ekspirasi.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Flail Chest.
terjadi ketika segmen dinding dada tidak lagi mempunyai kontinuitas dengan
keseluruhan dinding dada. Keadaan tersebut terjadi karena fraktur iga multipel
pada dua atau lebih tulang iga dengan dua atau lebih garis fraktur. Adanya
semen flail chest (segmen mengambang) menyebabkan gangguan pada pergerakan
dinding dada. Jika kerusakan parenkim paru di bawahnya terjadi sesuai dengan
kerusakan pada tulang maka akan menyebabkan hipoksia yang serius. Kesulitan
utama pada kelainan Flail Chest yaitu trauma pada parenkim paru yang mungkin
terjadi (kontusio paru). Walaupun ketidak-stabilan dinding dada menimbulkan
gerakan paradoksal dari dinding dada pada inspirasi dan ekspirasi, defek ini
sendiri saja tidak akan menyebabkan hipoksia. Penyebab timbulnya hipoksia pada
penderita ini terutama disebabkan nyeri yang mengakibatkan gerakan dinding dada
yang tertahan dan trauma jaringan parunya.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Flail Chest
mungkin tidak terlihat pada awalnya, karena splinting (terbelat) dengan dinding
dada. Gerakan pernafasan menjadi buruk dan toraks bergerak secara asimetris dan
tidak terkoordinasi. Palpasi gerakan pernafasan yang abnormal dan krepitasi iga
atau fraktur tulang rawan membantu diagnosisi. Dengan foto toraks akan lebih
jelas karena akan terlihat fraktur iga yang multipel, akan tetapi terpisahnya
sendi costochondral tidak akan terlihat. Pemeriksaan analisis gas darah yaitu
adanya hipoksia akibat kegagalan pernafasan, juga membantu dalam diagnosis
Flail Chest. Terapi awal yang diberikan termasuk pemberian ventilasi adekuat,
oksigen yang dilembabkan dan resusitasi cairan.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Bila tidak
ditemukan syok maka pemberian cairan kristoloid intravena harus lebih
berhati-hati untuk mencegah kelebihan pemberian cairan. Bila ada kerusakan
parenkim paru pada Flail Chest, maka akan sangat sensitif terhadap kekurangan
ataupun kelebihan resusitasi cairan. Pengukuran yang lebih spesifik harus
dilakukan agar pemberian cairan benar-benar optimal. Terapi definitif ditujukan
untuk mengembangkan paru-paru dan berupa oksigenasi yang cukup serta pemberian
cairan dan analgesia untuk memperbaiki ventilasi. Tidak semua penderita
membutuhkan penggunaan ventilator. Pencegahan hipoksia merupakan hal penting
pada penderita trauma, dan intubasi serta ventilasi perlu diberikan untuk waktu
singkat sampai diagnosis dan pola trauma yang terjadi pada penderita tersebut
ditemukan secara lengkap. Penilaian hati-hati dari frekuensi pernafasan,
tekanan oksigen arterial dan penilaian kinerja pernafasan akan memberikan suatu
indikasi timing / waktu untuk melakukan intubasi dan ventilasi.</span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Gangguan
Mekanika Bernapas pada Flail Chest</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Fraktur
sternum dengan pergeseran fragmennya menimbulkan nyeri yang menyebabkan
penderita menahan napas sehingga pernapasan menjadi dangkal. Hal ini diperberat
dengan akibat retensi sputum menyebabkan atelektasis, pneumonia yang
menyebabkan gangguan ventilasi, hipoksemia, hiperkarbia dan pada gilirannya
akan menyebabkan insufisiensi pernapasan dan berakhir dengan gagal pernapasan
akut.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<i><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Flail sternum</span></i><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
disebut juga central flail chest, bila berat akan menyebabkan volume
intratorasik berkurang sehingga mengganggu pengembangan paru, ventilasi menurun
mengakibatkan hipoksemia dan hiperkarbia. Gangguan ekspansi paru diakibatkan
elastic recoil ke dalam tak tertahankan sehingga volumenya berkurang. Penekanan
ventilasi dan atelektasis akan menyebabkan terjadinya pintas
arteriovenosa (AV) yang memperberat insufisiensi pernapasan sehingga bila
dibiarkan akan berakhir dengan gagal pernapasan akut.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<i><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Nyeri hebat</span></i><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> juga
akan menyebabkan penderita mengurangi gerakan segmen melayang sambil terus
menerus berupaya paksa menarik dan mengeluarkan napas, hal ini terlihat dengan
pernapasan cepat dan dangkal bila dibiarkan akan menyebabkan kelelahan
otot-otot pernapasan dan berakhir dengan gagal pernapasan akut.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Akibat dari atelektasis, pneumonia, pirau A-V
sendiri akan memperberat kerja napas, hal ini ditunjukkan dengan gambaran gas
darah memburuk, suatu tanda gagal pernapasan akut</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Prognosis</span></b><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Tulang iga patah pada 2 tempat
pada lebih dari 2 iga sehingga ada satu segmen dinding dada yang tidak ikut
pada pernafasan. Pada ekspirasi segmen akan menonjol keluar, pada inspirasi
justru masuk kedalam yang dikenal dengan pernafasan paradoksal</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pathofisiologi</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Dada merupakan organ besar yang
membuka bagian dari tubuh yang sangat mudah terkena tumbukan luka. Karena dada
merupakan tempat jantung, paru dan pembuluh darah besar. Trauma dada sering
menyebabkan gangguan ancaman kehidupan. Luka pada rongga thorak dan isinya
dapat membatasi kemampuan jantung untuk memompa darah atau kemampuan paru untuk
pertukaran udara dan osigen darah. Bahaya utama berhubungan dengan luka dada
biasanya berupa perdarahan dalam dan tusukan terhadap organ</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">. <span style="color: black;">Luka dada dapat meluas dari benjolan yang relatif kecil dan
goresan yang dapat mengancurkan atau terjadi trauma penetrasi. Luka dada dapat
berupa penetrasi atau non penetrasi ( tumpuln ). Luka dada penetrasi mungkin
disebabkan oleh luka dada yang terbuka, memberi keempatan bagi udara atmosfir
masuk ke dalam permukaan pleura dan mengganggua mekanisme ventilasi normal.
Luka dada penetrasi dapat menjadi kerusakan serius bagi paru, kantung dan
struktur thorak lain.</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Karakteristik</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Gerakan “paradoksal” dari (segmen)
dinding dada saat inspirasi/ekspirasi; tidak terlihat pada pasien dalam ventilator.
Menunjukkan trauma hebat. Biasanya selalu disertai trauma pada organ lain
(kepala, abdomen, ekstremitas) </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">F.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Komplikasi</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Komplikasi utama adalah gagal
napas, sebagai akibat adanya ineffective air movement, yang seringkali
diperberat oleh edema/kontusio paru, dan nyeri. Pada pasien dengan flail chest
tidak dibenarkan melakukan tindakan fiksasi pada daerah flail secara eksterna,
seperti melakukan splint/bandage yang melingkari dada, oleh karena akan
mengurangi gerakan mekanik pernapasan secara keseluruhan. </span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Tindakan operasi adalah dengan fiksasi fraktur iga sehingga tidak
didapatkan lagi area “flail” </span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Trauma hancur pada sternum atau iga dapat berakibat terjadinya
pemisahan total dari suatu bagian dinding dada, sehingga dinding dada tersebut
bersifat lebih mobil. Pada setiap gerakan respirasi, maka fragmen yang mobil
tersebut akan terhisap ke arah dalam. Pengembangan normal rongga pleura tidak
dapat lagi berlangsung, sehingga pertukaran gas respiratorik yang efektif
sangat terbatas.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">G.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Manifestasi klinis</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Biasanya karena ada pembengkakan
jaringan lunak di sekitar dan terbatasnya gerak pengembangan dinding dada,
deformitas, dan gerakan paradoksal flail chest yang ada akan tertutupi. Pada
mulanya, penderita mampu mengadakan kompensasi terhadap pengurangan cadangan respirasinya.
Namun bila terjadi penimbunan secret-sekret dan penurunan daya pengembangan
paru-paru akan terjadi anoksia berat, hiperkapnea, dan akhirnya kolaps.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">H.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Penatalaksanaan</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Sebaiknya pasien dirawat intensif
bila ada indikasi atau tanda-tanda kegagalan pernapasan atau karena ancaman
gagal napas yang biasanya dibuktikan melalui pemeriksaan AGD berkala dan
takipneu pain control.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> <span style="color: black;">Stabilisasi area
flail chest (memasukkan ke ventilator, fiksasi internal melalui operasi) bronchial
toilet fisioterapi agresif tindakan bronkoskopi untuk bronchial toilet.</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Tindakan stabilisasi yang bersifat sementara terhadap dinding dada
akan sangat menolong penderita, yaitu dengan menggunakan towl-clip traction
atau dengan menyatukan fragmen-fragmen yang terpisah dengan pembedahan.
Takipnea, hipoksia, dan hiperkarbia merupakan indikasi untuk intubasi
endotrakeal dan ventilasi dgn tekanan positif.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 366.0pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">J. </span></b><b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Diagnosa Keperawatan<span style="mso-tab-count: 1;"> </span></span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">1. <span style="color: black;">Ketidakefektifan pola pernapasan berhubungan dengan ekpansi
paru yang tidak maksimal karena akumulasi udara/cairan.</span></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">2. <span style="color: black;">Perubahan kenyamanan : Nyeri akut berhubungan dengan trauma
jaringan dan reflek spasme otot sekunder.</span></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">3. <span style="color: black;">Kerusakan integritas kulit berhubungan dengan trauma
mekanik terpasang bullow drainage.</span></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">4. <span style="color: black;">Gangguan mobilitas fisik berhubungan dengan ketidakcukupan
kekuatan dan ketahanan untuk ambulasi dengan alat eksternal.</span></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">5. <span style="color: black;">Risiko terhadap infeksi berhubungan dengan tempat masuknya
organisme sekunder terhadap trauma.</span></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: 7.1pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">K. Intervensi
Keperawatan</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">1.
<span style="color: black;">Kriteria hasil : Memperlihatkan frekuensi pernapasan
yang efektive, Mengalami perbaikan pertukaran gas-gas pada paru, Adaptive
mengatasi faktor-faktor penyebab.</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi :</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Berikan
posisi yang nyaman, biasanya dnegan peninggian kepala tempat tidur. Balik ke
sisi yang sakit. Dorong klien untuk duduk sebanyak mungkin.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
Meningkatkan inspirasi maksimal, meningkatkan ekpsnsi paru dan ventilasi pada
sisi yang tidak sakit.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: list 36.0pt; text-indent: -14.2pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Observasi fungsi pernapasan, catat
frekuensi pernapasan, dispnea atau perubahan tanda-tanda vital.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: list 36.0pt; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
Distress pernapasan dan perubahan pada tanda vital dapat terjadi sebgai akibat
stress fifiologi dan nyeri atau dapat menunjukkan terjadinya syock sehubungan
dengan hipoksia.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: list 36.0pt; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Jelaskan pada klien bahwa tindakan tersebut dilakukan
untuk menjamin keamanan.</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: list 36.0pt; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
Pengetahuan apa yang diharapkan dapat mengurangi ansietas dan mengembangkan
kepatuhan klien terhadap rencana teraupetik.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: list 36.0pt; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Jelaskan pada klien tentang etiologi/faktor pencetus
adanya sesak atau kolaps paru-paru.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: list 36.0pt; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
Pengetahuan apa yang diharapkan dapat mengembangkan kepatuhan klien terhadap
rencana teraupetik.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: list 36.0pt; text-indent: -14.2pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pertahankan perilaku tenang, bantu
pasien untuk kontrol diri dengan menggunakan pernapasan lebih lambat dan dalam.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: list 36.0pt; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/ </span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Membantu
klien mengalami efek fisiologi hipoksia, yang dapat dimanifestasikan sebagai
ketakutan/ansietas.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: list 36.0pt; text-indent: -14.2pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Perhatikan alat bullow drainase
berfungsi baik, cek setiap 1 – 2 jam:</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: list 36.0pt; text-indent: -14.2pt;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">2.
<span style="color: black;">Kriteria hasil : Nyeri berkurang/ dapat diadaptasi.
Dapat mengindentifikasi aktivitas yang meningkatkan/menurunkan nyeri. Pasien
tidak gelisah.</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi :</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Jelaskan dan bantu klien dengan tindakan pereda nyeri
nonfarmakologi dan non invasif.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
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<b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
Pendekatan dengan menggunakan relaksasi dan nonfarmakologi lainnya telah menunjukkan
keefektifan dalam mengurangi nyeri.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Ajarkan Relaksasi : Tehnik-tehnik untuk menurunkan
ketegangan otot rangka, yang dapat menurunkan intensitas nyeri dan juga
tingkatkan relaksasi masase.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> Akan
melancarkan peredaran darah, sehingga kebutuhan O2 oleh jaringan akan
terpenuhi, sehingga akan mengurangi nyerinya.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Ajarkan metode distraksi selama nyeri akut.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
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<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
Mengalihkan perhatian nyerinya ke hal-hal yang menyenangkan.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Berikan kesempatan waktu istirahat bila terasa nyeri dan
berikan posisi yang nyaman ; misal waktu tidur, belakangnya dipasang bantal
kecil.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
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<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
Istirahat akan merelaksasi semua jaringan sehingga akan meningkatkan
kenyamanan.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Tingkatkan pengetahuan tentang : sebab-sebab nyeri, dan
menghubungkan berapa lama nyeri akan berlangsung.</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
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<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
Pengetahuan yang akan dirasakan membantu mengurangi nyerinya. Dan dapat
membantu mengembangkan kepatuhan klien terhadap rencana teraupetik.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kolaborasi denmgan dokter, pemberian analgetik.</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
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<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
Analgetik memblok lintasan nyeri, sehingga nyeri akan berkurang.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Observasi tingkat nyeri, dan respon motorik klien, 30
menit setelah pemberian obat analgetik untuk mengkaji efektivitasnya. Serta
setiap 1 – 2 jam setelah tindakan perawatan selama 1 – 2 hari.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
Pengkajian yang optimal akan memberikan perawat data yang obyektif untuk
mencegah kemungkinan komplikasi dan melakukan intervensi yang tepat.</span></div>
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<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">3.
<span style="color: black;">Kriteria Hasil : tidak ada tanda-tanda infeksi seperti
pus. luka bersih tidak lembab dan tidak kotor. </span></span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Tanda-tanda vital dalam batas normal atau dapat
ditoleransi.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi :</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kaji kulit dan identifikasi pada tahap perkembangan luka.</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
mengetahui sejauh mana perkembangan luka mempermudah dalam melakukan tindakan
yang tepat.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kaji lokasi, ukuran, warna, bau, serta jumlah dan tipe
cairan luka.</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
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<b><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
mengidentifikasi tingkat keparahan luka akan mempermudah </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">intervensi.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pantau peningkatan suhu tubuh.</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> suhu
tubuh yang meningkat dapat diidentifikasikan sebagai adanya proses peradangan.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Berikan perawatan luka dengan tehnik aseptik. Balut luka
dengan kasa kering dan steril, gunakan plester kertas.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
tehnik asept</span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">ik membantu mempercepat penyembuhan luka dan mencegah terjadinya
infeksi.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Jika pemulihan tidak terjadi kolaborasi tindakan
lanjutan, misalnya debridement.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> agar
benda asing atau jaringan yang terinfeksi tidak menyebar luas pada area kulit
normal lainnya.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Setelah debridement, ganti balutan sesuai kebutuhan.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> balutan
dapat diganti satu atau dua kali sehari tergantung kondisi parah/ tidak nya
luka, agar tidak terjadi infeksi.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kolaborasi pemberian antibiotik sesuai indikasi.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
antibiotik berguna untuk mematikan mikroorganisme pathogen pada daerah yang
berisiko terjadi infeksi.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">4.
<span style="color: black;">Kriteria hasil : penampilan yang seimbang. melakukan
pergerakkan dan perpindahan. mempertahankan mobilitas optimal yang dapat di
toleransi, dengan karakteristik :</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="IT" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IT; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">0 = mandiri penuh</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="IT" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IT; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">1 = memerlukan alat Bantu.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">2 = memerlukan bantuan dari orang lain untuk bantuan,
pengawasan, dan pengajaran.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">3 = membutuhkan bantuan dari orang lain dan alat Bantu.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">4 = ketergantungan; tidak berpartisipasi dalam aktivitas.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi :</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kaji kebutuhan akan pelayanan kesehatan dan kebutuhan
akan peralatan.</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
mengidentifikasi masalah, memudahkan intervensi.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Tentukan tingkat motivasi pasien dalam melakukan
aktivitas.</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
mempengaruhi penilaian terhadap kemampuan aktivitas apakah karen</span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">a
ketidakmampuan ataukah ketidakmauan.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Ajarkan dan pantau pasien dalam hal penggunaan alat
bantu.</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
menilai batasan kemampuan aktivitas optimal.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Ajarkan dan dukung pasien dalam latihan ROM aktif dan
pasif.</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
mempertahankan /meningkatkan kekuatan dan ketahanan otot.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kolaborasi dengan ahli terapi fisik atau okupasi.</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
sebagai suaatu sumber untuk mengembangkan perencanaan dan
mempertahankan/meningkatkan mobilitas pasien.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">5.
<span style="color: black;">Kriteria hasil : tidak ada tanda-tanda infeksi
seperti pus. luka bersih tidak lembab dan tidak kotor. Tanda-tanda vital dalam
batas normal atau dapat ditoleransi.</span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi :</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pantau tanda-tanda vital.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
mengidentifikasi tanda-tanda peradangan terutama bila suhu tubuh meningkat.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Lakukan perawatan luka dengan teknik aseptik.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> mengendalikan
penyebaran mikroorganisme patogen.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Lakukan perawatan terhadap prosedur inpasif seperti
infus, kateter, drainase luka, dll.</span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
untuk mengurangi risiko infeksi nosokomial.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Jika ditemukan tanda infeksi kolaborasi untuk pemeriksaan
darah, seperti Hb dan leukosit.</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
penurunan Hb dan peningkatan jumlah leukosit dari normal bisa terjadi akibat
terjadinya proses infeksi.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Symbol;">· </span><span lang="FI" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kolaborasi untuk pemberian antibiotik.</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: -14.2pt;">
<b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/</span></b><span lang="SV" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
antibiotik mencegah perkembangan mikroorganisme patogen</span><span lang="FI" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-indent: -14.2pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-indent: -14.2pt;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">SOURCE:
http://xtianto91.wordpress.com</span></i></div>
Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-39003925372265256052012-09-13T02:59:00.001-07:002012-09-13T03:01:34.655-07:00ASKEP TRAUMA OPEN PNEMOTHORAKS<!--[if gte mso 9]><xml>
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<div align="center" class="MsoNormalCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: center; text-indent: -14.2pt;">
<b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">ASKEP TRAUMA OPEN PNEMOTHORAKS</span></b></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">A. KONSEP DASAR MEDIK</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">1. </span></b><b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">PENGERTIAN</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">a. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Trauma Tembus Paru</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Merupakan keadaan dimana dinding dada mengalam trauma
atau tusukan atau benturan yang cukup keras hingga tembus ke paru.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">(www.blogspot.com)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Merupakan cedera pada dada yang mengakibatkan kerusakan
pada paru. (www.indonurs-webng.com)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Merupakan penyebab umum dari beberapa gangguan paru
akibat adanya cedera pada dinding dada.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">(www.wikipedia.com)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">b. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Pneumotoraks</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Adalah pengumpilan udara dalam ruang potensial antara
pleura viseral dan parietal. (Kapita Selekta 2)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Adalah keadaan terdapat udara atau gas dalam ringga
pleura. (</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"><a href="http://www.indonurs-webng.com/"><span style="color: black; mso-themecolor: text1;">www.indonurs-webng.com</span></a><span style="color: black; mso-themecolor: text1;">)</span></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Merupakan dorongan udara melalui lubang dalam dinding
dada menghasilkan bunyi menghisap (sucking wounds).</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">(Keperawatan Medikal Bedah edisi 8, Bunner
dan Suddarth)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">c. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Open Pneumotoraks</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Merupakan gangguan pada dinding dada berupa hubungan
langsung antara pleura dan lingkungan. (Kapita Selekta 2)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Merupakan adanya luka terbuka yang cukup besar pada dada
sehingga udara dapat keluar dan masuk rongga intra toraks dengan mudah.
(www.indonurs-webng.com)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Merupakan adanya lubang pada dinding dada yang cukup
besar untuk memungkinkan udara mengalir dengan bebas dan masuk ke luar rongga
toraks bersama setiap upaya pernafasan.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">(Buku Ajar Keperawatan Medikal Bedah vol.1
edisi 8)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">2. </span></b><b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">ETIOLOGI</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Open
pneumotoraks disebabkan oleh trauma tembus dada. Berdasarkan kecepatannya,
trauma tembus dada dapat dikelompokkan menjadi 2 berdasarkan kecepatannya,
yaitu :</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">a. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Luka tusuk</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Umumnya
dianggap kecepatan rendah karena senjata (benda yang menusuk atau mengenai
dada) menghancurkan area kecil di sekitar luka. Kebanyakan luka tusuk
disebabkan oleh tusukan pisau. Namun, selain itu pada kasus kecelakaan yang
mengakibatkan perlukaan dada, dapat juga terjadi ujung iga yang patah (fraktur
iga) mengarah ke dalam sehingga merobek pleura parietalis dan viseralis
sehingga dapat mengakibatkan open pneumotoraks.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">b. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Luka tembak</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Luka tembak
pada dada dapat dikelompokkan sebagai kecepatan rendah, sedang, atau tinggi.
Faktor yang menentukan kecepatan dan mengakibatkan keluasan kerusakan termasuk
jarak darimana senjata ditembakkan, kaliber senjata, dan konstruksi serta
ukuran peluru. Peluru yang mengenai dada dapat menembus dada sehingga
memungkinkan udara mengalir bebas keluar dan masuk rongga toraks.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">3. </span></b><b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">PATOFISIOLOGI</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Pada manusia
normal tekanan dalam rongga pleura adalah negatif. Tekanan negatif disebabkan
karena kecenderungan paru untuk kolaps (elastic recoil) dan dinding dada yang
cenderung mengembang. Bilamana terjadi hubungan antara alveol atau ruang udara
intrapulmoner lainnya (kavitas, bulla) dengan rongga pleura oleh sebab apapun,
maka udara akan mengalir dari alveoli ke rongga pleura sampai terjadi
keseimbangan tekanan atau<br />
hubungan tersebut tertutup. </span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Serupa dengan
mekanisme di atas,</span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;"> </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">maka bila ada hubungan antara udara luar
dengan rongga pleura</span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;"> </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">melalui dinding dada; udara akan masuk ke
rongga pleura sampai perbedaan tekanan menghilang atau hubungan menutup.<br />
Perubahan patofisiologi yang terjadi pada dasarnya adalah akibat dari :</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">a. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Kegagalan ventilasi</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">b. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Kegagalan pertukaran gas pada tingkat alveolar.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">c. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Kegagalan sirkulasi karena perubahan hemodinamik.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: 1.0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Ketiga faktor diatas dapat menyebabkan hipoksia. Hipoksia
pada tingkat jaringan dapat menyebabkan ransangan terhadap cytokines yang dapat
memacu terjadinya adult respiratory distress syndrome ( ARDS), systemic
inflamation response syndrome (SIRS).</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">4. </span></b><b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">MANIFESTASI
KLINIS</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Gejala-gejalanya
sangat bervariasi, tergantung kepada jumlah udara yang masuk ke dalam rongga
pleura dan luasnya paru-paru yang mengalami kolaps (mengempis).</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Gejalanya bisa berupa:</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Nyeri dada tajam yang timbul secara tiba-tiba, dan
semakin nyeri jika penderita menarik nafas dalam atau terbatuk</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Sesak nafas</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Dada terasa sempit</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Mudah lelah</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Denyut jantung yang cepat</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Warna kulit menjadi kebiruan akibat kekurangan oksigen.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Gejala-gejala tersebut mungkin timbul pada saat istirahat
atau tidur.</span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;"> </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Gejala lainnya yang mungkin ditemukan:</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Hidung tampak kemerahan</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Cemas, stres, tegang</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Tekanan darah rendah (hipotensi).</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">5. </span></b><b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">PEMERIKSAAN
DIAGNOSTIK</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">a. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Ro. Thoraks</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Menyatakan akumulasi udara atau cairan pada
area pleura; dapat menunjukkan penyimpangan struktur mediastinal (jantung).</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">b. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Gas Darah Arteri (GDA)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Variabel tergantung dari derajat fungsi paru
yang dipengaruhi atau gangguan mekanik pernafasan dan kemampuan mengkompensasi
PaCO2 kadang meningkat. PaCO2 mungkin normal atau menurun ;saturasi O2 bisa
menurun.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">c. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Torasentesis<br />
Menyatakan darah atau cairan serosanguinosa.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">d. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Hb<br />
Mungkin menurun, menunjukkan kehilangan darah.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">6. </span></b><b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">PENATALAKSANAAN</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Pneumotoraks
terbuka membutuhkan intervensi kedaruratan.</span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;"> </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Menghenti</span><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">-</span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">kan
aliran udara yang melewati lubang pada dinding dada merupakan tindakan
menyelamatkan jiwa. Pada situasi darurat tersebut, apasaja dapat digunakan
untuk menup luka dada misalnya handuk, sapu tangan, atau punggung tangan. Jika
sadar, pasien diinstruksikan untuk menghirup dan mengejan dengan glotis
tertutup. </span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Aksi ini
membantu mengembangkan kembali paru dan mengeluarkan udara dari toraks. Di
rumah sakit, lubang ditutup dengan kassa yang dibasahi dengan petrolium.
Balutan tekan dipasang dan diamankan dengan lilitan melingkar. Biasanya, selang
dada yang dihubungkan dengan drainase water-seal (WSD) dipasang untuk
memungkinkan udara dan cairan mengalir. Anti biotik biasanya diresepkan untuk
melawan infeksi akibat kontaminasi.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">B. </span></b><b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Gambaran Umum
Alkalosis Respiratorik</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">1. </span></b><b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Definisi</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Alkalosis respiratorik adalah kondisi klinis dimana pH
arteriallebih tinggi dari 7,45 dari PaCO2 kurang dari 38mmHg. (Keseimbangan
Cairan</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Elektrolit dan Asam Basa, Horne)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Alkalosis respiratorik adalah kondisi akibat dari
peningkatan kecepatan ventilasi alveolar yang ditandai dengan tekanan
karbondioksida darah arteri (PACO2) <> 7,40. (www.indonurs.com)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Alkalosis respiratorik (kekurangan asam karbonat) adalah
penurunan primer dari PaCO2 <> 7,45. ( Patofisiologi, Price dan Wilson)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">2. </span></b><b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Kondisi
yang Dapat Mengakibatkan Alkalosis Respiratori</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<i style="mso-bidi-font-style: normal;"><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Perangsangan
sentral terhadap pernapasan</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Hiperventilasi psikogenik yang disebabkan oleh stress
emosional</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Keadaan hipermetabolik : demam tirotoksikosis</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Gangguan SSP</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Cedera kepal atau gangguan pembuluh darah otak</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Tumor otak</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Intoksikasi salisilat (awal)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<i style="mso-bidi-font-style: normal;"><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Hipoksia</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<i style="mso-bidi-font-style: normal;"><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Ventilasi mekanik</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<i style="mso-bidi-font-style: normal;"><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Mekanisme yang belum jelas</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Sepsis gram negative</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Sirosis hepatis</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Latihan fisik</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">3. </span></b><b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Mekanisme
Pengaturan Keseimbangan Asam Basa</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Karena
berbagai asam dan basa terus menerus memasuki tubuh melalui absorbsi makanan
dan katabolisme makanan, maka beberapa mekanisme diperlukan untuk menetralkan
atau membuang substansi-substansi ini. pH yang konstan dipelihara secara
bersama oleh :</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><i><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Sistem Penyangga tubuh (buffer) </span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Penyangga adalah campuran dari asam lemak dan
garm basanya. Istilah penyangga menjelaskan substansi kimia yang mengurangi
perubahan pH dalam larutan yang disebabkan penambahan asam ataupun basa.<br />
Empat sistem penyangga utama dari tubuh yang membantu memelihara pH agar tetap
konstan adalah :</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">a. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Bikarbonat</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Merupakan penyangga yang paling banyak secara
kuantitatif dan bekerja pada EFC.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">CO2+H2O↔H2CO3↔H++HCO3-</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Panah-panah
dua arah mennjukkan reaksi yang dapat berlangsung dua arah dengan kemungkinan
yang sama, tergantung dari kadar komponen-komponen pada masing-masing bagian
dari reaksi ini.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Fosfat<br />
Merupakan penyangga yang paling penting dalam sel darah merah dan sel tubulus
ginjal. H+ yang diekskresikan ke dalam kemih, disangga dengan fosfat (dikenal
sebagai asam yng dapat dititrasi).</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Hemoglobin<br />
Hemoglobin yang tereduksi mempunyai afinitas kuat dengan H+, maka kebanyakan
ion-ion ini menjadi terikat dengan hemoglobin.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Protein<br />
Paling banyak terdapat pada sel jaringan dan juga bekerja pada plasma</span><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><i><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Pernafasan (paru-paru)</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Komponen
pernafasan terutama dikendalikan oleh paru-paru melalui perubahan pada
ventilasi alveolar. Jika PCO2 diatas atau dibawah normal, jumlah ventilasi
alveolar tidak akan memadai (hipoventilasi) atau berlebihan (hiperventilasi).
PCO2 diatur oleh fungsi paru dan refleks pada batang otak yang mengendalikan
dorongan pernasfasan.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><i><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Ginjal</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: 1.0cm;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Ginjal ikut
menjaga keseimbangan asam-basa dengan mengatur (HCO3) plasma melalui 2 jalan :
(a) reabsorbsi HCO3- yang terfiltrasi dan mencegah kehilangannya dalam kemih;
(b) ekskresi kelebihan H= sebagai hasil metabolisme. Denagn demikian ginjal
mampu menahan atau membuang HC)3- sesuai kebutuhan.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">4. PEMERIKSAAN DIAGNOSTIK</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Nilai gas darah arteri (GDA)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">PaCO2 <> 7,40. Penurunan tekanan
oksigen darah arteri (PaCO2).</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Elektrolit serum</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Menentukan adanya gangguan metabolic asam
basa.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Fosfat serum</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Mungkin turun < 0,5 mg/dl (normalnya adalah
3,0-4,5 mg/dl). Karena alkalosis yang menyebabkan peningkatan ambilan fosfat ke
sel-sel.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">EKG</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Mendeteksi disritmia jantung, yang mungkin
terjadi dengan alkalosis.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">C. KONSEP DASAR KEPERAWATAN</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<b><span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">1. </span></b><b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">PENGKAJIAN</span></b><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;"><br />
Pengkajian Data Fokus</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">a. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Aktivitas dan Istirahat</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Dispnea dengn aktivitas maupun istirahat</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">b. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Sirkulasi</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">S3 / S4 / irama jantung, Gallop (gagal jantung sekunder
tanpa efusi)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Nadi apical (PMI) berpindah oleh adanya penyimpangan
mediastinal dengan ketegangan pneumotoraks.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Tanda Homman (bunyi renyah sehubungan dengan denyutan
jantung menunjukkan udara dalam mediastrum)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Tekanan darah : hipotensi</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">DJV</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">c. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Integritas ego</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Ketakutan</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Cemas</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Gelisah</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">d. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Nyeri
atau kenyamanan</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Nyeri dada unilateral, meningkat karena pernafasan, batuk</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Timbul tiba-tiba gejala sementara batuk/ regangan</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Mengerutkan wajah</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">e. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Pernafasan</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Kesulitan bernafas</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Peningkatan frekuensi/ takipnea dan kedalaman pernafasan</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Peningkatan kerja nafas, penggunaan otot aksesori
pernafasan pada dada, leher; retraksi interkostal, ekspirasi abdomen kuat</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Bunyi nafas menurun atau tidak ada (sisi yang terlibat)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Fremitus menurun (sisi yang terlibat)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Palpasi dada : gerakan dada tidak sama (paradoksik) bila
trauma/ kemps; penurunan pada jaringan dengan palpasi)</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.15pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">- </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Inspeksi : kulit pucat, sianosis, berkeringat</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-indent: -14.2pt;">
<span lang="IN" style="color: black; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">f. </span><span style="color: black; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text1;">Pemeriksaan Diagnostik</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">D. ASUHAN KEPERAWATAN GAWAT DARURAT</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Asuhan Keperawatan pada kasus Gawat Darurat
dengan pasien yang mengalami OPEN PNEUMOTORAKS, berbeda dengan pemberian ASKEP
pada Konsep Medikal Bedah.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Dalam mengkaji pasien Gawat Darurat dengan
kasus OPEN PNEUMOTORAKS, harus dilakukan dengan sistematis mulai dari:</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">A: Airway (jalur
nafas):</span></b></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pada airway yang perlu diperhatikan adalah
mempertahankan jalan nafas, memperhatikan apakah ada obstruksi pada jalan
nafas( benda asing,secret,darah). Pada kasus open pneumotoraks terdapat masalah
pada jalan napasnya yang disebabkan oleh penumpukan darah dan udara.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Diagnose :</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">
Bersihan jalan napas tidak efektif b/d penumpukan darah dan udara.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi :</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">a. Kaji
kesadaran pasien dengan menyentuh, menggoyang dan memanggil namanya.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/ mengetahui tingkat kesadaran pasien, apakah
masih dalam tahap unrespon, pain, voice, dan alert.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">b. Lakukan
panggilan untuk pertolongan darurat</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/ bantuan segera dapat membantu mempercepat
pertolongan.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">c.
Beri posisi terlentang pada permukaan rata yang tidak keras, kedua lengan
pasien disamping tubuhnya.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/ mengantisipasi trauma servikal, posisi yang
tepat dan lingkungan yang nyaman dapat penolong dan korban dalam melakukan
tindakan.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">d. Berikan
posisi nyaman pada klien seperti semifowler/fowler</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/meningkatkan inspirasi maksimal,meningkatkan
ekspansi paru dan ventilasi pada sisi yang tak sakit.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">e. Buka
jalan nafas dengan mengunakan tekhnik gabungan head tilt-chin lift atau dengan
tekhnik jaw thrust apabila klien dicurigai mengalami trauma cervical.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/membuka jalan nafas dengan mengangkat
epiglottis.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">f. Beri O<sub>2</sub>
atau pasang ventilator</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/alat dalam menurunkan kerja napas,
meningkatkan penghilangan distress respirasi dan sianosis sehubungan dengan
hipoksemia.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/mengurangi tekanan intrapleura</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">g. Berikan obat
jenis analgetik <br />
R/mengurangi hingga menghilangkan rasa nyeri</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">h. Lakukan
pemasangan WSD</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/untuk mengeluarkan darah yang menumpuk pada
rongga pleura.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Evaluasi :</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">1. Kebutuhan
oksigen pasien adekuat</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">2. Jalan nafas
pasien kembali efektif</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">B:Breathing
(pernapasan)</span></b></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pada auskultasi suara napas menghilang yang
mengindikasikan bahwa paru tidak mengembang dalam rongga pleura.perkusi dinding
dada hipersonor,semakin lama tekanan udara didalam rongga pleura didalam rongga
pleura akan meningkat dan melebihi tekanan atmosfir. Udara yang terkumpul dalam
rongga pleura ini dapat menekan paru sehingga dapat terjadi sesak nafas
tiba-tiba,nafas pendek bahkan sering menimbulkan gagal nafas.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Diagonose</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Ketidak efektifan pola nafas berhubungan
dengan penurunan kemampuan oksigenase karena akumulasi udara.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi:</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">a. Kaji
pernapasan klien dengan mendekatkan telinga di atas hidung atu mulut sambil
mempertahankan pembukaan jalan nafas <br />
R/mengetahui ada tidaknya pernapasan.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">b. Perhatikan
dada pasien dengan melihat gerakan naik turunnya dada pasien.<br />
R/mengetahui apakah masih terjadi pengembangan paru.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">c.
Auskultasi yang keluar waktu ekspirasi,merasakan adanya aliran udara.<br />
R/mendengarkan apakah terdapat suara tambahan atau tidak.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">d. Berikan
posisi nyaman pada klien seperti semifowler/fowler.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/Meningkatkan ekspansi paru.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">e.
Observasi kembali naik turunnya dada,mendengar dan merasakan udara yang keluar
pada ekshalasi.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/mengetahui keberhasilan tindakan yang telah
dilakukan</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">f. Berikan
O2 atau pasang ventilator</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/memenuhi kebutuhan oksigen pasien.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Evaluasi </span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">1. Pola napas
pasien menjadi 16-24 x/ menit</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">2. Tampak
pergerakan dada pasien simetris pada saat bernapas</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">C:Circulation
(sirkulasi)</span></b></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Peningkatan tekanan intratoraks mengakibatkan
tergesernya organ mediastinum secara massif ke arah berlawanan dari sisi paru
yang mengalami tekanan. Pergeseran mediastinum ke arah berlawanan dari area
cedera ini dapat menyebabkan penyumbatan aliran vena kava superior dan inferior
yang dapat mengurangi cardiac preload dan menurunkan cardiac output.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Diagnosa :</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Resiko gangguan perfusi jaringan cerebral b/d
penurunan aliran balik vena,penurunan curah jantung.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi :</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">a.
Tentukan ada tidaknya denyut nadi .</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">R/perabaan dilakukan untuk mengetahui apakah
jantung masih berkontrasi atau tidak. </span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">b. Hubungi
system darurat dengan memberikan informasi tentang hal-hal yang terjadi dan
peralatan yang diutuhkan.<br />
R/informasi yang diperoleh akan membantu dalam menentukan tindakan selanjutnya
sehingga pertolongannya akan lebih mudah</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">c.
Kolaborasi dalam pemasangan dan pemberian cairan infuse<br />
R/memenuhi kebutuhan cairan dan elektorlit. Pantau pemberian cairan yang
dilakukan, jangan sampai terjadi udem</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Evaluasi</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">1. Tekanan darah
kembali pada nilai 120/80</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">2. Tampak tidak
adanya sianosis</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">D:Disability
(kesadaran)</span></b></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Pada pasien open pneumotoraks memang mungkin
akan mengalami penurunan kesadaran tapi GCS nya sekitar 12-14</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">·
E:Exposure </span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Adanya luka tembus menyebabkan luka terbuka
dan bunyi aliran udara terdengar pada area luka tembus. Yang selanjutnya
disebut “ sucking” chest wound (luka dada menghisap).</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Resiko terjadinya infeksi b/d adanya luka
tusuk</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Intervensi:</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">a.</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> Luka
tembus perlu segera ditutup dengan pembalut darurat atau balutan tekan dibuat
kedap udara dengan petroleum jelly.<br />
R/ memungkinkan udara yang terhisap dapat dikeluarkan dan bagian yang terbuka
sebagai katup dimana udara dapat keluar dan paru-paru akan mengembang.</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">b. Pemberian
antobiotik<br />
R/mengurangi terjadi proses infeksi</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">c.
Pertahankan kebersihan daerah sekitar luka<br />
R/mencegah terjadinya iritasi </span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Evaluasi</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">1. Tidak
terjadinya infeksi pada daerah sekitar luka</span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">2. Paru-paru
dapat berkembang dengan baik</span></div>
<div class="MsoNormal" style="background: white; line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="background: white; line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></b><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"> </span></div>
<div align="center" class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">DAFTAR PUSTAKA</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div align="center" class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">Kristanty, Paula, dkk.2009.<b> Asuhan
Keperawatan Gawat Darurat. </b>Jakarta:TIM</span></div>
<div align="center" class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman";">http///G.Keperawatan Gadar Trauma
Dada.akses tanggal 28 maret 2010.</span></div>
<div align="center" class="MsoNormal" style="background: white; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
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Penyakit Paru, Fk Unair Surabaya, 2004 Arief , Wibowo Suryatenggara:
Pneumotoraks. Dlam Symposium Penatalaksanna Gawat Paru Masa Kini. Achmad
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<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Akhirnya
setelah sekian lama ditunggu dan di cari-cari Option File Final Transfer
2012-2013 PES 6 dapat juga Ane share niiihh… Silahkan buat sob pecinta PES 6
(original ) Ane kasihkan link downloadnya di bawah,</span><br />
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">1 - Full transfer untuk semua tim</span><span lang="IN" style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"> </span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">update
terakhir 7 September 2012</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">.<br />
2 - </span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Club</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"> penuh untuk semua tim dipromosikan di liga-liga </span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">T</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">op 5</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"> Dunia</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">.<br />
3 - Diperbarui </span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">costim</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"> </span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">dan face </span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">untuk semua tim papan atas dan juga untuk tim dipromosikan di EPL.</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"> Untuk
club yang belum diperbaharui kit nya, mohon bersabar.</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><br />
4 - </span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">P</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">emain muda baru di semua tim papan atas.<br />
5 - Update semua pemain (umur - posisi) dar</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">i www.</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">pesstatsdatabase.</span><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">com & www.goal.com</span><br />
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Silahkan
bagi yang ingin Option File PES 6 (original) Final Transfer</span><br />
<br />
<a href="http://www.sharebeast.com/za0me4b2n7ni" target="_blank">DOWNLOAD DISINI</a><br />
<br />
atau<br />
<br />
<a href="http://www.4shared.com/rar/Vp2zOvH-/pes_6_final_transfer.html" target="_blank">DOWNLOAD DISINI</a><br />
<br />
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Pass:
hariskumpulanaskep.blogspot.com</span><br />
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<br /></div>
Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com4tag:blogger.com,1999:blog-1799099966681267159.post-51640812378235543762012-08-30T19:25:00.002-07:002012-09-09T05:14:58.814-07:00OPTION FILE PES 6 30 AGUSTUS 2012<!--[if gte mso 9]><xml>
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mso-hansi-theme-font:minor-latin;
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<![endif]-->
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Bagi para
pecinta PES 6, kali ini saya akan postingkan option file tanggal 30/08/2012. </span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Ini option
file Non-Patch (original).</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<br /></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi81_5nYyRkmWC1gRQMJRgtctTou3RmJqkykReHS5qaRvfHrsIc5YlNX-6yhN5V-iJEd2huBw_-I-jXMALTMUz1Ix_zUnzpdRfmpGbOhmLUDNhtYxN4QSP7-p4OCI7iAd_6Rtq-_AYAarQ/s1600/of+pes6.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi81_5nYyRkmWC1gRQMJRgtctTou3RmJqkykReHS5qaRvfHrsIc5YlNX-6yhN5V-iJEd2huBw_-I-jXMALTMUz1Ix_zUnzpdRfmpGbOhmLUDNhtYxN4QSP7-p4OCI7iAd_6Rtq-_AYAarQ/s1600/of+pes6.png" /></a><span style="background: white; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Transfer pemain 30 Agustus 2012 antara lain:</span><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
V. Persie – Arsenal ke MU<br />
Park JS - MU ke QPR<br />
Kagawa - Dortmn ke MU<br />
Cassano – Milan ke Inter<br />
Podolski - Koln ke Arsenal<br />
Kuyt - Liverpool ke Fenerbence<br />
Ibra - Milan ke PSG</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Carroll –
Liverpool ke West Ham<br />
Tiago - Milan ke PSG<br />
Song – Arsenal ke Barca<br />
Pazzini – Inter ke Milan<br />
Nuri Sahin – Madrid ke Liverpool</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Bosingwa –
Chelsea ke QPR</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Modric –
Tottenham ke Madrid</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Bojan K– Roma
ke Milan </span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<span style="background: white;">dan masiiiiih banyak lagi…</span></span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<br /></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Langsung saja
Option File Non-Patch 30 Agustus 2012 <a href="http://www.sharebeast.com/8thptvrl5nb3" target="_blank">DOWNLOAD DISINI</a></span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<br /></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">atau</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<br /></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Link terbaru <a href="http://www.4shared.com/rar/Vp2zOvH-/pes_6_final_transfer.html" target="_blank">DOWNLOAD DISINI</a></span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<br /></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Pass :
hariskumpulanaskep.blogspot.com</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com15tag:blogger.com,1999:blog-1799099966681267159.post-91761461132828665542012-08-08T07:13:00.001-07:002012-08-08T07:14:18.893-07:00UPDATE TRANSFER PES 6 08 AGT 12<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBVNLl0ZyEo_DskN_hYtISNQ4_i7q2PKIfX0z2qs-MSv9zmikuhrD4Ez0dSOlKdTlF9yVBTwk_c5UVv3aCSzxcVKI5ahfKhUIRJqEu7cgEWWMED_a5K4aBvB4J_Jm4aKBFLyexujotlq8/s1600/pes6gl7.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBVNLl0ZyEo_DskN_hYtISNQ4_i7q2PKIfX0z2qs-MSv9zmikuhrD4Ez0dSOlKdTlF9yVBTwk_c5UVv3aCSzxcVKI5ahfKhUIRJqEu7cgEWWMED_a5K4aBvB4J_Jm4aKBFLyexujotlq8/s1600/pes6gl7.png" /></a></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;">Bagi
para pecinta PES 6, kali ini saya akan postingkan option file tanggal
08/08/2012. Transfer pemain dan update liga-liganya mungkin ada yang kurang
lengkap, maklum disesuaikan dengan sepengetahuan ane. Hehe.... Tapi tidak
salahnya juga dicoba terlebih dahulu, mungkin aja cocok kan ga dosa juga bro...hahaha
ga nyambung yaa...</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;">Bagi
yang mau Option File PES 6 08/08/12 <a href="http://www.4shared.com/rar/s_iYmmrQ/275648.html" target="_blank">DOWNLOAD DISINI</a> </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 16.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;">Catatan</span><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;">:
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apabila ingin mendownload Option File tersebut. Trims...</span></div>
Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com4tag:blogger.com,1999:blog-1799099966681267159.post-4812894547479495242012-08-08T06:01:00.002-07:002012-08-08T06:02:55.246-07:00KONSEP KELUARGA<br />
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<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">KONSEP KELUARGA</span></b></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1. Duvall dan Logan ( 1986 ) :<br />
Keluarga adalah sekumpulan orang dengan ikatan perkawinan, kelahiran, dan
adopsi yang bertujuan untuk menciptakan, mempertahankan budaya, dan meningkatkan
perkembangan fisik, mental, emosional, serta sosial dari tiap anggota keluarga.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">2. Bailon dan Maglaya ( 1978 ) :<br />
Keluarga adalah dua atau lebih individu yang hidup dalam satu rumah tangga
karena adanya hubungan darah, perkawinan, atau adopsi. Mereka saling
berinteraksi satu dengan yang lain, mempunyai peran masing-masing dan
menciptakan serta mempertahankan suatu budaya.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">3. Departemen Kesehatan RI ( 1988 ) :<br />
Keluarga merupakan unit terkecil dari masyarakat yang terdiri dari kepala
keluarga dan beberapa orang yang berkumpul dan tinggal di suatu tempat di bawah
satu atap dalam keadaan saling ketergantungan.</span></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Dapat disimpulkan bahwa karakteristik keluarga adalah
:<br />
1. Terdiri dari dua atau lebih individu yang diikat oleh hubungan darah,
perkawinan atau adopsi<br />
2. Anggota keluarga biasanya hidup bersama atau jika terpisah mereka tetap
memperhatikan satu sama lain<br />
3. Anggota keluarga berinteraksi satu sama lain dan masing-masing mempunyai
peran sosial : suami, istri, anak, kakak dan adik<br />
4. Mempunyai tujuan : menciptakan dan mempertahankan budaya, meningkatkan
perkembangan fisik, psikologis, dan sosial anggota.</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">STRUKTUR KELUARGA</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"><br />
1. Patrilineal : keluarga sedarah yang terdiri dari sanak saudara sedarah dalam
beberapa generasi, dimana hubungan itu disusun melalui jalur ayah<br />
2. Matrilineal : keluarga sedarah yang terdiri dari sanak saudara sedarah dalam
beberapa generasi dimana hubungan itu disusun melalui jalur garis ibu<br />
3. Matrilokal : sepasang suami istri yang tinggal bersama keluarga sedarah ibu<br />
4. Patrilokal : sepasang suami istri yang tinggal bersama keluarga sedarah
suami<br />
5. Keluarga kawinan : hubungan suami istri sebagai dasar bagi pembinaan
keluarga, dan beberapa sanak saudara yang menjadi bagian keluarga karena adanya
hubungan dengan suami atau istri.</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">CIRI-CIRI STRUKTUR KELUARGA</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"><br />
1. Terorganisasi : saling berhubungan, saling ketergantungan antara anggota
keluarga<br />
2. Ada keterbatasan : setiap anggota memiliki kebebasan, tetapi mereka juga
mempunyai keterbatasan dalam mejalankan fungsi dan tugasnya masing-masing<br />
3. Ada perbedaan dan kekhususan : setiap anggota keluarga mempunyai peranan dan
fungsinya masing-masing.</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">CIRI-CIRI KELUARGA INDONESIA </span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"><br />
1. Suami sebagai pengambil keputusan<br />
2. Merupakan suatu kesatuan yang utuh<br />
3. Berbentuk monogram<br />
4. Bertanggung jawab<br />
5. Pengambil keputusan<br />
6. Meneruskan nilai-nilai budaya bangsa<br />
7. Ikatan kekeluargaan sangat erat<br />
8. Mempunyai semangat gotong-royong</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">MACAM-MACAM STRUKTUR / TIPE / BENTUK KELUARGA</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"></span></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1. TRADISIONAL :</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"><br />
<i>a. The nuclear family (keluarga inti)</i><br />
Keluarga yang terdiri dari suami, istri dan anak.<br />
<i>b. The dyad family</i><br />
Keluarga yang terdiri dari suami dan istri (tanpa anak) yang hidup bersama
dalam satu rumah<br />
<i>c. Keluarga usila</i><br />
Keluarga yang terdiri dari suami istri yang sudah tua dengan anak sudah
memisahkan diri<br />
<i>d. The childless family</i><br />
Keluarga tanpa anak karena terlambat menikah dan untuk mendapatkan anak
terlambat waktunya, yang disebabkan karena mengejar karir/pendidikan yang
terjadi pada wanita<br />
<i>e. The extended family (keluarga luas/besar)</i><br />
Keluarga yang terdiri dari tiga generasi yang hidup bersama dalam satu rumah
seperti nuclear family disertai : paman, tante, orang tua (kakak-nenek),
keponakan, dll)<br />
f<i>. The single-parent family (keluarga duda/janda)</i><br />
Keluarga yang terdiri dari satu orang tua (ayah dan ibu) dengan anak, hal ini
terjadi biasanya melalui proses perceraian, kematian dan ditinggalkan
(menyalahi hukum pernikahan)<br />
<i>g. Commuter family</i><br />
Kedua orang tua bekerja di kota yang berbeda, tetapi salah satu kota tersebut
sebagai tempat tinggal dan orang tua yang bekerja diluar kota bisa berkumpul
pada anggota keluarga pada saat akhir pekan (week-end)<br />
<i>h. Multigenerational family</i><br />
Keluarga dengan beberapa generasi atau kelompok umur yang tinggal bersama dalam
satu rumah<br />
<i>i. Kin-network family</i><br />
Beberapa keluarga inti yang tinggal dalam satu rumah atau saling berdekatan dan
saling menggunakan barang-barang dan pelayanan yang sama. Misalnya : dapur,
kamar mandi, televisi, telpon, dll)<br />
<i>j. Blended family</i><br />
Keluarga yang dibentuk oleh duda atau janda yang menikah kembali dan membesarkan
anak dari perkawinan sebelumnya<br />
<i>k. The single adult living alone / single-adult family</i><br />
Keluarga yang terdiri dari orang dewasa yang hidup sendiri karena pilihannya
atau perpisahan (separasi), seperti : perceraian atau ditinggal mati</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">2. NON-TRADISIONAL :</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"><br />
<i>a. The unmarried teenage mother</i><br />
Keluarga yang terdiri dari orang tua (terutama ibu) dengan anak dari hubungan
tanpa nikah<br />
<i>b. The stepparent family</i><br />
Keluarga dengan orangtua tiri<br />
<i>c. Commune family</i><br />
Beberapa pasangan keluarga (dengan anaknya) yang tidak ada hubungan saudara,
yang hidup bersama dalam satu rumah, sumber dan fasilitas yang sama, pengalaman
yang sama, sosialisasi anak dengan melalui aktivitas kelompok / membesarkan
anak bersama<br />
<i>d. The nonmarital heterosexual cohabiting family</i><br />
Keluarga yang hidup bersama berganti-ganti pasangan tanpa melalui pernikahan<br />
<i>e. Gay and lesbian families</i><br />
Seseorang yang mempunyai persamaan sex hidup bersama sebagaimana pasangan
suami-istri (marital partners)<br />
<i>f. Cohabitating couple</i><br />
Orang dewasa yang hidup bersama diluar ikatan perkawinan karena beberapa alasan
tertentu<br />
<i>g. Group-marriage family</i><br />
Beberapa orang dewasa yang menggunakan alat-alat rumah tangga bersama, yang
merasa telah saling menikah satu dengan yang lainnya, berbagi sesuatu, termasuk
sexual dan membesarkan anaknya<br />
<i>h. Group network family</i><br />
Keluarga inti yang dibatasi oleh set aturan/nilai-nilai, hidup berdekatan satu
sama lain dan saling menggunakan barang-barang rumah tangga bersama, pelayanan
dan bertanggung jawab membesarkan anaknya<br />
<i>i. Foster family</i><br />
Keluarga menerima anak yang tidak ada hubungan keluarga/saudara dalam waktu
sementara, pada saat orangtua anak tersebut perlu mendapatkan bantuan untuk
menyatukan kembali keluarga yang aslinya<br />
<i>j. Homeless family</i><br />
Keluarga yang terbentuk dan tidak mempunyai perlindungan yang permanen karena
krisis personal yang dihubungkan dengan keadaan ekonomi dan atau problem
kesehatan mental<br />
<i>k. Gang</i><br />
Sebuah bentuk keluarga yang destruktif, dari orang-orang muda yang mencari
ikatan emosional dan keluarga yang mempunyai perhatian, tetapi berkembang dalam
kekerasan dan kriminal dalam kehidupannya.</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">PERANAN KELUARGA</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Peranan keluarga menggambarkan seperangkat perilaku
interpersonal, sifat, kegiatan, yang berhubungan dengan individu dalam posisi
dan situasi tertentu. Peranan individu dalam keluarga didasari oleh harapan dan
pola perilaku dari keluarga, kelompok dan masyarakat.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Berbagai peranan yang terdapat di dalam keluarga
adalah sebagai berikut :</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1. Peranan ayah :<br />
Ayah sebagai suami dari istri, berperanan sebagai pencari nafkah, pendidik, pelindung,
dan pemberi rasa aman, sebagai kepala keluarga, sebagai anggota dari kelompok
sosialnya, serta sebagai anggota masyarakat dari lingkungannya</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">2. Peranan ibu :<br />
Sebagai istri dan ibu dari anak-anaknya, ibu mempunyai peranan untuk mengurus
rumah tangga, sebagai pengasuh dan pendidik anak-anaknya, pelindung dan sebagai
salah satu kelompok dari peranan sosialnya, serta sebagai anggota masyarakat
dari lingkungannya, disamping itu juga dapat berperan sebagai pencari nafkah
tambahan dalam keluarganya.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">3. Peranan anak :<br />
Anak-anak melaksanakan peranan psiko-sosial sesuai dengan tingkat
perkembangannya, baik fisik, mental, sosial dan spiritual.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">FUNGSI KELUARGA</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1. Fungsi biologis :<br />
a. Meneruskan keturunan<br />
b. Memelihara dan membesarkan anak<br />
c. Memenuhi kebutuhan gizi keluarga<br />
d. Memelihara dan merawat anggota keluarga</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">2. Fungsi Psikologis :<br />
a. Memberikan kasih sayang dan rasa aman<br />
b. Memberikan perhatian di antara anggota keluarga<br />
c. Membina pendewasaan kepribadian anggota keluarga<br />
d. Memberikan identitas keluarga</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">3. Fungsi sosialisasi :<br />
a. Membina sosialisasi pada anak<br />
b. Membentuk norma-norma tingkah laku sesuai dengan tingkat perkembangan anak<br />
c. Meneruskan nilai-nilai budaya keluarga</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">4. Fungsi ekonomi :<br />
a. Mencari sumber-sumber penghasilan untuk memenuhi kebutuhan keluarga<br />
b. Pengaturan penggunaan penghasilan keluarga untuk memenuhi kebutuhan keluarga<br />
c. Menabung untuk memenuhi kebutuhan-kebutuhan keluarga di masa yang akan
datang (pendidikan, jaminan hari tua)</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">5. Fungsi pendidikan :<br />
a. Menyekolahkan anak untuk memberikan pengetahuan, ketrampilan dan membentuk
perilaku anak sesuai dengan bakat dan minat yang dimilikinya<br />
b. Mempersiapkan anak untuk kehidupan dewasa yang akan datang dalam memenuhi
peranannya sebagai orang dewasa<br />
c. Mendidik anak sesuai dengan tingkat-tingkat perkembangannya.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">TAHAP-TAHAP KEHIDUPAN / PERKEMBANGAN KELUARGA</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Meskipun setiap keluarga melalui tahapan
perkembangannya secara unik, namun secara umum seluruh keluarga mengikuti pola
yang sama (Rodgers cit Friedman, 1998) :</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1. Pasangan baru (keluarga baru)<br />
Keluarga baru dimulai saat masing-masing individu laki-laki dan perempuan
membentuk keluarga melalui perkawinan yang sah dan meninggalkan (psikologis)
keluarga masing-masing :<br />
a. Membina hubungan intim yang memuaskan<br />
b. Membina hubungan dengan keluarga lain, teman, kelompok sosial<br />
c. Mendiskusikan rencana memiliki anak</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">2. Keluarga child-bearing (kelahiran anak pertama)<br />
Keluarga yang menantikan kelahiran, dimulai dari kehamilan samapi kelahiran
anak pertama dan berlanjut damapi anak pertama berusia 30 bulan :<br />
a. Persiapan menjadi orang tua<br />
b. Adaptasi dengan perubahan anggota keluarga, peran, interaksi, hubungan
sexual dan kegiatan keluarga<br />
c. Mempertahankan hubungan yang memuaskan dengan pasangan</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">3. Keluarga dengan anak pra-sekolah<br />
Tahap ini dimulai saat kelahiran anak pertama (2,5 bulan) dan berakhir saat
anak berusia 5 tahun :<br />
a. Memenuhi kebutuhan anggota keluarga, seperti kebutuhan tempat tinggal,
privasi dan rasa aman<br />
b. Membantu anak untuk bersosialisasi<br />
c. Beradaptasi dengan anak yang baru lahir, sementara kebutuhan anak yang lain
juga harus terpenuhi<br />
d. Mempertahankan hubungan yang sehat, baik di dalam maupun di luar keluarga
(keluarga lain dan lingkungan sekitar)<br />
e. Pembagian waktu untuk individu, pasangan dan anak (tahap yang paling repot)<br />
f. Pembagian tanggung jawab anggota keluarga<br />
g. Kegiatan dan waktu untuk stimulasi tumbuh dan kembang anak</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">4. Keluarga dengan anak sekolah<br />
Tahap ini dimulai saat anak masuk sekolah pada usia enam tahun dan berakhir
pada usia 12 tahun. Umumnya keluarga sudah mencapai jumlah anggota keluarga
maksimal, sehingga keluarga sangat sibuk :<br />
a. Membantu sosialisasi anak : tetangga, sekolah dan lingkungan<br />
b. Mempertahankan keintiman pasangan<br />
c. Memenuhi kebutuhan dan biaya kehidupan yang semakin meningkat, termasuk
kebutuhan untuk meningkatkan kesehatan anggota keluarga</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">5. Keluarga dengan anak remaja<br />
Dimulai pada saat anak pertama berusia 13 tahun dan biasanya berakhir sampai
6-7 tahun kemudian, yaitu pada saat anak meninggalkan rumah orangtuanya. Tujuan
keluarga ini adalah melepas anak remaja dan memberi tanggung jawab serta
kebebasan yang lebih besar untuk mempersiapkan diri menjadi lebih dewasa :<br />
a. Memberikan kebebasan yang seimbang dengan tanggung jawab, mengingat remaja
sudah bertambah dewasa dan meningkat otonominya<br />
b. Mempertahankan hubungan yang intim dalam keluarga<br />
c. Mempertahankan komunikasi terbuka antara anak dan orangtua. Hindari
perdebatan, kecurigaan dan permusuhan<br />
d. Perubahan sistem peran dan peraturan untuk tumbuh kembang keluarga</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">6. Keluarga dengan anak dewasa (pelepasan)<br />
Tahap ini dimulai pada saat anak pertama meninggalkan rumah dan berakhir pada
saat anak terakhir meninggalkan rumah. Lamanya tahap ini tergantung dari jumlah
anak dalam keluarga, atau jika ada anak yang belum berkeluarga dan tetap
tinggal bersama orang tua :<br />
a. Memperluas keluarga inti menjadi keluarga besar<br />
b. Mempertahankan keintiman pasangan<br />
c. Membantu orangtua suami/istri yang sedang sakit dan memasuki masa tua<br />
d. Membantu anak untuk mandiri di masyarakat<br />
e. Penataan kembali peran dan kegiatan rumah tangga</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">7. Keluarga usia pertengahan<br />
Tahap ini dimulai pada saat anak yang terakhir meninggalkan rumah dan berakhir
saat pensiun atau salah satu pasangan meninggal :<br />
a. Mempertahankan kesehatan<br />
b. Mempertahankan hubungan yang memuaskan dengan teman sebaya dan anak-anak<br />
c. Meningkatkan keakraban pasangan</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">8. Keluarga usia lanjut<br />
Tahap terakhir perkembangan keluarga ini dimulai pada saat salah satu pasangan
pensiun, berlanjut saat salah satu pasangan meninggal damapi keduanya meninggal
:<br />
a. Mempertahankan suasana rumah yang menyenangkan<br />
b. Adaptasi dengan peruabahan kehilangan pasangan, teman, kekuatan fisik dan
pendapatan<br />
c. Mempertahankan keakraban suami istri dan saling merawat<br />
d. Mempertahankan hubungan dengan anak dan sosial masyarakat<br />
e. Melakukan life review (merenungkan hidupnya).</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">PERAWATAN KESEHATAN KELUARGA</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Perawatan kesehatan keluarga adalah tingkat perawatan
kesehatan masyarakat yang ditujukan atau dipusatkan pada keluarga sebagai unit
atau kesatuan yang dirawat, dengan sehat sebagai tujuan melalui perawatan
sebagai saran/penyalur.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Alasan Keluarga sebagai Unit Pelayanan :<br />
1. Keluarga sebagai unit utama masyarakat dan merupakan lembaga yang menyangkut
kehidupan masyarakat<br />
2. Keluarga sebagai suatu kelompok dapat menimbulkan, mencegah, mengabaikan
atau memperbaiki masalah-masalah kesehatan dalam kelompoknya<br />
3. Masalah-masalah kesehatan dalam keluarga saling berkaitan, dan apabila salah
satu angota keluarga mempunyai masalah kesehatan akan berpengaruh terhadap
anggota keluarga lainnya<br />
4. Dalam memelihara kesehatan anggota keluarga sebagai individu (pasien),
keluarga tetap berperan sebagai pengambil keputusan dalam memelihara kesehatan
para anggotanya<br />
5. Keluarga merupakan perantara yang efektif dan mudah untuk berbagai upaya
kesehatan masyarakat.</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Tujuan Perawatan Kesehatan Keluarga</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"><br />
1. Tujuan umum :<br />
Meningkatkan kemampuan keluarga dalam memelihara kesehatan keluarga mereka,
sehingga dapat meningkatkan status kesehatan keluarganya<br />
2. Tujuan khusus :<br />
a. Meningkatkan kemampuan keluarga dalam mengidentifikasi masalah kesehatan
yang dihadapi oleh keluarga<br />
b. Meningkatkan kemampuan keluarga dalam menanggulangi masalah-masalah
kesehatan dasar dalam keluarga<br />
c. Meningkatkan kemampuan keluarga dalam mengambil keputusan yang tepat dalam
mengatasi masalah kesehatan para anggotanya<br />
d. Meningkatkan kemampuan keluarga dalam memberikan asuhan keperawatan terhadap
anggota keluarga yang sakit dan dalam mengatasi masalah kesehatan anggota
keluarganya<br />
e. Meningkatkan produktivitas keluarga dalam meningkatkan mutu hidupnya</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Tugas-tugas Keluarga dalam Bidang Kesehatan</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"><br />
Untuk dapat mencapai tujuan asuhan keperawatan kesehatan keluarga, keluarga
mempunyai tugas dalam pemeliharaan kesehatan para anggotanya dan saling
memelihara. Freeman (1981) :<br />
1. Mengenal gangguan perkembangan kesehatan setiap anggota keluarga<br />
2. Mengambil keputusan untuk melakukan tindakan yang tepat<br />
3.Memberikan keperawatan kepada anggota keluarganya yang sakit, dan yang tidak
dapat membantu dirinya sendiri karena cacat atau usaianya yang terlalu muda<br />
4. Mempertahankan suasana di rumah yang menguntungkan kesehatan dan
perkembangan kepribadian anggota keluarga<br />
5. Mempertahankan hubungan timbal balik antara keluarga dan lembaga-lembaga
kesehatan, yang menunjukkan pemanfaatan dengan baik fasilitas-fasilitas
kesehatan yang ada.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Peran Perawat Keluarga :</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"></span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1. Pendidik<br />
Perawat perlu memberikan pendidikan kesehatan kepada keluarga agar :<br />
a. Keluarga dapat melakukan program asuhan kesehatan keluarga secara mandiri<br />
b. Bertanggung jawab terhadap masalah kesehatan keluarga</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">2. Koordinator<br />
Diperlukan pada perawatan berkelanjutan agar pelayanan yang komprehensif dapat
tercapai. Koordinasi juga sangat diperlukan untuk mengatur program kegiatan
atau terapi dari berbagai disiplin ilmu agar tidak terjadi tumpang tindih dan
pengulangan</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">3. Pelaksana<br />
Perawat yang bekerja dengan klien dan keluarga baik di rumah, klinik maupun di
rumah sakit bertanggung jawab dalam memberikan perawatan langsung. Kontak
pertama perawat kepada keluarga melalui anggota keluarga yang sakit. Perawat
dapat mendemonstrasikan kepada keluarga asuhan keperawatan yang diberikan
dengan harapan keluarga nanti dapat melakukan asuhan langsung kepada anggota
keluarga yang sakit</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">4. Pengawas kesehatan<br />
Sebagai pengawas kesehatan, perawat harus melakukan home visite atau kunjungan
rumah yang teratur untuk mengidentifikasi atau melakukan pengkajian tentang
kesehatan keluarga</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">5. Konsultan<br />
Perawat sebagai narasumber bagi keluarga di dalam mengatasi masalah kesehatan.
Agar keluarga mau meminta nasehat kepada perawat, maka hubungan
perawat-keluarga harus dibina dengan baik, perawat harus bersikap terbuka dan
dapat dipercaya</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">6. Kolaborasi<br />
Perawat komunitas juga harus bekerja dama dengan pelayanan rumah sakit atau
anggota tim kesehatan yang lain untuk mencapai tahap kesehatan keluarga yang
optimal</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">7. Fasilitator<br />
Membantu keluarga dalam menghadapi kendala untuk meningkatkan derajat
kesehatannya. Agar dapat melaksanakan peran fasilitator dengan baik, maka
perawat komunitas harus mengetahui sistem pelayanan kesehatan (sistem rujukan,
dana sehat, dll)</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">8. Penemu kasus<br />
Mengidentifikasi masalah kesehatan secara dini, sehingga tidak terjadi ledakan
atau wabah</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">9. Modifikasi lingkungan<br />
Perawat komunitas juga harus dapat mamodifikasi lingkungan, baik lingkungan
rumah maupun lingkungan masyarakat, agar dapat tercipta lingkungan yang sehat.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Prinsip-prinsip Perawatan Keluarga :</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Keluarga sebagai unit atau satu kesatuan dalam pelayanan kesehatan</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Dalam memberikan asuhan perawatan kesehatan keluarga, sehat sebagai
tujuan utama</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Asuhan keperawatan yang diberikan sebagai sarana dalam mencapai
peningkatan kesehatan keluarga</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Dalam memberikan asuhan keperawatan kesehatan keluarga, perawat
melibatkan peran serta keluarga dalam mengatasi masalah kesehatannya</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Lebih mengutamakan kegiatan-kegiatan yang bersifat promotif dan
preventif dengan tidak mengabaikan upaya kuratif dan rehabilitatif</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Dalam memberikan asuhan keperawatan kesehatan keluarga memanfaatkan
sumber daya keluarga semaksimal mungkin untuk kepentingan kesehatan
keluarga</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Sasaran asuhan perawatan kesehatan keluarga adalah keluarga secara
keseluruhan</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Pendekatan yang digunakan dalam memberikan asuhan keperawatan
kesehatan keluarga adalah pendekatan pemecahan masalah dengan menggunakan
proses keperawatan</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Kegiatan utama dalam memberikan asuhan keperawatan kesehatan keluarga
adalah penyuluhan kesehatan dan asuhan perawatan kesehatan dasar/perawatan
di rumah</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Diutamakan terhadap keluarga yang termasuk resiko tinggi.</span></li>
</ol>
<div class="MsoNormal">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;">*Sumber : http://yenibeth.wordpress.com</span></i></div>
Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-62211771641652780372012-07-22T07:23:00.003-07:002012-08-08T05:04:39.797-07:00ASKEP SECTIO CAESARIA (SC)
<br />
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><span style="font-size: 14.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">ASUHAN KEPERAWATAN</span></b></div>
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Seksio Sesaria</span></b></div>
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">A. Pengertian Sectio Caesaria (Seksio Sesaria)</span></b><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
Ada beberapa pengertian mengenai sectio caesaria :<br />
<a href="http://nursingbegin.com/askep-sectio-caesarea/" target="_blank" title="askep sectio caesaria"><b><span style="color: windowtext;">Sectio caesaria</span></b></a>
adalah suatu cara melahirkan janin dengan sayatan pada dinding uterus melalui
dinding depan perut. (Rustam Mochtar, 1992).<br />
Sectio caesaria adalah suatu persalinan buatan dimana janin dilahirkan melalui
suatu insisi pada dinding depan perut dan dinding rahim dengan syarat rahim
dalam keadaan utuh serta berat janin di atas 500 gram (Sarwono, 1991).<br />
Jadi operasi Seksio Sesaria ( sectio caesarea ) adalah suatu pembedahan guna
melahirkan janin ( persalinan buatan ), melalui insisi pada dinding abdomen dan
uterus bagian depan sehingga janin dilahirkan melalui perut dan dinding perut
dan dinding rahim agar anak lahir dengan keadaan utuh dan sehat.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
<b>B. Indikasi Sectio Caesaria</b><br />
Operasi sectio caesarea dilakukan jika kelahiran pervaginal mungkin akan
menyebabkan resiko pada ibu ataupun pada janin, dengan pertimbangan hal-hal
yang perlu tindakan SC proses persalinan normal lama/ kegagalan proses
persalinan normal ( Dystasia )<br style="mso-special-character: line-break;" />
<br style="mso-special-character: line-break;" />
</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Indikasi sectio caesaria pada Ibu </span></b><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
Disproporsi cevalo-pelvik ( ketidakseimbangan antar ukuran kepala dan panggul )<br />
Disfungsi uterus<br />
Distosia jaringan lunak<br />
Plasenta previa<br />
His lemah / melemah<br />
Rupture uteri mengancam<br />
Primi muda atau tua<br />
Partus dengan komplikasi<br />
Problema plasenta<br style="mso-special-character: line-break;" />
<br style="mso-special-character: line-break;" />
</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Indikasi Sectio Caesaria Pada Anak</span></b><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
Janin besar<br />
Gawat janin<br />
Janin dalam posisi sungsang atau melintang<br />
Fetal distress<br />
Kalainan letak<br />
Hydrocephalus<br style="mso-special-character: line-break;" />
<br style="mso-special-character: line-break;" />
</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3. Kontra Indikasi Sectio Caesaria : </span></b><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
Pada umumnya sectio caesarian tidak dilakukan pada janin mati, <a href="http://nursingbegin.com/klasifikasi-syok/" target="_blank" title="klasifikasi syok"><span style="color: windowtext;">syok</span></a>, anemi
berat sebelum diatasi, kelainan kongenital berat (Sarwono, 1991)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
<b>C. Jenis – Jenis Operasi Sectio Caesarea </b><br />
<b>1. Abdomen (sectio caesarea abdominalis)</b><br />
<b>a. Sectio caesarea transperitonealis</b><br />
SC klasik atau corporal (dengan insisi memanjang pada corpus uteri)<br />
Dilakukan dengan membuat sayatan memanjang pada korpus uteri kira-kira 10 cm.<br />
Kelebihan :</span></div>
<ul type="disc">
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Mengeluarkan janin dengan cepat</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tidak mengakibatkan komplikasi kandung kemih tertarik</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Sayatan bisa diperpanjang proksimal atau distal</span></li>
</ul>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kekurangan</span></div>
<ul type="disc">
<li class="MsoNormal" style="line-height: normal; mso-list: l3 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Infeksi mudah menyebar secara intra abdominal karena tidak ada
reperitonealis yang baik</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l3 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Untuk persalinan yang berikutnya lebih sering terjadi rupture uteri
spontan</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l3 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">SC ismika atau profundal (low servical dengan insisi pada segmen bawah
rahim)</span></li>
</ul>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">b.</span></b><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> <b>SC ektra
peritonealis</b> yaitu tanpa membuka peritoneum parietalis dengan demikian
tidak membuka cavum abdominal<br />
Dilakukan dengan melakukan sayatan melintang konkat pada segmen bawah rahim
(low servical transversal) kira-kira 10 cm<br />
Kelebihan :</span></div>
<ul type="disc">
<li class="MsoNormal" style="line-height: normal; mso-list: l1 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Penjahitan luka lebih mudah</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l1 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Penutupan luka dengan reperitonealisasi yang baik</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l1 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tumpang tindih dari peritoneal flap baik sekali untuk menahan
penyebaran isi uterus ke rongga peritoneum</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l1 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><a href="http://nursingbegin.com/penatalaksanaan-syok-hipovolemik/" target="_blank" title="syok hipovolemik"><span style="color: windowtext;">Perdarahan
</span></a>tidak begitu banyak</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l1 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kemungkinan rupture uteri spontan berkurang atau lebih kecil</span></li>
</ul>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kekurangan :</span></div>
<ul type="disc">
<li class="MsoNormal" style="line-height: normal; mso-list: l2 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Luka dapat melebar kekiri, kanan, dan bawah sehingga dapat menyebabkan
uteri pecah sehingga mengakibatkan perdarahan banyak</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l2 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Keluhan pada <a href="http://nursingbegin.com/prosedur-kateterisasi-urine-pada-wanita/" target="_blank" title="kateterisasi urine wanita"><span style="color: windowtext;">kandung
kemih</span></a> post operasi tinggi</span></li>
</ul>
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caesarea vaginalis)</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
Menurut sayatan pada rahim, sectio caesarea dapat dilakukan sebagai berikut<b> </b>(Mochtar,
Rustam, 1992) <b>:</b><br />
1. Sayatan memanjang ( longitudinal )<br />
2. Sayatan melintang ( Transversal )<br />
3. Sayatan huruf T ( T insicion )</span></div>
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<b>D. Prognosis Operasi Sectio Caesarea</b><br />
<b>Pada Ibu</b><br />
Dulu angka morbiditas dan mortalitas untuk ibu dan janin tinggi. Pada masa
sekarang oleh karena kemajuan yang pesat dalam tehnik operasi, anestesi,
penyediaan cairan dan darah, indikasi dan <a href="http://nursingbegin.com/prinsip-enam-benar-dalam-pemberian-obat/" target="_blank" title="prinsip enam benar dalam pemberian obat"><span style="color: windowtext;">antibiotika </span></a>angka ini sangat menurun.<br />
Angka kematian ibu pada rumah-rumah sakit dengan fasilitas operasi yang baik
dan oleh tenaga – tenaga yang cekatan adalah kurang dari 2 per 1000.<br />
<b>Pada anak</b><br />
Seperti halnya dengan ibunya, nasib anak yang dilahirkan dengan sectio caesaria
banyak tergantung dari keadaan yang menjadi alasan untuk melakukan sectio
caesaria. Menurut statistik di negara – negara dengan pengawasan antenatal dan
intra natal yang baik, kematian perinatal pasca sectio caesaria berkisar antara
4 hingga 7 %. (Sarwono, 1999).</span></div>
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<b>E. Komplikasi Operasi Sectio Caesarea</b><br />
Kemungkinan yang timbul setelah dilakukan operasi ini antara lain :<br />
1. Infeksi puerperal ( Nifas )<br />
- Ringan, dengan suhu meningkat dalam beberapa hari<br />
- Sedang, <a href="http://nursingbegin.com/gangguan-pengaturan-suhu-tubuh/" target="_blank" title="gangguan pengaturan suhu tubuh"><span style="color: windowtext;">suhu
meningkat</span></a> lebih tinggi disertai dengan dehidrasi dan perut sedikit
kembung<br />
- Berat, peritonealis, sepsis dan usus paralitik<br />
2. Perdarahan<br />
- Banyak pembuluh darah yang terputus dan terbuka<br />
- Perdarahan pada plasenta bed<br />
3. Luka kandung kemih, emboli paru dan keluhan kandung kemih bila
peritonealisasi terlalu tinggi<br />
4. Kemungkinan rupture tinggi spontan pada kehamilan berikutnya</span></div>
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<b>F. Pemeriksaan Diagnostik</b><br />
Pemantauan janin terhadap kesehatan janin<br />
Pemantauan EKG<br />
JDL dengan diferensial<br />
Elektrolit<br />
Hemoglobin/Hematokrit<br />
Golongan darah<br />
Urinalisis<br />
Amniosentesis terhadap maturitas paru janin sesuai indikasi<br />
Pemeriksaan sinar x sesuai indikasi.<br />
Ultrasound sesuai pesanan<br />
(Tucker, Susan Martin, 1998)</span></div>
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<b>G. Asuhan Keperawatan Sektio Caesaria</b><br />
<b><i style="mso-bidi-font-style: normal;">1. Devisit Volume Cairan b.d
Perdarahan </i></b><br />
Tujuan: Tidak terjadi devisit volume cairan, seimbang antara intake dan<br />
output baik jumlah maupun kualitas.<br />
Intervensi:<br />
a.Kaji kondisi status hemodinamika.<br />
R/ Pengeluaran cairan akibat operasi yang berlebih merupakan faktor utama
masalah.<br />
b.Ukur pengeluaran harian.<br />
R/ Jumlah cairan ditentukan dari jumlah kebutuhan harian ditambah dengan jumlah
cairan yang hilang selama masa post operasi dan harian.<br />
c.Berikan sejumlah cairan pengganti harian.<br />
R/ Tranfusi mungkin diperlukan pada kondisi perdarahan masif.<br />
d.Evaluasi status hemodinamika.<br />
R/ Penilaian dapat dilakukan secara harian melalui pemeriksaan fisik.</span></div>
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<b><i style="mso-bidi-font-style: normal;">2. Gangguan Aktivitas b.d kelemahan,
penurunan sirkulasi</i></b><br />
Tujuan: Kllien dapat melakukan aktivitas tanpa adanya komplikasi<br />
Intervensi:<br />
a.Kaji tingkat kemampuan klien untuk beraktivitas.<br />
R/ Mungkin klien tidak mengalami perubahan berarti, tetapi perdarahan masif
perlu diwaspadai untuk menccegah kondisi klien lebih buruk.<br />
b.Kaji pengaruh aktivitas terhadap kondisi luka dan kondisi tubuh umum.<br />
R/ Aktivitas merangsang peningkatan vaskularisasi dan pulsasi organ reproduksi,
tetapi dapat mempengaruhi kondisi luka post operasi dan berkurangnya energi.<br />
c.Bantu klien untuk memenuhi kebutuhan aktivitas sehari-hari.<br />
R/ Mengistiratkan klien secara optimal.<br />
d.Bantu klien untuk melakukan tindakan sesuai dengan kemampuan/kondisi klien.<br />
R/ Mengoptimalkan kondisi klien, pada abortus imminens, istirahat mutlak sangat
diperlukan.<br />
e.Evaluasi perkembangan kemampuan klien melakukan aktivitas.<br />
R/ Menilai kondisi umum klien.</span></div>
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<b><i style="mso-bidi-font-style: normal;">3. Gangguan rasa nyaman : Nyeri b.d
luka post operasi</i></b><i style="mso-bidi-font-style: normal;"><br />
</i>Tujuan: Klien dapat beradaptasi dengan nyeri yang dialami.<br />
Intervensi:<br />
a.Kaji kondisi nyeri yang dialami klien.<br />
R/ Pengukuran nilai ambang nyeri dapat dilakukan dengan skala<br />
maupun dsekripsi.<br />
b.Terangkan nyeri yang diderita klien dan penyebabnya.<br />
R/ Meningkatkan koping klien dalam melakukan guidance mengatasi nyeri.<br />
c.Ajarkan teknik distraksi.<br />
R/ Pengurangan persepsi nyeri.<br />
d.Kolaborasi pemberian <a href="http://nursingbegin.com/prinsip-enam-benar-dalam-pemberian-obat/" target="_blank" title="prinsip enam benar dalam pemberian obat"><span style="color: windowtext;">analgetika</span></a>.<br />
R/ Mengurangi onset terjadinya nyeri dapat dilakukan dengan pemberian analgetika
oral maupun sistemik dalam spectrum luas/spesifik.</span></div>
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<b><i style="mso-bidi-font-style: normal;">4. Resiko tinggi Infeksi b.d
perdarahan, luka post operasi.</i> </b><br />
Tujuan: Tidak terjadi infeksi selama perawatan perdarahan dan luka<br />
operasi.<br />
Intervensi:<br />
a.Kaji kondisi keluaran/dischart yang keluar ; jumlah, warna, dan bau dari luka
operasi.<br />
R/ Perubahan yang terjadi pada dischart dikaji setiap saat dischart keluar.
Adanya warna yang lebih gelap disertai bau tidak enak mungkin merupakan tanda
infeksi.<br />
b.Terangkan pada klien pentingnya perawatan luka selama masa post operasi.<br />
R/ Infeksi dapat timbul akibat kurangnya kebersihan luka.<br />
c.Lakukan pemeriksaan biakan pada dischart.<br />
R/ Berbagai kuman dapat teridentifikasi melalui dischart.<br />
d.Lakukan perawatan luka.<br />
R/ Inkubasi kuman pada area luka dapat menyebabkan infeksi.<br />
e.Terangkan pada klien cara mengidentifikasi tanda inveksi.<br />
R/ Berbagai manivestasi klinik dapat menjadi tanda nonspesifik infeksi; demam
dan peningkatan rasa nyeri mungkin merupakan gejala infeksi.</span></div>
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<b>Daftar Pustaka</b><br />
Allen, Carol Vestal, (1998) Memahami Proses Keperawatan, Penerbit Buku
Kedokteran, EGC, Jakarta.<br />
Betz Cecily L, Sowden Linda A. (2002). Buku Saku Keperawatan Pediatri. Jakarta
: EGC.<br />
Carpenito L. J, 2001, Diagnosa keperawatan, Jakarta : EGC<br />
Doengoes, M E, 2000, Rencana Askep pedoman untuk perencanaan dan
pendokumentasian perawatan pasien, Jakarta : EGC<br />
Hamilton, Persis Mary,(1995) Dasar-Dasar Keperawatan Maternitas, Edisi 6, EGC.
Jakarta.<br />
Ibrahim S. Cristina,(1993) Perawatan Kebidanan, Bratara Jakarta.<br />
Manuaba, Ida Bagus Gde, (1998), Ilmu Kebidanan, Penyakit Kandungan dan Keluarga
Berencana, EGC. Jakarta.<br />
Martius, Gerhard, (1997), Bedah Kebidanan Martius, Penerbit Buku Kedokteran
EGC, Jakarta.<br />
Muchtar, Rustam,(1998), Sinopsis Obstetri, Edisi 2, Jilid 1, EGC. Jakarta.<br />
Ngastiyah.( 1997 ). Perawatan Anak Sakit Jakarta : EGC<br />
Prawirohardjo, S. 2000. Buku acuan nasional pelayanan kesehatan maternal dan<br />
neonatal. Jakarta: Yayasan Bina Pustaka<br />
Sacharin Rosa M. (1996). Prinsip Keperawatan Pediatrik. Alih bahasa : Maulanny
R.F. Jakarta : EGC.<br />
Sarwono Prawiroharjo,(1999)., Ilmu Kebidanan, Edisi 2 Cetakan II Yayasan Bina
Pustaka Sarwono Prawirohardjo. Jakarta.<br />
Tucker, Susan Martin, (1998), Standar Perawatan Pasien, Edisi 5, Volume 4,
Penerbit Buku Kedokteran, EGC. Jakarta.<br />
Winkjosastro, Hanifa, 2005, Ilmu Kebidanan, Jakarta : Yayasan Bina Pustaka</span></div>
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<i style="mso-bidi-font-style: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Sumber: hanifsakala.blogspot.com</span></i></div>
Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-87215390655678618922012-07-22T06:54:00.001-07:002012-08-08T05:10:11.821-07:00ASKEP SINDROM STEVEN JOHNSON<br />
<div align="center" style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri","sans-serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Asuhan Keperawatan</span></b></div>
<div align="center" style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri","sans-serif"; font-size: 14.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Sindrom Steven Johnson</span></b></div>
<div style="line-height: 115%;">
<br /></div>
<div style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">A. Pengertian</span></b><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
• Sindrom Steven Johnson adalah sindrom yang mengenai kulit, selaput lendir di
orifisium dan mata dengan keadaan umum bervariasi dan ringan sampai berat,
kelainan pada kulit berupa eritema, vesikel atau bula dapat disertai purpura
(Djuanda, 1993: 127).<br />
• Sindrom Steven Johnson adalah penyakit kulit akut dan berat yang terdiri dari
erupsi kulit, kelainan dimukosa dan konjungtifitis (Junadi, 1982: 480).<br />
• Sindrom Steven Johnson adalah sindrom kelainan kulit berupa eritema,
vesikel/bula, dapat disertai purpura yang mengenai kulit, selaput lendir yang
orifisium dan mata dengan keadaan umum bervariasi dari baik sampai buruk
(Mansjoer, A. 2000: 136).</span></div>
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<b style="mso-bidi-font-weight: normal;">B. Etiologi</b><br />
Penyebab belum diketahui dengan pasti, namun beberapa faktor yang dapat
dianggap sebagai penyebab adalah:<br />
1. Alergi obat secara sistemik<br />
a. penisilin, analgetik, arti piuretik<br />
b. Penisilline dan semisentetiknya<br />
c. Sthreptomicine<br />
d. Sulfonamida<br />
e. Tetrasiklin<br />
f. Anti piretik atau analgesik (derifat, salisil/pirazolon, metamizol,
metampiron dan paracetamol)<br />
g. Kloepromazin<br />
h. Karbamazepin<br />
i. Kirin Antipirin<br />
j. Tegretol<br />
2. Infeksi mikroorganisme (bakteri, virus, jamur dan parasit)<br />
3. Neoplasma dan faktor endokrin<br />
4. Faktor fisik (sinar matahari, radiasi, sinar-X)</span></div>
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<b style="mso-bidi-font-weight: normal;">C. Manefestasi klinis</b><br />
Sindrom ini jarang dijumpai pada usia 3 tahun kebawah. Keadaan umumnya
bervariasi dari ringan sampai berat. Pada yang berat kesadarannya menurun,
penderita dapat soporous sampai koma. Mulainya penyakit akut dapat disertai
gejala prodromal berupa demam tinggi, malaise, nyeri kepala, batuk, pilek dan
nyeri tenggorokan.</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Pada sindrom ini terlihat adanya trias kelainan berupa:<br />
1. Kelainan kulit<br />
Kelainan kulit terdiri dari eritema, vesikel dan bula. Vesikel dan bula kemudian
memecah sehingga terjadi erosi yang luas. Disamping itu dapat juga terjadi
purpura. Pada bentuk yang berat kelainannya generalisata.<br />
2. Kelainan selaput lendir di orifisium<br />
Kelainan selaput lendir yang tersering ialah pada mukosa mulut (100%) kemudian
disusul oleh kelainan dilubang alat genetal (50%) sedangkan dilubang hidung dan
anus jarang (masing-masing 8% dan 4%).<br />
3. Kelainan berupa vesikel dan bula yang cepat memecah sehingga menjadi erosi
dan ekskoriasi dan krusta kehitaman. Juga dalam terbentuk pseudomembran.
Dibibir kelainan yang sering tampak ialah krusta berwarna hitam yang tebal.<br />
4. Kelainan dimukosa dapat juga terdapat difaring, traktus respiratorius bagian
atas dan esofagus. Stomatitis ini dapat menyebabkan penderita sukar tidak dapat
menelan. Adanya pseudomembran di faring dapat menyebabkan keluhan sukar
bernafas.<br />
5. Kelainan mata<br />
konjungitivitis (radang selaput yang melapisi permukaan dalam kelopak mata dan
bola mata), konjungtivitas kataralis , blefarokonjungtivitis, iritis, iridosiklitis,
kelopak mata edema dan sulit dibuka, pada kasus berat terjadi erosi dan
perforasi kornea yang dapat menyebabkan kebutaan. Cedera mukosa okuler
merupakan faktor pencetus yang menyebabkan terjadinya ocular cicatricial
pemphigoid, merupakan inflamasi kronik dari mukosa okuler yang menyebabkan
kebutaan. Waktu yang diperlukan mulai onset sampai terjadinya ocular
cicatricial pemphigoid bervariasi mulai dari beberapa bulan sampai 31 tahun.<br />
6. Disamping trias kelainan tersebut dapat pula terdapat kelainan lain,
misalnya: nefritis dan onikolisis.<br />
7. Gejala prodromal berkisar antara 1-14 hari berupa demam, malaise, batuk,
korizal, sakit nyeri dada, muntah, pegal otot dan atralgia yang sangat
bervariasi dalam derajat berat dan kombinasi gejala tersebut.</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<b style="mso-bidi-font-weight: normal;">D. Komplikasi</b><br />
Komplikasi yang tersering ialah bronkopneunomia yang didapati sejumlah 16 %
diantara seluruh kasus yang ada. Komplikasi yang lain ialah kehilangan cairan
atau darah, gangguan keseimbangan elektrolit dan syok. Pada mata dapat terjadi
kebutaan karena gangguan lakrimasi.</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<b style="mso-bidi-font-weight: normal;">E. Patofisiologi</b><br />
Patogenesisnya belum jelas, disangka disebabkan oleh reaksi hipersensitif tipe
III dan IV. Reaksi: </span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">tipe III
terjadi akibat terbentuknya komplek antigen antibodi yang membentuk
mikro-presitipasi sehingga terjadi aktifitas sistem komplemen. Akibatnya
terjadi akumulasi neutrofil yang kemudian melepaskan lisozim dan menyebabkan
kerusakan jaringan pada organ sasaran (target organ). Reaksi hipersentifitas
tipe IV terjadi akibat limfosit T yang tersintesisasi berkontak kembali dengan
antigen yang sama kemudian limfokin dilepaskan sehingga terjadi reaksi radang
(Djuanda, 2000: 147) .<br />
1. Reaksi Hipersensitif tipe III.<br />
Hal ini terjadi sewaktu komplek antigen antibodi yang bersirkulasi dalam darah
mengendap didalam pembuluh darah atau jaringan sebelah hilir. Antibodi tidak
ditujukan kepada jaringan tersebut, tetapi terperangkap dalam jaringan
kapilernya. Pada beberapa kasus antigen asing dapat melekat ke jaringan
menyebabkan terbentuknya kompleks antigen antibodi ditempat tersebut. Reaksi
tipe III mengaktifkan komplemen dan degranulasi sel mast sehingga terjadi
kerusakan jaringan atau kapiler ditempat terjadinya rekasi tersebut. Neutrofil
tertarik ke daerah tersebut dan mulai memfagositosis sel-sel yang rusak
sehingga terjadi pelepasan enzim-enzim sel serta penimbunan sisa sel. Hal ini
menyebabkan siklus peradangan berlanjut (Corwin, 2000: 72).<br />
2. Reaksi Hipersensitif Tipe IV<br />
Pada reaksi ini diperantarai oleh sel T, terjadi pengaktifan sel T penghasil
Limfokin atau sitotoksik oleh suatu antigen sehingga terjadi penghancuran
sel-sel yang bersangkutan. Reaksi yang diperantarai oleh sel ini bersifat
lambat (delayed) memerlukan waktu 14 jam sampai 27 jam untuk terbentuknya.</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<b style="mso-bidi-font-weight: normal;">F. Pemeriksaan diagnostik</b><br />
1. Pemeriksaan laboratorium:<br />
Tidak ada pemeriksaan labor (selain biopsi) yang dapat membantu dokter dalam
menegakkan diagnosa.<br />
2. Pemeriksaan darah lengkap (CBC) dapat menunjukkan kadar sel darah putih yang
normal atau leukositosis nonspesifik. Penurunan tajam kadar sel darah putih
dapat mengindikasikan kemungkinan infeksi bakterial berat.<br />
3. Determine renal function and evaluate urine for blood.<br />
4. Pemeriksaan elektrolit<br />
5. Kultur darah, urine, dan luka diindikasikan ketika infeksi dicurigai
terjadi.<br />
6. Pemeriksaan bronchoscopy, esophagogastro duodenoscopy (EGD), dan kolonoskopi
dapat dilakukan<br />
7. Chest radiography untuk mengindikasikan adanya pneumonitis<br />
8. Pemeriksaan histopatologi dan imonohistokimia dapat mendukung ditegakkannya
diagnosa.</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br /></span></div>
<div style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">G. Penatalaksanaan
Medis</span></b><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
1. Kortikosteroid<br />
Bila keadaan umum baik dan lesi tidak menyeluruh cukup diobati dengan
prednisone 30-40 mg sehari. Namun bila keadaan umumnya buruk dan lesi
menyeluruh harus diobati secara tepat dan cepat. Kortikosteroid merupakan
tindakan file-saving dan digunakan deksametason intravena</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">dengan dosis
permulaan 4-6 x 5 mg sehari.Umumnya masa kritis diatasi dalam beberapa hari.
Pasien steven-Johnson berat harus segera dirawat dan diberikan deksametason 6×5
mg intravena. Setelah masa krisis teratasi, keadaan umum membaik, tidak timbul
lesi baru, lesi lama mengalami involusi, dosis diturunkan secara cepat, setiap
hari diturunkan 5 mg. Setelah dosis mencapai 5 mg sehari, deksametason
intravena diganti dengan tablet kortikosteroid, misalnya prednisone yang
diberikan keesokan harinya dengan dosis 20 mg sehari, sehari kemudian
diturunkan lagi menjadi 10 mg kemudian obat tersebut dihentikan. Lama
pengobatan kira-kira 10 hari.Seminggu setelah pemberian kortikosteroid
dilakukan pemeriksaan elektrolit (K, Na dan Cl). Bila ada gangguan harus
diatasi, misalnya bila terjadi hipokalemia diberikan KCL 3 x 500 mg/hari dan
diet rendah garam bila terjadi hipermatremia. Untuk mengatasi efek katabolik
dari kortikosteroid diberikan diet tinggi protein/anabolik seperti nandrolok
dekanoat dan nanadrolon. Fenilpropionat dosis 25-50 mg untuk dewasa (dosis
untuk anak tergantung berat badan).<br />
2. Antibiotik<br />
Untuk mencegah terjadinya infeksi misalnya bronkopneumonia yang dapat
menyebabkan kematian, dapat diberi antibiotic yang jarang menyebabkan alergi,
berspektrum luas dan bersifat bakteriosidal misalnya gentamisin dengan dosis 2
x 80 mg.Infus dan tranfusi darah.<br />
3. Pengaturan keseimbangan cairan/elektrolit dan nutrisi penting karena pasien
sukar atau tidak dapat menelan akibat lesi dimulut dan tenggorokan serta
kesadaran dapat menurun. Untuk itu dapat diberikan infus misalnya glukosa 5 %
dan larutan Darrow. Bila terapi tidak memberi perbaikan dalam 2-3 hari, maka
dapat diberikan transfusi darah sebanyak 300 cc selama 2 hari berturut-turut,
terutama pada kasus yang disertai purpura yang luas.<br />
4. Pada kasus dengan purpura yang luas dapat pula ditambahkan vitamin C 500 mg
atau 1000 mg intravena sehari dan hemostatik.<br />
5. Topikal :<br />
Terapi topical untuk lesi di mulut dapat berupa kenalog in orabase. Untuk lesi
di kulit yang erosif dapat diberikan sufratulle atau krim sulfadiazine perak.</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<b style="mso-bidi-font-weight: normal;">H. Asuhan Keperawatan</b><br />
<b style="mso-bidi-font-weight: normal;">1. Pengkajian</b><br />
a. Identitas pasien<br />
• Nama;<br />
• Jenis kelamin<br />
• Umur<br />
• Status perkawinan<br />
• Pekerjaan<br />
• Agama</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">• Pendidikan
terakhir<br />
• Alamat.<br />
b. Riwayat Kesehatan lalu<br />
c. Riwayat kesehatan sekarang<br />
d. Riwayat kesehatan keluarga<br />
e. Riwayat pengobatan<br />
f. Data sosial ekonomi<br />
g. Aktifitas sehari-hari<br />
h. Pemeriksaan Fisik<br />
• Keadaan umum<br />
• Tanda-tanda Vital : suhu tubuh, tekanan darah, nadi, pernafasan.</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<b style="mso-bidi-font-weight: normal;">2. Diagnosa Keperawatan dan Intervensi</b><br />
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">a.
Gangguan integritas kulit b.d. inflamasi dermal dan epidermal</i></b><br />
KH: menunjukkan kulit dan jaringan kulit yang utuh<br />
Intervensi:<br />
• Observasi kulit setiap hari catat turgor sirkulasi dan sensori serta
perubahan<br />
lainnya yang terjadi.<br />
Rasional: menentukan garis dasar dimana perubahan pada status dapat<br />
dibandingkan dan melakukan intervensi yang tepat<br />
• Gunakan pakaian tipis dan alat tenun yang lembut<br />
Rasional: menurunkan iritasi garis jahitan dan tekanan dari baju, membiarkan
insisi terbuka terhadap udara meningkat proses penyembuhan dan<br />
menurunkan resiko infeksi<br />
• Jaga kebersihan alat tenun<br />
Rasional: untuk mencegah infeksi<br />
• Kolaborasi dengan tim medis<br />
Rasional: untuk mencegah infeksi lebih lanjut</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">b.
Gangguan nutrisi kurang dari kebutuhan tubuh b.d. kesulitan menelan</i></b><br />
KH: menunjukkan berat badan stabil/peningkatan berat badan<br />
Intervensi:<br />
• Kaji kebiasaan makanan yang disukai/tidak disukai<br />
Rasional: memberikan pasien/orang terdekat rasa kontrol, meningkatkan
partisipasi dalam perawatan dan dapat memperbaiki pemasukan<br />
• Berikan makanan dalam porsi sedikit tapi sering<br />
Rasional: membantu mencegah distensi gaster/ketidaknyamanan</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">• Hidangkan
makanan dalam keadaan hangat<br />
Rasional: meningkatkan nafsu makan<br />
• Kerjasama dengan ahli gizi<br />
Rasional: kalori protein dan vitamin untuk memenuhi peningkatan kebutuhan metabolik,
mempertahankan berat badan dan mendorong regenerasi jaringan.</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">c.
Gangguan rasa nyaman, nyeri b.d. inflamasi pada kulit</i></b><br />
KH:<br />
• Melaporkan nyeri berkurang<br />
• Menunjukkan ekspresi wajah/postur tubuh rileks<br />
Intervensi:<br />
• Kaji keluhan nyeri, perhatikan lokasi dan intensitasnya<br />
Rasional: nyeri hampir selalu ada pada beberapa derajat beratnya keterlibatan
jaringan<br />
• Berikan tindakan kenyamanan dasar ex: pijatan pada area yang sakit<br />
Rasional: meningkatkan relaksasi, menurunkan tegangan otot dan kelelahan umum<br />
• Pantau TTV<br />
Rasional: metode IV sering digunakan pada awal untuk memaksimalkan efek<br />
obat<br />
• Berikan analgetik sesuai indikasi<br />
Rasional: menghilangkan rasa nyeri</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">d.
Gangguan intoleransi aktivitas b.d. kelemahan fisik</i></b><br />
KH: klien melaporkan peningkatan toleransi aktivitas<br />
Intervensi:<br />
• Kaji respon individu terhadap aktivitas<br />
Rasional: mengetahui tingkat kemampuan individu dalam pemenuhan aktivitas
sehari-hari.<br />
• Bantu klien dalam memenuhi aktivitas sehari-hari dengan tingkat keterbatasan
yang dimiliki klien<br />
Rasional: energi yang dikeluarkan lebih optimal<br />
• Jelaskan pentingnya pembatasan energy<br />
Rasional: energi penting untuk membantu proses metabolisme tubuh<br />
• Libatkan keluarga dalam pemenuhan aktivitas klien<br />
Rasional: klien mendapat dukungan psikologi dari keluarga</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">e.
Gangguan persepsi sensori: kurang penglihatan b.d konjungtifitis</i></b><br />
KH :<br />
• Kooperatif dalam tindakan</span></div>
<div style="line-height: 115%; margin-top: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">• Menyadari hilangnya pengelihatan secara permanen<br />
Intervensi:<br />
• Kaji dan catat ketajaman pengelihatan<br />
Rasional: Menetukan kemampuan visual<br />
• Kaji deskripsi fungsional apa yang dapat dilihat/tidak.<br />
Rasional: Memberikan keakuratan terhadap penglihatan dan perawatan.<br />
• Sesuaikan lingkungan dengan kemampuan pengelihatan:<br />
Rasional: Meningkatkan self care dan mengurangi ketergantungan.<br />
• Orientasikan terhadap lingkungan.<br />
Rasional: Mengenal keadaan lingkungan.<br />
• Kaji jumlah dan tipe rangsangan yang dapat diterima klien.<br />
Rasional: Meningkatkan rangsangan pada waktu kemampuan penglihatan menurun.</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">DAFTAR PUSTAKA<br />
• Corwin, Elizabeth. J. 2001. Buku Saku Patofisiologi. Jakarta: EGC.<br />
• Doenges. 2000. Rencana Asuhan Keperawatan Edisi 3. Jakarta: EGC.<br />
• Hamzah, Mochtar. 2005. Ilmu Penyakit Kulit dan Kelamin Edisi 4. Jakarta:
Balai Penerbit FKUI.<br />
• Price dan Wilson. 1991. Patofisiologi Konsep Klinik Proses-Proses Penyakit
Edisi 2. Jakarta: EGC.<br />
• Tim Penyusun. 1982. Kapita Selekta Kedokteran Jilid 2. Jakarta: Media
Aesculapius.<br />
• Tim Penyusun. 2000. Kapita Selekta Kedokteran 2. Jakarta: Media Aesculapius.<br />
• Kamus kedokteran Dorland_EGC,<br />
• Kamus kedokteran _penerbitdjambatan,<br />
• Ilmu penyakit kulit kelamin_FK UI, saripati penyakit kulit_EGC</span></div>
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<br />
<div align="center" class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 20.85pt; text-align: center;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Asuhan
Keperawatan</span></b></div>
<div align="center" class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 20.85pt; text-align: center;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Persalinan
Normal</span></b></div>
<div align="center" class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 20.85pt; text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 20.85pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 20.85pt;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Definisi</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 27.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Persalinan normal adalah pervaginam tanpa bantuan
apapun tidak kurang dari 18 jam, tanpa adanya gangguan jalannya persalinan.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 27.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tanda- tanda
persalinan normal:</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: 27.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Timbulnya his persalinan ialah his pembukaan dengan
sifatnya sebagai berikut :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">-
Nyeri melingkar dari punggung memancar ke perut bagian depan.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">-
Teratur</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">-
Makin lama makin pendek intervalnya dan makin kuat intensitasnya.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">-
Kalau di bawa berjalan bertambah kuat.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">-
Mempunyai pengaruh pada pendataran dan atau pembukaan cervix.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span></span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2<b>. </b></span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Keluarnya lendir berdarah dari jalan lahir (show).</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">-
Dengan pendataran dan pebukaan, lendir dari canalis cervikalis keluar disertai
dngan sedikit darah.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">-
Perdarahan yang sedikit ini disebabkan karena lepasnya selaput ajnin pada
bagian bawah segmen bawah rahim hingga beberapa kapilair terputus.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>3. Keluarnya cairan banyak dengan
sekonyong-konyong dari jalan lahir.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Hal ini terjadi kalau ketuban
pecah atau selaput janin robek. Ketuban itu biasanya pecah, kalau pembukaan
lengkap atau hampir lengkap dan dalam hal ini keluarnya cairan merupakan tanda
yang lambat sekali.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Tetapi kadang-kadang ketuban
itu pecah pada pembukaan kecil, malahan kadang-kadang selaput janin robek
sebelum persalinan.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Walaupun selaput robek sebelum
persalinan, kita boleh mengharapkan bahwa persalinan akan mulai dalam 24 jam
setelah air ketuban keluar. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Ketuban dinyatakan pecah dini bila terjadi sebelum proses persalinan
berlangsung. Ketuban pecah dini disebabkan oleh karena berkurangnya kekuatan
nmembran atau meningkatnya tekanan intra uteri atau oleh kedua faktor tersebut.
Berkurangnya kekuatan membrane disebabkan adanya infeksi yang dapat berasal
dari vagina serviks.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;">
</span>(Sarwono Prawiro, 2002)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Ketuban pecah dini merupakan pecahnya ketuban sebelum terdapat tanda
persalinan dan ditunggu satu jam sebelum dimulainya tanda persalina, waktu
sejak pecah ketuban sampai terjadi kontrasi rahim disebut kejadian ketuban
pecah dini (periode laten ).</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;">
</span>(Ida Bagus Manuaba EGC, 1998)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Ketuban pecah dini merupakan masalah penting dalam obstetric terkaitan
dengan penyulit kelahiran premature dan terjadinya infeksi khorioamnionitis
sampai sepsis yang meningkatkan morbiditas dan mortalitas perinata, dan
menyebabkan infeksi ibu.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>(Buku Acuan Nasional Pelayanan
Kesehatan Maternal dan Neonatal, 2001)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Ketuban pecah dini atau sponkaneous/early/premature rupture of the membrane
(PROM) adalah pecahnya ketuban sebelum partus yaitu bila pembukaan pada premi
dari 3 cm dan pada multipara kurang dari 5 cm.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>(Rustam Mochtar, 1998)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Etiologi</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Penyebab ketuban pecah dini mempunyai dimensi multifaktorial yang dapat
dijabarkan sebagai berikut:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 45.0pt list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">-
Serviks inkompeten.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 45.0pt list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">-
Ketegangan rahim berlebihan: kehamilan ganda, hidramnion.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 45.0pt list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">-
Kelainan letak janin dalam rahim: letak sungsang, letak lintang.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 45.0pt list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">-
Kemungkinan kesempitan panggul: bagian terendah belum masuk PAP.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 45.0pt list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">-
Infeksi yang menyebabkan terjadinya proses biomekanik pada selaput ketuban
dalam bentuk proleolitik sel sehingga memudahkan ketuban pecah.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 45.0pt list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">-
</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3. Patofisiologi</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">a. Terjadi
penbukaan premature serviks.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">b. Membrane terkait
dengan pembukaan terjadi: selaput ketuban tidak kuat sebagai akibat kurangnya
jaringan ikat dan vaskularisasi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">c. Bila terjadi
pembukaan serviks maka selaput ketuban sangat lemah dan mudah pecah dengan
mengeluarkan air ketuban.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">d. Melemahnya daya tahan
ketuban dipercepat dengan infeksi yang mengeluarkan enzim: enzim proteolitik
dan enzim kolagenase.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">4. Manifestasi klinis</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">a. Keluar air
ketuban warna putih keruh, jernih, kuning, hijau atau kecoklatan
sedikit-sedikit atau skaligus banyak.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">b. Dapat disertai demam
bila sudah ada infeksi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">c. Janin mudah diraba.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">d. Pada pemeriksaan
dalam, selaput dalam sudah tidak ada air ketuban, sudah kering.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">e. Inspekulo:
tampak air ketuban mengalir atau selaput ketuban tidak ada dan air ketuban
sudah kering.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 4;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">5. Komplikasi ketuban pecah dini</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">a. Infeksi intrapartum
(korioamnionitis)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">b. Persalinan preterm, jika terjadi pada usia
kehamilan preterm</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">c. Prolaps tali pusat</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">d. Oligohidamnion</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">6. Pemeriksaan diagnostic</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 36.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Ultrasonografi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">ultrasonografi dapat mengidentifikasikan kehamilan
ganda, anomaly janin, atau melokalisai kantong amnion pada amniosintesis. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 36.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Amniosintesis</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">cairan amnion dapat dikirim ke laboratorium untuk
evaluasi kematangan paru janin.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 36.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3. Pemantauan janin</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">membantu dalam mengevaluasi janin.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 36.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">4. Protein C-reaktif</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">peningkatan protein C-reaktif serum menunjukkan
peningkatan korioamnionitis.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 36.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">5. Histopatologi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">cairan ditampung dalam tabung reaksi kemudian dibakar
sampai tertinggal endapan tersebut dilihat dibawah mikroskop dan bila air
ketuban mengalami kelainan maka akan terlihat seperti daun pakis.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 36.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">6. Kertas lakmus</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">bila merah menunjukkan cairan mengandung urine yang
bersifat asam, bila biru menunjukkan cairan mengandung air ketuban yang
bersifat basa.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">7. Penatalaksanaan</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 36.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">a. Penanganan
umum:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Konfirmasi
usia kehamilan,kalau ada dengan USG</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Lakikan
pemeriksaan inspekulo untuk menilai cairan yang keluar (jumlah, warna, bau) dan
membedakannya dengan urin. Dengan pemeriksaan tes lakmus,bila kertas lakmus
biru menunjukkan air ketuban (basa), dan bila kertas lakmus merah menunjukkan
cairan urine (asam)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Jika ibu
mengeluh perdarahan pada akhir kehamilan (setelah 32 minggu), jangan melakukan
menit pemeriksaan dalam secara digital</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tentukan ada
tidaknya infeksi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tentukan
tanda-tanda inpartus</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 36.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">b. Penanganan khusus:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Konfirmasi diagnosis:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 20.85pt 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bau cairan
ketuban yang khas</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 38.85pt 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Jika keluarnya
cairan ketuban sedikit-sedikit, tampung cairan yang keluar dan nilai 1 jam
kemudian</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Dengan
speculum DTT, lakukan pemeriksaan inspekulo, nilai apakah cairan keluar melalui
ostium uteri atau terkumpul di forniks posterior</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 4;"> </span>(Prawirohardjo,
2002)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 36.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">c. Penanganan
konservatif:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 38.85pt 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Rawat di rumah
sakit</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 38.85pt 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Berikan
antibiotic (ampisilin 4 x 500 mg atau erittromisin bila tidak tahan ampisilin)
dan metronidazol 2 x 500 mg selama 7 hari</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 38.85pt 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Jika umur
kehamilan < 32 – 34 minggu, dirawat selama air ketuban masih keluar atau
sampai air ketuban tidak keluar lagi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 38.85pt 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Jika usia
kehamilan 32 -37 minggu, belum inpartu, tidak ada infeksi,tes busa negative;
beri deksametason, observasi tanda-tanda infeksi dan kkesejahteraan janin,
terminasi pada kehamilan 37 minggu</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 38.85pt 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Jika usia
kehamilan 32 – 37 minggu, sudah inpartu,tidak ada infeksi, berikan tokolitik
(salbutamol), deksametason dan induksi sesudah 24 jam</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 38.85pt 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Jika usia
kehamilan 32 -37minggu, ada infeksi, beri antibiotic dan lakukan induksi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 38.85pt 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Nilai
tanda-tanda infeksi (suhu, lekosit, tanda-tanda infeksi intra uterin). Klien
dianjurkan pada posisi trendelenburg untuk menghindari prolap tali pusat.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 38.85pt 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 36.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">d. Penanganan aktif:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 38.85pt 41.85pt 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kehamilan
>37 minggu, induksi dengan oksitosin, bila gagal seksio sesarea. Dapat pula
diberikan misoprotal 50 μg intravaginal tiap 6 jam maksimal 4 kali</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 38.85pt 41.85pt 54.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;">Ø </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bila ada
tanda-tanda infeksi berikan antibiotic dosis tinggi dan persalinan diakhiri:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">a. Bila skor
pelvic < 5, lakukan pematangan serviks kemudian induksi, jika tidak
berhasil, akhiri persalinan dengan seksio sesarea</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">b. Bila skor pelvic >
5, induksi persalinan, partus pervaginam</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 99.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>(prawirohardjo,
2002)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">8. Implikasi keperwatan/ diagnosa keperawatan</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed; mso-yfti-tbllook: 480;">
<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: 0cm 5.4pt 0cm 5.4pt; width: 95.9pt;" valign="top" width="128">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diagnosa keperawatan</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: 0cm 5.4pt 0cm 5.4pt; width: 86.7pt;" valign="top" width="116">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tujuan</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: 0cm 5.4pt 0cm 5.4pt; width: 5.0cm;" valign="top" width="189">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-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: 0cm 5.4pt 0cm 5.4pt; width: 5.0cm;" valign="top" width="189">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Rasional</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 95.9pt;" valign="top" width="128">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Resti infeksi berhubungan dengan peningkatan paparan terhadap organisme,
penurunan daya tahan terhadap mikroorganisme penyebab infeksi</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: 0cm 5.4pt 0cm 5.4pt; width: 86.7pt;" valign="top" width="116">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Mencapai penyembuhan luka tepat waktu</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: 0cm 5.4pt 0cm 5.4pt; width: 5.0cm;" valign="top" width="189">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 12.35pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1.Informasikan pada klien tentang pentingnya
personal hygine</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 12.35pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2.ajarkan teknik cuci tangan yang benar</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: 0cm 5.4pt 0cm 5.4pt; width: 5.0cm;" valign="top" width="189">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Mencegah terpajan mikroorganisme
infeksius</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Mencegah kontaminasi silang menurunkan
resiko tinggi infeksi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 2;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 95.9pt;" valign="top" width="128">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Cemas berhubungan dengan adanya ancaman bahaya</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: 0cm 5.4pt 0cm 5.4pt; width: 86.7pt;" valign="top" width="116">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Cemas dapat berkurang secara efektif</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: 0cm 5.4pt 0cm 5.4pt; width: 5.0cm;" valign="top" width="189">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 12.35pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Menggali bahwa individu cemas dan menyadari
situasi yang secara potensial dapt mencetuskan cemas, seperti yang ditunjukan
sarat secara fisiologis, emosional dan perilaku<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 12.35pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Mendorong individu menggali cemas dan
ekspresikan segala kecemasannya</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: 0cm 5.4pt 0cm 5.4pt; width: 5.0cm;" valign="top" width="189">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 13.5pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Selain cemas
ekspresikan kemarahan juga adalah reaksi yang sering terhadap suatu penyakit</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 13.5pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Ekspresinya dapt
berupa agresi, suatu reaksi kompleks perasaan dan perilaku dengan intensitas,
durasi dan ekspresi yang berbeda</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 3; 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: 0cm 5.4pt 0cm 5.4pt; width: 95.9pt;" valign="top" width="128">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Resiko kekurangan volume cairan berhubungan dengan peningkatan aktifitas,
metabolisme tubuh </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: 0cm 5.4pt 0cm 5.4pt; width: 86.7pt;" valign="top" width="116">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 9.5pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1.Input dan output volume cairan seimbang</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 9.5pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2.Berat badan bertambah</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: 0cm 5.4pt 0cm 5.4pt; width: 5.0cm;" valign="top" width="189">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 12.35pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Observasi dan catat masukan volume cairan </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 12.35pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Pantau berat badan setiap hari</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: 0cm 5.4pt 0cm 5.4pt; width: 5.0cm;" valign="top" width="189">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 13.4pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Mengawasi masukan kebutuhan cairan</span></div>
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intervensi</span></div>
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<br /></div>Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-63360022866781255422012-07-19T04:58:00.001-07:002012-08-08T05:08:21.344-07:00ASKEP HNP<!--[if gte mso 9]><xml>
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<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">ASUHAN
KEPERAWATAN</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">PADA KLEIN
DENGAN HNP (HERNIA NUKLEUS PULPOSUS)</span></b></div>
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<br /></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l14 level1 lfo1; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">Landasan teori</span></b></div>
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<i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Pengertian</span></i></div>
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<span lang="EN-US">HNP adalah Suatu
nyeri yang disebabkan oleh proses patologik dikolumna vertebralis pada diskus
intervertebralis (diskogenik) (Harsono, 1996)</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US">HNP adalah
keadaan dimana nukleus pulposus keluar menonjol untuk kemudia menekan ke arah
kanalis spinalis melalui anulus fibrosis yang robek.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l14 level2 lfo1; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Etiologi</span></i></div>
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<span lang="EN-US">HNP terjadi
karena proses degenratif diskus intervetebralis </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l14 level2 lfo1; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Insiden</span></i></div>
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<span lang="EN-US">Angka kejadi dan
kesakitan banyak terjadi pada usia pertengahan. Pada umumnya HNP didahului oelh
aktiivtas yang berlebihan, misalnya mengangkat beban berat (terutama mendadak)
mendorong barang berat. Laki—laki lebih banyak dari pada wanita</span></div>
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<i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US">gejala</span></i></div>
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<span lang="EN-US">Gejala utama
yang muncul adalah rasa nyeri di punggung bawah disertai otot-otot sekitar lesi
dan nyeri tekan .</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US">HNP terbagi atas
:</span></div>
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<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">HNP sentral </span></div>
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<span lang="EN-US">HNP sentral akan
menimbulkan paraparesis flasid, parestesia, dan retensi urine</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l15 level1 lfo3; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">HNP lateral </span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US">Rasa nyeri
terletak pada punggung bawah, ditengah-tengah abtra pantat dan betis, belakang
tumit dan telapak kaki.Ditempat itu juga akan terasa nyeri tekan. Kekuatan
ekstensi jari ke V kaki berkurang dan refleks achiler negatif. Pada HNP lateral
L 4-5 rasa nyeri dan tekan didapatkan di punggung bawah, bagian lateral pantat,
tungkai bawah bagian lateral, dan di dorsum pedis. Kekuatan ekstensi ibu jari
kaki berkurang dan refleks patela negatif. Sensibilitas [ada dermatom yang
sdesuai dengan radiks yang terkena menurun. Pada percobaan lasegue atau test
mengnagkat tungkai yang lurus (straigh leg raising) yaitu mengangkat tungkai
secara lurus dengan fleksi di sendi panggul, akan dirasakan nyeri disepanjang
bagian belakang (tanda lasefue positif). Valsava dab nafsinger akan memberikan
hasil posistif .</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l14 level2 lfo1; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US">patofisiologi</span></i></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US">Pada umumnya HNP
didahului oeleh aktiivta syang berat dengan keluahan utamanya adalah nyeri di
punggung bawah disertai nyeri otot sekitar lesi dan nyeri tekan . Hal ini
desebabkan oleh spasme otot-otot tersebut dan spasme menyebabkan mengurangnya
lordosis lumbal dan terjadi skoliosis.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l14 level2 lfo1; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">F.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Penatalaksanaan</span></i></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l14 level3 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Terapi konservatif</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l14 level4 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US"><span style="mso-spacerun: yes;"> </span>Tirah baring</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt;">
<span lang="EN-US">Penderita hrus
tetap berbaring di tempat tidur selama beberapa hari dengan sikap yang baik
adalah sikap<span style="mso-spacerun: yes;"> </span>dalam posisi setengah duduk
dimana tungkai dalam sikap fleksi pada sendi panggul dan lutut. tertentu. Tempat
tidur tidak boleh memakai pegas/per dengan demikina tempat tidur harus dari
papan yang larus dan diutu[ dengan lembar busa tipis. Tirah baring bermanfaat
untuk nyeri punggung bawah mekanik akut. Lama tirah baring tergantung pada
berat ringannya gangguan yang dirasakan penderita. Pada HNP memerlukan waktu
yang lebih lama. Setelah berbaring dianggp cukup maka dilakukan latihan /
dipasang korset<span style="mso-spacerun: yes;"> </span>untuk mencegah
terjadinya kontraktur dan mengembalikan lagi fungsi-fungsi otot.</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l14 level4 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Medikamentosa</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt;">
<span lang="EN-US">1.<span style="mso-spacerun: yes;"> </span>Symtomatik</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt;">
<span lang="EN-US">Analgetik
(salisilat, parasetamol), kortikosteroid (prednison, prednisolon),
anti-inflamasi non-steroid (AINS) seperti piroksikan, antidepresan trisiklik (
amitriptilin), obat penenang minor (diasepam, klordiasepoksid).</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt;">
<span lang="EN-US">2.<span style="mso-spacerun: yes;"> </span>Kausal</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt;">
<span lang="EN-US">Kolagenese</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l14 level4 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US"><span style="mso-spacerun: yes;"> </span>Fisioterapi</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt;">
<span lang="EN-US">Biasanya dalam
bentuk diatermy (pemanasan dengan jangkauan permukaan yang lebih dalam) untuk
relaksasi otot dan mengurnagi lordosis.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l14 level3 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Terapi operatif</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US">Terapi operatif
dikerjakan apabila dengan tindakan konservatif tidak memberikan hasil yang
nyata, kambuh berulang atau terjadi defisit neurologik</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l14 level3 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Rehabilitasi</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Mengupayakan penderita segera
bekerja seperti semula</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Agar tidak menggantungkan diri
pada orang lain dalam melakkan kegiatan sehari-hari (the activity of daily
living)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Klien tidak mengalami
komplikasi pneumonia, infeksi saluran kencing dan sebagainya).</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l14 level1 lfo1; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;"><span style="mso-list: Ignore;">II.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 14.0pt; line-height: 150%;">konsep keperawatan</span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l14 level2 lfo1; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Pengkajian</span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo2; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Identitas</span></i></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US">HNP terjadi pada
umur pertengahan, kebanyakan pada jenis kelamin pria dan pekerjaan atau
aktivitas berat (mengangkat baran berat atau mendorong benda berat)</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo2; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Keluahan Utama</span></i></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US">Nyeri pada
punggung bawah</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US">P, trauma
(mengangkat atau mendorong benda berat)</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US">Q, sifat nyeri
seperti ditusuk-tusuk atau seperti disayat, mendenyut, seperti kena api, nyeri
tumpul atau kemeng yang terus-menerus. Penyebaran nyeri apakah bersifat nyeri
radikular atau nyeri acuan (referred fain). Nyeri tadi bersifat menetap, atau
hilang timbul, makin lama makin<span style="mso-spacerun: yes;"> </span>nyeri .</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US">R, letak atau
lokasi nyeri menunjukkan nyeri dengan setepat-tepatnya sehingga letak nyeri
dapat diketahui dengan cermat.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US">S, Pengaruh
posisi tubuh atau atau anggota tubuh berkaitan dengan aktivitas tubuh, posisi
yang bagaimana yang dapat meredakan rasa nyeri dan memperberat nyeri. Pengaruh
pada aktivitas yang menimbulkan rasa nyeri seperti berjalan, turun tangga,
menyapu, gerakan yang mendesak. Obat-oabata yang ssedang diminum seperti
analgetik, berapa lama diminumkan.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US">T Sifanya akut,
sub akut, perlahan-lahan atau bertahap, bersifat menetap, hilng timbul, makin
lama makin nyeri.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo2; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Riwayat Keperawatan</span></i></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Apakah klien pernah menderita
Tb tulang, osteomilitis, keganasan (mieloma multipleks), metabolik
(osteoporosis)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Riwayat menstruasi, adneksitis
dupleks kronis, bisa menimbulkan nyeri punggung bawah</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo2; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Status mental</span></i></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US">Pada umumny
aklien menolak bila langsung menanyakan tentang banyak pikiran/pikiran sedang (ruwet).
Lebih bijakasana bila kita menanyakan kemungkinan adanya ketidakseimbangan
mental secara tidak langsung (faktor-faktor stres) </span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo2; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Pemeriksaan</span></i></div>
<ol start="5" style="margin-top: 0cm;" type="1"><ol start="1" style="margin-top: 0cm;" type="a">
<li class="MsoNormal" style="mso-list: l7 level2 lfo2; tab-stops: list 72.0pt;"><span lang="EN-US">Pemeriksaan Umum</span></li>
</ol>
</ol>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l7 level3 lfo2; text-indent: -18.0pt;">
<span lang="EN-US" 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><span lang="EN-US">Keadaan umum</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l7 level4 lfo2; text-indent: -18.0pt;">
<span lang="EN-US" 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-US">pemeriksaan tanda-tanda vital, dilengkapi pemeriksaan jantung,
paru-paru, perut.</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l7 level4 lfo2; text-indent: -18.0pt;">
<span lang="EN-US" 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-US">Inspeksi</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">inspeksi punggung, pantat dan
tungkai dalam berbagai posisi dan gerakan untuk evalusi neyurogenik</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kurvatura yang berlebihan,
pendataran arkus lumbal,adanya angulus, pelvis ya ng miring/asimitris,
muskulatur paravertebral atau<span style="mso-spacerun: yes;"> </span>pantat
yang asimetris, postur tungkai yang abnormal.</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Hambatan pada pegerakan
punggung , pelvis dan tungkai selama begerak.</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Klien dapat menegenakan pakaian
secara wajar/tidak</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kemungkinan adanya atropi,
faskulasi, pembengkakan, perubahan warna kulit.</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l7 level4 lfo2; text-indent: -18.0pt;">
<span lang="EN-US" 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-US">palpasi dan perkusi</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">paplasi dan perkusi harus
dikerjakan dengan hati-hati atau halus sehingga tidak membingungkan klien</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Paplasi pada daerah yang ringan
rasa nyerinya ke arah yang paling terasanyeri.</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Ketika meraba
kolumnavertebralis dicari kemungkinan adanya deviasi ke lateral atau
antero-posterior</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Palpasi dna perkusi perut,
distensi pewrut, kandung kencing penuh dll.</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l7 level3 lfo2; text-indent: -18.0pt;">
<span lang="EN-US" 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><span lang="EN-US">Neuorologik</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l7 level4 lfo2; text-indent: -18.0pt;">
<span lang="EN-US" 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-US">Pemeriksaan motorik</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kekuatan fleksi dan ekstensi
tungkai atas, tungkai bawah, kaki, ibu jari dan jari lainnya dengan menyuruh
klien unutk melakukan gerak fleksi dan ekstensi dengan menahan gerakan.</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">atropi otot pada maleolus atau
kaput fibula dengan membandingkan kanan-kiri.</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">fakulasi (kontraksi involunter
yang bersifat halus) pada otot-otot tertentu.</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l7 level4 lfo2; text-indent: -18.0pt;">
<span lang="EN-US" 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-US">Pemeriksan sensorik</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt;">
<span lang="EN-US">Pemeriksaan
rasa raba, rasa sakit, rasa suhu, rasa dalam dan rasa getar (vibrasi) untuk
menentukan dermatom mana yang terganggu sehingga dapat ditentuakn pula radiks
mana yang terganggu.</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l7 level4 lfo2; text-indent: -18.0pt;">
<span lang="EN-US" 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-US">pemeriksaan refleks</span></div>
<div class="MsoNormal" style="margin-left: 135.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">refleks lutut /patela/hammer
(klien bebraring.duduk dengan tungkai menjuntai), pada HNP lateral di L4-5
refleks negatif.</span></div>
<div class="MsoNormal" style="margin-left: 135.0pt; mso-list: l7 level5 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Rfleks tumit.achiles (klien
dalam posisi berbaring , luutu posisi fleksi, tumit diletakkan diatas tungkai
yang satunya dan ujung kaki ditahan dalam posisi dorsofleksi ringan, kemudian
tendon achiles dipukul. Pada aHNP lateral 4-5 refleks ini negatif.</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l7 level4 lfo2; text-indent: -18.0pt;">
<span lang="EN-US" 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-US">Pemeriksaan range of movement (ROM)</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt;">
<span lang="EN-US">Pemeriksaan ini
dapat dilakukan aktif atau pasif untuk memperkirakan derajat nyeri, functio
laesa, atau untuk mememriksa ada/tidaknya penyebaran nyeri.</span></div>
<div class="MsoNormal" style="margin-left: 162.0pt;">
<br /></div>
<ol start="5" style="margin-top: 0cm;" type="1"><ol start="2" style="margin-top: 0cm;" type="a">
<li class="MsoNormal" style="mso-list: l7 level2 lfo2; tab-stops: list 72.0pt;"><span lang="EN-US">Pemeriksaan penunjang</span></li>
</ol>
</ol>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l7 level3 lfo2; text-indent: -18.0pt;">
<span lang="EN-US" 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><span lang="EN-US">foto rontgen, Foto rontgen dari depan, samping, dan serong) untuk
identifikasi ruang antar vertebra menyempit. Mielografi adalah pemeriksaan
dengan bahan kontras melalu tindakan lumbal pungsi dan pemotrata dengan sinar
tembus. Apabila diketahiu adanya penyumbatan.hambatan kanalis spinalis yang
mungkin disebabkan HNP.</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l7 level3 lfo2; text-indent: -18.0pt;">
<span lang="EN-US" 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><span lang="EN-US">Elektroneuromiografi (ENMG)</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt;">
<span lang="EN-US">Untuk
menegetahui radiks mana yang terkena / melihat adanya polineuropati.</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l7 level3 lfo2; text-indent: -18.0pt;">
<span lang="EN-US" 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><span lang="EN-US">Sken tomografi</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt;">
<span lang="EN-US">Melihat gambaran
vertebra dan jaringan disekitarnya termasuk diskusi intervertebralis.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo2; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Penatalaksanaan</span></i></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US">(lihat pada
landsan teori)</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo2; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Dignosa keperawatan</span></i></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt; text-indent: 7.2pt;">
<span lang="EN-US"><span style="mso-spacerun: yes;"> </span>Diagnosa keperawatan
merupakan suatu pernyataan dari masalah pasien yang nyata ataupun potensial dan
membutuhkan tindakan keperawatan sehingga masalah pasien dapat ditanggulangi
atau dikurangi. (Lismidar, 1990)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l9 level4 lfo4; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Nyeri berhubungan dengan
penjepitan saraf pada diskus intervetebralis</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l9 level4 lfo4; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Cemas berhubuangan dengan
prosedur operasi, diagnosis, prognosis, anestesi, nyeri, hilangnya fungsi</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l9 level4 lfo4; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Perubahan<span style="mso-spacerun: yes;"> </span>mobilitas fisik berhubungan dengan
hemiparese/hemiplagia</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l9 level4 lfo4; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Perubahan eliminasi alvi
(konstipasi) berhubungan dengan imobilisasi, intake cairan yang tidak adekuat</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l9 level4 lfo4; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">5)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kurangnya pemenuhan perawatan
diri yang berhubungan dengan hemiparese/hemiplegi</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l9 level4 lfo4; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">6)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Resiko gangguan integritas
kulit yang berhubungan tirah baring lama </span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; tab-stops: list 144.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">B.<span style="mso-spacerun: yes;"> </span>Perencanaan</span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US">Setelah
merumuskan diagnosa keperawatan maka perlu dibuat perencanaan intervensi
keperawatan dan aktivitas keperawatan. Tujuan perencanaan adalah untuk
mengurangi, menghilangkan dan mencegah masalah keperawatan klien. Tahapan
perencanaan keperawatan klien adalah penentuan prioritas diagnosa
keperawatan,penetuan tujuan, penetapan kriteria hasil dan menntukan intervensi
keperawatan. </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US">Rencana
keperawatan dari diagnosa keperawatan diatas adalah :</span></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US">1. Perubahan rasa nyaman (nyeri) berhubungan dengan
dampak penjepitan saraf pada radiks intervertebralis</span></i></div>
<div class="MsoNormal" style="margin-left: 35.45pt; mso-outline-level: 1;">
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Tujuan :</span></i></b></div>
<div class="MsoNormal" style="margin-left: 35.45pt; mso-outline-level: 1;">
<span lang="EN-US">Nyeri berkurang atau rasa nyaman terpenuhi</span></div>
<div class="MsoNormal" style="margin-left: 35.45pt; mso-outline-level: 1;">
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Kriteria :</span></i></b></div>
<div class="MsoNormal" style="margin-left: 49.65pt; mso-list: l3 level1 lfo14; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Klien mengatakan tidak terasa
nyeri.</span></div>
<div class="MsoNormal" style="margin-left: 49.65pt; mso-list: l3 level1 lfo14; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">lokasi nyeri minimal</span></div>
<div class="MsoNormal" style="margin-left: 49.65pt; mso-list: l3 level1 lfo14; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">keparahan nyeri berskala 0</span></div>
<div class="MsoNormal" style="margin-left: 49.65pt; mso-list: l3 level1 lfo14; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Indikator nyeri verbal dan
noverbal<span style="mso-spacerun: yes;"> </span>(tidak menyeringai)</span></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: 0cm 5.4pt 0cm 5.4pt;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 178.35pt;" valign="top" width="238">
<div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">INTERVENSI</span></b></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: 0cm 5.4pt 0cm 5.4pt; width: 205.25pt;" valign="top" width="274">
<div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">RASIONAL</span></b></div>
</td>
</tr>
<tr>
<td style="border-bottom: none; border-left: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-left-alt: solid windowtext .5pt; mso-border-right-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 178.35pt;" valign="top" width="238">
<div class="MsoNormal">
<span lang="EN-US">Identifikasi klien dalam membantu
menghilangkan rasa nyerinya</span></div>
</td>
<td style="border-right: solid windowtext 1.0pt; border: none; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 205.25pt;" valign="top" width="274">
<div class="MsoNormal">
<span lang="EN-US">Pengetahuan yang mendalam tentang nyeri
dan kefektifan tindakan penghilangan nyeri.</span></div>
</td>
</tr>
<tr>
<td style="border-bottom: none; border-left: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-left-alt: solid windowtext .5pt; mso-border-right-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 178.35pt;" valign="top" width="238">
<div class="MsoNormal">
<span lang="EN-US">Berikan informasi tentang penyebab dan
cara mengatasinya</span></div>
</td>
<td style="border-right: solid windowtext 1.0pt; border: none; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 205.25pt;" valign="top" width="274">
<div class="MsoNormal">
<span lang="EN-US">Informasi mengurangi ansietas yang
berhubungan dengan sesuatu yang diperkirakan.</span></div>
</td>
</tr>
<tr>
<td style="border-bottom: none; border-left: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-left-alt: solid windowtext .5pt; mso-border-right-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 178.35pt;" valign="top" width="238">
<div class="MsoNormal">
<span lang="EN-US">Tindakan penghilangan rasa nyeri
noninvasif dan nonfarmakologis (posisi, balutan (24-48 jam), distraksi dan
relaksasi.</span></div>
</td>
<td style="border-right: solid windowtext 1.0pt; border: none; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 205.25pt;" valign="top" width="274">
<div class="MsoNormal">
<span lang="EN-US">Tindakan ini memungkinkan klien untuk
mendapatkan rasa kontrol terhadap nyeri.</span></div>
</td>
</tr>
<tr style="mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-bottom-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 178.35pt;" valign="top" width="238">
<div class="MsoNormal">
<span lang="EN-US">Terapi analgetik</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-bottom-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 205.25pt;" valign="top" width="274">
<div class="MsoNormal">
<span lang="EN-US">Terapi farmakologi diperlukan untuk
memberikan<span style="mso-spacerun: yes;"> </span>peredam nyeri.</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 6.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US">2. Cemas berhubuangan dengan prosedur operasi, diagnosis, prognosis,
anestesi, nyeri, hilangnya fungsi,</span></i><span lang="EN-US">.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 6.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US">Tujuan :<span style="mso-spacerun: yes;"> </span></span></i><span lang="EN-US">Rasa cemas klien akan berkurang/hilang.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 6.0pt;">
<span lang="EN-US">Krite<i style="mso-bidi-font-style: normal;">ria hasil :</i></span></div>
<div class="MsoNormal" style="margin-top: 6.0pt; text-indent: 35.45pt;">
<span style="mso-ansi-language: IN;">-</span><span lang="EN-US">Klien mampu mengungkapkan
ketakutan/kekuatirannya.</span></div>
<div class="MsoNormal" style="margin-top: 6.0pt; text-indent: 35.45pt;">
<span style="mso-ansi-language: IN;">-</span><span lang="EN-US">Respon klien tampak
tersenyum.</span></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: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 480;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 211.6pt;" valign="top" width="282">
<div align="center" class="MsoNormal" style="margin-top: 6.0pt; text-align: center;">
<span lang="EN-US">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: 0cm 5.4pt 0cm 5.4pt; width: 172.0pt;" valign="top" width="229">
<div align="center" class="MsoNormal" style="margin-top: 6.0pt; text-align: center;">
<span lang="EN-US">RASIONAL</span></div>
</td>
</tr>
<tr style="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: 0cm 5.4pt 0cm 5.4pt; width: 211.6pt;" valign="top" width="282">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 22.15pt; margin-right: 0cm; margin-top: 6.0pt; mso-list: l12 level1 lfo12; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Diskusikan mengenai
kemungkinan kemajuan dari fungsi gerak untuk mempertahankan harapan klien
dalam memenuhi kebutuhan sehari-hari</span></div>
<div class="MsoNormal" style="margin-top: 6.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 22.15pt; margin-right: 0cm; margin-top: 6.0pt; mso-list: l12 level1 lfo12; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Berikan informasi mengenai
klien yang juga pernah mengalami gangguan seperti yang dialami klien
danmenjalani operasi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 4.15pt; margin-right: 0cm; margin-top: 6.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 22.15pt; margin-right: 0cm; margin-top: 6.0pt; mso-list: l12 level1 lfo12; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Berikan informasi mengenai
sumber-sumber dan alat-lat yang tersedia yang dapat membantu klien </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 22.15pt; margin-right: 0cm; margin-top: 6.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 22.15pt; margin-right: 0cm; margin-top: 6.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 22.15pt; margin-right: 0cm; margin-top: 6.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 22.15pt; margin-right: 0cm; margin-top: 6.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 22.15pt; margin-right: 0cm; margin-top: 6.0pt; mso-list: l12 level1 lfo12; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Berikan support sistem
(perawat, keluarga atau teman dekat dan pendekatan spiritual)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 22.15pt; margin-right: 0cm; margin-top: 6.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 22.15pt; margin-right: 0cm; margin-top: 6.0pt; mso-list: l12 level1 lfo12; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Reinforcement terhadap
potensi dan sumber yang dimiliki berhubungan dengan penyakit, perawatan dan
tindakan </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: 0cm 5.4pt 0cm 5.4pt; width: 172.0pt;" valign="top" width="229">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 15.85pt; margin-right: 0cm; margin-top: 6.0pt; mso-list: l4 level1 lfo13; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Menunjukkan kepada klien
bahwa dia dapat berkomunikasi dengan efektif tanpa menggunakan alat khusus,
sehingga dapat mengurangi rasa cemasnya.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 15.85pt; margin-right: 0cm; margin-top: 6.0pt; mso-list: l4 level1 lfo13; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Harapan-harapan yang tidak
realistik tiak dapat mengurangi kecemasan,<span style="mso-spacerun: yes;">
</span>justru malah menimbulkan ketidak percayaan klien terhadap perawat.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 15.85pt; margin-right: 0cm; margin-top: 6.0pt; mso-list: l4 level1 lfo13; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Memungkinkan klien untuk
memilih metode komunikasi yang paling tepat untuk kehidupannya sehari-hari
disesuaikan dnegan tingkat keterampilannya sehingga dapat mengurangi rasa
cemas dan frustasinya.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 15.85pt; margin-right: 0cm; margin-top: 6.0pt; mso-list: l4 level1 lfo13; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Dukungan dari bebarapa orang
yang memiliki pengalaman yang sama akan sangat membantu klien.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 15.85pt; margin-right: 0cm; margin-top: 6.0pt; mso-list: l4 level1 lfo13; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Agar klien menyadari
sumber-sumber apa saja yang ada disekitarnya yang dapat mendukung dia untuk
berkomunikasi.</span></div>
<div class="MsoNormal" style="margin-top: 6.0pt;">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US">3<i style="mso-bidi-font-style: normal;">. Perubahan mobilitas fisik berhubungan
dengan hemiparese/hemiplegia</i></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; tab-stops: list 144.0pt;">
<span lang="EN-US">Tujuan :</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; tab-stops: 90.0pt;">
<span lang="EN-US">Klien mampu melaksanakan aktivitas fisik sesuai dengan kemampuannya</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; tab-stops: list 170.85pt;">
<span lang="EN-US">Kriteria hasil</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l16 level1 lfo5; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Tidak terjadi kontraktur sendi</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l16 level1 lfo5; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Bertabahnya kekuatan otot</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l16 level1 lfo5; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Klien menunjukkan tindakan
untuk meningkatkan mobilitas</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: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 480;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 211.3pt;" valign="top" width="282">
<div align="center" class="MsoNormal" style="margin-top: 6.0pt; text-align: center;">
<span lang="EN-US">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: 0cm 5.4pt 0cm 5.4pt; width: 172.3pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="margin-top: 6.0pt; text-align: center;">
<span lang="EN-US">RASIONAL</span></div>
</td>
</tr>
<tr style="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: 0cm 5.4pt 0cm 5.4pt; width: 211.3pt;" valign="top" width="282">
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l5 level5 lfo6; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Ubah posisi klien tiap 2 jam</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l5 level5 lfo6; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Ajarkan klien untuk melakukan
latihan gerak aktif pada ekstrimitas yang tidak sakit</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l5 level5 lfo6; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Lakukan gerak pasif pada
ekstrimitas yang sakit</span></div>
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l5 level5 lfo6; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">d)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kolaborasi dengan ahli
fisioterapi untuk latihan fisik klien</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: 0cm 5.4pt 0cm 5.4pt; width: 172.3pt;" valign="top" width="230">
<div class="MsoNormal" style="margin-left: 16.1pt; mso-list: l2 level5 lfo7; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Menurunkan resiko terjadinnya
iskemia jaringan akibat sirkulasi darah yang jelek pada daerah yang tertekan </span></div>
<div class="MsoNormal" style="margin-left: 16.1pt; mso-list: l2 level5 lfo7; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Gerakan aktif memberikan
massa, tonus dan kekuatan otot serta memperbaiki fungsi jantung dan
pernapasan</span></div>
<div class="MsoNormal" style="margin-left: 16.1pt; mso-list: l2 level5 lfo7; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US"><span style="mso-spacerun: yes;"> </span>Otot volunter akan kehilangan tonus dan
kekuatannya bila tidak dilatih untuk digerakkan</span></div>
<div class="MsoNormal" style="margin-top: 6.0pt;">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US">4. Kurangnya perawatan diri berhubungan dengan
hemiparese/hemiplegi, nyeri</span></i></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US">Tujuan</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US">Kebutuhan
perawatan diri klien terpenuhi</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US">Kriteria hasil</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo9; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Klien dapat melakukan aktivitas
perawatan diri sesuai dengan kemampuan klien</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo9; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Klien dapat mengidentifikasi
sumber pribadi/komunitas untuk memberikan bantuan sesuai kebutuhan</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: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 480;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 204.4pt;" valign="top" width="273">
<div align="center" class="MsoNormal" style="margin-top: 6.0pt; text-align: center;">
<span lang="EN-US">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: 0cm 5.4pt 0cm 5.4pt; width: 179.2pt;" valign="top" width="239">
<div align="center" class="MsoNormal" style="margin-top: 6.0pt; text-align: center;">
<span lang="EN-US">RASIONAL</span></div>
</td>
</tr>
<tr style="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: 0cm 5.4pt 0cm 5.4pt; width: 204.4pt;" valign="top" width="273">
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l7 level2 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Monitor kemampuan dan tingkat
kekurangan dalam melakukan perawatan diri </span></div>
<div class="MsoNormal" style="margin-left: -4.85pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l7 level2 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Beri motivasi kepada klien
untuk tetap melakukan aktivitas dan beri bantuan dengan sikap sungguh</span></div>
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l7 level2 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Hindari melakukan sesuatu
untuk klien yang dapat dilakukan klien sendiri, tetapi berikan bantuan sesuai
kebutuhan</span></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" style="margin-left: 13.15pt; mso-list: l7 level2 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Berikan umpan balik yang positif
untuk setiap usaha yang dilakukannya atau keberhasilannya</span></div>
<div class="MsoNormal" style="margin-left: -4.85pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l7 level2 lfo2; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kolaborasi dengan ahli
fisioterapi/okupasi </span></div>
<div class="MsoNormal" style="margin-left: -4.85pt;">
<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 .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 179.2pt;" valign="top" width="239">
<div class="MsoNormal" style="margin-left: 24.35pt; mso-list: l15 level2 lfo3; text-indent: -16.8pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Membantu dalam
mengantisipasi/merencanakan pemenuhan kebutuhan secara individual </span></div>
<div class="MsoNormal" style="margin-left: 24.35pt; mso-list: l15 level2 lfo3; text-indent: -16.8pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Meningkatkan harga diri dan
semangat untuk berusaha terus-menerus</span></div>
<div class="MsoNormal" style="margin-left: 24.35pt; mso-list: l15 level2 lfo3; text-indent: -16.8pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Klien mungkin menjadi sangat
ketakutan dan sangat tergantung dan meskipun bantuan yang diberikan
bermanfaat dalam mencegah frustasi, adalah penting bagi klien untuk melakukan
sebanyak mungkin untuk diri-sendiri untuk emepertahankan harga diri dan
meningkatkan pemulihan</span></div>
<div class="MsoNormal" style="margin-left: 24.35pt; mso-list: l15 level2 lfo3; text-indent: -16.8pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Meningkatkan perasaan makna
diri dan kemandirian serta mendorong klien untuk berusaha secara kontinyu</span></div>
<div class="MsoNormal" style="margin-left: 24.35pt; mso-list: l15 level2 lfo3; text-indent: -16.8pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Memberikan bantuan yang
mantap untuk mengembangkan rencana terapi dan mengidentifikasi kebutuhan alat
penyokong khusus</span></div>
<div class="MsoNormal" style="margin-top: 6.0pt;">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US">5. Gangguan eliminasi alvi (konstipasi) berhubngan
dengan imobilisasi, intake cairan yang tidak adekuat</span></i></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US">Tujuan</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; tab-stops: list 81.0pt;">
<span lang="EN-US">Klien tidak mengalami kopnstipasi</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US">Kriteria hasil</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l11 level1 lfo10; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Klien dapat defekasi secara
spontan dan lancar tanpa menggunakan obat</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l11 level1 lfo10; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Konsistensifses lunak</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l11 level1 lfo10; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Tidak teraba masa pada kolon (
scibala )</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l11 level1 lfo10; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Bising usus normal ( 15-30 kali
permenit )</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<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: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 480;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 211.25pt;" valign="top" width="282">
<div align="center" class="MsoNormal" style="margin-top: 6.0pt; text-align: center;">
<span lang="EN-US">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: 0cm 5.4pt 0cm 5.4pt; width: 172.35pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="margin-top: 6.0pt; text-align: center;">
<span lang="EN-US">RASIONAL</span></div>
</td>
</tr>
<tr style="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: 0cm 5.4pt 0cm 5.4pt; width: 211.25pt;" valign="top" width="282">
<div class="MsoNormal" style="margin-left: 22.15pt; mso-list: l10 level5 lfo8; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Berikan penjelasan pada klien
dan keluarga tentang penyebab konstipasi</span></div>
<div class="MsoNormal" style="margin-left: 4.15pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 22.15pt; mso-list: l10 level5 lfo8; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Auskultasi bising usus </span></div>
<div class="MsoNormal" style="margin-left: 4.15pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 22.15pt; mso-list: l10 level5 lfo8; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Anjurkan pada klien untuk
makan maknanan yang mengandung serat</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 22.15pt; mso-list: l10 level5 lfo8; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">d)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Berikan intake cairan yang
cukup (2 liter perhari) jika tidak ada kontraindikasi </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 22.15pt; mso-list: l10 level5 lfo8; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">e)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Lakukan mobilisasi sesuai
dengan keadaan klien </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 22.15pt; mso-list: l10 level5 lfo8; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">f)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kolaborasi dengan tim dokter
dalam pemberian pelunak feses (laxatif, suppositoria, enema)</span></div>
<div class="MsoNormal" style="margin-left: -4.85pt;">
<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 .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 172.35pt;" valign="top" width="230">
<div class="MsoNormal" style="margin-left: 23.45pt; mso-list: l6 level1 lfo17; text-indent: -24.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Klien dan keluarga akan
mengerti tentang penyebab obstipasi </span></div>
<div class="MsoNormal" style="margin-left: 23.45pt; mso-list: l6 level1 lfo17; text-indent: -24.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Bising usu menandakan sifat
aktivitas peristaltik</span></div>
<div class="MsoNormal" style="margin-left: 23.45pt; mso-list: l6 level1 lfo17; text-indent: -24.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Diit seimbang tinggi
kandungan serat merangsang peristaltik dan eliminasi reguler</span></div>
<div class="MsoNormal" style="margin-left: 23.45pt; mso-list: l6 level1 lfo17; text-indent: -24.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Masukan cairan adekuat
membantu mempertahankan konsistensi feses yang sesuai pada usus dan membantu eliminasi
reguler</span></div>
<div class="MsoNormal" style="margin-left: 23.45pt; mso-list: l6 level1 lfo17; text-indent: -24.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Aktivitas fisik reguler
membantu eliminasi dengan memperbaiki tonus oto abdomen dan merangsang nafsu
makan dan peristaltik</span></div>
<div class="MsoNormal" style="margin-left: 23.45pt; mso-list: l6 level1 lfo17; text-indent: -24.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">f.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pelunak feses meningkatkan
efisiensi pembasahan air usus, yang melunakkan massa feses dan membantu
eliminasi</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US">6. Resiko gangguan integritas kulit berhubungan dengan
tirah baring lama</span></i></div>
<div class="MsoNormal" style="margin-left: 36.0pt; tab-stops: 81.0pt;">
<span lang="EN-US">Tujuan</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; tab-stops: list 63.0pt left 81.0pt; text-indent: -5.4pt;">
<span lang="EN-US"><span style="mso-spacerun: yes;"> </span>Klien mampu mempertahankan
keutuhan kulit</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; tab-stops: 81.0pt;">
<span lang="EN-US">Kriteria hasil</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l1 level1 lfo11; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Klien mau berpartisipasi
terhadap pencegahan luka</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l1 level1 lfo11; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Klien mengetahui penyebab dan
cara pencegahan luka</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l1 level1 lfo11; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Tidak ada tanda-tanda kemerahan
atau luka</span></div>
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<br /></div>
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<div align="center" class="MsoNormal" style="margin-top: 6.0pt; text-align: center;">
<span lang="EN-US">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: 0cm 5.4pt 0cm 5.4pt; width: 174.25pt;" valign="top" width="232">
<div align="center" class="MsoNormal" style="margin-top: 6.0pt; text-align: center;">
<span lang="EN-US">RASIONAL</span></div>
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<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 209.35pt;" valign="top" width="279">
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l8 level1 lfo15; text-indent: -12.75pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Anjurkan untuk melakukan
latihan ROM (range of motion) dan mobilisasi jika mungkin</span></div>
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l8 level1 lfo15; text-indent: -12.75pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Rubah posisi tiap 2 jam </span></div>
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l8 level1 lfo15; text-indent: -12.75pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Gunakan bantal air atau
pengganjal yang lunak di bawah daerah-daerah yang menonjol</span></div>
<div class="MsoNormal" style="margin-left: .4pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l8 level1 lfo15; text-indent: -12.75pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Lakukan massage pada daerah yang menonjol yang baru mengalami
tekanan pada waktu berubah posisi </span></div>
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l8 level1 lfo15; text-indent: -12.75pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Observasi terhadap eritema
dan kepucatan dan palpasi area sekitar terhadap kehangatan dan pelunakan
jaringan tiap merubah posisi<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-left: 13.15pt; mso-list: l8 level1 lfo15; text-indent: -12.75pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">f.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Jaga kebersihan kulit dan
seminimal mungkin hindari trauma, panas terhadap kulit</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: 0cm 5.4pt 0cm 5.4pt; width: 174.25pt;" valign="top" width="232">
<div class="MsoNormal" style="margin-left: 18.45pt; mso-list: l13 level1 lfo16; tab-stops: list 18.45pt 63.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Meningkatkan aliran darah
kesemua daerah </span></div>
<div class="MsoNormal" style="margin-left: .45pt; tab-stops: list 63.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.45pt; mso-list: l13 level1 lfo16; tab-stops: list 18.45pt 63.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Menghindari tekanan dan
meningkatkan aliran darah</span></div>
<div class="MsoNormal" style="margin-left: 18.45pt; mso-list: l13 level1 lfo16; tab-stops: list 18.45pt 63.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Menghindari tekanan yang
berlebih pada daerah yang menonjol</span></div>
<div class="MsoNormal" style="margin-left: 18.45pt; mso-list: l13 level1 lfo16; tab-stops: list 18.45pt 63.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Menghindari
kerusakan-kerusakan kapiler-kapiler</span></div>
<div class="MsoNormal" style="margin-left: .45pt; tab-stops: list 63.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.45pt; mso-list: l13 level1 lfo16; tab-stops: list 18.45pt 63.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Hangat dan pelunakan adalah
tanda kerusakan jaringan</span></div>
<div class="MsoNormal" style="tab-stops: list 63.0pt;">
<br /></div>
<div class="MsoNormal" style="tab-stops: list 63.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.45pt; mso-list: l13 level1 lfo16; tab-stops: list 18.45pt 63.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">f.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Mempertahankan keutuhan kulit</span></div>
<div class="MsoNormal" style="margin-top: 6.0pt;">
<br /></div>
</td>
</tr>
</tbody></table>Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-55916745856612712432012-07-19T04:53:00.000-07:002012-08-08T05:10:03.343-07:00ASKEP SCABIES<!--[if gte mso 9]><xml>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">ASUHAN
KEPERAWATAN SCABIES</span></b></div>
<div style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
A. Definisi</span></b><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
Scabies merupakan penyakit kulit menular yang disebabkan oleh seekor tungau
(kutu/mite) yang bernama Sarcoptes scabei, filum Arthopoda , kelas Arachnida,
ordo Ackarina, superfamili Sarcoptes. Pada manusia oleh S. scabiei var homonis,
pada babi oleh S. scabiei var suis, pada kambing oleh S. scabiei var caprae,
pada biri-biri oleh S. scabiei var ovis.</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Penyakit scabies ini merupakan penyakit menular oleh kutu tuma
gatal Sarcoptes scabei, kutu tersebut memasuki kulit stratum korneum, membentuk
kanalikuli atau terowongan lurus atau berkelok sepanjang 0,6 sampai 1,2
centimeter.<br />
Kecil ukurannya, hanya bisa dilihat dibawah lensa mikroskop, yang hidup didalam
jaringan kulit penderita, hidup membuat terowongan yang bentuknya memanjang
dimalam hari. Itu sebabnya rasa gatal makin menjadi-jadi dimalam hari, sehingga
membuat orang sulit tidur. Dibandingkan penyakit kulit gatal lainnya, scabies
merupakan penyakit kulit dengan rasa gatal yang lebih dibandingkan dengan
penyakit kulit lain.<br />
Sinonim dari penyakit ini adalah kudis, the itch, gudig, budukan, dan gatal
agogo. Akibatnya, penyakit ini menimbulkan rasa gatal yang panas dan edema yang
disebabkan oleh garukan. Kutu betina dan jantan berbeda. Kutu betina panjangnya
0,3 sampai 0,4 milimeter dengan empat pasang kaki, dua pasang di depan dengan
ujung alat penghisap dan sisanya di belakang berupa alat tajam. Sedangkan,
untuk kutu jantan, memiliki ukuran setengah dari betinanya. Dia akan mati
setelah kawin. Bila kutu itu membuat terowongan dalam kulit, tak pernah membuat
jalur yang bercabang.<br />
Di dalam terowongan ini, kutu bersarang dan mengeluarkan telurnya. Dalam waktu
tujuh sampai 14 hari, telur menetas dan membentuk larva yang dapat berubah
menjadi nimfa, selanjutnya terbentuk parasit dewasa. Hal yang paling disukai
kutu betina adalah bagian kulit yang tipis dan lembab, yaitu daerah sekitar
sela jari longlegs dan tangan, siku, pergelangan tangan, bahu, dan daerah
kemaluan. Pada bayi yang memiliki kulit serba tipis, telapak tangan, kaki,
muka, dan kulit kepala sering diserang kutu tersebut.<br />
Faktor penunjang penyakit ini antara lain social ekonomi rendah, hygiene buruk,
sering berganti pasangan seksual, kesalahan diagnosis, dan perkembangan
demografis serta ekologik. Penularan penyakit skabies inidapat terjadi scara
langsung maupun tidak langsung, karenanya tak heran jika penyakit gudik
(skabies) dapat dijumpai di sebuah keluarga, di kelas sekolah, di asrama, di
pesantren. </span></div>
<div style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">B. Etiologi</span></b><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
Scabies dapat disebabkan oleh kutu atau kuman Sercoptes scabei varian hominis.
Sarcoptes scabieiini termasuk filum Arthopoda, kelas Arachnida, ordo Ackarina,
superfamili Sarcoptes. Pada manusia disebut Sarcoptes scabiei var hominis.
Kecuali itu terdapat S. scabiei yang lainnya pada kambing dan babi. Secara
morfologik merupakan tungau kecil, berbentuk oval, punggungnya cembung dan
bagian perutnya rata. Tungau ini transient, berwarna putih kotor, dan tidak
bermata. Ukurannya yang betina berkisar antara 330-450 mikron x 250-350 mikron,
sedangkan yang jantan lebih kecil, yakni 200-240 mikron x 150-200 mikron.
Bentuk dewasa mempunyai 4 pasang kaki, 2pasang longlegs di depan sebagai alat
alat untuk melekat dan 2pasang longlegs kedua pada betina berakhir dengan
rambut, sedangkan pada yang jantan pasangan longlegs ketiga berakhir dengan
rambut dan keempat berakhir dengan alat perekat. Siklus hidup tungau ini
sebagai berikut. Setelah kopulasi (perkawinan) yang terjadi di atas kulit, yang
jantan akan mati, kadang-kadang masih dapat hidup dalam terowongan yang digali
oleh yang betina. Tungau betina yang telah dibuahi menggali terowongan dalam
stratum korneum, dengan kecepatan 2-3 milimeter sehari dan sambil meletakkan
telurnya 2 atau 4 butir sehari sampai mencapai jumlah 40 atau 50. Bentuk betina
yang telah dibuahi ini dapat hidup sebulan lamanya. Telurnya akan menetas,
biasanya dalam waktu 3-5 hari, dan menjadi larva yang mempunyai 3 pasang kaki.
Larva ini dapat tinggal dalam terowongan, tetapi dapat juga keluar. Setelah 2-3
hari larva akan menjadi nimfa yang mempunyai 2 bentuk, jantan dan betina,
dengan 4 pasang kaki. Seluruh siklus hidupnya mulai dari telur sampai bentuk
dewasa memerlukan waktu antara 8-12 hari. Telur menetas menjadi larva dalam
waktu 3-4 hari, kemudian larva meninggalkan terowongan dan masuk ke dalam
folikel rambut. Selanjutnya larva berubah menjadi nimfa yang akan menjadi
parasit dewasa. Tungau betina akan mati setelah meninggalkan telur, sedangkan
tungau jantan mati setelah kopulasi. Sarcoptes scabiei betina dapat hidup diluar
pada suhu kamar selama lebih kurang 7-14 hari.Yang diserang adalah bagian kulit
yang tipis dan lembab, contohnya lipatan kulit pada orang dewasa. Pada bayi,
karena seluruh kulitnya masih tipis, maka seluruh badan dapat terserang
penyakit skabies ini.</span></div>
<div style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">C. Pengklasifikasian
Skabies</span></b><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
Terdapat beberapa bentuk skabies atipik yang jarang ditemukan dan sulit
dikenal, sehingga dapat menimbulkan kesalahan diagnosis. Beberapa bentuk
tersebut antara lain (Sungkar, S, 1995):<br />
1. Skabies pada orang bersih (scabies of cultivated). Bentuk ini ditandai
dengan lesi berupa papul dan terowongan yang sedikit jumlahnya sehingga sangat
sukar ditemukan.<br />
2. Skabies incognito. Bentuk ini timbul pada scabies yang diobati dengan
kortikosteroid sehingga gejala dan tanda klinis membaik, tetapi tungau tetap
ada dan penularan masih bisa terjadi. Skabies incognito sering juga menunjukkan
gejala klinis yang tidak biasa, distribusi atipik, lesi luas dan mirip penyakit
lain.<br />
3. Skabies nodular. Pada bentuk ini lesi berupa nodus coklat kemerahan yang
gatal. Nodus biasanya terdapat didaerah tertutup, terutama pada genitalia
laki-laki, inguinal dan aksila. Nodus ini timbul sebagai reaksi
hipersensetivitas terhadap tungau scabies. Pada nodus yang berumur lebih dari
satu bulan tungau jarang ditemukan. Nodus mungkin dapat menetap selama beberapa
bulan sampai satu tahun meskipun telah diberi pengobatan anti scabies dan
kortikosteroid.<br />
4. Skabies yang ditularkan melalui hewan. Di Amerika, sumber utama skabies
adalah anjing. Kelainan ini berbeda dengan skabies manusia yaitu tidak terdapat
terowongan, tidak menyerang sela jari dan genitalia eksterna. Lesi biasanya
terdapat pada daerah dimana orang sering kontak/memeluk binatang kesayangannya
yaitu paha, perut, dada dan lengan. Masa inkubasi lebih pendek dan transmisi
lebih mudah. Kelainan ini bersifat sementara (4 – 8 minggu) dan dapat sembuh
sendiri karena S. scabiei var. binatang tidak dapat melanjutkan siklus hidupnya
pada manusia.<br />
5. Skabies Norwegia. Skabies Norwegia atau skabies krustosa ditandai oleh lesi
yang luas dengan krusta, skuama generalisata dan hyperkeratosis yang tebal.
Tempat predileksi biasanya kulit kepala yang berambut, telinga bokong, siku,
lutut, telapak tangan dan kaki yang dapat disertai distrofi kuku. Berbeda
dengan scabies biasa, rasa gatal pada penderita skabies Norwegia tidak menonjol
tetapi bentuk ini sangat menular karena jumlah tungau yang menginfestasi sangat
banyak (ribuan). Skabies Norwegia terjadi akibat defisiensi imunologik sehingga
sistem imun tubuh gagal membatasi proliferasi tungau dapat berkembangbiak
dengan mudah.<br />
6. Skabies pada bayi dan anak. Lesi skabies pada anak dapat mengenai seluruh
tubuh, termasuk seluruh kepala, leher, telapak tangan, telapak kaki, dan sering
terjadi infeksi sekunder berupa impetigo, ektima sehingga terowongan jarang
ditemukan. Pada bayi, lesi di muka. (Harahap. M, 2000).<br />
7. Skabies terbaring ditempat tidur (bed ridden). Penderita penyakit kronis dan
orang tua yang terpaksa harus tinggal ditempat tidur dapat menderita skabies
yang lesinya terbatas. (Harahap. M, 2000).</span></div>
<div style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">D.
Manifestasi Klinis</span></b><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
Diagnosis dibuat dengan menemukan 2 dari 4 tanda cardinal berikut :<br />
1. Pruritus noktuma (gatal pada malam hari) karena aktivitas tungau lebih
tinggi pada suhu yang lembab dan panas.<br />
2. Umumnya ditemukan pada sekelompok manusia, misalnya mengenai seliruh anggota
keluarga.<br />
3. Adanya terowongan (kunikulus) pada tempat-tempat predileksi yang berwarna
putih atau keabu-abuan, berbentuk garis lurus atau berkelok, rata-rata panjang
1cm, pada uung menjadi pimorfi (pustu, ekskoriosi). Tempat predileksi biasanya
daerah dengan stratum komeum tpis, yaitu sela-sela jari tangan, pergelangan
tangan bagian volar, siku bagian luar, lipat ketiak bagian depan, aerola mammae
dan lipat glutea, umbilicus, bokong, genitalia eksterna, dan perut bagian
bawah. Pada bayi dapat menyerang bagian telapak tangan dan telapak kaki bahkan
seluruh permukaan ulit. Pada remaja dan orang dewasa dapat timbul pada kulit
kepala dan wajah.<br />
4. Menemukan tungau merupakan hal yang paling diagnostk. Dapat ditemikan satu
atau lebih stadium hidup tungau ini.<br />
Pada pasien yang selalu menjaga hygiene, lesi yang timbul hanya sedikit
sehingga diagnosis kadang kala sulit ditegakkan. Jia penyakit berlangsung lama,
dapat timbul likenifikasi, impetigo, dan furunkulsis.</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">E. Patofisiologi Skabies</span></b><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
Kelainan kulit dapat disebabkan tidak hanya dari tungau scabies, akan tetapi
juga oleh penderita sendiri akibat garukan. Dan karena bersalaman atau
bergandengan sehingga terjadi kontak kulit yang kuat, menyebabkan lesi timbul
pada pergelangan tangan. Gatal yang terjadi disebabkan leh sensitisasi terhadap
secret dan ekskret tungau yang memerlukan waktu kira-kira sebulan setelah
infestasi. Pada saat itu kelainan kulit menyerupai dermatitis dengan
ditemuannya papul, vesikel, dan urtika. Dengan garukan dapat timbul erosi,
ekskoriasi, krusta, dan infeksi sekunder. Kelainan kulit dan gatal yang terjadi
dapat lebih luas dari lokasi tungau.</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">-Tungau
scabies penderita sendiri dan digaruk</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">-Kontak kulit
kuat</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">-Bersalaman
bergandengan</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">-Timbul lesi</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">-Pergelangan
tangan</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">-Gatal</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">-Sensitivitas
terhadap secret</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">-Waktu 1
bulan setelah infestasi</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">-Timbul
papul,vesikel,urtika timbul erosi,eks koriosi, krusta</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">-Digaruk
infeksi skunder</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">-Kelainan
kulit dermatitis menyebar luas</span></div>
<div style="line-height: 115%; margin-bottom: .0001pt; margin: 0cm;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<b style="mso-bidi-font-weight: normal;">F. Pemeriksaan Penunjang</b><br />
Cara menemukan tungau :<br />
1. Carilah mula-mula terowongan, kemudian pada ujung dapat terlihat papul atau
vesiel. Congkel dengan jarum dan letakkan diatas kaca obyek, lalu tutup dengan
aca penutup dan lhat dengan mikroskop cahaya.<br />
2. Dengan cara menyikat dengan siat dan ditampung diatas selembar kertas putih
dan dilihat dengan kaca pembesar.<br />
3. Dengan membuat bipsi irisan, caranya ; jepit lesidengan 2 jari kemudian buat
irisa tipis dengan pisau dan periksa dengan miroskop cahaya.<br />
4. Dengan biopsy eksisional dan diperiska dengan pewarnaan HE.</span></div>
<div style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">G.
Penatalaksanaan</span></b><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
Syarat obat yang ideal adalah efektif terhadap semua stadium tungau, tidak
menimbulkan iritasi dan toksik, tidak berbau atau kotor, tidak merusak atau
mewarnai pakaian, mudah diperoleh dan harganya murah.<br />
Jenis obat topical :<br />
1. Belerang endap (sulfur presipitatum) 4-20% dalam bentuk salep atau krim.
Pada bayi dan orang dewasa sulfur presipitatum 5% dalam minyak sangat aman dan
efektif. Kekurangannya adalah pemakaian tidak boleh kurang dari 3 hari karena
tidak efektif terhadap stadium telur, berbau, mengotori pakaian dan dapat
menimbulkan iritasi.<br />
2. Emulsi benzyl-benzoat 20-25% efektif terhadap semua stadium, diberikan
setiap malam selama 3 kali. Obat ini sulit diperoleh, sering memberi iritasi,
dan kadang-kadang makin gatal setelah dipakai.<br />
3. Gama benzena heksa klorida (gameksan) 1% daam bentuk krim atau losio,
termasuk obat pilihan arena efektif terhadap semua stadium, mudah digunakan,
dan jarang memberi iritasi. Obat ini tidak dianurkan pada anak dibawah umur 6
tahun dan wanta hamil karena toksi terhadap susunan saraf pusat. Pemberiannya
cup sekali dalam 8 jam. Jika masihada gejala, diulangi seminggu kemudian.<br />
4. Krokamiton 10% dalamkrim atau losio mempunyaidua efek sebagai antiskabies
dan antigatal. Harus dijauhkan dari mata, mulut, dan uretra. Krim( eurax) hanya
efetif pada 50-60% pasien. Digunakan selama 2 malam berturut-turut dan
dbersihkan setelah 24 jam pemakaian terakhir.<br />
5. Krim permetrin 5% merupakan obat yang paling efektif dan aman arena sangat
mematikan untuk parasit S.scabei dan memiliki toksisitas rendah pada manusia.<br />
6. Pemberian antibitika dapat digunakan jika ada infeksi sekunder, misalnya
bernanah di area yang terkena (sela-sela jari, alat kelamin) akibat garukan.</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<b style="mso-bidi-font-weight: normal;">PROSES KEPERAWATAN</b><br />
<b style="mso-bidi-font-weight: normal;">A. Pengkajian</b><br />
1. Biodata<br />
a. Identitas pasien<br />
b. Identitas orang tua<br />
2. Riwayat kesehatan<br />
a. Keluhan utama<br />
Pada pasien scabies terdapat lesi dikulit bagian punggung dan merasakan gatal
terutama pada malam hari.<br />
b. Riwayat kesehatan sekarang<br />
Pasien mulai merasakan gatal yang memanas dan kemudian menjadi edema karena
garukan akibat rasa gatal yang sangat hebat.<br />
c. Riwayat kesehatan dahulu<br />
Pasien pernah masuk RS karena alergi.<br />
d. Riwayat kesehatan keluarga<br />
Dalam keluarga pasien ada yang menderita penyakit seperti yang klien alami yaitu
kurap, kudis.<br />
3. Pola fungsi kesehatan<br />
a. Pola persepsi terhadap kesehatan<br />
Apabila sakit, klien biasa membeliobat di tko obat terdeat atauapabila tidak
terjadi perubahan pasien memaksakan diri ke puskesmas atau RS terdekat.<br />
b. Pola aktivitas latihan<br />
Aktivitas latihan selama sakit : Aktivitas 0 1 2 3 4<br />
1) Makan<br />
2) Mandi<br />
3) Berpakaian<br />
4) Eliminasi<br />
5) Mobilisasi di tempat tidur<br />
Keterangan<br />
0 : Mandiri<br />
1 : Dengan menggunakan alat bantu<br />
2 : Dengan menggunakan bantuan dari orang lain<br />
3 : Dengan bantuan orang lain dan alat bantu<br />
4 : Tergantung total, tidak berpartisipasi dalam beraktivitas<br />
c. Pola istirahat tidur<br />
Pada pasien scabies terjadi gangguan pola tidur akibat gatal yang hebat pada
malam hari.<br />
d. Pola nutrisi metabolik<br />
Tidak ada gangguan dalam nutrisi metaboliknya.<br />
e. Pola elimnesi<br />
Klien BAB 1x sehari, dengan konsitensi lembek, wrna kuning bau khas dan BAK
4-5x sehari, dengan bau khas warna kuning jernih.<br />
f. Pola kognitif perceptual<br />
Saat pengkajian kien dalam keadaan sadar, bicara jelas, pendengaran dan penglihatan
normal.<br />
g. Pola peran hubungan : Sistem dukungan orang tua.<br />
h. Pola konsep diri<br />
i. Pola seksual reproduksi<br />
Pada klien scabies mengalami gangguan pada seksual reproduksinya.<br />
j. Pola koping<br />
1) Masalah utama yang terjadi selama klien sakit, klien selalu merasa gatal,
dan pasien menjadi malas untuk bekerja.<br />
2) Kehilangan atau perubahan yang terjadi klien malas untuk melakukan aktivitas
sehari-hari.</span></div>
<div style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">B. Diagnosa
Keperawatan</span></b><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
1. Nyeri akut berhubungan dengan agen cidera biologi.<br />
2. Gangguan pola tidur berhubungan dengan rasa gatal yang hebat khususnya pada
malam hari.<br />
3. Gangguan citra tubuh berhubungan dengan perubahan dalam penampilan.<br />
4. Ansietas berhubungan dengan perubahan status kesehatan.<br />
5. Kerusakan integritas kulit berhubungan dengan edema.<br />
6. Resiko infeksi dengan factor risiko:<br />
a. Jaringan kulit rusak<br />
b. Prosedur infasif</span></div>
<div style="line-height: 115%;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">C. Rencana
Intervensi</span></b><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<i style="mso-bidi-font-style: normal;">Dx 1: Nyeri akut berhubungan dengan agen
cidera biologi.</i><br />
Tujuan : Setelah dilakukan tindakan asuhan keperawatan diharapkan nyeri klien
dapat teratasi dengan<br />
KH:<br />
1. Nyeri terkontrol<br />
2. Gatal mulai hilang<br />
3. Puss hilang<br />
4. Kulit tidak memerah<br />
Intervensi:<br />
1. Kaji intensitas nyeri, karakteristik dan catat lokasi.<br />
2. Berikan perawatan kulit dengan sering, hilangkan rangsangan lingkungan yang
kurang menyenangkan.<br />
3. Kolaborasi dengan dokter untuk pemberian analgesic.<br />
4. Kolaborasi pemberian antibiotika.</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<i style="mso-bidi-font-style: normal;">Dx 2: Gangguan pola tidur berhubungan
dengan rasa gatal yang hebat khususnya pada malam hari.</i><br />
Tujuan : Setelah dilakukan tindakan asuhan keperawatan diharapkan tidur klien
tidak terganggu.<br />
KH :<br />
1. Mata klien tidak bengkak lagi.<br />
2. Klien tidak sering terbangun di malam hari.<br />
3. Klien tidak pucat.<br />
Intervensi:<br />
1. Kaji tidur klien<br />
2. Berikan kenyamanan pada klien (kebersihan tempat tidur klien)<br />
3. Kolaborasi dengan dokter pemberian analgetic.<br />
4. Catat banyaknya klien terbangun dimalam hari.<br />
5. Berikan lingkungan yang nyaman dan kurangi kebisingan.<br />
6. Berikan minum hangat (susu) jika perlu.<br />
7. Berikan musik klasik sebagai pengantar tidur</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<i style="mso-bidi-font-style: normal;">Dx 3 : Gangguan citra tubuh berhubungan
dengan perubahan dalam penampilan.</i><br />
Tujuan : Setelah dilakukan tindakan asuhan keperawatan diharapkan klien tidak
mengalami gangguan dalam cara penerapan citra diri.<br />
KH :<br />
1. Mengungkapkan penerimaan atas penyakit yang di alaminya.<br />
2. Mengakui dan memantapkan kembali system dukungan yang ada.<br />
Intervensi:<br />
1. Dorong individu untuk mengekspresian perasaan khususnya mengenai pikiran,
pandangan dirinya.<br />
2. Dorong individu untuk bertanya mengenai masalah penanganan, perkembangan
kesehatan.</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<i style="mso-bidi-font-style: normal;">Dx 4 : Ansietas berhubungan dengan
perubahan status kesehatan.</i><br />
Tujuan : Setelah dilakukan tindakan asuhan keperawatan diharapkan klien tidak
cemas lagi.<br />
KH :<br />
1. Klien tidak resah<br />
2. Klien tampak tenang dan mampu menerima kenyaataan<br />
3. Klien mampu mengidentifiasi dan mengungkapkan gejala cemas<br />
Intervensi:<br />
1. Identifiasi kecemasan<br />
2. Gunakan pendekatan yang menyenangkan.<br />
3. Temani pasien untuk memberian keamanan dan mengurangi takut.<br />
4. Bantu pasien mengenal situasi yang menimbulkan kecemasan.<br />
5. Berikan informasi faktual tentang diagnosis, tindakan prognosis.<br />
6. Berikan obat untuk mengurangi kecamasan</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
<i style="mso-bidi-font-style: normal;">Dx 5 : Kerusakan integritas kulit
berhubungan dengan edema.</i><br />
Tujuan : Setelah dilakukan tindakan asuhan keperawatan diharapkan lapisan kulit
klien terlihat normal.<br />
KH :<br />
1. Integritas kulit yang baik dapat dipetahankan (sensasi, elastisitas,
temperatur).<br />
2. Tidak ada luka atau lesi pada kulit.<br />
3. Mampu melindungi kulit dan mempertahankan kelembapan kulit serta perawatan
alami.<br />
4. Perfusi jaringan baik .<br />
Intervensi:<br />
1. Anjurkan pasien menggunakan pakaian yang longgar.<br />
2. Jaga kebersihan kulit agar tetap bersih dan kering.<br />
3. Monitor kulit akan adanya kemerahan.<br />
4. Mandikan pasien dengan air hangat dan sabun</span></div>
<div style="line-height: 115%;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
Dx 6 : Resiko infeksi dengan factor risiko:</span></i><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br />
a. Jaringan kulit rusak<br />
b. Prosedur infasif<br />
Tujuan : Setelah dilakukan tindakan asuhan keperawatan diharapkan klien tidak
terjadi resiko infeksi.<br />
KH :<br />
1. Klien bebas dari tanda dan gejala infeksi.<br />
2. Menunjukan kemampuan untuk mencegah timbulnya infeksi.<br />
3. Menunjukkan perilaku hidup sehat.<br />
4. Mendeskripsikan proses penularan penyakit, factor yang mempengaruhi
penularan dan penatalaksanaannya.<br />
Intervensi:<br />
1. Monitor tanda dan gejala infeksi.<br />
2. Monitor kerentanan terhadap infeksi.<br />
3. Batasi pengunjung bila perlu.<br />
4. Instruksikan pada pengunjung untuk mencuci tangan saat berkunjung dan
setelah meninggalkan pasien.<br />
5. Pertahankan lingkngan aseptic selama pemasangan alat.<br />
6. Berikan perawatan kulit pada area epidema.<br />
7. Inspeksi kulit dan membrane mukosa terhadap kemerahan, panas.<br />
8. Inspeksi kondisi luka<br />
9. Berikan terapi anibiotik bila perlu.<br />
10. Ajarkan cara menghindari infeksi.</span></div>
<div style="line-height: 115%;">
<br /></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">DAFTAR PUSTAKA</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Defka. 2010. Asuhan Keperawatan Skabies.
(http://defkanurse.wordpress.com/2010/08/06/asuhan-keperawatan-skabies/,
diakses tanggal 18 Januari 2011).</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Mansjoer, Arif., Suprohaita, Wardhani, W.A., dan Setiowulan,
wiwiek │Eds.│. Kapita Selekta Kedokteran. Jakarta : Media Auscalapius.</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Nenk. 2009. Skabies
(http://www.lenterabiru.com/2009/09/skabies.htm, diakses tanggal 18 Januari
2011).</span></div>
<div style="line-height: 115%;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Staf Pengajar Ilmu Kesehatan Anak. 1985. Buku Kuliah 3 Ilmu
Kesehatan Anak. Jakarta: Fakultas Kedokteran Universitas Indonesia.</span></div>
<div class="MsoNormal">
<br /></div>Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-83783058344360600362012-07-19T04:42:00.004-07:002012-08-08T05:08:47.292-07:00ASKEP GEA<!--[if gte mso 9]><xml>
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<br />
<div align="center" class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">ASUHAN KEPERAWATAN</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div align="center" class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">GASTROENTERITIS AKUT</span></b></div>
<div align="center" class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; tab-stops: list 32.2pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">A. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">TINJAUAN UMUM</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">1. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">DEFENISI</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">a. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gastroenteritis (diare akut) adalah inflamasi lambung
dan<span style="mso-spacerun: yes;"> </span>usus yang disebabkan oleh
berbagai bakteri, virus, dan pathogen parasitik. (Wong, 2004).</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">b. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gastroenteritis
adalah defekasi encer lebih dari tiga kali dengan / tanpa darah dan atau lendir
dalam tinja. (Silvia A. Price, 2005) </span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">c. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gastroenteritis
akut adalah diare yang terjadi lebih dari 3 minggu yang terutama ditemukan pada
sindrom pasca enteritis, intoleransi laktosa, cow´s milk protein<span style="mso-spacerun: yes;"> </span>intoleransi (C.L Betz, 2002)</span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">d. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gastroenteritis
adalah kondisi dimana terjadi frekwensi defekasi yang abnormal (lebih dari 3
kali/hari) serta perubahan dalam isi (lebih dari 200 g / hari) dan konsistensi
feses cair. (Brunner & Suddarth ; 2002). </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 2;"> </span>Berdasarkan
uraian pengertian di atas maka penulis menyimpulkan bahwa Gastroenteritis
adalah inflamasi lambung dan usus yang disebabkan oleh berbagai bakteri,
virus,<span style="mso-spacerun: yes;"> </span>pathogen parasitik yang terjadi
lebih dari tiga kali sehari dengan konsistensi feses cair dengan/tanpa darah
dan atau lendir dalam tinja.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">2. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">ETIOLOGI</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Ada beberapa penyebab
Gastroenteritis </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>a. Penyebab langsung <span style="mso-tab-count: 1;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>1. Infeksi : </span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">a) infeksi virus (rota virus dan virus echo)</span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">b) infeksi bakteri (Vibriocoma, Ecserchia coli, salmonella, shigella,
yarsinia enterecolica).</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">c) infeksi parasit (cacing protozoa dan jamur) </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>2. Non infeksi : </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">a) Alergi makanan : susu dan protein </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">b) Gangguan metabolic atau malabsorbsi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">c) Iritasi langsung pada saluran pencernaan oleh makanan.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>b. Penyebab tidak langsung </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Alergi, kesehatan, cuaca,
musim, umur, dan lingkungan. (C.L Betzar,<span style="mso-spacerun: yes;">
</span><span style="mso-tab-count: 1;"> </span>A. Sowden, 2002)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">3. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">PATOFISIOLOGI</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diare sekresi biasanya diare dengan volume banyak disebabkan oleh
peningkatan produksi dan sekresi air, serta elektrolit oleh mukosa usus,
kedalam lumen usus. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diare osmotic terjadi bila air terdorong kedalam usus oleh tekanan osmotic
dari partikel yang tidak dapat diabsorbsi sehingga reabsorbsi air menjadi
lambat. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diare osmotic campuran disebabkan oleh peningkatan kerja peristaltic dari
usus, (biasanya karena penyakit usus implamasi dari kombinasi peningkatan
sekresi atau penurunan absorbsi dalam usus. (Sylvia A. Price, 2005).</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">4. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">MANIFESTASI KLINIK </span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Frekuensi defekasi meningkat bersamaan dengan meningkatnya kandungan cairan
dalam feses. Pasien mengeluh kram perut, distensi, gemuruh usus (borboringus),
anoreksia, dan haus. Kontraksi spasmosik yang nyeri dan peregangan yang tidak
efektif pada anus dapat terjadi pada setiap defekasi. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gastroenteroitis dapat eksploratif atau bertahap dalam sifat dan awitan.
Gejala yang berkaitan langsung dalam diare diantaranya adalah dehidrasi dan
kelemahan. Feses berair adalah karateristik dari penyakit usus halus dan adanya
mucus dan pus dalam feses menunjukkan adanya ebteritis inflamasi atau colitis.
(Sylvia A. Price, 2005).</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">5. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">EVALUASI DIAGNOSTIK</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Apabila penyebab Gastroenteritis tidak terbukti maka tes diagnostic berikut
harus dilakukan yaitu : </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">a. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hitung darah lengkap.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">b. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Sifat kimia </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">c. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Urinalisis </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">d. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pemeriksaan feses
rutin </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">e. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pemeriksaan feses
untuk infeksi atau parasit.<span style="mso-spacerun: yes;"> </span>(Sylvia A.
Price, 2005).</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">6. </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">PENATALAKSANAAN </span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Penatalaksanaan medis utama diarahkan pada pengendalian atau pengobatan
penyakit dasar. Obat-obatan tertentu misalnya prednisone dapat mengurangi
beratnya diare dan penyakit. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Untuk diare ringan cairan oral dengan segera ditingkatkan dan glikosa serta
elektrolit dapat diberikan untuk rehidrasi ringan. (Sylvia A. Price, 2005).</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">7.</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> <b style="mso-bidi-font-weight: normal;">KOMPLIKASI </b></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>a. Cardiac Dysritmia </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 252.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>b.
Asidosis metabolic <span style="mso-tab-count: 1;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>c. Dehidrasi </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>d. Hipotensi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>e. Kematian </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>f.<span style="mso-spacerun: yes;">
</span>Kontraksi ventrikel premature. (Sylvia A. Price, 2005).</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">B. Konsep Dasar Asuhan
Keperawatan </span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Untuk melaksanakan asuhan keperawatan digunakan suatau pendekatan
proses<span style="mso-spacerun: yes;"> </span>keperawatan yang terdiri dari
langkah-langkah ilmiah yaitu : Pengkajian Keperawatan, Dampak Kebutuhan Dasar
Manusia (KDM), Diagnosa Keperawatan, Intervensi Keperawatan, Implementasi
Keperawatan dan Evaluasi Keperawatan.(Wartonoh, 2006)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span><b style="mso-bidi-font-weight: normal;">1. Pengkajian Keperawatan </b></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Data pengkajian keperawatan pada
pasien yang<span style="mso-spacerun: yes;"> </span>mengalami Gastroenteritis
adalah sebagai berikut. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">a. Pengumpulan data</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">1) </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Aktifitas / Istirahat </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gejala : Kelemahan, kelelahan, malaise, cepat lelah, perasaan gelisah,<span style="mso-spacerun: yes;"> </span>ansietas. Pembatasan aktifitas/kerja
sehubungan dengan proses<span style="mso-spacerun: yes;"> </span>penyakit.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 70.9pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">2) </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Integritas ego </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Gejala<span style="mso-spacerun: yes;"> </span>: Ansietas, ketakutan, emosi, kesal, perasaan
tak berdaya/ tak ada harapan.Faktor<span style="mso-spacerun: yes;">
</span>stress akut/kronis, misalnya : hubungan keluarga/pekerjaan, pengobatan
yang mahal.Faktor budaya /peningkatan pervalensi pada populasi yahudi
sering<span style="mso-spacerun: yes;"> </span>meningkat pada individu Eropa
Utara dan keturunan Angio-Saxon.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Tanda<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;">
</span>Menolak, perhatian menyempit, depresi.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">3) </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Eliminasi </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Gejala<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;">
</span>Episode diare yang tak dapat diperkirakan, hilang timbul, sering, tak
terkontrol, flatus lembut dan semiciar, bau busuk dan berlemak<span style="mso-spacerun: yes;"> </span>(steatore), melena. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">4) </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Makanan/cairan </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Gejala<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;">
</span>Anoreksia : mual/muntah , penurunan berat badan, tak toleran pada diet,
produk susu, makanan berlemak. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Tanda :Penurunan
lemak subkutan/massa otot. Kelemahan,tonus otot buruk dan turgor kulit buruk,
membran mukosa pucat.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">5) </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hygiene </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tanda<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;"> </span>Ketidak mampuan menghadapi perawatan diri,
bau badan.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">6) </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Nyeri/Kenyamanan </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Gejala<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;">
</span>Nyeri tekan abdomen dengan nyeri kram pada kuadran kanan bawah<span style="mso-spacerun: yes;"> </span>; nyeri abdomen tengah bawah (keterlibatan
jejunum), nyeri tekan menyebar kebagian periumbilikal, Titik nyeri berpindah,
nyeri tekan (erthritis). </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Tanda<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;">
</span>Nyeri tekan abdomen/distensi. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">7) </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Keamanan </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Gejala<span style="mso-spacerun: yes;"> </span>: Riwayat lupus eritematosus, anemia
hemolitik, vaskulitas. Artritis (memperburuk gejala dengan eksaserbasi penyakit
usus). Peningkatan suhu tubuh 39,6-40˚C (ekaserbi akut). Penglihatan kabur,
Alergi terhadap makanan/produk susu (mengeluarkan histamine kedalam usus dan
mempunyai efek inflamasi. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Tanda : Lesi kulit
mungkin ada, misalnya eritema nodusum (meningkat,nyeri tekan, kemerahan dan
membengkak) pada tangan, muka, pioderma gangrenosa (lesi tekan purulen/lepuh
dengan batas keunguan) pada paha, kaki dan mata kanan. Ankilosa spondalitis.
Uveitis, konjungtivitis/iritasi. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">8) </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Interaksi social </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Gejala : Masalah
berhubungan / peran sehubungan dengan kondisi .<span style="mso-spacerun: yes;"> </span>Ketidakmampuan aktif secara social. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">9) </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Penyuluhan/pembelajaran
</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Gejala :<span style="mso-spacerun: yes;"> </span>Riwayat keluarga berpenyakit inflamasi usus.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 31.5pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>2. Analisa data </span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Dengan melihat data
subyektif dan data obyektif dapat menentukan permasalahan yang dihadapai klien
dengan memperlihatkan masalah dapat di ketahui penyebab efek dari masalah
tersebut. Dari analisa data di tentukan diagnosa keperawatan yang muncul.<span style="mso-spacerun: yes;"> </span>(Doenges, 2000)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span><b style="mso-bidi-font-weight: normal;">3. Diagnosa Keperawatan </b></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Diagnosa keperawatan yang
dapat muncul pada pasien diare anak : <b style="mso-bidi-font-weight: normal;"><span style="mso-spacerun: yes;"> </span></b></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">a. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diare
berhubungan dengan inflamasi, atau malabsorbsi usus </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">b. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Resiko tinggi terhadap
kekurangan volume cairan berhubungan dengan kehilangan banyak
cairan (diare berat dan muntah). </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">c. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Perubahan nutrisi kurang dari kebutuhan tubuh
berhubungan dengan gangguan absorbsi nutrient. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">d. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Ansietas berhubungan dengan factor psikologis /
rangsang simpatis (proses inflamasi). </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">e. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Nyeri berhubungan
dengan hiperperistaltik, diare lama, iritasi kulit, akskoreasi fisura
oerirektal. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">f. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Koping
indivudu tidak efektif berhubungan dengan proses penyakit yang tidak diduga. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Arial; mso-fareast-language: IN;">g. </span><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kurang pengetahuan berhubungan dengan kurang mengingat
informasi atau tidak mengenal sumber. (Brunner dan Suddarth, 2000)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>5. Intervensi Keperawatan </span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>a. Diare berhubungan dengan
inflamasi, atau malabsorbsi usus. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Tujuan:Melaporkan
penurunan frekuensi defekasi,konsistensi kembali normal.</span></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: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 480;">
<tbody>
<tr style="height: 24.75pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid windowtext 1.0pt; height: 24.75pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 72.75pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Intervensi</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; height: 24.75pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Rasional</span></div>
</td>
</tr>
<tr style="height: 80.5pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; height: 80.5pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1.<span style="mso-spacerun: yes;"> </span>Observasi dan catat frekwensi
devekasi, karakteristi, jumlah dan<span style="mso-spacerun: yes;">
</span>factor pencetus</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2 . Tingkatkan tirah baring </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3.<span style="mso-spacerun: yes;"> </span>Identifikasi makanan dan cairan
yang menyebabkan diare</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">4. Berikan cairan peroral, tawarkan<span style="mso-spacerun: yes;">
</span>minum air putih tiap 1 jam. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">5. Kolaborasi pemberian obat </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>antikolinergi</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 80.5pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Membantu membedakan penyakit individu dan mengkaji beratnya.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Istirahat menurunkan mobilitas usus juga laju metabolisme bila infeksi
atau perdarahan sebagai komplikasi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3. Menghindarkan iritan,<span style="mso-spacerun: yes;"> </span>meningkatkan
istirahat usus.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">4. Memberikan istirahat kolon dengan menghilanhkan atau menurunkan
rangsang makanan / cairan.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">5. Menurunkan mortilitas / peristaltic GI dan menurunkan sekresi digesti
untuk menghilangkan kram dan diare<span style="mso-spacerun: yes;"> </span></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">b. Risiko tinggi kekurangan volume cairan berhubungan dengan<span style="mso-spacerun: yes;"> </span>kehilangan banyak<span style="mso-spacerun: yes;"> </span>cairan (diare berat dan muntah) </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Tujuan : Mempertahankan volume
cairan adekuat. </span></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: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 480;">
<tbody>
<tr style="height: 25.5pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid windowtext 1.0pt; height: 25.5pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Intervensi</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; height: 25.5pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Rasional</span></div>
</td>
</tr>
<tr style="height: 71.5pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; height: 71.5pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Awasi masukan dan haluan, karakter dan jumlah feses</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>2.<span style="mso-spacerun: yes;"> </span>Kaji tanda vital </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 207.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3.<span style="mso-spacerun: yes;"> </span>Observasi
kulit kering berlebihan dan membrane mukosa, penurunan turgor<span style="mso-spacerun: yes;"> </span>Kulit, pengisapan kapiler lambat. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 198.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">4.<span style="mso-spacerun: yes;"> </span>Catat
kelemahan otot umum atau </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Disritmia jantung </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">5.<span style="mso-spacerun: yes;"> </span>Berikan cairan parenteral
sesuai indikasi </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">6. Berikan obat sesuai indikasi antidiare </span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 71.5pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Memberikan informasi tentang </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Keseimbangan cairan </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Hipotensi (termasuk postoral), takikardia demam dapat<span style="mso-spacerun: yes;"> </span>menunjukkan terhadap<span style="mso-spacerun: yes;"> </span>Efek / kehilangan cairan </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3. Menunjukkan kehilangan cairan berlebih atau dehidrasi. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">4. Kelemahan usus berlebihan dapat </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Menimbulkan ketidakseimbangan </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Elektrolit<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">5. Mempertahankan istirahat usus akan memerlukan penggantian cairan untuk
memeperbaiki kehilanngan /anemia </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">6. Menurunkan kehilangan cairan dari usus</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -45.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">c . Perubahan nutrisi kurang dari kebutuhan berhubungan dengan gangguan
absorbsi<span style="mso-spacerun: yes;"> </span>nutrient. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Tujuan<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;">
</span>Menunjukkan berat badan stabil atau peningkatan<span style="mso-spacerun: yes;"> </span>berat badan sesuai<span style="mso-spacerun: yes;"> </span>sasaran<span style="mso-spacerun: yes;">
</span></span></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: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 480;">
<tbody>
<tr style="height: 24.0pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid windowtext 1.0pt; height: 24.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Intervensi</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; height: 24.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Rasional</span></div>
</td>
</tr>
<tr style="height: 8.5pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; height: 8.5pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Timbang berat badan tiap hari </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Dorong tirah baring dan/atau pembatasan aktifitas selama fase sakit
akut. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3. Anjurkan istirahat sebelum makan </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">4.<span style="mso-spacerun: yes;"> </span>Dorong pasien untuk menyatakan </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 189.0pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;">
</span>Permasalahaan mulai makan diet </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">5. Pertahankan puasa sesuai indikasi </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">6. Berikan nutrisi parenteral total, terapi<span style="mso-spacerun: yes;"> </span>IV sesuai indikasi. </span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 8.5pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Memberikan informasi tentang kebutuhan diet / keefektifan terapi </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Menurunkan kebutuhan metabolic untuk mencegah penurunan kalori dan
simpanan energi. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3. Menenangkan peristaltic dan meningkatkan energi untuk makanan. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">4. Keragu-raguan untuk makan mungkin dakibatkan oleh takut makanan akan
menyebabkan eksaserbasi gejala. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">5. Istirahat usus menurunkan peristaltic dan diare dimana menyebabkan
malabsorbsi </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>/ kehilangan nutrient. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">6. Program ini mengistirahatkan saluran GI sementara memberikan,<span style="mso-spacerun: yes;"> </span></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>d .Ansietas berhubungan dengan
factor psikologis / rangsang simpatis (proses<span style="mso-spacerun: yes;">
</span>inflamasi) </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Tujuan :<span style="mso-spacerun: yes;"> </span>Menurunkan rileks dan melaporkan
penurunan<span style="mso-spacerun: yes;"> </span>ansietas sampai tingkat yang
dapat ditangani.<span style="mso-spacerun: yes;"> </span></span></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: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 480;">
<tbody>
<tr style="height: 15.0pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid windowtext 1.0pt; height: 15.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Intervensi</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; height: 15.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Rasional</span></div>
</td>
</tr>
<tr style="height: 283.05pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; height: 283.05pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1.<span style="mso-spacerun: yes;"> </span>Dorong menyatakan
perasaan,<span style="mso-spacerun: yes;"> </span>berikan umpan
balik<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2.<span style="mso-spacerun: yes;"> </span>Akui bahwa ansietas dan masalah
mirip dengan yang diekspresikan orang lain </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3.<span style="mso-spacerun: yes;"> </span>Bantu klien belajar mekanisme
koping baru misalnya tekhnik mengatasi stress, keterampilan organisasi<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">4.<span style="mso-spacerun: yes;"> </span>Berikan lingkungan tenang dan
istirahat<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">5. Rujuk pada perawat spesialis psikiatri, pelayanan social, penasehat
agama.<span style="mso-spacerun: yes;"> </span></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 283.05pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 210.6pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1.<span style="mso-spacerun: yes;"> </span>Membuat
hubungan teraupetik, </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -12.6pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Membantu
pasien / orang terdekat dalam mengidentifikasi masalah yang<span style="mso-spacerun: yes;"> </span>menyebabkan stress.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -12.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -1.65pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Validasi bahwa perasaan normal dapat membantu
menurunkan stress.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -1.65pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3. Belajar cara baru untuk mengatasi masalah dapat
membantu dalam menurunkan stress dan ansietas.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -1.65pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>4.
Memindahkan klien dari stress luar, meningkatkan relaksasi, membantu
menurunkan ansietas. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -1.65pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">5. Di butuhkan bantuan tambahan untuk meningkatkan
control dan mengatasi episode akut.<span style="mso-spacerun: yes;"> </span></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>e.<span style="mso-spacerun: yes;"> </span>Nyeri berhubungan dengan hiperperistaltik,
diare lama, iritasi kulit, anoreksia<span style="mso-spacerun: yes;">
</span>fisura perirektal. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Tujuan<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;">
</span>Melaporkan nyeri hilang / terkontrol<span style="mso-spacerun: yes;">
</span></span></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: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 1184;">
<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: 0cm 5.4pt 0cm 5.4pt; width: 212.15pt;" valign="top" width="283">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-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: 0cm 5.4pt 0cm 5.4pt; width: 212.2pt;" valign="top" width="283">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-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: 0cm 5.4pt 0cm 5.4pt; width: 212.15pt;" valign="top" width="283">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Dorong klien untuk melaporkan nyeri </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Kaji laporan kram abdomen atau nyeri, catat lokasi, lamanya,
intensitas (skala 0-10) selidiki dan laporkan perubahan karakteristik nyeri. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3.Ijinkan klien untuk memulai posisi yang nyaman, misalnya ; lutut
fleksi.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">4.Observasi / catat distensi abdomen, peningkatan suhu, penurunan tekanan
darah. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">5. Berikan obat sesuai indikasi<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Analgesik.</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: 0cm 5.4pt 0cm 5.4pt; width: 212.2pt;" valign="top" width="283">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: .5pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Mencoba untuk mentoleransi nyeri dari pada <span style="mso-spacerun: yes;"> </span>meminta analgesic.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: .5pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Perubahan pada karakteristik nyeri dapat
menunjukkan penyebaran penyakit/ terjadinya komplikasi, misalnya ;vistula
kemih, perforasi, toksik megakolon. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: .5pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3. Menurunkan tegangan abdomen dan meningkatkan rasa
control. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 210.6pt; text-indent: .5pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">4. Dapat menunjukkan
terjadinya obtruksi usus karena inflamasi, edema, dan jaringan parut. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: .5pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">5. Nyeri bervariasi dari ringan sampai berat dan
perlu penanganan untuk memudahkan<span style="mso-spacerun: yes;">
</span>istirahat adekuat<span style="mso-spacerun: yes;"> </span>dan<span style="mso-spacerun: yes;"> </span>penyembuhan.</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>f. Koping individu tidak
efektif berhubungan dengan proses penyakit yang tidak<span style="mso-spacerun: yes;"> </span>diduga </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Tujuan<span style="mso-spacerun: yes;"> </span>: Menunjukkan perubahan pola hidup yang perlu
untuk membatasi /<span style="mso-spacerun: yes;"> </span>mencegah<span style="mso-spacerun: yes;"> </span></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: .9pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 1184;">
<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: 0cm 5.4pt 0cm 5.4pt; width: 211.5pt;" valign="top" width="282">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-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: 0cm 5.4pt 0cm 5.4pt; width: 211.5pt;" valign="top" width="282">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-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: 0cm 5.4pt 0cm 5.4pt; width: 211.5pt;" valign="top" width="282">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -.9pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Kaji pemahaman klien / orang terdekat dan metode
sebelumnya dalam menerima proses penyakit. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -.9pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Berikan kesempatan pada klien untuk mendiskusikan
bagaimana penyakit telah mempengaruhi hubungan.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -.9pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -.9pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3.Bantu klien mengidentifikasi keterampilan koping
efektif secara individu.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -.9pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -.9pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -.9pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">4. Masukkan klien atau orang terdekat dalam tim
pertemuan untuk mengembangkan program individu . </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -9.0pt;">
<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 .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 211.5pt;" valign="top" width="282">
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: .25pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Perawat mampu untuk menerima lebih nyata tentang
masalah saat ini.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: .25pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: .25pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">2. Stressor penyakit mempengaruhi semua arah hidup
dank lien mengalami kesulitan mengatasi perasaan lemah / nyeri.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: .25pt;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3. Penggunaan perilaku yang berhasil sebelumnya
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datang<span style="mso-spacerun: yes;"> </span></span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">4. Meningkatkan klontinuitas perawatan dan
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">g. Kurang pengetahuan berhubungan dengan kurang mengingat informasi atau
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Tujuan<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;">
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3.<span style="mso-spacerun: yes;"> </span>Kaji ulang obat, tujuan,
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cairan dan factor pola hidup dapan mencetus gejala. </span></div>
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<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 210.6pt; text-indent: -1.65pt;">
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iritasi kulit / kerusakan infeksi </span></div>
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<br /></div>Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com1tag:blogger.com,1999:blog-1799099966681267159.post-34505482844945267882012-07-19T04:38:00.001-07:002012-08-08T05:18:49.894-07:00ASKEP PARAPLEGIA<!--[if gte mso 9]><xml>
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<div align="center" class="MsoNormal" style="mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: center;">
<b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">PARAPLEGIA</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
<b style="mso-bidi-font-weight: normal;">A Pengertian</b><br />
Lesi total transversal medula spinalis segmen thorako lumbal adalah lesi yang
mengenai seluruh medula spinalis pada segmen thorakolumbal yang bermanifestasi
dengan kelumpuhan anggota gerak bawah1.<br />
<br />
<b style="mso-bidi-font-weight: normal;">B Etiologi</b><br />
Penyebab lesi total transversal medula spinalis meliputi 3:<br />
1. Cedera Medula Spinalis Akibat Kecelakaan<br />
2. Kista / Tumor: siringomielia, Meningioma, Schwannoma, Glioma, Sarkoma. Dan
tumor metastase.<br />
3. Infeksi : spondilitis tuberkulosa, meningitis atau herpes zoster<br />
4. Kelainan tulang vertebra: Kolaps tulang belakang yang terjadi karena
pengeroposan tulang akibat kanker, osteoporosis atau cedera yang hebat,
Artritis degeneratif (osteoartritis) yang menyebabkan terbentuknya penonjolan
tulang yang tidak beraturan (taji tulang) yang menekan akar saraf, Stenosis
spinalis (penyempitan rongga di sekitar korda spinalis), sering terjadi pada
usia lanjut<br />
5. Hematoma Spinalis.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
<b style="mso-bidi-font-weight: normal;">C Epidemiologi</b><br />
Pada praktek klinis, lesi total transversal medula spinalis jarang terjadi,
kecuali faktor penyebabnya berupa trauma berat, misalnya peluru dan atau
fraktur tulang belakang yang total1. Data epidemiologik dari berbagai negara
menyebutkan bahwa angka kejadian cedera medula spinalis sekitar 11,5-53,4 kasus
per 100.000 penduduk per tahun2.<br />
<br />
<b style="mso-bidi-font-weight: normal;">D Patofisiologi dan Gejala Klinis</b><br />
Akibat lesi di medula spnalis dapat terjadi manifestasi:<br />
1. Gangguan fungsi motorik<br />
a. Gangguan motorik di tingkat lesi:. Karena lesi total juga merusak kornu
anterior medula spinalis dapat terjadi kelumpuhan LMN pada otot-otot yang
dipersyarafi oleh kelompok motoneuron yang terkena lesi dan menyebabkan nyeri
punggung yang terjadi secara tiba-tiba1,3,.<br />
b. Gangguan motorik di bawah lesi: dapat terjadi kelumpuhan UMN karena jaras
kortikospinal lateral segmen thorakal terputus.<br />
Gerakan refleks tertentu yang tidak dikendalikan oleh otak akan tetap utuh atau
bahkan meningkat.<br />
Contohnya, refleks lutut tetap ada dan bahkan meningkat. Meningkatnya refleks
ini menyebabkan kejang tungkai. Refleks yang tetap dipertahankan menyebabkan
otot yang terkena menjadi memendek, sehingga terjadi kelumpuhan jenis spastik.
Otot yang spastik teraba kencang dan keras dan sering mengalami kedutan1,3.<br />
2. Gangguan fungsi sensorik : karena lesi total juga merusak kornu posterior
medula spinalis maka akan terjadi penurunan atau hilang fungsi sensibilitas
dibawah lesi. Sehingga klien tidak dapat merasakan adanya rangsang taktil,
rangsang nyeri, rangsang thermal, rangsang discrim dan rangsang lokalis1.<br />
3. Gangguan fungsi autonom: karena terputusnya jaras ascenden spinothalamicus
maka klien akan terjadi kehilangan perasaan akan kencing dan alvi1.<br />
<br />
<b style="mso-bidi-font-weight: normal;">E Pemeriksaan</b><br />
1. Laboratorium:<br />
a. Hematology:<br />
Hemoglobin dapat menurun karena destruksi sumsum tulang vertebra atau
perdarahan.<br />
Peningkatan Leukosit menandakan selain adanya infeksi juga stress fisik ataupun
terjadi kematian jaringan.<br />
b. Kimia klinik:<br />
PT / PTT untuk melihat fungsi pembekuan darah sebelum pemberian terapi
antikoagulan.<br />
Dapat terjadi gangguan elektrolit karena terjadi gangguan dalam fungsi
perkemihan, dan fungsi gastrointerstinal.<br />
2. Radiodiagnostik:<br />
1. CT Scan: untuk melihat adanya edema, hematoma, iskemi dan infark<br />
2. MRI : menunjukkan daerah yang mengalami fraktur, infark, hemoragik.<br />
3. Rontgen: menunjukkan daerah yang mengalami fraktur, dan kelainan tulang,
gambaran infeksi TB paru.<br />
<br />
<br />
<b style="mso-bidi-font-weight: normal;">F Penatalaksanaan :</b><br />
Pada dasarnya , penatalaksanaan keperawatan pada klien paraplegi adalah<br />
1. Melakukan alih baring karena klien tidak bisa lagi menggerakan tungkainya,
disamping untuk mengurangi resiko luka dekubitus pada klien, disamping itu juga
melakukan perawatan kulit dipunggung yang baik dengan memasase, memberikan
minyak untuk mengurangi penekanan,<br />
2. ROM dilakukan untuk meningkatkan sirkulasi darah ke anggota gerak yang
lumpuh.<br />
3. Penanganan pada paraplegi juga membantu eliminasi urin dan feses klien
karena telah terjadi kerusakan jaras ascenden spinotalamikus dimana klien sudah
tidak bisa merasakan sensasi ingin kencing dan BAB.<br />
4. Nyeri yang diraskan dapat dilakukan dengan tehnik masase atau dengan
distraksi.<br />
<br />
<b style="mso-bidi-font-weight: normal;">G Asuhan Keperawatan</b><br />
<b style="mso-bidi-font-weight: normal;">1. Pengkajian</b><br />
a. Identitas klien<br />
Meliputi nama, umur (kebanyakan terjadi pada usia tua), jenis kelamin,
pendidikan, alamat, pekerjaan, agama, suku bangsa, tanggal dan jam MRS, nomor
register, diagnose medis.<br />
b. Keluhan utama<br />
Biasanya didapatkan laporan kelemahan dan kelumpuhan ekstrimitas, inkontinensia
defekasi dan berkemih<br />
c. Riwayat penyakit sekarang<br />
Biasanya terjadi riwayat trauma, pengkajian yang didapat meliputi hilanya
sensibilitas, paralisis, ieus paralitik, retensi urine, hilangnya refleks.<br />
d. Riwayat penyakit dahulu<br />
Adanya riwayat infeksi, tumor, cedera tulang belakang, DM, jantung, anemia,
obat antikoagulan, alkohol.<br />
e. Riwayat penyakit keluarga.<br />
Mengkaji adanya generasi dahulu yang menderita hipertensi atau DM.<br />
f. Pola-pola fungsi kesehatan<br />
1) Aktifitas /Istirahat<br />
Kelumpuhan otot (terjadi kelemahan selama syok pada bawah lesi. Kelemahan umum
/kelemahan otot (trauma dan adanya kompresi saraf).<br />
2) Sirkulasi<br />
Hipotensi, Hipotensi posturak, bradikardi, ekstremitas dingin dan pucat.<br />
3) Eliminasi<br />
Retensi urine, distensi abdomen, peristaltik usus hilang, melena, emisis
berwarna seperti kopi tanah /hematemesis.<br />
4) Integritas Ego<br />
Takut, cemas, gelisah, menarik diri.<br />
5) Makanan /cairan<br />
Mengalami distensi abdomen, peristaltik usus hilang (ileus paralitik)<br />
6) Higiene<br />
Sangat ketergantungan dalam melakukan aktifitas sehari-hari (bervariasi)<br />
7) Neurosensori<br />
Kesadaran: GCS<br />
Fungsi motorik: Kelumpuhan, kelemahan<br />
Fungsi sensorik: Kehilangan sensasi / sensibilitas.<br />
Refleks fisiologis: Kehilangan refleks /refleks asimetris termasuk tendon
dalam. Kehilangan tonus otot /vasomotor,<br />
Refleks patologis: munculnya refleks patologis,<br />
Perubahan reaksi pupil, ptosis, hilangnya keringat bagian tubuh yang terkena
karena pengaruh trauma spinal.<br />
8) Nyeri /kenyamanan<br />
Mengalami deformitas, postur, nyeri tekan vertebral.<br />
9) Pernapasan<br />
Pernapasan dangkal, periode apnea, penurunan bunyi napas, ronki, pucat,
sianosis.<br />
10) Keamanan<br />
Suhu yang berfluktasi, jatuh.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
<b style="mso-bidi-font-weight: normal;">2. Diagnosa Keperawatan</b><br />
1. Kerusakan mobilitas fisik yang berhubungan dengan kerusakan neuron fungsi
motorik dan sesorik.<br />
2. Resiko terhadap kerusakan integritas kulit yang berhubungan dengan penurunan
immobilitas, penurunan sensorik.<br />
3. Retensi urine yang berhubungan dengan ketidakmampuan untuk berkemih secara
spontan, terputusnya jaras spinothalamikus.<br />
4. Konstipasi berhubungan dengan adanya atoni usus sebagai akibat gangguan
autonomik, terputusnya jaras spinothalamikus.<br />
5. Nyeri yang berhubungan dengan pengobatan, immobilitas lama, cedera psikis.<br />
<br />
<b style="mso-bidi-font-weight: normal;">3. Intervensi</b><br />
<i style="mso-bidi-font-style: normal;">1.Kerusakan mobilitas fisik yang
berhubungan dengan kerusakan neuron, fungsi motorik dan sesorik.</i><br />
Tujuan:<br />
Memperbaiki mobilitas<br />
Kriteria Hasil: Mempertahankan posisi fungsi dibuktikan oleh tak adanya
kontraktur, footdrop, meningkatkan kekuatan bagian tubuh yang sakit
/kompensasi, mendemonstrasikan teknik /perilaku yang memungkinkan melakukan
kembali aktifitas.<br />
1. Kaji fungsi-fungsi sensori dan motorik pasien setiap 4 jam.<br />
2. Ganti posisi pasien setiap 2 jam dengan memperhatikan kestabilan tubuh dan
kenyamanan pasien.<br />
3. Beri papan penahan pada kaki<br />
4. Gunakan otot orthopedhi, edar, handsplits<br />
5. Lakukan ROM Pasif setelah 48-72 setelah cedera 4-5 kali /hari<br />
6. Monitor adanya nyeri dan kelelahan pada pasien.<br />
7. Konsultasikan kepada fisiotrepi untuk latihan dan penggunaan otot seperti
splints</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Rasional<br />
</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">1. Menetapkan kemampuan dan keterbatasan pasien setiap
4 jam.<br />
2. Mencegah terjadinya dekubitus.<br />
3. Mencegah terjadinya foodrop<br />
4. Mencegah terjadinya kontraktur.<br />
5. Meningkatkan stimulasi dan mencegah kontraktur<br />
6. Menunjukan adanya aktifitas yang berlebihan.<br />
7. Memberikan pancingan yang sesuai.<br />
<br />
<i style="mso-bidi-font-style: normal;">2.Resiko terhadap kerusakan integritas
kulit yang berhubungan dengan penurunan immobilitas, penurunan sensorik.</i><br />
Tujuan : Mempertahankan Intergritas kulit<br />
Kriteria Hasil : Keadaan kulit pasien utuh, bebas dari kemerahan, bebas dari
infeksi pada lokasi yang tertekan.<br />
1. Kaji faktor resiko terjadinya gangguan integritas kulit<br />
2. Kaji keadaan pasien setiap 8 jam<br />
3. Gunakan tempat tidur khusus (dengan busa)<br />
4. Ganti posisi setiap 2 jam dengan sikap anatomis<br />
5. Pertahankan kebersihan dan kekeringan tempat tidur dan tubuh pasien.<br />
6. Lakukan pemijatan khusus / lembut diatas daerah tulang yang menonjol setiap
2 jam dengan gerakan memutar.<br />
7. Kaji status nutrisi pasien dan berikan makanan dengan tinggi protein<br />
8. Lakukan perawatan kulit pada daerah yang lecet / rusak setiap hari</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Rasional</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
1. Salah satunya yaitu immobilisasi, hilangnya sensasi, Inkontinensia bladder
/bowel.<br />
2. Mencegah lebih dini terjadinya dekubitus.<br />
3. Mengurangi tekanan 1 tekanan sehingga mengurangi resiko dekubitas<br />
4. Daerah yang tertekan akan menimbulkan hipoksia, perubahan posisi
meningkatkan sirkulasi darah.<br />
5. Lingkungan yang lembab dan kotor mempermudah terjadinya kerusakan kulit<br />
6. R/ Meningkatkan sirkulasi darah<br />
7. Mempertahankan integritas kulit dan proses penyembuhan<br />
8. Mempercepat proses penyembuhan<br />
<br />
<i style="mso-bidi-font-style: normal;">3.Retensi urine yang berhubungan dengan
ketidakmampuan untuk berkemih secara spontan, terputusnya jaras
spinothalamikus.</i><br />
Tujuan : Peningkatan eliminasi urine<br />
Kriteria Hasil : Pasien dpat mempertahankan pengosongan blodder tanpa residu
dan distensi, keadaan urine jernih, kultur urine negatif, intake dan output cairan
seimbang<br />
1. Kaji tanda-tanda infeksi saluran kemih<br />
2. Kaji intake dan output cairan<br />
3. Lakukan pemasangan kateter sesuai program.<br />
4. Anjurkan pasien untuk minum 2-3 liter setiap hari<br />
5. Cek bladder pasien setiap 2 jam<br />
6. Lakukan pemeriksaan urinalisa, kultur dan sensitibilitas<br />
7. Monitor temperatur tubuh setiap 8 jam</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Rasional</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
1. Efek dari tidak efektifnya bladder adalah adanya infeksi saluran kemih<br />
2. Mengetahui adekuatnya gunsi gnjal dan efektifnya blodder.<br />
3. Efek trauma medulla spinalis adlah adanya gangguan refleks berkemih sehingga
perlu bantuan dalam pengeluaran urine<br />
4. Mencegah urine lebih pekat yang berakibat timbulnya infeksi<br />
5. Mengetahui adanya residu sebagai akibat autonomic hyperrefleksia<br />
6. Mengetahui adanya infeksi<br />
7. Temperatur yang meningkat indikasi adanya infeksi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
<i style="mso-bidi-font-style: normal;">4.Konstipasi berhubungan dengan adanya
atoni usus sebagai akibat gangguan autonomik, terputusnya jaras
spinothalamikus.</i><br />
Tujuan : Memperbaiki fungsi usus<br />
Kriteria hasil : Pasien bebas konstipasi, keadaan feses yang lembek, berbentuk.<br />
1. kaji pola eliminasi bowel<br />
2. Berikan minum 1800 – 2000 ml/hari jika tidak ada kontraindikasi<br />
3. Auskultasi bising usus, kaji adanya distensi abdomen<br />
4. Hindari penggunaan laktasif oral<br />
5. Lakukan mobilisasi jika memungkinkan<br />
6. Evaluasi dan catat adanya perdarah pada saat eliminasi<br />
7. Berikan suppositoria sesuai program<br />
8. Berikan diet tinggi serat</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Rasional</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
1. Menentukan adanya perubahan eliminasi<br />
2. Mencegah konstipasi<br />
3. Bising usus menentukan pergerakan perstaltik<br />
4. Kebiasaan menggunakan laktasif akan tejadi ketergantungan<br />
5. Meningkatkan pergerakan peritaltik<br />
6. Kemungkinan perdarahan akibat iritasi penggunaan suppositoria<br />
7. Pelunak feses sehingga memudahkan eliminasi<br />
8. Serat meningkatkan konsistensi feses</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
<i style="mso-bidi-font-style: normal;">5.Nyeri yang berhubungan dengan pengobatan,
immobilitas lama, cedera psikis.</i><br />
Tujuan : Memberikan rasa nyaman: nyeri<br />
Kriteria hasil : Melaporkan penurunan rasa nyeri /ketidak nyaman,
mengidentifikasikan cara-cara untuk mengatasi nyeri, mendemonstrasikan
penggunaan keterampilan relaksasi dan aktifitas hiburan sesuai kebutuhan
individu.<br />
1. Kaji terhadap adanya nyeri, bantu pasien mengidentifikasi dan menghitung
nyeri, misalnya lokasi, tipe nyeri, intensitas pada skala 0 – 1.<br />
2. Berikan tindakan kenyamanan, misalnya, perubahan posisi, masase, kompres hangat
/ dingin sesuai indikasi.<br />
3. Dorong penggunaan teknik relaksasi, misalnya, pedoman imajinasi visualisasi,
latihan nafas dalam.<br />
4. kolaborasi pemberian obat sesuai indikasi, relaksasi otot, misalnya dontren
(dantrium); analgetik; antiansietis.misalnya diazepam (valium)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Rasional</span></b><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
1. Pasien biasanya melaporkan nyeri diatas tingkat cedera misalnya dada /
punggung atau kemungkinan sakit kepala dari alat stabilizer<br />
2. Tindakan alternatif mengontrol nyeri digunakan untuk keuntungan emosionlan,
selain menurunkan kebutuhan otot nyeri / efek tak diinginkan pada fungsi
pernafasan.<br />
3. Memfokuskan kembali perhatian, meningkatkan rasa kontrol, dan dapat
meningkatkan kemampuan koping<br />
4. Dibutuhkan untuk menghilangkan spasme /nyeri otot atau untuk
menghilangkan-ansietas dan meningkatkan istrirahat. </span></div>
<div class="MsoNormal">
<br /></div>Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-39182214399222910292012-07-19T04:28:00.002-07:002012-08-08T05:08:47.286-07:00ASKEP GASTRITIS<br />
<div align="center" class="MsoNormal" style="line-height: normal; margin-left: 17.85pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 2; text-align: center; text-indent: -17.85pt;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 18pt;">Konsep Dasar
Penyakit Gastritis</span></b><br />
</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 18.0pt; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12pt;">1.
Pengertian</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Gastritis
adalah peradangan pada permukaan mukosa lambung yang dimana ditemukan adanya
kerusakan-kerusakan berupa erosi. ( Soeparman, Waspadji, Sarwono, 1998 ).</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Terjadinya radang
difus di mukosa lambung, dengan erosi-erosi yang mungkin berdarah dan sering
menyebabkan nyeri epigastrium. ( Junaidi, Purnawan, dkk, 1996 ).</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Gastritis
adalah peradangan pada mukosa gaster yang merupakan akibat ketidakmampuan
gaster menerima suatu zat atau makanan, yang mana penyakit ini digolongkan
sebagai suatu infeksi pada saluran
pencernaan. ( Price, Sylvia, A,
1995 ).</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Gastritis
merupakan peradangan yang umum, terjadinya pada seluruh populasi terutama pada
tahun-tahun lanjut dan kehidupan dewasa. ( Guyton, Arthur C, Hall E, Johni,
1999 ).</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Gastritis
merupakan salah satu gangguan pada saluran cerna berupa erosi dan perdarahan
akibat factor-faktor agresif atau akibat gangguan sirkulasi akut mukosa
lambung. ( Mansjoer, Arif, 1990 ).</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12pt;">2.
Etiologi</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Adapun
etiologi Gastritis menurut Soeparman, dkk, 1990, yaitu sebagai berikut :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12pt; line-height: 115%;">a. </span><span lang="SV" style="font-size: 12pt; line-height: 115%;">Gastritis akut erosif dapat timbul tanpa diketahui
sebabnya. </span><span style="font-size: 12pt; line-height: 115%;">Penyebab yang paling sering dijumpai adalah :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">1) </span><span lang="FI" style="font-size: 12pt; line-height: 115%;">Obat analgetik antiinflamasi, terutama aspirin. </span><span lang="SV" style="font-size: 12pt; line-height: 115%;">Dalam dosis rendah sudah dapat menyebabkan erosi
mukosa lambung.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12pt; line-height: 115%;">2) Bahan kimia misalnya
lysol.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12pt; line-height: 115%;">3) Merokok.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12pt; line-height: 115%;">4) Alkohol.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12pt; line-height: 115%;">5) Stress fisik yang
disebabkan oleh luka baker, sepsis, trauma, pembedahan, gagal pernafasan, gagal
ginjal, kerusakan suasana saraf pusat.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12pt; line-height: 115%;">6) Refluks usus lambung.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<span style="font-size: 12pt; line-height: 115%;">7) Endotoksin.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12pt; line-height: 115%;">b.
Gastritis kronik</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Etiologi pada umumnya belum diketahui Gastritis kronik juga sering dijumpai
bersama-sama dengan penyakit lain, misalnya : anemia pernisiosa, anemia
defisiensi besi karena adanya perdarahan kronis.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 115%;">3.
Patofisiologi</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-size: 12pt; line-height: 115%;">Lambung merupakan tempat penyimpanan makanan pada
saluran pencernaan. Makanan yang masuk ke saluran pencernaan yang mengandung
zat iritan ( alcohol, nikotin, asam, dan pedas ) dan endotoksin akan
menyebabkan stressor fisis. Dan stressor psikologis akan menstimulasi saraf
simpatis dan parasimpatis. Kedua penyebab yaitu stressor fisis dan stressor
psikologis akan menyebabkan peningkatan enzim lambung ( Hcl dan Gastrin )
kemudian terjadilah akumulasi dan konsentrasi asam meningkat pada lambung.
Akibat dari asam lambung meningkat akan mengiritasi mukosa lambung, maka
terjadi lisis yang akan menimbulkan penyakit gastritis. Manifestasi dari
Gastritis secara psikologis yaitu cemas. Sedangkan manifestasi klinis yaitu
nyeri epigastrium, mual, anoreksia, distensi abdomen dan susah tidur. (
Soeparman, dkk, 1990 ).</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-size: 12pt; line-height: 115%;">Terdapat gangguan keseimbangan factor agresif dan
factor divensive sehingga terjadi kerusakan atau kelainan patologi. Dengan
adanya iritasi yang terus menerus, jaringan jadi mengakibatkan peradangan dan
nekrosis pada dinding lambung.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Factor-faktor penyebab iritasi lambung menurut arief Mansjoer, 2001 :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 36.0pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 1184;">
<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: 0cm 5.4pt 0cm 5.4pt; width: 191.7pt;" valign="top" width="256"><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-size: 12pt; line-height: 115%;">Faktor agresif</span></b><span style="font-size: 12pt; line-height: 115%;"></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: 0cm 5.4pt 0cm 5.4pt; width: 196.65pt;" valign="top" width="262"><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-size: 12pt; line-height: 115%;">Faktor defensive</span></b><span style="font-size: 12pt; line-height: 115%;"></span></div>
</td>
</tr>
<tr style="height: 108.1pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; height: 108.1pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 191.7pt;" valign="top" width="256"><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 18.0pt;">
<span style="font-size: 12pt; line-height: 115%;">· Asam
lambung</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 18.0pt;">
<span style="font-size: 12pt; line-height: 115%;">· Pepsin</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 18.0pt;">
<span style="font-size: 12pt; line-height: 115%;">· AINSD</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 18.0pt;">
<span style="font-size: 12pt; line-height: 115%;">· Empedu</span></div>
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<span style="font-size: 12pt; line-height: 115%;">· Infeksi
virus</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 18.0pt;">
<span style="font-size: 12pt; line-height: 115%;">· Infeksi
bakteri ; H. pylori</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 18.0pt;">
<span lang="ES-AR" style="font-size: 12pt; line-height: 115%;">· Bahan korosif; asam dan
basa</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 108.1pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 196.65pt;" valign="top" width="262"><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 18.0pt;">
<span style="font-size: 12pt; line-height: 115%;">· Mukus</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 18.0pt;">
<span style="font-size: 12pt; line-height: 115%;">· Bikarbonas
mukosa</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 18.0pt;">
<span style="font-size: 12pt; line-height: 115%;">· Prostaglandin
mikrosirkulasi</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 115%;">4.
Klasifikasi</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Berdasarkan klasifikasinya Gastritis menurut Price, Sylvia A, et al, 1995
dapat dibagi menjadi dua jenis, yang paling sering terjadi yaitu :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">a. Gastritis superfisialis akut</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Gastritis ini merupakan jenis yang paling sering ditemukan, biasanya jinak,
dapat sembuh sendiri. Ini merupakan respon dari mukosa lambung terhadap
berbagai iritan local. Endoktoksin, bakteri kafein, alcohol dan aspirin serta
makanan berbumbu ( lada ataupun cuka ) dapat menjadi penyebab timbulnya gejala
yang mengarah pada gastritis.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12pt; line-height: 115%;">b. Gastritis atrofik
kronik</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Merupakan gastritis karena adanya atrifi progresif pada epitel kelenjer
yang disertai hilangnya sel parietal dan chief cell. Hal ini menyebabkan penurunan
dari produksi asam klorida, pepsin dan factor intrinsic menurun. Dinding
lambung menipis dan mukosa permukaannya menjadi rata. Gastritis atrofik kronik
diduga menjadi factor predisposisi timbulnya tukak lambung dan karsinoma.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 115%;">5.
Manifestasi klinis</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Manifestasi klinis Gastritis menurut Price, Sylvia A, 1995, yaitu :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">a. Gastritis akut</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Dapat bervariasi dari keluhan seperti anoreksia atau mual, sampai gejala
yang lebih berat seperti nyeri epigastrium, muntah, perdarahan dan hematomesis.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<span style="font-size: 12pt; line-height: 115%;">b. Gastritis atrofik
kronik</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Manifestasi klinik pada gastritis ini umumnya bervariasi dan tak jelas
seperti perasaan penuh, anoreksia dan adanya distress epigastrik yang tak
nyata.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 115%;">6. Pemeriksaan
penunjang</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Adapun pemeriksaan penunjang Gastritis menurut Hudak dan Gallo, 1996,
seperti di bawah ini :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">a. Nilai haemoglobin dan hematokrit
untuk menentukan adanya anemia akibat perdarahan.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">b. Kadar serum
gastrin rendah atau normal, atau meninggi pada gastritis kronik yang berat.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">c. Pemeriksaan rontgen dengan sinar X
barium untuk melihat kelainan mukosa lambung.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">d. Endoskopi dengan menggunakan gastrocopy
untuk melihat kelainan mukosa lambung.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">e. Pemeriksaan asam lambung untuk
mengetahui ada atau tidak peningkatan asam lambung.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="font-size: 12pt; line-height: 115%;">7. Komplikasi dari
gastritis.</span></b><span lang="SV" style="font-size: 12pt; line-height: 115%;">
( Mansjoer Arief, et al , 1999)</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt left 2.0cm;">
<span style="font-size: 12pt; line-height: 115%;">1)
Perdarahan saluran cerna bagian atas</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt left 2.0cm;">
<span style="font-size: 12pt; line-height: 115%;">2)
Ulkus</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt left 2.0cm;">
<span style="font-size: 12pt; line-height: 115%;">3)
Perporasi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt left 2.0cm;">
<span style="font-size: 12pt; line-height: 115%;">4)
Anemia kerena gangguan absorbsi vitamin B<sub>12</sub></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 2.0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 115%;">8.
Pengobatan</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">a. Gastistis akut menurut Price, Sylvia
A, 1995, yaitu :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<span style="font-size: 12pt; line-height: 115%;">1) Pemberian obat-obat
anti muntah dalam membantu menghilangkan gejala mual dan muntah.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<span style="font-size: 12pt; line-height: 115%;">2) Jika muntah terus
menerus perlu dilakukan pemantauan terhadap pemenuhan cairan dan elektrolit
dengan memberikan infus intravena.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<span style="font-size: 12pt; line-height: 115%;">3) Mengatasi penyebab
apabila diketahui.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<span style="font-size: 12pt; line-height: 115%;">4) Pemberian obat-obat H<sub>2
</sub> blocking (seperti ranitidine). Berguna mengurangi asam lambung.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt;">
<span lang="FI" style="font-size: 12pt; line-height: 115%;">5) Istirahat
fisik dan psikis serta makan lunak selama masa timbulnya penyakit.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">b. Gastritis kronis
menurut Soeparman, dkk, 1990, yaitu :</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt 54.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">1)
Pengobatan biasanya tergantung pada penyebab kelainan yang dicurigai, yang
keluhannya dapat dihubungkan dengan Gastritis kronis.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt 54.0pt;">
<span style="font-size: 12pt; line-height: 115%;">2) Pemberian vitamin B<sub>12.
</sub></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 36.0pt 54.0pt;">
<span style="font-size: 12pt; line-height: 115%;">3) Jika penyebabnya ditemukan
misalnya refluks usus lambung, sebaiknya dilakukan koreksi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 115%;">9. Pencegahan</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Ada beberapa hal yang perlu dilakukan untuk mencegah timbulnya kembali
serangan Gastritis baik akut maupun kronis, menurut Long C, Barbara, 1996,
yaitu :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12pt; line-height: 115%;">a. Usahakan makan
secara teratur.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12pt; line-height: 115%;">b. Hindari makanan yang
merangsang seperti asam, pedas, maupun makanan yang terlalu manis.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">c.
Hindari buah-buahan seperti durian, nenas, dan nangka.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12pt; line-height: 115%;">d. Hindari makanan
ketan.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">e.
Hindari sayuran yang rendah serat dan mengandung banyak gas seperti kol.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span lang="FI" style="font-size: 12pt; line-height: 115%;">f.
Hindari minuman alkohol dan merokok.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12pt; line-height: 115%;">g. Kurangi
mengkonsumsi kopi dan teh<sub> </sub> </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span style="font-size: 12pt; line-height: 115%;">h. Tetap lakukan
makanan dengan porsi kecil tapi sering (tiap 2 atau 3 jam) dengan makan roti
atau makanan lainnya.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 4;">
<b><span lang="SV" style="font-size: 12pt; line-height: 115%;">C.
Konsep Dasar Asuhan Keperawatan Gastritis</span></b><b><span style="font-size: 12pt; line-height: 115%;"></span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Proses keperawatan adalah suatu metode dimana suatu
konsep diterapkan dalam praktek keperawatan yang mana hal ini disebut sebagai
penekanan <i>Problem Solving</i> yang memerlukan ilmu, tekhnik dan keterampilan
inter personal dan ini ditujukan untuk memenuhi kebutuhan klien atau keluarga
(Nursalam, 2001).</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Proses keperawatan sendiri terdiri atas lima tahap
yang mendasar dan berhubungan. Kelima tahap tersebut adalah pengkajian,
penentuan diagnosis, perencanaan, pelaksanaan dan evaluasi (Iyer et al, 1996).</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Semua tahap ini berhubungan dengan fungsi
intelektual problem sorving dan mendefinisikan suatu tindakan keperawatan.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">1. Pengkajian</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Merupakan awal dari proses keperawatan yang meliputi aspek bio, psiko,
sosio, spiritual. Pengkajian dimaksudkan untuk mendapatkan informasi atau
data-data tentang pasien. Dimana data tersebut bisa berasal dari pasien sendiri
yang disebut data primer maupun informasi yang berasal dari keluarga pasien dan
catatan-catatan yang ada kaitannya dengan kondisi pasien serta informasi
dari tim kesehatan yang merawat pasien disebut data sekunder.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Pengkajian merupakan tahap awal dari proses keperawatan dan merupakan dasar
utama dari proses keperawatan secara keseluruhan. Pengkajian keperawatan dibagi
menjadi 4 tahap yaitu : pengumpulan data, validasi data, pengorganisasian data
dan identifikasi masalah atau analisa masalah. (La Ode Jumadi Gaffar, S.Kp,
1999).</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Untuk klien dengan Gastritis pada pengkajian
didapat data-data sebagai berikut:</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">a. Aktivitas/istirahat :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Gejala :
kelemahan, kelelahan</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Tanda :
tacikardia, hiperventilasi 9respon terhadap aktivitas)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Sirkulasi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Gejala :
hipotensi (termasuk postural)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Tacikardia, disritmia (hipovolemia/hipoksemia)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Kelemahan nadi perifer</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Pengisian kapiler lambat/perlahan</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Kelembaban kulit/membrane mokosa : berkeringat</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Psikologik</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">b. Integritas ego</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Gejala : faktor
stress akut atau kronis</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Tanda : tanda ansietas (gelisah)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">c. Eliminasi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;"> Gejala : riwayat perawatan di rumah
sebelumnya pernah mendapat masalah </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">d. Abdomen</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Tanda : nyeri tekan abdomen, distensi. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">e. Makanan/cairan</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-size: 12pt; line-height: 115%;">Gejala : anoreksia, mual, muntah, nyeri ulu
hati. </span><span lang="SV" style="font-size: 12pt; line-height: 115%;">Tidak toleran
terhadap makanan; pedas, asam atau terlalu manis.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Tanda : membran mukosa agak
kering (terutama bibir), jumlah makanan kurang dari kebutuhan tubuh.
Cairan peroral kurang dari 2000
cc/hari. </span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">f. Neurosensori</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-size: 12pt; line-height: 115%;">Gejala : rasa
pusing, kelemahan fisik.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">g. Nyeri/kenyamanan</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Gejala : nyeri digambarkan sebagai nyeri yang
tajam, dangkal ataupun perih rasa ketidaknyamanan/distress samar-samar setelah
makan banyak dan hilang dengan makan. </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">nyeri epigastrium pada kuadran 1 dan 2. Nyeri
berkurang setelah diberikan antansida. </span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Factor pencetus : makanan yang merangsang, perokok,
alkoholisme,</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">
Penggunaan obat-obat tertentu, stressor psikologik.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Tanda : wajah
berkerut, agak pucat.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">h. Psikososial dan penyakit keluarga</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Kemungkinan dalam keluarga ada yang menderita
penyakit gastrointestinal. Bagaimana persepsi klien terhadap penyakitnya dan
bagaimana pemecahan yang diambilnya untuk mengatasinya.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">i. Penyuluhan dan
pembelajaran</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-size: 12pt; line-height: 115%;">Gejala
: adanya kebiasaan untuk makan makanan yang pedas.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12pt; line-height: 115%;">2. Diagnosa Keperawatan</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Diagnosa keperawatan adalah suatu pernyataan yang menjelaskan respon
manusia (status kesehatan atau rperubahan pola) dari individu atau kelompok
dimana perawat secara akuntabilitas dapat mengidentifikasi dan memberikan
intervensi secara pasti untuk menjadi status kesehatan, menurunkan, membatasi,
mencegah dan merubah (Carpenito, 200).</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Doenges (2000) mengatakan bahwa diagnosa keperawatan adalah : masalah
kesehatan actual, dan potensial dimana berdasarkan pendidikan dan pengalaman
dia mampu dan mempunyai kewenangan memberikan tindakan keperawatan.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Adapun diagnosa keperawatan pada klien dengan gastritis, yaitu :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 63.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">a.
Nyeri berhubungan dengan iritasi lambung.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 63.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">b. Perubahan
nutrisi kurang dari kebutuhan tubuh berhubungan mual dan anorexia.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 63.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">c.
Gangguan pemenuhan istirahat dan tidur berhubungan dengan nyerigaigastrium</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 63.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">d. Defisit
knowledge berhubungan dengan kurang informasi.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.0pt;">
<span style="font-size: 12pt; line-height: 115%;">3. Perencanaan</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Tahapan dalam perencanaan ini meliputi menentukan prioritas, menentukan kriteria
hasil, menentukan rencana tindakan dan pendukomentasian (Nursalam, 2001),
terdapat tiga rencana tindakan dalam tahap rencana tindakan yaitu : rencana
tindakan perawat, rencana tindakan pelimpahan (medis dan tim kesehatan lain)
dan program atau perintah medis untuk klien yang dalam pelaksanaannya dibantu
perawat (Carpenito, 2001).</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Berdasarkan diagnosa keperawatan yang timbul pada klien dengan gastritis,
maka rencana keperawatan yang dapat dirumuskan antara lain :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 63.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">a.
Nyeri yang berhubungan dengan iritasi lambung.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span lang="SV" style="font-size: 12pt; line-height: 115%;">Tujuan</span></i><span lang="SV" style="font-size: 12pt; line-height: 115%;"> : nyeri berkurang sampai dengan hilang.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span lang="SV" style="font-size: 12pt; line-height: 115%;">Kriteria hasil</span></i><span lang="SV" style="font-size: 12pt; line-height: 115%;"> : - klien mengatakan nyeri berkurang</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">
</span><span style="font-size: 12pt; line-height: 115%;">- klien tampak rileks</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 108.0pt;">
<span style="font-size: 12pt; line-height: 115%;"> - tanda-tanda ulta : TD, nadi dalam batas
normal</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span style="font-size: 12pt; line-height: 115%;">Rencana tindakan </span></i><span style="font-size: 12pt; line-height: 115%;">:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 63.0pt;">
<span style="font-size: 12pt; line-height: 115%;">1. Kaji penyebab
timbulnya nyeri atau terjadinya nyeri.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">
Rasional : digunakan sebagai dasar tindakan selanjutnya</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 63.0pt;">
<span style="font-size: 12pt; line-height: 115%;">2. Catat karateristik
nyeri meliputi durasi, lokasi dan intensitasnya (skala 0 – 10)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Rasional : mengetahui seberapa jauh nyeri dan menentukan
etiologinya serta mengantisipasi terjadinya komplikasi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">3. Observasi tanda-tanda vital</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">
Rasional : mengetahui keadaan umum klien</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-size: 12pt; line-height: 115%;">4. Ciptakan suasana
perawatan yang tenang.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-size: 12pt; line-height: 115%;">
</span><span lang="SV" style="font-size: 12pt; line-height: 115%;">Rasional : mengurangi stimulus yang tidak diinginkan</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 63.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">5. Ajarkan
tehnik rileksasi dan nafas dalam</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Rasional : dapat mengurangi ketegangan
syaraf sehingga klien lebih rilex dan nyeri berkurang</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 81.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">6. Kolaborasi
dengan dokter dalam pemberian obat analgetik</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">
</span><span style="font-size: 12pt; line-height: 115%;">Rasional : medikamentosa dapat mengurangi nyeri.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">b. Perubahan nutrisi
kurang dari kebutuhan tubuh berhubungan dengan mual dan anoreksia.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">
<i>Tujuan</i> : kebutuhan nutrisi terpenuhi.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">
<i>Kriteria hasil</i> : klien tidak mual lagi</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">
klien menghabiskan porsi makanan</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">peningkatan HB, peningkatan BB mencapai berat badan
ideal, conjungtiva tidak eremis. </span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">
</span><i><span style="font-size: 12pt; line-height: 115%;">Rencana tindakan</span></i><span style="font-size: 12pt; line-height: 115%;"> :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 90.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">1. Kaji
status nutrisi dan factor-faktor penyebab kurangnya intake nutrisi.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Rasional : untuk mengetahui sejauh mana perkembangan dari keadaan
pasien. Dan perubahan yang terjadi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 90.0pt;">
<span style="font-size: 12pt; line-height: 115%;">2. Anjurkan klien makan
dalam porsi kecil tapi sering</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Rasional : mencegah perangsangan yang mendadak pada lambung</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span style="font-size: 12pt; line-height: 115%;">3. Hindari makanan yang
keras dan merangsang peningkatan asam lambung seperti pedas, asam, kopi,
alcohol dan lain-lain.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Rasional : untuk menghindari kerja lambung yang berat dan
meminimalkan Iritasi pada
lambung.
</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 90.0pt;">
<span style="font-size: 12pt; line-height: 115%;">4. Timbang berat badan
setiap hari</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Rasional : untuk mengetahui perkembangan
berat badan.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 90.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">5. Kolaborasi
dengan dokter dalam pemberian antiematik</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Rasional : untuk mencegah mual, nyeri dan
rasa tidak nyaman.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">c. Gangguan
pemenuhan istirahat tidur berhubungan dengan nyeri epigastrium</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span lang="SV" style="font-size: 12pt; line-height: 115%;">Tujuan </span></i><span lang="SV" style="font-size: 12pt; line-height: 115%;"> : setelah dilakukan intervensi diharapkan istirahat dantidur
terpenuhi.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span style="font-size: 12pt; line-height: 115%;">Kriteria hasil </span></i><span style="font-size: 12pt; line-height: 115%;">:</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.8pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">- Klien dapat tidur
sesuai kebutuhannya.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.8pt;">
<span style="font-size: 12pt; line-height: 115%;">- Klien tidak terlihat lesu dan lemah</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 45.8pt;">
<span style="font-size: 12pt; line-height: 115%;">- Tidak terlihat lingkaran hitam pada
palpebra inferior dan superior.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span style="font-size: 12pt; line-height: 115%;">Rencana tindakan</span></i><span style="font-size: 12pt; line-height: 115%;"> :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 81.8pt;">
<span style="font-size: 12pt; line-height: 115%;">1. Kaji tingkat
kebutuhan istirahat tidur</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Rasional : untuk mengetahui tingkat gangguan kebutuhan istirahat
Tidur</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 81.8pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">2. Atur
posisi yang nyaman bagi klien.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Rasional : dengan posisi yang mendukung
dapat memberikan rasa nyaman</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 81.8pt;">
<span style="font-size: 12pt; line-height: 115%;">3. Diskusikan dengan
pasien tentang pola dan kebiasaan pada saat akan tidur.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Rasional : dengan menggunakan kebiasaan
yang sama walaupun dengan </span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">lingkungan yang berbeda diharapkan klien dapat
tidur seperti biasa. </span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 81.8pt;">
<span style="font-size: 12pt; line-height: 115%;">4. Ganti laken dan
pakaian klien setiap hari.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Rasional : agar klien merasa nyaman dan
tidak gerah pada saat tidur.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 81.8pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">5. Ciptakan
lingkungan yang terang dan nyaman.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Rasional : dengan lingkungan terang
diharapkan klien tidur dengan nyenyak.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 81.8pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">6. Berikan
obat sesuai dengan indikasi.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Rasional : mengurangi nyeri yang klien
rasakan.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 54.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">d. Defisit
knowledge berhubungan dengan kurangnya informasi tentang
pengertian gastritis, etiologi, tanda dan gejala serta
pencegahan.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 27.0pt;">
<i><span lang="FI" style="font-size: 12pt; line-height: 115%;">Tujuan
</span></i><span lang="FI" style="font-size: 12pt; line-height: 115%;"> : setelah dilakukan
tindakan keperawatan kurangnya informasi dapat.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<i><span lang="SV" style="font-size: 12pt; line-height: 115%;">Kriteria
hasil</span></i><span lang="SV" style="font-size: 12pt; line-height: 115%;">
:</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 72.0pt;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">
- Klien dan keluarga tidak bertanya lagi</span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;"> -
Klien dan keluarga mengerti tentang pengertian gastritis etiologi, tanda dan
gejala pencegahan. </span><span style="font-size: 12pt; line-height: 115%;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span style="font-size: 12pt; line-height: 115%;">Rencana tindakan</span></i><span style="font-size: 12pt; line-height: 115%;"> :</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 73.8pt 252.0pt;">
<span style="font-size: 12pt; line-height: 115%;">1. Kaji tingkat
pengetahuan klien</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Rasional : untuk mengetahui tingkat pengetahuan klien.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 73.8pt 252.0pt;">
<span style="font-size: 12pt; line-height: 115%;">2. Beri penjelasan
tentang penyakit gastritis, etiologi, tanda dan gejala serta pencegahan dan
anjurkan pasien untuk kooperatif.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12pt; line-height: 115%;">Resional : Dengan penjelasan dapat meningkatkan pengetahuan
klien serta keluarga dan diharapkan dapat mencegah dari kekambuhan.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: list 73.8pt 252.0pt;">
<span style="font-size: 12pt; line-height: 115%;">3. Berimotivasi klien
untuk sembuh</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-size: 12pt; line-height: 115%;">Rasional : agar klien bermotivasi untuk
sembuh.</span><span style="font-size: 12pt; line-height: 115%;"></span></div>Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-77940835302284051042012-07-17T06:09:00.002-07:002012-08-08T05:04:39.805-07:00ASKEP KPD<br />
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; mso-outline-level: 3; text-align: center;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Asuhan
keperawatan Ketuban Pecah Dini</span></b></div>
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; mso-outline-level: 3; text-align: center;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">(KPD)</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; mso-outline-level: 3;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; mso-outline-level: 3;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"> <b>Konsep
Dasar</b></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.1.
Definisi</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
KPD ( Ketuban Pecah Dini ) adalah pecah nya ketuban sebelum terdapat tanda
persalinan mulai dan di tunggu satu jam belum terjadi inpartu sebagian besar
KPD adalah hamil aterm di atas 27 minggu, sedangkan dibawah 36 minggu tidak
terlalu banyak </span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">( Ida Bagus, 2001 )</span></i></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
KPD ( Ketuban Pecah Dini ) adalah ketuban yang pecah spontan yang terjadi pada
sembarang usia kehamilan sebelum persalinan di mulai <i>( Mansjoer Arif, 2000 :
310 )</i></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
Ketuban pecah dini adalah pecahnya selaput ketuban secara spontan satu
jam atau lebih sebelum terjadi tanda-tanda persalinan. <i>(Arief Mansjoer, 1999
: 310)</i></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.2.</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
<b>Anatomi Fisiologi</b></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
</span></b><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Volume air ketuban pada
kehamilan cukup bulan adalah 1000 – 1500 cc</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
</span></b><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Ciri-ciri kimiawi :</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Air ketuban berwarna putih
kekeruhan, berbau khas amis, dan berasa manis, reaksinya agak alkalis atau
netral, berat jenis 1,008. Komposisinya terdiri atas 98 % air, sisanya albumin,
urea, asam urik, kreatinin, sel-sel epitel, rambut lanugo, verniks kaseosa dan
garam anorganik. </span><span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: NO-BOK; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Kadar protein kira-kira 2,6
gr % per liter terutama sebagai albumin.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: NO-BOK; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Dijumpai lecitin spingomyelin
dalam air ketuban amat berguna untuk mengetahui apakah janin sudah mempunyai
paru-paru yang matang. Sebab peningkatan kadar lecitin pertanda bahwa permukaan
paru-paru diliputi zat surfaktan. Ini merupakan syarat bagi paru-paru untuk
berkembang dan bernapas. Bila persalinan berjalan lama atau ada gawat janin
atau pada letak sungsang akan kita jumpai warna ketuban keruh kehijau-hijauan,
karena telah bercampur dengan mekonium.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt; mso-list: l3 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt; text-indent: 0cm;">
<span style="font-family: Symbol; font-size: 10.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Fungsi Air Ketuban</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt; mso-list: l0 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt; text-indent: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-language: IN; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Untuk proteksi janin.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt; mso-list: l0 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt; text-indent: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-language: IN; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Untuk mencegah perlengketan janin dengan amnion.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt; mso-list: l0 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt; text-indent: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-language: IN; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: NO-BOK; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Agar janin dapat bergerak dengan bebas.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt; mso-list: l0 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt; text-indent: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-language: IN; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Regulasi terhadap panas dan perubahan suhu.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt; mso-list: l0 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt; text-indent: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-language: IN; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Mungkin untuk menambah suplai cairan janin</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt; mso-list: l0 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt; text-indent: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-language: IN; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Meratakan tekanan intra – uterin dan membersihkan jalan lahir bila ketuban
pecah.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt; mso-list: l0 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt; text-indent: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-language: IN; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Peredaran air ketuban dengan darah cukup lancar dan perputarannya cepat,
kira-kira 350-500 cc.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt; mso-list: l1 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt; text-indent: 0cm;">
<span style="font-family: Symbol; font-size: 10.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Asal Air Ketuban</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt; mso-list: l2 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt; text-indent: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-language: IN; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Kencing janin (fetal urin)</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt; mso-list: l2 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt; text-indent: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-language: IN; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Transudasi dari darah ibu</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt; mso-list: l2 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt; text-indent: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-language: IN; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Sekresi dari epitel amnion</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt; mso-list: l2 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt; text-indent: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: Cambria; mso-bidi-theme-font: major-latin; mso-fareast-font-family: Cambria; mso-fareast-language: IN; mso-fareast-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Asal campuran (<i>mixed origin</i>)</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">( Ida Bagus, 2001 )</span></i></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: NO-BOK; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.3.</span></b><span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: NO-BOK; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
<b>Etiologi</b></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: NO-BOK; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Penyebab ketuban pecah dini
(KPD) mempunyai dimensi multifaktorial yang dapat dijabarkan sebagai berikut :</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.3.1. Serviks
inkopeten</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.3.2. Ketegangan rahim
berlebihan; kehamilan ganda, hidramnion</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: NO-BOK; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.3.3. Kelainan letak
janin dalam rahim, letak sunsang, letang lintang</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: NO-BOK; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.3.4. Kemungkinan
kesempitan panggul : perut gantung, bagian terendah belum masuk PAP,
sepalopelvik disproforsi</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: NO-BOK; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.3.5. </span><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Kelainan bawaan dari selaput
ketuban</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: NO-BOK; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.3.6. Infeksi yang
menyebabkan terjadi proses biomekanik pada selaput ketuban dalam bentuk
proteolitik sehingga menyebabkan ketuban pecah.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<i><span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: NO-BOK; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">( Arif Monsjoer, dkk, 2001 :
310 )</span></i></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
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<b><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.4.</span></b><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
<b>Manifestasi Klinik</b></span></div>
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<span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.4.1. keluar ketuban
warna putih, keruh, jernih, kuning, hijau / kecoklatan sedikit / banyak</span></div>
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<span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.4.2. dapat di sertai
demam bila sudah ada infeksi</span></div>
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<span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.4.3. janin mudah teraba</span></div>
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<span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.4.4. pada periksa dalam
selaput ketuban tidak ada , air ketuban sudah kering</span></div>
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<i><span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.4.5.</span></i><span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
inspeksikula, tampak air ketuban mengalir / selaput ketuban tidak ada dan air
ketuban ketuban sudah kering <i>( Arief Mansjoer, dkk,2001 : 310 )</i></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b><span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.5.</span></b><span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
<b>Patofisiologi</b></span></div>
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<span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Kantong amnion yang utuh
berfungsi sebagai suatu mekanik terhadap<b>. </b>infeksi tetapi selain itu
cairan amnion mempunyai beberapa sifat bakteri<b> </b>ostatik yang dapat
memainkan peran dalam pencegahan kario amnionitis dan<b> </b>infeksi janin.
Membran yang utuh bukan merupakan sawar mutlak terhadap<b> </b>infeksi karena
kolonisasibakteri terjadi 10% pasien dalam persalinan cukup<b> </b>bulan,
dengan membrane yang utuh sampai 25% pasien dalam persalinan<b> </b>kurang
bulan. Janin kurang bulan dengan ketuban pecah dini, resiko infeksi<b> </b>dan
sepsis yang keberadaannya di dalam rahim ahkan dapat menjadi<b> </b>problematik,
bagi ibu resikonya bukan saja terjadi kariomnitis tetapi juga bisa<b> </b>terjadi
kegagalan induksi, maka harus dilakukan operasi section caesaria.</span></div>
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<br /></div>
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<b><span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.6.</span></b><span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
<b>Komplikasi</b></span></div>
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<span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
1.1.6.1. infeksi</span></div>
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<span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Infeksi yang terjadi secara
langsung pada selaput ketuban maupun asenden dari vagina atau infeksi pada
cairan ketuban bisa menyebabkan terjadinya KPD.</span></div>
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<span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
1.1.6.2. partus peterm</span></div>
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<span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Persalinan preterm atau partus
prematur adalah persalinan yang terjadi pada kehamilan kurang dari 37 minggu (
antara 20 – 37 minggu ) atau dengan berat janin kurang dari 2500 gram (
Manuaba, 1998 : 221)</span></div>
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<span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
1.1.6.3. prolap Tali pusat</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"> Tali
pusat menumbung</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
1.1.6.4. distasia ( partus Kering)</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
Pengeluaran cairan ketuban untuk waktu yang akan lama akan menyebabkan dry
labour atau persalinan kering</span></div>
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<br /></div>
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<b><span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.7. Pemeriksaan Penunjang </span></b></div>
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<span lang="IT" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: IT; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.6.1. Pemeriksaan
Leukosid darah > 15000 / ul bila terjadi infeksi</span></div>
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<span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.6.2. test lakmus
merah berubah menjadi biru</span></div>
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<span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.6.3. amnio sentetis</span></div>
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<i><span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.6.4.</span></i><span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"> USG ( menentukan
usia kehamilan , indeks cairan amnion berkurang
) </span></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span><i><span lang="ES">( Arief Monsjoer, dkk, 2001 :
313 )</span></i></span></div>
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<br /></div>
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<b><span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.8. Penatalaksanaan </span></b></div>
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<span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.8.1. Keperawatan</span></div>
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<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">a.
Rawat rumah sakit dengan tirah baring.</span></div>
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<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">b.
Tidak ada tanda-tanda infeksi dan gawat janin.</span></div>
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<span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">c.
Umur kehamilan kurang 37 minggu.</span></div>
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<span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">d.
Antibiotik profilaksis dengan amoksisilin 3 x </span><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">500 mg selama 5 hari.</span></div>
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<span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">e.
</span><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Memberikan tokolitik bila ada
kontraksi uterus dan memberikan kortikosteroid untuk mematangkan fungsi paru
janin.</span></div>
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<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">f.
Jangan melakukan periksan dalam vagina kecuali ada tanda-tanda persalinan.</span></div>
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<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">g.
</span><span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Melakukan terminasi kehamilan
bila ada tanda-tanda infeksi atau gawat janin.</span></div>
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<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">h.
Bila dalam 3 x 24 jam tidak ada pelepasan air dan tidak ada kontraksi uterus
maka lakukan mobilisasi bertahap. Apabila pelepasan air berlangsung terus,
lakukan terminasi kehamilan.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.1.8.2. Medis</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">a.
</span><span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Bila didapatkan infeksi berat
maka berikan antibiotik dosis tinggi. </span><span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Bila ditemukan tanda-tanda inpartu, infeksi dan gawat
janin maka lakukan terminasi kehamilan.</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">b.
</span><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Induksi atau akselerasi
persalinan.</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">c.
Lakukan seksiosesaria bila induksi atau akselerasi persalinan mengalami
kegagalan.</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">d.
</span><span lang="EN-GB" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Lakukan seksio histerektomi
bila tanda-tanda infeksi uterus berat ditemukan.</span></div>
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<br /></div>
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<span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
<b>ASUHAN KEPERAWATAN</b></span></div>
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<b><span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.2.1. pengkajian </span></b></div>
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<span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.2.1.1. Biodata klien </span></div>
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<b><span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
</span></b><span lang="ES" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: ES; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Biodata klien berisi tentang :
Nama, Umur, Pendidikan, Pekerjaan, Suku, Agama, Alamat, No. Medical Record,
Nama Suami, Umur, Pendidikan, Pekerjaan , Suku, Agama, Alamat, Tanggal
Pengkajian.</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.2.1.2. Keluhan utama :</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">keluar cairan warna putih, keruh,
jernih, kuning, hijau / kecoklatan sedikit / banyak, pada periksa dalam selaput
ketuban tidak ada, air ketuban sudah kering, inspeksikula tampak air ketuban
mengalir / selaput ketuban tidak ada dan air ketuban sudahkering </span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.2.1.3. Riwayat haid</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
Umur menarchi pertama kali, lama haid, jumlah darah yang keluar, konsistensi,
siklus haid, hari pertama haid dan terakhir, perkiraan tanggal partus</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.2.1.4.Riwayat Perkawinan</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
Kehamilan ini merupakan hasil pernikahan ke berapa? Apakah perkawinan sah atau
tidak, atau tidak direstui dengan orang tua ?</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.2.1.5. </span><span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Riwayat Obstetris</span></div>
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<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
Berapa kali dilakukan pemeriksaan ANC, hasil laboraturium : USG ,
darah, urine, keluhan selama kehamilan termasuk situasi emosional dan impresi,
upaya mengatasi keluhan, tindakan dan pengobatan yang diperoleh</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.2.1.6.Riwayat penyakit dahulu </span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
Penyakit
yang pernah di diderita pada masa lalu, bagaimana cara pengobatan yang dijalani
nya, dimana mendapat pertolongan, apakah penyakit tersebut diderita sampai saat
ini atau kambuh berulang – ulang </span></div>
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<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.2.1.7. Riwayat kesehatan
keluarga</span></div>
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<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">
Adakah
anggota keluarga yang menderita penyakit yang diturunkan secara genetic seperti
panggul sempit, apakah keluarga ada yg menderita penyakit menular, kelainan
congenital atau gangguan kejiwaan yang pernah di derita oleh keluarga</span></div>
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<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.2.1.8. Kebiasaan sehari –hari </span></div>
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<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">a. Pola nutrisi : pada umum nya
klien dengan KPD mengalami penurunan nafsu makan, frekuensi minum klien juga
mengalami penurunan</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">b. Pola istirahat dan tidur
: klien dengan KPD mengalami nyeri pada daerah pinggang sehingga pola tidur
klien menjadi terganggu, apakah mudah terganggu dengan suara-suara, posisi saat
tidur (penekanan pada perineum)</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">c. Pola eliminasi : Apakah
terjadi diuresis, setelah melahirkan, adakah inkontinensia (hilangnya
infolunter pengeluaran urin),hilangnya kontrol blas, terjadi over distensi
blass atau tidak atau retensi urine karena rasa takut luka episiotomi, apakah
perlu bantuan saat BAK. Pola BAB, freguensi, konsistensi,rasa takut BAB karena
luka perineum, kebiasaan penggunaan toilet.</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">d. Personal Hygiene : Pola mandi,
kebersihan mulut dan gigi, penggunaan pembalut dan kebersihan genitalia,
pola berpakaian,
tata rias rambut
dan wajah</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">e. Aktifitas : Kemampuan
mobilisasi klien dibatasi, karena klien dengan KPD di anjurkan untuk bedresh
total</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">f. Rekreasi dan hiburan : Situasi
atau tempat yang menyenangkan, kegiatan yang membuat fresh dan relaks.</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.2.1.9. pemeriksaan fisik </span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">a.
Pemeriksaan kesadaran klie, BB / TB, tekanan darah, nadi, pernafasan dan suhu</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">b.
Head To Toe</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">§ Rambut
: warna rambut, jenis rambut, bau nya, apakah ada luka lesi / lecet</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">§ Mata
: sklera nya apakah ihterik / tdk,
konjungtiva anemis / tidak, apakah palpebra oedema / tidak,bagaimana fungsi
penglihatan nya baik / tidak, apakah klien menggunakan alat bantu penglihatan /
tidak. Pada umu nya ibu hamil konjungtiva anemis</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">§ Telinga
: apakah simetris kiri dan kanan, apakah ada terdapat
serumen / tidak, apakah klien menggunakan alt bantu pendengaran / tidak,
bagaimana fungsi pendengaran klien baik / tidak</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">§
Hidung : apakah klien bernafas dengan cuping hidung /
tidak, apakah terdapat serumen / tidak, apakah fungsi penciuman klien baik /
tidak</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">§ Mulut dan
gigi : bagaimana keadaan mukosa bibir
klien, apakah lembab atau kering, keadaan gigi dan gusi apakah ada peradangan
dan pendarahan, apakah ada karies gigi / tidak, keadaan lidah klien bersih /
tidak, apakah keadaan mulut klien berbau / tidak. Pada ibu hamil pada umum nya
berkaries gigi, hal itu disebabkan karena ibu hamil mengalami penurunan kalsium</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">§
Leher : apakah klien mengalami pembengkakan
tyroid</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">§ Paru – paru</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">I : warna kulit, apakah
pengembangan dada nya simetris kiri dan kanan, apakah ada terdapat luka memar /
lecet, frekuensi pernafasan nya</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">P : apakah ada teraba massa /
tidak , apakah ada teraba pembengkakan / tidak, getaran dinding dada apakah
simetris / tidak antara kiri dan kanan</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">P : bunyi Paru</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">A : suara nafas </span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">§ Jantung </span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">I : warna kulit, apakah ada luka
lesi / lecet, ictus cordis apakah terlihat / tidak</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">P : frekuensi jantung berapa,
apakah teraba ictus cordis pada ICS% Midclavikula</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">P : bunyi jantung</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">A : apakah ada suara tambahan /
tidak pada jantung klien</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">§ Abdomen </span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">I : keadaan perut, warna nya,
apakah ada / tidak luka lesi dan lecet </span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">P : tinggi fundus klien, letak
bayi, persentase kepala apakah sudah masuk PAP / belum</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">P : bunyi abdomen </span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">A : bising usu klien, DJJ janin
apakah masih terdengar / tidak </span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">§ Payudara : puting susu
klien apakah menonjol / tidak,warna aerola, kondisi mamae, kondisi ASI klien,
apakah sudah mengeluarkan ASI /belum</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">§ Ekstremitas</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Atas : warna kulit, apakah ada
luka lesi / memar, apakah ada oedema / tidak</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Bawah : apakah ada luka memar /
tidak , apakah oedema / tidak</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">§ Genitalia : apakah ada
varises atau tidak, apakah ada oedema / tidak pada daerah genitalia klien</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="SV" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: SV; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">§ Intergumen : warna kulit,
keadaan kulit, dan turgor kulit baik / tidak </span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-style: italic; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1.2.2. Tindakan Keperawatan</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">1. </i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Resiko infeksi berhubungan dengan prosedur invasif,
pecah ketuban, kerusakan kulit, penurunan hemoglobin,
pemajanan pada patogen </span></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Tujuan : </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- infeksi tidak
terjadi pada ibu</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">kriteria hasil </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- pencapaian tepat waktu pada pemulihan luka tanpa
komplikasi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Intervensi</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- Tinjau ulang kondisi/faktor risiko yang ada
sebelumnya.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-Catat waktu pecah ketuban.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- <span style="mso-spacerun: yes;"> </span>Kaji terhadap
tanda dan gejala infeksi (misalnya: peningkatan suhu, nadi, jumlah sel darah
putih, atau bau/warna rabas vagina).</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-Berikan perawatan perineal sedikitnya setiap 4 jam
bila ketuban telah pecah</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Rasional</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"> - Kondisi dasar ibu, seperti diabetes atau
hemoragi, menimbulkan potensial resiko infeksi atau penyembuhan luka yang
buruk. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Resiko
rioamnionitis meningkat dengan berjalannya waktu, sehingga meningkatkan resiko
infeksi ibu dan janin.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"><span style="mso-spacerun: yes;"> </span>- Pecah ketuban
terjadi 24jam sebelum pembedahan dapat menyebabkan amnionitis sebelum
intervensi bedah dan dapat mengubah penyembuhan luka.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- Untuk mencegah agar tidak terjadi infeksi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">2. Gangguan rasa nyaman : nyeri berhubungan dengan
terjadi nya ketegangan otot rahim</span></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Tujuan :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-
rasa nyeri berkurang </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Kriteria hasil :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-
klien tampak tenang</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-
klien tampak nyaman</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Intervensi</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-monitor tanda – tanda vital : TD, pernafasan, nadi
dan suhu</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-ajrakan klien teknik relaksasi </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-atur posisi klien</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- berikan lingkungan yang nyaman dan batasi pengunjung</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Rasional</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- nyeri dapat mengakibatkan peningkatan
frekuesni pernafasan dan nadi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- untuk mengurangi rasa nyeri yang dirasakan
klien</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- untuk memberikan kenyamanan pada klien
agar klien dapat beristirahat.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">3. Ansietas berhubungan dengan kurang nya pengetahuan
atau konfirmasi tentang penyakit</span></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Tujuan :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-
klien pengetahuan klien bertambah setelah diberikan informasi mengenai penyakit
nya.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">kriteria hasil :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-
klien tidak resah lagi dengan peyakit nya</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Intervensi</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- tinjau proses penyakit dan harapan masa depan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- dorong periode istirahat yang adekuat dengan
aktifitas terjadwal</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- berikan pelayanan kesehatan mengenai penyakit
nya</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-jelas kan kepada klien apa yg terjadi, berikan
kesempatan untuk bertanya dan berikan jawaban yang terbuka dan jujur </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Rasional</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- memberikan pengetahuan dasar dimana klien
dapat membuat pilihan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- agar klien tidak merasa jenuh dan
mempercepat proses penyembuhan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- agar klien mengerti dengan bahaya
nya infeksi dan penyakit nya</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- menunjukkan realitas situasi yang dapat membantu
klien atau orang terdekat menerima realitas dan mulai menerima apa yang terjadi
</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">4. Gangguan kebutuhan istirahat tidur
berhubungan dengan adanya nyeri , peningkatan HIS</span></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">tujuan :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-
kebutuhan istirahat tidur klien terpenuhi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Kriteria hasil :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-
klien dapat tidur dengan tenang dan tidak gelisah</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-
klien menunjukkan pola tidur yang adekuat</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Intervensi</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- lakukan pengkajian terhadap gangguan
kebutuhan tidur</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- motivasi klien agar mengalihkan perhatian</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- monitor kebutuhan tidur</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- ciptakan suasana nyaman </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Rasional</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- agar dapat memberikan gambaran sampai
sejauh mana kebutuhan tidur terganggu</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- dengan mengalihkan perhatian, maka
perhatian klien tidak hanya tertuju pada rasa nyeri sehingga membantu relaksasi
pada klien sewaktu tidur</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- untuk mengetahui apakah kebutuhan tidur
klien terpenuhi seperti biasa atau belum</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- suasana yang tenang dapat membantu
relaksasi sehingga nyeri berkurang dan klien bisa tidur </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">5. </span></b><b style="mso-bidi-font-weight: normal;"><span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: NO-BOK; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Intoleransi aktifitas b.d.
kelemahan fisik</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Tujuan: </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- aktivitas kembali sesuai
kemampuan pasien.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Kriteria hasil: </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- pasien bisa beraktivitas seperti biasa.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Intervensi</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- Bantu pasien dalam memenuhi
kebutuhan sehari-hari seminimal</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">mungkin.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- Beri posisi nyaman.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: NO-BOK; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-</span><span lang="NO-BOK" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"> </span><span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Anjurkan menghemat energy hindari kegiatan yang melelahkan.</span></div>
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<span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">-</span><span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"> </span><span lang="FI" style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Jelaskan pentingnya mobilisasi diri.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Rasional</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- agar kebutuhan sehari – hari klien dapat
terpenuhi seperti biasa nya</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"> - agar klien merasa nyaman dan tenang</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">- kelelahan dapat menyebabkan lama nya
proses penyembuhan klien,,jadi dengan menghindari kegiatan yang melelahkan
dapat membantu proses penyembuhan</span></div>
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<br /></div>
<br />Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-61932860712873570712012-07-16T02:58:00.007-07:002012-08-08T05:04:39.789-07:00ASKEP HIPEREMESIS GRAVIDARUM<br />
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<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">ASUHAN KEPERAWATAN</span></b></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">HIPEREMESIS GRAVIDARUM</span></b></div>
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<br /></div>
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<br /></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">A. Pengertian</span></b></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Hiperemesis</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"> Gravidarum adalah mual dan muntah yang berlebihan
sehingga pekerjaan sehari-hari terganggu dan keadaan umum ibu menjadi buruk.
(Sarwono Prawirohardjo, Ilmu Kebidanan, 1999).</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Hiperemesis gravidarum adalah muntah yang terjadi
sampai umur kehamilan 20 minggu, begitu hebat dimana segala apa yang dimakan
dan diminum dimuntahkan sehingga mempengaruhi keadaan umum dan pekerjaan
sehari-hari, berat badan menurun, dehidrasi, terdapat aseton dalam urine, bukan
karena penyakit seperti Appendisitis, Pielitis dan sebagainya (<a href="http://zerich150105.wordpress.com/"><span style="color: blue;">http://zerich150105.wordpress.com/</span></a>).</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Dalam buku obstetri patologi (1982) Hiperemesis
Gravidarum adalah suatu keadaan dimana seorang ibu hamil memuntahkan segala apa
yang di makan dan di minum sehingga berat badannya sangat turun, turgor kulit
kurang, diuresis kurang dan timbul aseton dalam air kencing (<a href="http://healthblogheg.blogspot.com/"><span style="color: blue;">http://healthblogheg.blogspot.com/</span></a>).</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Hiperemesis Gravidarum adalah suatu keadaan pada ibu
hamil yang ditandai dengan muntah-muntah yang berlebihan (muntah berat) dan
terus-menerus pada minggu kelima sampai dengan minggu kedua belas Penyuluhan
Gizi Rumah Sakit A. Wahab Sjahranie Samarinda (<a href="http://healthblogheg.blogspot.com/"><span style="color: blue;">http://healthblogheg.blogspot.com/</span></a>).</span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Etiologi</span></b></li>
</ol>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Penyebab Hiperemesis gravidarum belum diketahui secara
pasti. Perubahan-perubahan anatomik pada otak, jantung, hati dan susunan saraf
disebabkan oleh kekurangan vitamin serta zat-zat lain akibat inanisi.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Beberapa faktor predisposisi dan faktor lain yang
ditemukan :</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">a) Faktor predisposisi
yang sering dikemukakan adalah primigravida, mola hidatidosa dan kehamilan
ganda. Frekuensi yang tinggi pada mola hidatidosa dan kehamilan ganda
memimbulkan dugaan bahwa faktor hormon memegang peranan, karena pada kedua
keadaan tersebut hormon Khorionik gonadotropin dibentuk berlebihan.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">b) Masuknya vili
khorialis dalam sirkulasi maternal dan perubahan metabolik akibat hamil serta resistensi
yang menurun dari pihak ibu tehadap perubahan ini merupakan faktor organik.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">c) Alergi. Sebagai salah
satu respon dari jaringan.ibu terhadap anak, juga disebut sebagai salah satu
faktor organik.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">d) Faktor psikologik memegang
peranan yang penting pada penyakit ini walaupun hubungannya dengan terjadinya
hiperemesis gravidarum belum diketahui dengan pasti. Rumah tangga yang retak,
kehilangan pekerjaan, takut terhadap kehamilan dan persalinan, takut terhadap
tanggung jawab sebagai ibu, dapat menyebabkan konflik mental yang dapat
memperberat mual dan muntah sebagai ekspresi tidak sadar terhadap keengganan
menjadi hamil atau sebagai pelarian karena kesukaran hidup. Tidak jarang dengan
memberikan suasana yang baru sudah dapat membantu mengurangi frekwensi muntah
klien</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">(<a href="http://zerich150105.wordpress.com/"><span style="color: blue;">http://zerich150105.wordpress.com/</span></a>).</span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l11 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Patofisiologi</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"><br />
Ada yang menyatakan bahwa, perasaan mual adalah akibat dari meningkatnya
kadar estrogen, oleh karena keluhan ini terjadi pada trimester pertama.<br />
Pengaruh psikologik hormon estrogen ini tidak jelas, mungkin berasal dari
sistem saraf pusat atau akibat berkurangnya pengosongan lambung.
Penyesuaian terjadi pada kebanyakan wanita hamil, meskipun demikian mual
dan muntah dapat berlangsung berbulan-bulan.<br />
Hiperemesis garavidarum yang merupakan komplikasi mual dan muntah pada
hamil muda, bila terjadi terus-menerus dapat menyebabkan dehidrasi dan
tidak seimbangnya elektrolit dengan alkalosis hipokloremik. Belum jelas
mengapa gejala ini hanya terjadi pada sebagian kecil wanita, tetapi faktor
psikologik merupakan faktor utama, disamping faktor hormonal. Yang jelas
wanita yang sebelum kehamilan sudah menderita lambung spastik dengan
gejala tak suka makan dan mual, akan mengalami emesis gravidarum yang
berat.Hiperemesis gravidarum ini dapat mengakibatkan cadangan karbohidrat
dan lemak habis terpakai untuk keperluan energi. Karena oksidasi lemak
yang tak sempurna, terjadilah ketosis dengan tertimbunnya asam
aseton-asetik, asam hidroksi butirik dan aseton dalam darah. Kekurangan
cairan yang diminum dan kehilangan cairan karena muntah menyebabkan
dehidrasi, sehmgga cairan ekstraselurer dan plasma berkurang. Natrium dan
Khlorida darah turun, demikian pula Khlorida air kemih. Selain itu
dehidrasi menyebabkan hemokonsentrasi, sehingga aliran darah ke jaringan
berkurang. Hal ini menyebabkan jumlah zat makanan dan oksigen ke jaringan
berkurang pula dan tertimbunlah zat metabolik yang toksik. Kekurangan
Kalium sebagai akibat dari muntah dan bertambahnya ekskresi lewat ginjal,
bertambahnya frekuensi muntah-muntah yang lebih banyak, dapat merusak hati
dan terjadilah lingkaran setan yang sulit dipatahkan.<br />
(<a href="http://zerich150105.wordpress.com/"><span style="color: blue;">http://zerich150105.wordpress.com/</span></a>).</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l11 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Tanda Dan Gejala<br />
</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Hiperemesis gravidarum, menurut berat ringannya
gejala dapat dibagi dalam 3 (tiga) tingkatan yaitu :</span></li>
</ol>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">a) <b>Tingkatan I :</b></span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Muntah terus menerus yang mempengaruhi keadaan umum
penderita, ibu merasa lemah, nafsu makan tidak ada, berat badan menurun dan
nyeri pada epigastrium. Nadi meningkat sekitar 100 kali per menit, tekanan
darah sistol menurun turgor kulit berkurang, lidah mengering dan mata cekung.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">b) <b>Tingkatan II :</b></span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Penderita tampak lebih lemah dan apatis, turgor kulit
lebih berkurang, lidah mengering dan nampak kotor, nadi kecil dan cepat, suhu
kadang-kadang naik dan mata sedikit ikterus. Berat badan menurun dan mata
menjadi cekung, tensi rendah, hemokonsentrasi, oliguri dan konstipasi.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Aseton dapat tercium dalam hawa pernapasan, karena
mempunyai aroma yang khas dan dapat pula ditemukan dalam kencing.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">c) <b>Tingkatan III:</b></span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Keadaan umum lebih parah, muntah berhenti, kesadaran
menurun dan somnolen sampai koma, nadi kecil dan cepat, suhu badan meningkat
dan tensi menurun. Komplikasi fatal dapat terjadi pada susunan saraf yang
dikenal sebagai ensefalopati Wemicke, dengan gejala : nistagtnus dan diplopia.
Keadaan ini adalah akibat sangat kekurangan zat makanan, termasuk vitamin B
kompleks. Timbulnya ikterus adalah tanda adanya payah hati.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">(<a href="http://healthblogheg.blogspot.com/"><span style="color: blue;">http://healthblogheg.blogspot.com/</span></a>)</span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l7 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Komplikasi</span></b></li>
</ol>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Dehidrasi berat, ikterik, takikardia, suhu meningkat,
alkalosis, kelaparan gangguan emosional yang berhubungan dengan kehamilan dan
hubungan keluarga, menarik diri dan depresi (<a href="http://healthblogheg.blogspot.com/"><span style="color: blue;">http://healthblogheg.blogspot.com/</span></a>)</span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l1 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Pemeriksaan Diagnostik</span></b></li>
</ol>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">a) USG (dengan
menggunakan waktu yang tepat) : mengkaji usia gestasi janin dan adanya gestasi
multipel, mendeteksi abnormalitas janin, melokalisasi plasenta.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">b) Urinalisis : kultur,
mendeteksi bakteri, BUN.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">c) Pemeriksaan fungsi
hepar: AST, ALT dan kadar LDH.<br />
(<a href="http://zerich150105.wordpress.com/"><span style="color: blue;">http://zerich150105.wordpress.com/</span></a>)</span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l6 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Penatalaksanaan</span></b></li>
</ol>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Pencegahan terhadap Hiperemesis gravidarum perlu
dilaksanakan dengan jalan memberikan pcnerapan tentang kehamilan dan persalinan
sebagai suatu proses yang fisiologik, memberikan keyakinan bahwa mual dan
kadang-kadang muntah merupakan gejala yang flsiologik pada kehamilan muda dan
akan hilang setelah kehamilan 4 bulan, mengajurkan mengubah makan sehari-hari
dengan makanan dalam jumlah kecil tetapi lebih sering. Waktu bangun pagi jangan
segera turun dari tempat tidur, tetapi dianjurkan untuk makan roti kering atau
biskuit dengan teh hangat.Makanan yang berminyak dan berbau lemak sebaiknya
dihindarkan. Makanan dan minuman sebaiknya disajikan dalam keadaan panas atau
sangat dingin.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Obat-obatan</span></b></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Sedativa yang sering digunakan adalah Phenobarbital.
Vitamin yang dianjurkan Vitamin B1 dan B6 Keadaan yang lebih berat diberikan
antiemetik sepeiti Disiklomin hidrokhloride atau Khlorpromasin. Anti histamin
ini juga dianjurkan seperti Dramamin, Avomin</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Isolasi</span></b></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Penderita disendirikan dalam kamar yang tenang tetapi
cerah dan peredaran udara yang baik. Tidak diberikan makan/minuman selama 24
-28 jam. Kadang-kadang dengan isolasi saja gejaia-gejala akan berkurang atau
hilang tanpa pengobatan.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Terapi psikologik</span></b></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Perlu diyakinkan pada penderita bahwa penyakit dapat
disembuhkan, hilangkan rasa takut oleh karena kehamilan, kurangi pekerjaan yang
serta menghilangkan masalah dan konflik, yang kiranya dapat menjadi latar
belakang penyakit ini.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Cairan parenteral</span></b></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Berikan cairan- parenteral yang cukup elektrolit,
karbohidrat dan protein dengan Glukosa 5% dalam cairan garam fisiologik
sebanyak 2-3 liter per hari. Bila perlu dapat ditambah Kalium dan vitamin,
khususnya vitamin B kompleks dan vitamin C. Bila ada kekurangan protein, dapat
diberikan pula asam amino secara intra vena.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Penghentian kehamilan</span></b></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Pada sebagian kecil kasus keadaan tidak menjadi baik,
bahkan mundur. Usahakan mengadakan pemeriksaan medik dan psikiatri bila keadaan
memburuk. Delirium, kebutaan, tachikardi, ikterus anuria dan perdarahan
merupakan manifestasi komplikasi organik. Dalam keadaan demikian perlu
dipertimbangkan untuk mengakhiri kehamilan. Keputusan untuk melakukan abortus
terapeutik sering sulit diambil, oleh karena di satu pihak tidak boleh
dilakukan terlalu cepat, tetapi dilain pihak tak boleh menunggu sampai terjadi
gejala ireversibel pada organ vital.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Diet</span></b></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">a) Diet hiperemesis I
diberikan pada hiperemesis tingkat III.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Makanan hanya berupa rod kering dan buah-buahan.
Cairan tidak diberikan bersama makanan tetapi 1 — 2 jam sesudahnya. Makanan ini
kurang dalam semua zat – zat gizi, kecuali vitamin C, karena itu hanya
diberikan selama beberapa hari.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">b) Diet hiperemesis II
diberikan bila rasa mual dan muntah berkurang.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Secara berangsur mulai diberikan makanan yang bernilai
gizi linggi. Minuman tidak diberikan bersama makanan . Makanan ini rendah dalam
semua zat-zal gizi kecuali vitamin A dan D.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">c) Diet hiperemesis III
diberikan kepada penderita dengan hiperemesis ringan.<br />
Menurut kesanggupan penderita minuman boleh diberikan bersama makanan. Makanan
ini cukup dalam semua zat gizi kecuali Kalsium.</span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l8 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Prognosis<br />
</span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Dengan penanganan yang baik prognosis Hiperemesis
gravidarum sangat memuaskan. Penyakit ini biasanya dapat membatasi diri,
namun demikian pada tingkatan yang berat, penyakit ini dapat mengancam
jiwa ibu dan janin.</span></li>
</ol>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><u><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">ASUHAN KEPERAWATAN</span></u></b></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">A. Pengkajian Keperawatan</span></b></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l13 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Aktifitas istirahat<br />
Tekanan darah sistol menurun, denyut nadi meningkat (> 100 kali per
menit).</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l13 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Integritas ego<br />
Konflik interpersonal keluarga, kesulitan ekonomi, perubahan persepsi
tentang kondisinya, kehamilan tak direncanakan.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l13 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Eliminasi<br />
Pcrubahan pada konsistensi; defekasi, peningkatan frekuensi berkemih
Urinalisis : peningkatan konsentrasi urine.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l13 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Makanan/cairan<br />
Mual dan muntah yang berlebihan (4 – 8 minggu) , nyeri epigastrium,
pengurangan berat badan (5 – 10 Kg), membran mukosa mulut iritasi dan
merah, Hb dan Ht rendah, nafas berbau aseton, turgor kulit berkurang, mata
cekung dan lidah kering.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l13 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Pernafasan<br />
Frekuensi pernapasan meningkat.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l13 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Keamanan<br />
Suhu kadang naik, badan lemah, icterus dan dapat jatuh dalam koma</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l13 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Seksualitas<br />
Penghentian menstruasi, bila keadaan ibu membahayakan maka dilakukan
abortus terapeutik.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l13 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Interaksi sosial<br />
Perubahan status kesehatan/stressor kehamilan, perubahan peran, respon
anggota keluarga yang dapat bervariasi terhadap hospitalisasi dan sakit,
sistem pendukung yang kurang.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l13 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Pembelajaran dan penyuluhan</span></li>
</ol>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1. </span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Segala yang dimakan dan diminum dimuntahkan, apalagi
apalahi kalau belangsung sudah lama.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">2. </span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Berat badan turun lebih dari 1/10 dari berast badan
normal</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">3. </span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Turgor kulit, lidah kering</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">4. </span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Adanya aseton dalam urine<br />
(<a href="http://zerich150105.wordpress.com/"><span style="color: blue;">http://zerich150105.wordpress.com/</span></a>)</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">B. Diagnosa Keperawatan</span></b></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l4 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Perubahan nutrisi kurang dari kebutuhan berhubungan dengan frekuensi
mual dan muntah berlebihan.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l4 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Deflsit volume cairan berhubungan dengan kehilangan cairan yang
berlebihan.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l4 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Koping tidak efektif berhubungan dengan perubahan psikologi kehamilan.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l4 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Intoleransi aktivitas berhubungan dengan kelemahan.<br />
(<a href="http://zerich150105.wordpress.com/"><span style="color: blue;">http://zerich150105.wordpress.com/</span></a>)</span></li>
</ol>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">C. Rencana Keperawatan</span></b></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1) Perubahan nutrisi
kurang dari kebutuhan berhubungan dengan frekuensi mual dan muntah berlebihan.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<i><u><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Intervensi</span></u></i></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l9 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Batasi intake oral hingga muntah berhenti.<br />
<i>Rasional :</i> Memelihara keseimbangan cairan elektfolit dan mencegah
muntah selanjutnya.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l9 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Berikan obat anti emetik yang diprogramkan dengan dosis rendah,
misalnya Phenergan 10-20mg/i.v.<br />
<i>Rasional :</i> Mencegah muntah serta memelihara keseimbangan cairan dan
elektrolit</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l9 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Pertahankan terapi cairan yang diprogramkan.<br />
<i>Rasional :</i> Koreksi adanya hipovolemia dan keseimbangan elektrolit</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l9 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Catat intake dan output.<br />
<i>Rasional :</i> Menentukan hidrasi cairan dan pengeluaran melului
muntah.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l9 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Anjurkan makan dalam porsi kecil tapi sering<br />
<i>Rasional :</i> Dapat mencukupi asupan nutrisi yang dibutuhkan tubuh</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l9 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Anjurkan untuk menghindari makanan yang berlemak<br />
<i>Rasional :</i> dapat menstimulus mual dan muntah</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l9 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">anjurkan untuk makan makanan selingan seperti biskuit, roti dan the
(panas) hangat sebelum bagun tidur pada siang hari dan sebelum tidur<br />
<i>Rasional :</i> Makanan selingan dapat mengurangi atau menghindari
rangsang mual muntah yang berlebih</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l9 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Catal intake TPN, jika intake oral tidak dapat diberikan dalam periode
tertentu.<br />
<i>Rasional :</i> Untuk mempertahankan keseimbangan nutrisi.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l9 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Inspeksi adanya iritasi atau Iesi pada mulut.<br />
<i>Rasional :</i> Untuk mengetahui integritas inukosa mulut.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l9 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Kaji kebersihan oral dan personal hygiene serta penggunaan cairan
pembersih mulut sesering mungkin.<br />
<i>Rasional :</i> Untuk mempertahankan integritas mukosa mulut</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l9 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Pantau kadar Hemoglobin dan Hemotokrit<br />
<i>Rasional :</i> Mengidenfifikasi adanya anemi dan potensial penurunan
kapasitas pcmbawa oksigen ibu. Klien dengan kadar Hb < 12 mg/dl atau
kadar Ht rendah dipertimbangkan anemi pada trimester I.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l9 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Test urine terhadap aseton, albumin dan glukosa..<br />
<i>Rasional :</i> Menetapkan data dasar ; dilakukan secara rutin untuk
mendeteksi situasi potensial resiko tinggi seperti ketidakadekuatan asupan
karbohidrat, Diabetik kcloasedosis dan Hipertensi karena kehamilan.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l9 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Ukur pembesaran uterus<br />
<i>Rasional :</i> Malnutrisi ibu berdampak terhadap pertumbuhan janin dan
memperberat penurunan komplemen sel otak pada janin, yang mengakibatkan
kemunduran pcrkembangan janin dan kcmungkinan-kemungkinan lebih lanjUT</span></li>
</ol>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">2) Defisit volume cairan
berhubungan dengan kehilangan cairan yang berlebihan</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<i><u><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Intervensi</span></u></i></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">1. </span></i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Tentukan frekuensi atau beratnya mual/muntah.<br />
<i>Rasional : </i></span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Memberikan data berkenaan dengan semua kondisi.
Peningkatan kadar hormon Korionik gonadotropin (HCG), perubahan metabolisme
karbohidrat dan penurunan motilitas gastrik memperberat mual/muntah pada
trimester</span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l2 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Tinjau ulang riwayat kemungkinah masalah medis lain (misalnya Ulkus
peptikum, gastritis.<br />
<i>Rasional :</i></span></li>
</ol>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Membantu dalam mengenyampingkan penyebab lain untuk
mengatasi masalah khusus dalam mengidentifikasi intervensi.</span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l10 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Kaji suhu badan dan turgor kulit, membran mukosa, TD, input/output dan
berat jenis urine. Timbang BB klien dan bandingkan dengan standar<br />
<i>Rasional :</i> Sebagai indikator dalam membantu mengevaluasi tingkat
atau kebutuhan hidrasi.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l10 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Anjurkan peningkatan asupan minuman berkarbonat, makan sesering
mungkin dengan jumlah sedikit. Makanan tinggi karbonat seperti : roti
kering sebelum bangun dari tidur.<br />
<i>Rasional :</i> Membantu dalam meminimalkan mual/muntah dengan
menurunkan keasaman lambung.</span></li>
</ol>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">3) Cemas berhubungan
dengan Koping tidak efektif; perubahan psikologi kehamilan</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<i><u><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Intervensi :</span></u></i></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l3 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Kontrol lingkungan klien dan batasi pengunjung<br />
<i>Rasional :</i> Untuk mencegah dan mengurangi kecemasan</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l3 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Kaji tingkat fungsi psikologis klien<br />
<i>Rasional :</i> Untuk menjaga intergritas psikologis</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l3 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Berikan support psikologis<br />
<i>Rasional :</i> Untuk menurunkan kecemasan dan membina rasa saling
percaya</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l3 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Berikan penguatan positif<br />
<i>Rasional :</i> Untuk meringankan pengaruh psikologis akibat kehamilan</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l3 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Berikan pelayanan kesehatan yang maksimal<br />
<i>Rasional :</i> Penting untuk meningkatkan kesehatan mental klien</span></li>
</ol>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">4) Intoleransi aktifitas
berhubungan dengan kelemahan</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<i><u><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Intervensi :</span></u></i></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l5 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Anjurkan klien membatasi aktifitas dengan isrirahat yang cukup.<br />
<i>Rasional :</i> Menghemat energi dan menghindari pengeluaran tenaga yang
terus-menerus untuk meminimalkan kelelahan/kepekaan uterus</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l5 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Anjurkan klien untuk menghindari mengangkat berat.</span></li>
</ol>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Rasional</span></i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;"> : Aktifitas yang ditoleransi sebelumnya mungkin tidak
dimodifikasi untuk wanita beresiko.</span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l12 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Bantu klien beraktifitas secara bertahap<br />
<i>Rasional : </i>Aktifitas bertahap meminimalkan terjadinya trauma seita
meringankan dalam memenuhi kebutuhannya.</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l12 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-latin;">Anjurkan tirah baring yang dimodifikasi sesuai indikasi<br />
<i>Rasional : </i>Tingkat aktifitas mungkin periu dimodifikasi sesuai
indikasi.<br />
(<a href="http://zerich150105.wordpress.com/"><span style="color: blue;">http://zerich150105.wordpress.com/</span></a>)</span></li>
</ol>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;">DAFTAR
PUSTAKA<br />
<br />
<br />
Doengoes, Marilyn E. 2001. Rencana Perawatan Maternal / Bayi. Jakarta : EGC<br />
<br />
Wolf, weitzel,Fuerst.1984. Dasar – Dasar Ilmu Keperawatan. Jakarta : Gunung
Agung.<br />
<br />
Hamilton, Persis Mary. 1995. Dasar – Dasar Keperawatan Maternitas edisi 6.
Jakarta : EGC<br />
<br />
Mochtar, Rustam. 1998. Sinopsis Obsteri jilid I. Jakarta : EGC.<br />
<br />
Arif, Mansjoer, dkk. 2001. Kapita Selekta Kedokteran edisi 3 jilid I. Jakarta :
Media Acculapius.<br />
<br />
Teber, Ben-Zian. 2002. Kapita Selekta Kedokteran Obstetri dan Ginekologi.
Jakarta : EGC<br />
<br />
Prawiroharjo, Sarwono. 2005. Ilmu Kebidanan. Jakarta ; Tridasa Printer.</span></div>
<br />Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-70296118601204260862012-07-16T02:51:00.005-07:002012-08-08T05:04:39.801-07:00ASKEP RETENSIO PLASENTA<br />
<div align="center" class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: center;">
<b><span style="font-family: "Times New Roman", "serif"; font-size: 12pt;">ASKEP RETENSIO PLASENTA</span></b></div>
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<b><span style="font-family: "Times New Roman", "serif"; font-size: 12pt;"><br /></span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Times New Roman", "serif"; font-size: 12pt;">I.KONSEP
DASAR<br />
A.Pengertian<br />
Retensio Placenta adalah tertahannya atau keadaan dimana uri/placenta belum
lahir dalam waktu satu jam setelah bayi lahir. <br />
Pada proses persalinan, kelahiran placenta kadang mengalami hambatan yang dapat
berpengaruh bagi ibu bersalin. Dimana terjadi keterlambatan bisa timbul
perdarahan yang merupakan salah satu penyebab kematian ibu pada masa post
partum. Apabila sebagian placenta lepas sebagian lagi belum, terjadi perdarahan
karena uterus tidak bisa berkontraksi dan beretraksi dengan baik pada batas
antara dua bagian itu. Selanjutnya apabila sebagian besar placenta sudah lahir,
tetapi sebagian kecil masih melekat pada dinding uterus, dapat timbul
perdarahan masa nifas.<br />
Disamping kematian, perdarahan post partum akibat retensio placenta memperbesar
kemungkinan terjadinya infeksi puerperal karena daya tahan penderita yang
kurang. Oleh karena itu sebaiknya penanganan kala III pada persalinan mengikuti
prosedur tetap yang berlaku.<br />
<br />
B.Etiologi<br />
Penyebab terjadinya Retensio Placenta adalah :<br />
1)Placenta belum lepas dari dinding uterus<br />
Placenta yang belum lepas dari dinding uterus. Hal ini dapat terjadi karena (a)
kontraksii uterus kurang kuat untuk melepaskan placenta, dan (b) placenta yang
tumbuh melekat erat lebih dalam. Pada keadaan ini tidak terjadi perdarahan dan
merupakan indikasi untuk mengeluarkannya. <br />
2)Placenta sudah lepas tetapi belum dilahirkan. Keadaan ini dapat terjadi karena
atonia uteri dan dapat menyebabkan perdarahan yang banyak dan adanya lingkaran
konstriksi pada bagian bawah rahim. Hal ini dapat disebabkan karena (a)
penanganan kala III yang keliru/salah dan (b) terjadinya kontraksi pada bagian
bawah uterus yang menghalangi placenta (placenta inkaserata).<br />
Menurut tingkat perlekatannya, retensio placenta dibedakan atas beberapa
tingkatan yaitu sebagai berikut :<br />
oPlacenta Adhesiva; placenta melekat pada desidua endometrium lebih dalam <br />
oPlacenta Inkreta; placenta melekat sampai pada villi khorialis dan tumbuh
lebih dalam menembus desidua sampai miometrium.<br />
oPlacenta Akreta; placenta menembus lebih dalam kedalam miometrium tetapi belum
mencapai lapisan serosa.<br />
oPlacenta Perkreta; placenta telah menembus mencapai serosa atau peritonium
dinding rahim.<br />
oPlacenta Inkarserata; adalah tertahannya di dalam kavum uteri karena kontraksi
ostium uteri.<br />
<br />
C.Penanganan<br />
1)Penanganan Umum<br />
oJika placenta terlihat dalam vagina, mintalah ibu untuk mengedan. Jika anda
dapat merasakan placenta dalam vagina, keluarkan placentaa tersebut.<br />
oPastikan kandung kemih sudah kosong.<br />
oJika placenta belum keluar, berikan oksitoksin 10 unti i.m. Jika belum
dilakukan pada penanganan aktif kala III.<br />
oJika uterus berkontraksi, lakukan PTT.<br />
oJika PTT belum berhasil cobalah untuk melakukan pengeluaran placenta secara
manual.<br />
2)Penanganan Khusus<br />
oRetensio placenta dengan separasi parsial :<br />
-Tentukan jenis retensio yang terjadi.<br />
-Regangan tali pusat dan minta klien untuk mengedan, bila ekspulsi placenta
tidak terjadi, coba traksi terkontrol tali pusat.<br />
-Pasang infus oksitoksin 20 unit dalam 500 ml cairan dengan 40 tetes/menit.<br />
-Bila traksi terkontrol gagal, lakukan manual placenta.<br />
-Transfusi jika perlu.<br />
-Beri antibiotik dan atasi komplikasi.<br />
oPlacenta inkaserata :<br />
-Tentukan diagnosa kerja<br />
-Siapkan alat dan bahan untuk menghilangkan konstriksi serviks dan melahirkan
plasenta.<br />
-Siapkan anastesi serta infus oksitoksin 20 ui dalam 500 ml dengan 40
tetes/menit.<br />
-Pemantauan tanda vital, kontraksi uterus, TFU, perdarahan pasca tindakan.<br />
oPlacenta akreta :<br />
-Tentukan diagnosis<br />
-Stabilitas pasien<br />
-Rujuk klien ke RS karena tindakan kasus ini perlu dioperasi.<br />
oPlacenta manual :<br />
-Kaji ulang indikasi dan persetujuan tindakan.<br />
-Kaji ulang prinsip perawatan dan pasang infus.<br />
-Berikan sedativa, analgetik, dan antibiotik dengan dosis tunggal.<br />
-Pasang sarung tangan DTT.<br />
-Jepit tali pusat, tegangkan sejajar lantai.<br />
-Masukan tangan secara obstetrik menelusuri tali pusat dan tangan lain menahan
fundus uteri.<br />
-Cari insersi pinggir placenta dengan bagian lateral jari-jari tangan.<br />
-Buka tangan obstetrik seperti memberi salam dan jari-jari dirapatkan, untuk
menentukan tempat implantasi.<br />
-Gerakan tangan secara perlahan bergeser kekranial sehingga semua permukaan
maternal plasenta dapat dilepaskan.<br />
-Jika tidak terlepas kemungkinan akreta. Siapkan untuk laparatomi.<br />
-Pegang plasenta, keluarkan tangan beserta plasenta secara pelahan.<br />
-Pindahkan tangan luar kesupra simphisis untuk menahan uterus saat placenta
dikeluarkan, dan periksa placenta.<br />
-Berikan oksitoksin 10 iu dalam 500 ml cairan dengan 60 tts/menit.<br />
-Periksa dan perbaiki robekan jalan lahir.<br />
-Pantau tanda vital dan kontrol kontraksi uterus dan TFU.<br />
-Teruskan infus dan transfusi jika perlu.<br />
<br />
II.KONSEP DASAR ASUHAN KEPERAWATAN<br />
A.Pengkajian<br />
Beberapa hal yang perlu dikaji dalam asuhan keperawatan pada ibu dengan
retensio placenta adalah sebagai berikut :<br />
Identitas klien</span><span style="font-family: "Symbol"; font-size: 12pt;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">q</span></span><span style="font-family: "Times New Roman", "serif"; font-size: 12pt;"><br />
Data biologis/fisiologis meliputi; keluhan utama, riwayat kesehatan</span><span style="font-family: "Symbol"; font-size: 12pt;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">q</span></span><span style="font-family: "Times New Roman", "serif"; font-size: 12pt;"> masa lalu, riwayat penyakit keluarga, riwayat
obstetrik (GPA, riwayat kehamilan, persalinan, dan nifas), dan pola kegiatan
sehari-hari sebagai berikut :<br />
1)Sirkulasi :<br />
-Perubahan tekanan darah dan nadi (mungkintidak tejadi sampai kehilangan darah
bermakna)<br />
-Pelambatan pengisian kapiler<br />
-Pucat, kulit dingin/lembab<br />
-Perdarahan vena gelap dari uterus ada secara eksternal (placentaa tertahan)<br />
-Dapat mengalami perdarahan vagina berlebihan<br />
-Haemoragi berat atau gejala syock diluar proporsi jumlah kehilangan darah.<br />
2)Eliminasi :<br />
-Kesulitan berkemih dapat menunjukan haematoma dari porsi atas vagina<br />
3)Nyeri/Ketidaknyamanan :<br />
-Sensasi nyeri terbakar/robekan (laserasi), nyeri tekan abdominal (fragmen
placenta tertahan) dan nyeri uterus lateral.<br />
4)Keamanan :<br />
-Laserasi jalan lahir: darah memang terang sedikit menetap (mungkin tersembunyi)
dengan uterus keras, uterus berkontraksi baik; robekan terlihat pada labia
mayora/labia minora, dari muara vagina ke perineum; robekan luas dari
episiotomie, ekstensi episiotomi kedalam kubah vagina, atau robekan pada
serviks.<br />
5)Seksualitas :<br />
-Uterus kuat; kontraksi baik atau kontraksi parsial, dan agak menonjol (fragmen
placenta yang tertahan)<br />
-Kehamilan baru dapat mempengaruhi overdistensi uterus (gestasi multipel,
polihidramnion, makrosomia), abrupsio placenta, placenta previa.<br />
Pemeriksaan fisik meliputi; keadaan umum, tanda vital, pemeriksaan obstetrik
(inspeksi, palpasi, perkusi, dan auskultasi).</span><span style="font-family: "Symbol"; font-size: 12pt;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">q</span></span><span style="font-family: "Times New Roman", "serif"; font-size: 12pt;"><br />
Pemeriksaan laboratorium. (Hb 10 gr%)</span><span style="font-family: "Symbol"; font-size: 12pt;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">q</span></span><span style="font-family: "Times New Roman", "serif"; font-size: 12pt;"><br />
<br />
B.Diagnosa dan Rencana Intervensi Keperawatan<br />
1.Defisit volume cairan tubuh berhubungan dengan kehilangan melalui vaskuler
yang berlebihan.<br />
Intervensi : <br />
-Tinjau ulang catatan kehamilan dan persalinan/kelahiran, perhatiakan
faktor-faktor penyebab atau pemberat pada situasi hemoragi (misalnya laserasi,
fragmen plasenta tertahan, sepsis, abrupsio plasenta, emboli cairan amnion atau
retensi janin mati selama lebih dari 5 minggu)<br />
Rasional : Membantu dalam membuat rencana perawatan yang tepat dan memberikan
kesempatan untuk mencegah dan membatasi terjadinya komplikasi.<br />
-Kaji dan catat jumlah, tipe dan sisi perdarahan; timbang dan hitung pembalut,
simpan bekuan dan jaringan untuk dievaluasi oleh perawat.<br />
Rasional : Perkiraan kehilangan darah, arteial versus vena, dan adanya
bekuan-bekuan membantu membuat diagnosa banding dan menentukan kebutuhan
penggantian.<br />
-Kaji lokasi uterus dan derajat kontraksilitas uterus. Dengan perlahan masase
penonjolan uterus dengan satu tangan sambil menempatkan tangan kedua diatas
simpisis pubis.<br />
Rasional : Derajat kontraktilitas uterus membantu dalam diagnosa banding.
Peningkatan kontraktilitas miometrium dapat menurunkan kehilangan darah.
Penempatan satu tangan diatas simphisis pubis mencegah kemungkinan inversi
uterus selama masase.<br />
-Perhatikan hipotensi atau takikardi, perlambatan pengisian kapiler atau
sianosis dasar kuku, membran mukosa dan bibir.<br />
Rasional : Tanda-tanda ini menunjukan hipovolemi dan terjadinya syok. Perubahan
pada tekanan darah tidak dapat dideteksi sampai volume cairan telah menurun
sampai 30 - 50%. Sianosis adalah tanda akhir dari hipoksia.<br />
-Pantau parameter hemodinamik seperti tekanan vena sentral atau tekanan baji
arteri pulmonal bila ada.<br />
Rasional : Memberikan pengukuran lebih langsung dari volume sirkulasi dan
kebutuhan penggantian. <br />
-Lakukan tirah baring dengan kaki ditinggikan 20-30 derajat dan tubuh
horizontal.<br />
Rasional : Perdarahan dapat menurunkan atau menghentikan reduksi aktivitas.
Pengubahan posisi yang tepat meningkatkan aliran balik vena, menjamin
persediaan darah keotak dan organ vital lainnya lebih besar. <br />
-Pantau masukan dan keluaran, perhatikan berat jenis urin.<br />
Rasional : Bermanfaat dalam memperkirakan luas/signifikansi kehilangan cairan.
Volume perfusi/sirkulasi adekuat ditunjukan dengan keluaran 30 – 50 ml/jam atau
lebih besar.<br />
-Hindari pengulangan/gunakan kewaspadaan bila melakukan pemeriksaan vagina dan/atau
rektal<br />
Rasional : Dapat meningkatkan hemoragi bila laserasi servikal, vaginal atau
perineal atau hematoma terjadi.<br />
- Berikan lingkungan yang tenang dan dukungan psikologis<br />
Rasional : Meningkatkan relaksasi, menurunkan ansietas dan kebutuhan metabolik.<br />
-Kaji nyeri perineal menetap atau perasaan penuh pada vagina. Berikan tekanan
balik pada laserasi labial atau perineal.<br />
Rasional : Haematoma sering merupakan akibat dari perdarahan lanjut pada
laserasi jalan lahir.<br />
-Pantau klien dengan plasenta acreta (penetrasi sedikit dari myometrium dengan
jaringan plasenta), HKK atau abrupsio placenta terhadap tanda-tanda KID
(koagulasi intravascular diseminata).<br />
Rasional : Tromboplastin dilepaskan selama upaya pengangkatan placenta secara
manual yang dapat mengakibatkan koagulopati.<br />
-Mulai Infus 1 atau 2 i.v dari cairan isotonik atau elektrolit dengan kateter
!8 G atau melalui jalur vena sentral. Berikan darah lengkap atau produk darah
(plasma, kriopresipitat, trombosit) sesuai indikasi. <br />
Rasional : Perlu untuk infus cepat atau multipel dari cairan atau produk darah
untuk meningkatkan volume sirkulasi dan mencegah pembekuan.<br />
-Berikan obat-obatan sesuai indikasi : <br />
Oksitoksin, Metilergononovin maleat, Prostaglandin F2 alfa.<br />
Rasional : Meningkatkan kontraktilitas dari uterus yang menonjol dan
miometrium, menutup sinus vena yang terpajan, dan menghentikan hemoragi pada
adanya atonia.<br />
Magnesium sulfat<br />
Rasional : Beberapa penelitian melaporkan penggunaan MGSO4 memudahkan relaksasi
uterus selama pemeriksaan manual.<br />
Terapi Antibiotik.<br />
Rasional : Antibiotok bertindak secara profilaktik untuk mencegah infeksi atau
mungkin perlu diperlukan untuk infeksi yang disebabkan atau diperberat pada
subinvolusi uterus atau hemoragi.<br />
-Pantau pemeriksaan laboratotium sesuai indikasi : Hb dan Ht.<br />
Rasional : Membantu dalam menentukan kehilangan darah. Setiap ml darah membawa
0,5 mgHb.<br />
<br />
2.Resiko tinggi terjadi Infeksi berhubungan dengan trauma jaringan. <br />
Intervensi : <br />
-Demonstrasikan mencuci tangan yang tepat dan teknik perawatan diri. Tinjau ulang
cara yang tepat untuk menangani dan membuang material yang terkontaminasi
misalnya pembalut, tissue, dan balutan.<br />
Rasional : Mencegah kontaminasi silang/penyebaran organinisme infeksious..<br />
-Perhatikan perubahan pada tanda vital atau jumlah SDP<br />
Rasional : Peningkatan suhu dari 100,4 ºF (38ºC) pada dua hari beturut-turut
(tidak menghitung 24 jam pertama pasca partum), tachikardia, atau leukositosis
dengan perpindahan kekiri menandakan infeksi.<br />
-Perhatikan gejala malaise, mengigil, anoreksia, nyeri tekan uterus atau nyeri
pelvis.<br />
Rasional : Gejala-gejala ini menandakan keterlibatan sistemik, kemungkinan
menimbulkan bakterimia, shock, dan kematian bila tidak teratasi.<br />
-Selidiki sumber potensial lain dari infeksi, seperti pernapasan (perubahan
pada bunyi napas, batuk produktif, sputum purulent), mastitis (bengkak,
eritema, nyeri), atau infeksi saluran kemih (urine keruh, bau busuk, dorongan,
frekuensi, nyeri).<br />
Rasional : Diagnosa banding adalah penting untuk pengobatan yang efektif.<br />
-Kaji keadaan Hb atau Ht. Berikan suplemen zat besi sesuai indikasi.<br />
Rasional : Anemia sering menyertai infeksi, memperlambat pemulihan dan merusak
sistem imun.<br />
<br />
3.Nyeri berhubungan dengan trauma atau distensi jaringan.<br />
Intervensi : <br />
-Tentukan karakteristik, tipe, lokasi, dan durasi nyeri. Kaji klien terhadap
nyeri perineal yang menetap, perasaan penuh pada vagina, kontraksi uterus atau
nyeri tekan abdomen.<br />
Rasional : Membantu dalam diagnosa banding dan pemilihan metode tindakan.
Ketidaknyamanan berkenaan dengan hematoma, karena tekanan dari hemaoragik
tersembunyi kevagina atau jaringan perineal. Nyeri tekan abdominal mungkin
sebagai akibat dari atonia uterus atau tertahannya bagian-bagian placenta.
Nyeri berat, baik pada uterus dan abdomen, dapat terjadi dengan inversio
uterus.<br />
-Kaji kemungkinan penyebab psikologis dari ketidaknyamana.<br />
Rasional : Situasi darurat dapat mencetuskan rasa takut dan ansietas, yang
memperberat persepsi ketidaknyamanan.<br />
-Berikan tindakan kenyamanan seperti pemberian kompres es pada perineum atau
lampu pemanas pada penyembungan episiotomi.<br />
Rasional : Kompres dingan meminimalkan edema, dan menurunkan hematoma serta
sensasi nyeri, panas meningkatkan vasodilatasi yang memudahkan resorbsi
hematoma.<br />
-Berikan analgesik, narkotik, atau sedativa sesuai indikasi<br />
Rasional : Menurunkan nyeri dan ancietas, meningkatkan relaksasi.<br />
<br />
4.Perubahan perfusi jaringan berhubungan dengan hipovalemia<br />
Intervensi : <br />
-Perhatikan Hb/Ht sebelum dan sesudah kehilangan darah. Kaji status nutrisi,
tinggi dan berat badan.<br />
Rasional : Nilai bandingan membantu menentukan beratnya kehilangan darah.
Status yang ada sebelumnya dari kesehatan yang buruk meningkatkan luasnya
cedera dari kekurangan oksigen.<br />
-Pantau tanda vital; catat derajat dan durasi episode hipovolemik. <br />
Rasional : Luasnya keterlibatan hipofisis dapat dihubungkan dengan derajat dan
durasi hipotensi. Penigkatan frekuensi pernapasan dapat menunjukan upaya untuk
mengatasi asidosis metabolik.<br />
-Perhatikan tingkat kesadaran dan adanya perubahan prilaku.<br />
Rasional : Perubahan sensorium adalah indikator dini dari hipoksia, sianosis,
tanda lanjut dan mungkin tidak tampak sampai kadar PO2 turun dibawah 50 mmHg.<br />
-Kaji warna dasar kuku, mukosa mulut, gusi dan lidah, perhatikan suhu kulit. <br />
Rasional : Pada kompensasi vasokontriksi dan pirau organ vital, sirkulasi pada
pembuluh darah perifer diperlukan yang mengakibatkan sianosis dan suhu kulit
dingin.<br />
-Beri terapi oksigen sesuai kebutuhan<br />
Rasional : Memaksimalkan ketersediaan oksigen untuk transpor sirkulasi
kejaringan.<br />
-Pasang jalan napas; penghisap sesuai indikasi<br />
Rasional : Memudahkan pemberian oksigen.<br />
<br />
5.Ancietas berhubungan dengan ancaman perubahan pada status kesehatan.<br />
Intervensi : <br />
-Evaluasi respon psikologis serta persepsi klien terhadap kejadian hemoragii
pasca partum. Klarifikasi kesalahan konsep.<br />
Rasional : Membantu dalam menentukan rencana perawatan. Persepsi klien tentang
kejadian mungkin menyimpang, akan memperberat ancietasnya.<br />
-Evaluasi respon fisiologis pada hemoragik pasca partum; misalnya tachikardi,
tachipnea, gelisah atau iritabilitas.<br />
Rasional : Meskipun perubahan pada tanda vital mungkin karena respon
fisiologis, ini dapat diperberat atau dikomplikasi oleh faktor-faktor
psikologis.<br />
-Sampaikan sikap tenang, empati dan mendukung.<br />
Rasional : Dapat membantu klien mempertahankan kontrol emosional dalam berespon
terhadap perubahan status fisiologis. Membantu dalam menurunkan tranmisi
ansietas antar pribadi. <br />
-Bantu klien dalam mengidentifikasi perasaan ansietas, berikan kesempatan pada
klien untuk mengungkapkan perasaan.<br />
Rasional : Pengungkapan memberikan kesempatan untuk memperjelas informasi,
memperbaiki kesalahan konsep, dan meningkatkan perspektif, memudahkan proses
pemecahan masalah.<br />
-Beritahu kepada klien tujuan dari setiap tindakan yang akan dilakukan<br />
Rasional : Kecemasan klien akan berkurang bila sebelum sebuah tindakan
dilakukan oleh perawat.<br />
<br />
6.Kurang Pengetahuan berhubungan dengan kurangnya informasi yang diperoleh.<br />
Intervensi : <br />
-Jelaskan faktor predisposisi atau penyebab dan tindakan khusus terhadap
penyebab hemoragi.<br />
Rasional : Memberikan informasi untuk membantu klien/pasangan memahami dan
mengatasi situasi.<br />
-Kaji tingkat pengetahuan klien, kesiapan dan kemampuan klien untuk belajar.
Dengarkan, bicarakan dengan tenang, dan berikan waktu untuk bertanya dan
meninjau materi.<br />
Rasional : Memberikan informasi yang perlu untuk mengembangkan rencana
perawatan individu. Menurunkan stress dan ancietas, yang menghambat
pembelanjaran, dan memberikan klarifikasi dan pengulangan untuk meningkatkan
pemahaman.<br />
-Diskusikan implikasi jangka pendek dari hemoragi pasca partum, seperti
perlambatan atau intrupsi pada proses kedekatan ibu-bayi (klien tidak mampu
melakukan perawatan terhadap diri dan bayinya segera sesuai keinginannya).<br />
Rasional : Menurunkan ansietas dan memberikan kerangka waktu yang realistis
untuk melakukan ikatan serta aktivitas-aktivitas perawatan bayi.<br />
-Diskusikan implikasi jangka panjang hemoragi pasca partum dengan tepat,
misalnya resiko hemoragi pasca partum pada kehamilan selanjutnya, ataonia
uterus, atau ketidakmampuan untuk melahirkan anak pada masa datang bila
histerektomie dilakukan.<br />
Rasional : Memungkinan klien untuk membuat keputusan berdasarkan informasi dan
mulai mengatasi perasaan tentang kejadian-kejadian masa lalu dan sekarang.</span></div>
<div class="MsoNormal">
<br /></div>
<br />Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-45407798961136242992012-06-02T18:29:00.001-07:002012-08-08T05:04:39.775-07:00ASKEP MOLAHIDATIDOSA<div align="center" style="line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Asuhan Keperawatan</span></b></div>
<div align="center" style="line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Molahidatidosa</span></b></div>
<div style="line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm;">
<br /></div>
<div style="line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Definisi</span></b></div>
<div style="line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Mola hidatidosa adalah chorionic villi
(jonjotan/gantungan) yang tumbuh berganda berupa gelembung-gelembung kecil yang
mengandung banyak cairan sehingga menyerupai buah anggur atau mata ikan. Karena
itu disebut juga hamil anggur atau mata ikan.<br />
(Mochtar, Rustam, dkk, 1998 : 238)<br />
Mola hidatidosa adalah kehamilan abnormal, dengan ciri-ciri stoma villus
korialis langka, vaskularisasi dan edematus. Janin biasanya meninggal akan
tetapi villus-villus yang membesar dan edematus itu hidup dan tumbuh terus,
gambaran yang diberikan adalah sebagai segugus buah anggur. (Wiknjosastro,
Hanifa, dkk, 2002 : 339)<br />
Mola hidatidosa adalah kehamilan abnormal di mana hampir seluruh villi
kariolisnya mengalami perubahan hidrofobik.<br />
(Mansjoer, Arif, dkk, 2001 : 265)<br />
Mola hidatidosa adalah kelainan villi chorialis yang terdiri dari berbagai
tingkat proliferasi tropoblast dan edema stroma villi. (Jack A. Pritchard, dkk,
1991 : 514)<br />
Mola hidatidosa adalah pembengkakan kistik, hidropik, daripada villi choriales,
sdisertai proliperasi hiperplastik dan anaplastik epitel chorion. Tidak
terbentuk fetus ( Soekojo, Saleh, 1973 : 325).<br />
Mola hidatidosa adalah perubahan abnormal dari villi korionik menjadi sejumlah
kista yang menyerupai anggur yang dipenuhi dengan cairan. Embrio mati dan mola
tumbuh dengan cepat, membesarnya uterus dan menghasilkan sejumlah besar human
chorionic gonadotropin (hCG) (Hamilton, C. Mary, 1995 : 104)</span></div>
<div style="line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm;">
<br /></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Etiologi</span></strong></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Penyebab mola hidatidosa tidak diketahui
secara pasti, namun faktor penyebabnya adalah :<br />
a.Faktor ovum : ovum memang sudah patologik sehingga mati, tetapi terlambat
dikeluarkan.<br />
b.Imunoselektif dari tropoblast<br />
c.Keadaan sosio-ekonomi yang rendah</span></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">d.Paritas tinggi<br />
e.Kekurangan protein<br />
f.Infeksi virus dan faktor kromosom yang belum jelas<br />
(Mochtar, Rustam ,1998 : 238)</span></div>
<div style="line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm;">
<br /></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Patofisiologi</span></strong></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Mola hidatidosa dapat terbagi menjadi :<br />
a.Mola hidatidosa komplet (klasik), jika tidak ditemukan janin<br />
b.Mola hidatidosa inkomplet (parsial), jika disertai janin atau bagian janin.</span></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Ada beberapa teori yang diajukan untuk menerangkan
patogenesis dari penyakit trofoblast :<br />
Teori missed abortion. Mudigah mati pada kehamilan 3 – 5 minggu karena itu
terjadi gangguan peredarah darah sehingga terjadi penimbunan cairan masenkim
dari villi dan akhirnya terbentuklah gelembung-gelembung.<br />
Teori neoplasma dari Park. Sel-sel trofoblast adalah abnormal dan memiliki
fungsi yang abnormal dimana terjadi reabsorbsi cairan yang berlebihan ke dalam
villi sehigga timbul gelembung.<br />
Studi dari Hertig lebih menegaskan lagi bahwa mola hidatidosa semata-mata
akibat akumulasi cairan yang menyertai degenerasi awal atau tiak adanya embrio
komplit pada minggu ke tiga dan ke lima. Adanya sirkulasi maternal yang terus
menerus dan tidak adanya fetus menyebabkan trofoblast berproliferasi dan
melakukan fungsinya selama pembentukan cairan.<br />
(Silvia, Wilson, 2000 : 467)</span></div>
<div style="line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm;">
<br /></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Gambaran Klinik</span></strong></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Gambaran klinik yang biasanya timbul pada
klien dengan ”mola hidatidosa adalah :<br />
a.Amenore dan tanda-tanda kehamilan<br />
b.Perdarahan pervaginam berulang. Darah cenderung berwarna coklat. Pada keadaan
lanjut kadang keluar gelembung mola.<br />
c.Pembesaran uterus lebih besar dari usia kehamilan.<br />
d.Tidak terabanya bagian janin pada palpasi dan tidak terdengarnya BJJ
sekalipun uterus sudah membesar setinggi pusat atau lebih.<br />
e.Preeklampsia atau eklampsia yang terjadi sebelum kehamilan 24 minggu.<br />
(Mansjoer, Arif, dkk, 2001 : 266)</span></div>
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<br /></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Anatomi Fisiologi</span></strong></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Anatomi</span></strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;"><br />
Uterus adalah organ yang tebal, berotot, berbentuk buah pear, terletak dalam
rongga panggul kecil di antara kandung kemih dan anus, ototnya desebut
miometrium dan selaput lendir yang melapisi bagian dalamnya disebut
endometrium. Peritonium menutupi sebagian besar permukaan luar uterus, letak
uterus sedikit anteflexi pada bagian lehernya dan anteversi (meliuk agak
memutar ke depan) dengan fundusnya terletak di atas kandung kencing. Bagian
bawah bersambung dengan vagina dan bagian atasnya tuba uterin masuk ke
dalamnya. Ligamentum latum uteri dibentuk oleh dua lapisan peritoneum, di
setiap sisi uterus terdapat ovarium dan tuba uterina. Panjang uterus 5 – 8 cm
dengan berat 30 – 60 gram. (Verrals, Silvia, 2003 : 164)<br />
Uterus terbagi atas 3 bagian yaitu :<br />
a).Fundus : bagian lambung di atas muara tuba uterina<br />
b).Badan uterus : melebar dari fundus ke serviks<br />
c).Isthmus : terletak antara badan dan serviks<br />
Bagian bawah serviks yang sempit pada uterus disebut serviks. Rongga serviks
bersambung dengan rongga badan uterus melalui os interna (mulut interna) dan
bersambung dengan rongga vagina melalui os eksterna</span></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Ligamentum pada uterus :<br />
Ligamentum teres uteri : ada dua buah kiri dan kanan. Berjalan melalui annulus
inguinalis, profundus ke kanalis iguinalis. Setiap ligamen panjangnya 10 – 12,5
cm, terdiri atas jaringan ikat dan otot, berisi pembuluh darah dan ditutupi
peritoneum.<br />
Peritoneum di antara kedua uterus dan kandung kencing di depannya, membentuk
kantong utero-vesikuler. Di bagian belakang, peritoneum membungkus badan dan
serviks uteri dan melebar ke bawah sampai fornix posterior vagina, selanjutnya
melipat ke depan rectum dan membentuk ruang retri-vaginal.<br />
Ligamentum latum uteri : Peritoneum yang menutupi uterus, di garis tengh badan
uterus melebar ke lateral membentuk ligamentum lebar, di dalamnya terdapat tuba
uterin, ovarium diikat pada bagian posterior ligamentum latum yang berisi darah
dan saluran limfe untuk uterus maupun ovarium.</span></div>
<div style="line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm;">
<br /></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Fisiologi</span></strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;"><br />
Untuk menahan ovum yang telah dibuahi selama perkembangan sebutir ovum, sesudah
keluar dari overium diantarkan melalui tuba uterin ke uterus (pembuahan ovum
secara normal terjadi dalam tuba uterin) sewaktu hamil yang secara normal
berlangsung selama 40 minggu, uterus bertambah besar, tapi dindingnya menjadi
lebih tipis tetapi lebih kuat dan membesar sampai keluar pelvis, masuk ke dalam
rongga abdomen pada masa fetus.<br />
Pada umumnya setiap kehamilan berakhir dengan lahirnya bayi yang sempurna.
Tetapi dalm kenyataannya tidak selalu demikian. Sering kali perkembangan
kehamilan mendapat gangguan. Demikian pula dengan penyakit trofoblast, pada
hakekatnya merupakan kegagalan reproduksi. Di sini kehamilan tidak berkembang
menjadi janin yang sempurna, melainkan berkembang menjadi keadaan patologik
yang terjadi pada minggu-minggu pertama kehamilan, berupa degenerasi hidrifik
dari jonjot karion, sehingga menyerupai gelembung yang disebut ”mola
hidatidosa”. Pada ummnya penderita ”mola hidatidosa akan menjadi baik kembali,
tetapi ada diantaranya yang kemudian mengalami degenerasi keganasan yang berupa
karsinoma.<br />
(Wiknjosastro, Hanifa, 2002 : 339)</span></div>
<div style="line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm;">
<br /></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Tes Diagnostik</span></strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;"><br />
a.Pemeriksaan kadar beta hCG : pada mola terdapat peningkatan kadar beta hCG
darah atau urin<br />
b.Uji Sonde : Sonde (penduga rahim) dimasukkan pelan-pelan dan hati-hati ke
dalam kanalis servikalis dan kavum uteri. Bila tidak ada tahanan, sonde diputar
setelah ditarik sedikit, bila tetap tidak ada tahanan, kemungkinan mola (cara
Acosta-Sison)<br />
c.Foto rontgen abdomen : tidak terlihat tilang-tulang janini (pada kehamilan 3
– 4 bulan<br />
d.Ultrasonografi : pada mola akan terlihat badai salju (snow flake pattern) dan
tidak terlihat janin<br />
e.Foto thoraks : pada mola ada gambaram emboli udara<br />
f.Pemeriksaan T3 dan T4 bila ada gejala tirotoksikosis<br />
(Arif Mansjoer, dkk, 2001 : 266)</span></div>
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<strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Penatalaksanaan Medik</span></strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;"><br />
Penanganan yang biasa dilakukan pada mola hidatidosa adalah :<br />
a.Diagnosis dini akan menguntungkan prognosis<br />
b.Pemeriksaan USG sangat membantu diagnosis. Pada fasilitas kesehatan di mana
sumber daya sangat terbatas, dapat dilakukan :<br />
Evaluasi klinik dengan fokus pada :<br />
Riwayat haid terakhir dan kehamilan<br />
Perdarahan tidak teratur atau spotting<br />
Pembesaran abnormal uterus<br />
Pelunakan serviks dan korpus uteri<br />
Kajian uji kehamilan dengan pengenceran urin<br />
Pastikan tidak ada janin (Ballottement) atau DJJ sebelum upaya diagnosis dengan
perasat Hanifa Wiknjosastro atau Acosta Sisson<br />
c.Lakukan pengosongan jaringan mola dengan segera<br />
d.Antisipasi komplikasi (krisis tiroid, perdarahan hebat atau perforasi uterus)<br />
e.Lakukan pengamatan lanjut hingga minimal 1 tahun.</span></div>
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<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Selain dari penanganan di atas, masih
terdapat beberapa penanganan khusus yang dilakukan pada pasien dengan mola
hidatidosa, yaitu :</span></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Segera lakukan evakuasi jaringan mola dan
sementara proses evakuasi berlangsung berikan infus 10 IU oksitosin dalam 500
ml NaCl atau RL dengan kecepatan 40-60 tetes per menit (sebagai tindakan
preventif terhadap perdarahan hebat dan efektifitas kontraksi terhadap
pengosongan uterus secara tepat).<br />
Pengosongan dengan Aspirasi Vakum lebih aman dari kuretase tajam. Bila sumber
vakum adalah tabung manual, siapkan peralatan AVM minimal 3 set agar dapat
digunakan secara bergantian hingga pengosongan kavum uteri selesai<br />
Kenali dan tangani komplikasi seperti tirotoksikasi atau krisis tiroid baik
sebelum, selama dan setelah prosedur evakuasi<br />
Anemia sedang cukup diberikan Sulfas Ferosus 600 mg/hari, untuk anemia berat
lakukan transfusi<br />
Kadar hCG diatas 100.000 IU/L praevakuasi menunjukkan masih terdapat trofoblast
aktif (diluar uterus atau invasif), berikan kemoterapi MTX dan pantau beta-hCG
serta besar uterus secara klinis dan USG tiap 2 minggu<br />
Selama pemantauan, pasien dianjurkan untuk menggunakan kontrasepsi hormonal
(apabila masih ingin anak) atau tubektomy apabila ingin menghentikan
fertilisasi</span></div>
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<strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">KONSEP ASUHAN KEPERAWATAN</span></strong></div>
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<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Proses keperawatan adalah metode kerja dalam
pemberian pelayanan keperawatan untuk menganalisa masalah pasien secara
sistematis, menentukan cara pemecahannya, melakukan tindakan dan mengevaluasi
hasil tindakan yang telah dilaksanakan.<br />
Proses keperawatan adalah serangkaian perbuatan atau tindakan untuk menetapkan,
merencanakan danmelaksanakan pelayanan keperawatan dalam rangka membantu klien
untuk mencapai dan memelihara kesehatannya seoptimal mungkin. Tindakan
keperawatan tersebut dilaksanakan secara berurutan, terus menerus, saling
berkaitan dan dinamis.</span></div>
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<strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Pengkajian</span></strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;"><br />
Pengkajian adalah pendekatan sistematis untuk mengumpulkan data dan
menganalisanya sehingga dapat diketahui masalah dan kebutuhan perawatan bagi
klien. Adapun hal-hal yang perlu dikaji adalah :</span></div>
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<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Biodata<br />
Mengkaji identitas klien dan penanggung yang meliputi : nama, umur, agama, suku
bangsa, pendidikan, pekerjaan, status perkawinan, perkawinan ke-, lamanya
perkawinan dan alamat<br />
Keluhan utama<br />
Kaji adanya menstruasi tidak lancar dan adanya perdarahan pervaginam berulang<br />
Riwayat kesehatan, yang terdiri atas :<br />
Riwayat kesehatan sekarang<br />
Yait keluhan sampai saat klien pergi ke Rumah Sakit atau pada saat pengkajian
seperti perdarahan pervaginam di luar siklus haid, pembesaran uterus lebih
besar dari usia kehamilan.<br />
Riwayat kesehatan masa lalu<br />
Riwayat pembedahan<br />
Kaji adanya pembedahan yang pernah dialami oleh klien, jenis pembedahan, kapan,
oleh siapa dan di mana tindakan tersebut berlangsung.<br />
Riwayat penyakit yang perna dialami<br />
Kaji adanya penyakit yang pernah dialami oleh klien misalnya DM, jantung,
hipertensi, masalah ginekologi/urinari, penyakit endokrin, dan
penyakit-penyakit lainnya.<br />
Riwayat kesehatan keluarga<br />
Yang dapat dikaji melalui genogram dan dari genogram tersebut dapat
diidentifikasi mengenai penyakit turunan dan penyakit menular yang terdapat
dalam keluarga.<br />
Riwayat kesehatan reproduksi<br />
Kaji tentang mennorhoe, siklus menstruasi, lamanya, banyaknya, sifat darah, bau,
warna dan adanya dismenorhoe serta kaji kapan menopause terjadi, gejala serta
keluahan yang menyertainya<br />
Riwayat kehamilan, persalinan dan nifas<br />
Kaji bagaimana keadaan anak klien mulai dari dalam kandungan hingga saat ini,
bagaimana keadaan kesehatan anaknya.<br />
Riwayat seksual<br />
Kaji mengenai aktivitas seksual klien, jenis kontrasepsi yang digunakan serta
keluahn yang menyertainya.<br />
Riwayat pemakaian obat<br />
Kaji riwayat pemakaian obat-obatankontrasepsi oral, obat digitalis dan jenis
obat lainnya.<br />
Pola aktivitas sehari-hari<br />
Kaji mengenai nutrisi, cairan dan elektrolit, eliminasi (BAB dan BAK),
istirahat tidur, hygiene, ketergantungan, baik sebelum dan saat sakit.<br />
Pemeriksaan fisik, meliputi :<br />
Inspeksi adalah proses observasi yang sistematis yang tidak hanya terbatas pada
penglihatan tetapi juga meliputi indera pendengaran dan penghidu.<br />
Hal yang diinspeksi antara lain : mengobservasi kulit terhadap warna, perubahan
warna, laserasi, lesi terhadap drainase, pola pernafasan terhadap kedalaman dan
kesimetrisan, bahasa tubuh, pergerakan dan postur, penggunaan ekstremitas,
adanya keterbatasan fifik, dan seterusnya<br />
Palpasi adalah menyentuh atau menekan permukaan luar tubuh dengan jari.<br />
Sentuhan : merasakan suatu pembengkakan, mencatat suhu, derajat kelembaban dan
tekstur kulit atau menentukan kekuatan kontraksi uterus<br />
Tekanan : menentukan karakter nadi, mengevaluasi edema, memperhatikan posisi
janin atau mencubit kulit untuk mengamati turgor<br />
Pemeriksaan dalam : menentukan tegangan/tonus otot atau respon nyeri yang
abnormal<br />
Perkusi adalah melakukan ketukan langsung atau tidak langsung pada permukaan
tubuh tertentu untuk memastikan informasi tentang organ atau jaringan yang ada
dibawahnya<br />
Menggunakan jari : ketuk lutut dan dada dan dengarkan bunyi yang menunjukkan
ada tidaknya cairan, massa atau konsolidasi<br />
Menggunakan palu perkusi : ketuk lutut dan amati ada tidaknya refleks/gerakan
pada kaki bawah, memeriksa refleks kulit perut apakah ada kontraksi dinding
perut atau tidak<br />
Auskultasi adalah mendengarkan bunyi dalam tubuh dengan bentuan stetoskop
dengan menggambarkan dan menginterpretasikan bunyi yang terdengar<br />
Mendengar : mendengarkan di ruang antekubiti untuk tekanan darah, dada untuk
bunyi jantung/paru abdomen untuk bising usus atau denyut jantung janin.<br />
(Johnson & Taylor, 2005 : 39)<br />
Pemeriksaan laboratorium : darah dan urine serta pemeriksaan penunjang :
rontgen, USG, biopsi, pap smear<br />
Keluarga berencana<br />
Kaji mengenai pengetahuan klien tentang KB, apakah klien setuju, apakah klien
menggunakan kontrasepsi, dan menggunakan KB jenis apa.<br />
Data lain-lain<br />
Kaji mengenai perawatan dan pengobatan yang telah diberikan selama dirawat di
RS.<br />
Data psikososial<br />
Kaji orang terdekat dengan klien, bagaimana pola komunikasi dalam keluarga, hal
yang menjadi beban pikiran klien dan mekanisme koping yang digunakan.<br />
Status sosio-ekonomi<br />
Kaji masalah finansial klien<br />
Data spiritual<br />
Kaji tentang keyakinan klien terhadap Tuhan YME, dan kegiatan keagamaan yang
biasa dilakukan.</span></div>
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<strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Diagnosa Keperawatan yang Lazim
Muncul</span></strong></div>
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<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Secara singkat diagnosa keperawatan dapat
diartikan :<br />
Sebagai rumusan atau keputusan atau keputusan yang diambil sebagai hasil dari
pengkajian keperawatan<br />
Diagnosa keperawatan adalah pernyataan yang digambarkan sebagai respon
seseorang atau kelompok (keadan kesehatan yang merupakan keadaan aktual maupun
potensial) dimana perawat secara legal mengidentifikasi, menetapkan intervensi
untuk mempertahankan keadaan kesehatan atau menurunkan. (Carpenito, Lynda,
2001: 458)</span></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Diagnosa keperawatan yang lazim muncul pada
kasus ”mola hidatidosa” adalah :<br />
1.Nyeri berhubungan dengan terputusnya kontinuitas jaringan<br />
2.Intoleran aktivitas berhubungan dengan kelemahan<br />
3.Gangguan pola tidur berhubungan dengan adanya nyeri<br />
4.Gangguan rasa nyaman : hipertermi berhubungan dengan proses infeksi<br />
5.Kecemasan berhubungan dengan perubahan status kesehatan<br />
6.Risiko nutrisi kurang dari kebutuhan berhubungan dengan mual muntah<br />
7.Risiko terjadi infeksi berhubungan dengan tindakan kuretase<br />
8.Risiko terjadinya gangguan perfusi jaringan berhubungan dengan adanya
perdarahan</span></div>
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<strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Intervensi</span></strong></div>
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<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">DIAGNOSA I<br />
Nyeri berhubungan dengan terputusnya kontinuitas jaringan<br />
Tujuan :<br />
Klien akan meninjukkan nyeri berkurang/hilang dengan kriteria :<br />
Klien mengatakan nyeri berkurang/hilang<br />
Ekspresi wajah tenang<br />
TTV dalam batas normal<br />
Intervensi :<br />
1.Kaji tingkat nyeri, lokasi dan skala nyeri yang dirasakan klien<br />
Rasional :<br />
Mengetahui tingkat nyeri yang dirasakan sehingga dapat membantu menentukan
intervensi yang tepat<br />
2.Observasi tanda-tanda vital tiap 8 jam<br />
Rasional :<br />
Perubahan tanda-tanda vital terutama suhu dan nadi merupakan salah satu
indikasi peningkatan nyeri yang dialami oleh klien<br />
3.Anjurkan klien untuk melakukan teknik relaksasi<br />
Rasional :<br />
Teknik relaksasi dapat membuat klien merasa sedikit nyaman dan distraksi dapat
mengalihkan perhatian klien terhadap nyeri sehingga dapat mambantu mengurangi
nyeri yang dirasakan<br />
4.Beri posisi yang nyaman<br />
Rasional :<br />
Posisi yang nyaman dapat menghindarkan penekanan pada area luka/nyeri<br />
5.Kolaborasi pemberian analgetik<br />
Rasional :<br />
Obat-obatan analgetik akan memblok reseptor nyeri sehingga nyeri tidat dapat
dipersepsikan</span></div>
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<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">DIAGNOSA II<br />
Intoleran aktivitas berhubungan dengan kelemahan<br />
Tujuan :<br />
Klien akan menunjukkan terpenuhinya kebutuhan rawat diri dengan kriteria :<br />
Kebutuhan personal hygiene terpenuhi<br />
Klien nampak rapi dan bersih<br />
Intervensi :<br />
1.Kaji kemampuan klien dalam memenuhi rawat diri<br />
Rasional :<br />
Untuk mengetahui tingkat kemampuan/ketergantungan klien dalam merawat diri
sehingga dapat membantu klien dalam memenuhi kebutuhan hygienenya<br />
2.Bantu klien dalam memenuhi kebutuhan sehari-hari<br />
Rasional :<br />
Kebutuhan hygiene klien terpenuhi tanpa membuat klien ketergantungan pada
perawat<br />
3.Anjurkan klien untuk melakukan aktivitas sesuai kemampuannya<br />
Rasional :<br />
Pelaksanaan aktivitas dapat membantu klien untuk mengembalikan kekuatan secara
bertahap dan menambah kemandirian dalam memenuhi kebutuhannya<br />
4.Anjurkan keluarga klien untuk selalu berada di dekat klien dan membantu
memenuhi kebutuhan klien<br />
Rasional :<br />
Membantu memenuhi kebutuhan klien yang tidak terpenuhi secara mandiri</span></div>
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<br /></div>
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<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">DIAGNOSA III<br />
Gangguan pola tidur berhubungan dengan adanya nyeri<br />
Tujuan :<br />
Klien akan mengungkapkan pola tidurnya tidak terganggu dengan kriteria :<br />
Klien dapat tidur 7-8 jam per hari<br />
Konjungtiva tidak anemis<br />
Intervensi :<br />
1.Kaji pola tidur<br />
Rasional :<br />
Dengan mengetahui pola tidur klien, akan memudahkan dalam menentukan intervensi
selanjutnya<br />
2.Ciptakan lingkungan yang nyaman dan tenang<br />
Rasional :<br />
Memberikan kesempatan pada klien untuk beristirahat<br />
3.Anjurkan klien minum susu hangat sebelum tidur<br />
Rasional :<br />
Susu mengandung protein yang tinggi sehingga dapat merangsang untuk tidur<br />
4.Batasi jumlah penjaga klien<br />
Rasional :<br />
Dengan jumlah penjaga klien yang dibatasi maka kebisingan di ruangan dapat
dikurangi sehingga klien dapat beristirahat<br />
5.Memberlakukan jam besuk<br />
Rasional :<br />
Memberikan kesempatan pada klien untuk beristirahat<br />
6.Kolaborasi dengan tim medis pemberian obat tidur Diazepam<br />
Rasional :<br />
Diazepam berfungsi untuk merelaksasi otot sehingga klien dapat tenang dan mudah
tidur</span></div>
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<br /></div>
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<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">DIAGNOSA IV<br />
Gangguan rasa nyaman : hipertermi berhubungan dengan proses infeksi<br />
Tujuan :<br />
Klien akan menunjukkan tidak terjadi panas dengan kriteria :<br />
Tanda-tanda vital dalam batas normal<br />
Klien tidak mengalami komplikasi<br />
Intervensi :<br />
1.Pantau suhu klien, perhatikan menggigil/diaforesis<br />
Rasional :<br />
Suhu diatas normal menunjukkan terjadinya proses infeksi, pola demam dapat
membantu diagnosa<br />
2.Pantau suhu lingkungan<br />
Rasional :<br />
Suhu ruangan harus diubah atau dipertahankan, suhu harus mendekati normal<br />
3.Anjurkan untuk minum air hangat dalam jumlah yang banyak<br />
Rasional :<br />
Minum banyak dapat membantu menurunkan demam<br />
4.Berikan kompres hangat<br />
Rasional :<br />
Kompres hangat dapat membantu penyerapan panas sehingga dapat menurunkan suhu
tubuh<br />
5.Kolaborasi pemberian obat antipiretik<br />
Rasional :<br />
Digunakan untuk mengurangi demam dengan aksi pada hipothalamus</span></div>
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<br /></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">DIAGNOSA V<br />
Kecemasan berhubungan dengan perubahan status kesehatan<br />
Tujuan :<br />
Klien akan menunjukkan kecemasan berkurang/hilang dengan kriteria :<br />
Ekspresi wajah tenang<br />
Klien tidak sering bertanya tentang penyakitnya<br />
Intervensi :<br />
1.Kaji tingkat kecemasan klien<br />
Rasional :<br />
Mengetahui sejauh mana kecemasan tersebut mengganggu klien<br />
2.Beri kesempatan pada klien untuk mengungkapkan perasaannya<br />
Rasional :<br />
Ungkapan perasaan dapat memberikan rasa lega sehingga mengurangi kecemasan<br />
3.Mendengarkan keluhan klien dengan empati<br />
Rasional :<br />
Dengan mendengarkan keluahan klien secara empati maka klien akan merasa
diperhatikan<br />
4.Jelaskan pada klien tentang proses penyakit dan terapi yang diberikan<br />
Rasional :<br />
menambah pengetahuan klien sehingga klien tahu dan mengerti tentang penyakitnya<br />
5.Beri dorongan spiritual/support<br />
Rasional :<br />
Menciptakan ketenangan batin sehingga kecemasan dapat berkurang</span></div>
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<br /></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">DIAGNOSA VI<br />
Risiko nutrisi kurang dari kebutuhan berhubungan dengan mual muntah<br />
Tujuan :<br />
Klien akan mengungkapkan nutrisi terpenuhi dengan kriteria :<br />
Nafsu makan meningkat<br />
Porsi makan dihabiskan<br />
Intervensi :<br />
1.Kaji status nutrisi klien<br />
Rasional :<br />
Sebagai awal untuk menetapkan rencana selanjutnya<br />
2.Anjurkan makan sedikit demi sedikit tapi sering<br />
Rasional :<br />
Makan sedikit demi sedikit tapi sering mampu membantu untuk meminimalkan
anoreksia<br />
3.Anjurkan untuk makan makanan dalam keadaan hangat dan bervariasi<br />
Rasional :<br />
Makanan yang hangat dan bervariasi dapat menbangkitkan nafsu makan klien<br />
4.Timbang berat badan sesuai indikasi<br />
Rasional :<br />
Mengevaluasi keefektifan atau kebutuhan mengubah pemberian nutrisi<br />
5.Tingkatkan kenyamanan lingkungan termasuk sosialisasi saat makan, anjurkan
orang terdekat untuk membawa makanan yang disukai klien<br />
Rasional :<br />
Sosialisasi waktu makan dengan orang terdekat atau teman dapat meningkatkan
pemasukan dan menormalkan fungsi makanan</span></div>
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<br /></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">DIAGNOSA VII<br />
Risiko terjadi infeksi berhubungan dengan tindakan kuretase<br />
Tujuan :<br />
Klien akan terbebas dari infeksi dengan kriteria :<br />
Tidak tampak tanda-tanda infeksi<br />
Vital sign dalam batas normal<br />
Intervensi :<br />
1.Kaji adanya tanda-tanda infeksi<br />
Rasional :<br />
Mengetahui adanya gejala awal dari proses infeksi</span></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">2.Observasi vital sign<br />
Rasional :<br />
Perubahan vital sign merupakan salah satu indikator dari terjadinya proses
infeksi dalam tubuh<br />
3.Observasi daerah kulit yang mengalami kerusakan (luka, garis jahitan), daerah
yang terpasang alat invasif (infus, kateter)<br />
Rasional :<br />
Deteksi dini perkembangan infeksi memungkinkan untuk melakukan tindakan dengan
segera dan pencegahan komplikasi selanjutnya<br />
4.Kolaborasi dengan tim medis untuk pemberian obat antibiotik<br />
Rasional :<br />
Anti biotik dapat menghambat pembentukan sel bakteri, sehingga proses infeksi
tidak terjadi. Disamping itu antibiotik juga dapat langsung membunuh sel
bakteri penyebab infeksi</span></div>
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<br /></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">DIAGNOSA VIII<br />
Risiko terjadinya gangguan perfusi jaringan berhubungan dengan adanya perdarahan<br />
Tujuan :<br />
Klien akan menunjukkan gangguan perfusi jaringan perifer tidak terjadi dengan
kriteria :<br />
Hb dalam batas normal (12-14 g%)<br />
Turgor kulit baik, vital sign dalam batas normal<br />
Tidak ada mual muntah<br />
Intervensi :<br />
1.Awasi tanda-tanda vital, kaji warna kulit/membran mukosa, dasar kuku<br />
Rasional :<br />
Memberika informasi tentang derajat/keadekuatan perfusi jaringan dan membantu
menentukan intervensi selanjutnya<br />
2.Selidiki perubahan tingkat kesadaran, keluhan pusing dan sakit kepala<br />
Rasional :<br />
Perubahan dapat menunjukkan ketidak adekuatan perfusi serebral sebagai akibat
tekanan darah arterial<br />
3.Kaji kulit terhadap dingin, pucat, berkeringat, pegisian kapiler lambat dan
nadi perifer lemah<br />
Rasional :<br />
Vasokonstriksi adalah respon simpatis terhadap penurunan volume sirkulasi dan
dapat terjadi sebagai efek samping vasopressin<br />
4.Berikan cairan intravena, produk darah<br />
Rasional :<br />
Menggantikan kehilangan daran, mempertahankan volume sirkulasi<br />
5.Penatalaksanaan pemberian obat antikoagulan tranexid 500 mg 3×1 tablet<br />
Rasional :<br />
Obat anti kagulan berfungsi mempercepat terjadinya pembekuan darah / mengurangi
perarahan</span></div>
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<br /></div>
<div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; line-height: 13.5pt; margin-bottom: .0001pt; margin: 0cm; orphans: 2; widows: 2; word-spacing: 0px;">
<strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;">Sumber:</span></strong><span style="color: black; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;"><br />
1.Carpenito, Lynda, (2001), Buku Saku Diagnosa Keperawatan, Penerbit Buku
Kedokteran EGC, Jakarta<br />
2.Hamilton, C. Mary, 1995, Dasar-dasar Keperawatan Maternitas, edisi 6, EGC,
Jakarta<br />
3.Soekojo, Saleh, 1973, Patologi, UI Patologi Anatomik, Jakarta<br />
4.Mochtar, Rustam, 1998. Sinopsis Obstetri, Jilid I. EGC. Jakarta<br />
5.Johnson & Taylor, 2005. Buku Ajar Praktik Kebidanan. EGC. Jakarta<br />
6.Mansjoer, Arif, dkk. 2001. Kapita Selekta Kedokteran, Jilid I. Media
Aesculapius. Jakarta</span></div>
<div class="MsoNormal">
<br /></div>Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-61387249227417038012012-05-16T04:07:00.000-07:002012-08-08T05:08:47.289-07:00ASKEP TRAUMA ABDOMEN<br />
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</div>
<div class="MsoNormal" style="line-height: 15.75pt; margin-bottom: 0pt; text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="font-family: "Times", "Times New Roman", serif;">TRAUMA ABDOMEN</span></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="font-family: "Times", "Times New Roman", serif;"><br /></span></span></div>
<span style="font-family: "Times", "Times New Roman", serif;">
</span><div class="MsoNormal" style="line-height: 14.25pt; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="font-family: "Times", "Times New Roman", serif;">A. PENGERTIAN</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Trauma adalah cedera/rudapaksa atau kerugian psikologis atau emosional
(Dorland, 2002).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Trauma adalah luka atau cedera fisik lainnya atau cedera fisiologis akibat
gangguan emosional yang hebat (Brooker, 2001).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Trauma adalah penyebab kematian utama pada anak dan orang dewasa kurang dari 44
tahun. Penyalahgunaan alkohol dan obat telah menjadi faktor implikasi pada
trauma tumpul dan tembus serta trauma yang disengaja atau tidak disengaja
(Smeltzer, 2001).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Trauma abdomen adalah cedera pada abdomen, dapat berupa trauma tumpul dan
tembus serta trauma yang disengaja atau tidak disengaja (Smeltzer, 2001).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Trauma perut merupakan luka pada isi rongga perut dapat terjadi dengan atau
tanpa tembusnya dinding perut dimana pada penanganan/penatalaksanaan lebih
bersifat kedaruratan dapat pula dilakukan tindakan laparatomi (FKUI, 1995).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
B. ETIOLOGI DAN KLASIFIKASI</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
1. Trauma tembus (trauma perut dengan penetrasi kedalam rongga peritonium).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Disebabkan oleh : luka tusuk, luka tembak.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
2. Trauma tumpul (trauma perut tanpa penetrasi kedalam rongga peritonium).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Disebabkan oleh : pukulan, benturan, ledakan, deselerasi, kompresi atau sabuk
pengaman (set-belt) (FKUI, 1995).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
C. PATOFISIOLOGI</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Bila suatu kekuatan eksternal dibenturkan pada tubuh manusia (akibat kecelakaan
lalulintas, penganiayaan, kecelakaan olah raga dan terjatuh dari ketinggian),
maka beratnya trauma merupakan hasil dari interaksi antara faktor – faktor
fisik dari kekuatan tersebut dengan jaringan tubuh. Berat trauma yang terjadi
berhubungan dengan kemampuan obyek statis (yang ditubruk) untuk menahan tubuh.
Pada tempat benturan karena terjadinya perbedaan pergerakan dari jaringan tubuh
yang akan menimbulkan disrupsi jaringan. Hal ini juga karakteristik dari
permukaan yang menghentikan tubuh juga penting. Trauma juga tergantung pada
elastitisitas dan viskositas dari jaringan tubuh. Elastisitas adalah kemampuan
jaringan untuk kembali pada keadaan yang sebelumnya. Viskositas adalah
kemampuan jaringan untuk menjaga bentuk aslinya walaupun ada benturan.
Toleransi tubuh menahan benturan tergantung pada kedua keadaan tersebut..
Beratnya trauma yang terjadi tergantung kepada seberapa jauh gaya yang ada akan
dapat melewati ketahanan jaringan. Komponen lain yang harus dipertimbangkan
dalam beratnya trauma adalah posisi tubuh relatif terhadap permukaan benturan.
Hal tersebut dapat terjadi cidera organ intra abdominal yang disebabkan
beberapa mekanisme :</span></span></div>
<span style="font-family: "Times", "Times New Roman", serif;">
</span><div class="MsoNormal" style="line-height: 14.25pt; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="font-family: "Times", "Times New Roman", serif;">Meningkatnya tekanan intra abdominal yang mendadak dan hebat oleh gaya
tekan dari luar seperti benturan setir atau sabuk pengaman yang letaknya tidak
benar dapat mengakibatkan terjadinya ruptur dari organ padat maupun organ
berongga.</span></span></div>
<span style="font-family: "Times", "Times New Roman", serif;">
</span><div class="MsoNormal" style="line-height: 14.25pt; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="font-family: "Times", "Times New Roman", serif;">Terjepitnya organ intra abdominal antara dinding abdomen anterior dan
vertebrae atau struktur tulang dinding thoraks.</span></span></div>
<span style="font-family: "Times", "Times New Roman", serif;">
</span><div class="MsoNormal" style="line-height: 15.75pt; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="font-family: "Times", "Times New Roman", serif;">Terjadi gaya akselerasi – deselerasi secara mendadak dapat menyebabkan gaya
robek pada organ dan pedikel vaskuler.</span></span></div>
<span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: minor-latin; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: minor-latin;"><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
E. KOMPLIKASI</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Segera : hemoragi, syok, dan cedera.</span></span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;"><span style="font-family: "Times", "Times New Roman", serif;">F</span></span></span><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: minor-latin; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: minor-latin;"><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Lambat : infeksi (Smeltzer, 2001).</span></span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;"><span style="font-family: "Times", "Times New Roman", serif;">F</span></span></span><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: minor-latin; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: minor-latin;"><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
F. PEMERIKSAAN DIAGNOSTIK</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Pemeriksaan rektum : adanya darah
menunjukkan kelainan pada usus besar ; kuldosentesi, kemungkinan adanya darah
dalam lambung ; dan kateterisasi, adanya darah menunjukkan adanya lesi pada
saluran kencing.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Laboratorium : hemoglobin, hematokrit,
leukosit dan analisis urine.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Radiologik : bila diindikasikan untuk
melakukan laparatomi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">IVP/sistogram : hanya dilakukan bila ada
kecurigaan terhadap trauma saluran kencing.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Parasentesis perut : tindakan ini
dilakukan pada trauma tumpul perut yang diragukan adanya kelainan dalam rongga
perut atau trauma tumpul perut yang disertai dengan trauma kepala yang berat,
dilakukan dengan menggunakan jarum pungsi no 18 atau 20 yang ditusukkan melalui
dinding perut didaerah kuadran bawah atau digaris tengah dibawah pusat dengan
menggosokkan buli-buli terlebih dahulu.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Lavase peritoneal : pungsi dan
aspirasi/bilasan rongga perut dengan memasukkan cairan garam fisiologis melalui
kanula yang dimasukkan kedalam rongga peritonium (FKUI, 1995).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
G. PENATALAKSANAAN</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Penatalaksanaan kedaruratan ; ABCDE.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Pemasangan NGT untuk pengosongan isi
lambung dan mencegah aspirasi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Kateter dipasang untuk mengosongkan
kandung kencing dan menilai urin yang keluar (perdarahan).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Pembedahan/laparatomi (untuk trauma
tembus dan trauma tumpul jika terjadi rangsangan peritoneal : syok ; bising
usus tidak terdengar ; prolaps visera melalui luka tusuk ; darah dalam lambung,
buli-buli, rektum ; udara bebas intraperitoneal ; lavase peritoneal positif ;
cairan bebas dalam rongga perut) (FKUI, 1995).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
MANAJEMEN KEPERAWATAN</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
A. PENGKAJIAN</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Pengkajian adalah langkah awal dan dasar dalam proses keperawatan secara
menyeluruh (Boedihartono, 1994).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Pengkajian pasien trauma abdomen (Smeltzer, 2001) adalah meliputi :</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
1. Trauma Tembus abdomen</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Dapatkan riwayat mekanisme cedera ;
kekuatan tusukan/tembakan ; kekuatan tumpul (pukulan).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Inspeksi abdomen untuk tanda cedera
sebelumnya : cedera tusuk, memar, dan tempat keluarnya peluru.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Auskultasi ada/tidaknya bising usus dan
catat data dasar sehingga perubahan dapat dideteksi. Adanya bising usus adalah
tanda awal keterlibatan intraperitoneal ; jika ada tanda iritasi peritonium,
biasanya dilakukan laparatomi (insisi pembedahan kedalam rongga abdomen).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Kaji pasien untuk progresi distensi
abdomen, gerakkan melindungi, nyeri tekan, kekakuan otot atau nyeri lepas,
penurunan bising usus, hipotensi dan syok.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Kaji cedera dada yang sering mengikuti
cedera intra-abdomen, observasi cedera yang berkaitan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Catat semua tanda fisik selama
pemeriksaan pasien.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
2. Trauma tumpul abdomen</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Dapatkan riwayat detil jika mungkin
(sering tidak bisa didapatkan, tidak akurat, atau salah). dapatkan semua data
yang mungkin tentang hal-hal sebagai berikut :</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
• Metode cedera.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
• Waktu awitan gejala.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
• Lokasi penumpang jika kecelakaan lalu lintas (sopir sering menderita ruptur
limpa atau hati). Sabuk keselamatan digunakan/tidak, tipe restrain yang
digunakan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
• Waktu makan atau minum terakhir.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
• Kecenderungan perdarahan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
• Penyakit danmedikasi terbaru.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
• Riwayat immunisasi, dengan perhatian pada tetanus.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
• Alergi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">Lakukan pemeriksaan cepat pada seluruh
tubuh pasienuntuk mendeteksi masalah yang mengancam kehidupan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
PENATALAKSANAAN KEDARURATAN</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
1. Mulai prosedur resusitasi (memperbaiki jalan napas, pernapasan, sirkulasi)
sesuai indikasi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
2. Pertahankan pasien pada brankar atau tandu papan ; gerakkan dapat
menyebabkan fragmentasi bekuan pada pada pembuluh darah besar dan menimbulkan
hemoragi masif.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
a) Pastikan kepatenan jalan napas dan kestabilan pernapasan serta sistem saraf.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
b) Jika pasien koma, bebat leher sampai setelah sinar x leher didapatkan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
c) Gunting baju dari luka.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
d) Hitung jumlah luka.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
e) Tentukan lokasi luka masuk dan keluar.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
3. Kaji tanda dan gejala hemoragi. Hemoragi sering menyertai cedera abdomen,
khususnya hati dan limpa mengalami trauma.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
4. Kontrol perdarahan dan pertahanan volume darah sampai pembedahan dilakukan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
a) Berikan kompresi pada luka perdarahan eksternal dan bendungan luka dada.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
b) Pasang kateter IV diameter besar untuk penggantian cairan cepat dan
memperbaiki dinamika sirkulasi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
c) Perhatikan kejadian syoksetelah respons awal terjadi terhadap transfusi ;
ini sering merupakan tanda adanya perdarrahan internal.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
d) Dokter dapat melakukan parasentesis untuk mengidentifikasi tempat
perdarahan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
5. Aspirasi lambung dengan selang nasogastrik. Prosedur ini membantu mendeteksi
luka lambung, mengurangi kontaminasi terhadap rongga peritonium, dan mencegah
komplikasi paru karena aspirasi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
6. Tutupi visera abdomen yang keluar dengan balutan steril, balutan salin basah
untuk mencegah nkekeringan visera.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
a) Fleksikan lutut pasien ; posisi ini mencegah protusi lanjut.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
b) Tunda pemberian cairan oral untuk mencegah meningkatnya peristaltik dan
muntah.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
7. Pasang kateter uretra menetap untuk mendapatkan kepastian adanya hematuria
dan pantau haluaran urine.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
8. Pertahankan lembar alur terus menerus tentang tanda vital, haluaran urine,
pembacaan tekanan vena sentral pasien (bila diindikasikan), nilai hematokrit,
dan status neurologik.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
9. Siapkan untuk parasentesis atau lavase peritonium ketika terdapat
ketidakpastian mengenai perdarahan intraperitonium.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
10. Siapkan sinografi untuk menentukan apakah terdapat penetrasi peritonium
pada kasus luka tusuk.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
a) Jahitan dilakukan disekeliling luka.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
b) Kateter kecil dimasukkan ke dalam luka.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
c) Agens kontras dimasukkan melalui kateter ; sinar x menunjukkan apakah
penetrasi peritonium telah dilakukan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
11. Berikan profilaksis tetanus sesuai ketentuan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
12. Berikan antibiotik spektrum luas untuk mencegah infeksi. trauma dapat
menyebabkan infeksi akibat karena kerusakan barier mekanis, bakteri eksogen
dari lingkungan pada waktu cedera dan manuver diagnostik dan terapeutik
(infeksi nosokomial).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
13. Siapkan pasien untuk pembedahan jika terdapat bukti adanya syok, kehilangan
darah, adanya udara bebas dibawah diafragma, eviserasi, atau hematuria.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
PENATALAKSANAAN DIRUANG PERAWATAN LANJUTAN</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
B. DIAGNOSA KEPERAWATAN</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Diagnosa keperawatan adalah suatu penyatuan dari masalah pasien yang nyata
maupun potensial berdasarkan data yang telah dikumpulkan (Boedihartono, 1994).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Diagnosa keperawatan pada pasien dengan trauma abdomen (Wilkinson, 2006) adalah
:</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
1. Kerusakan integritas kulit berhubungan dengan cedera tusuk.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
2. Risiko tinggi terhadap infeksi berhubungan dengan gangguan integritas kulit.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
3. Nyeri akut berhubungan dengan trauma/diskontinuitas jaringan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
4. Intoleransi aktivitas berhubungan dengan kelemahan umum.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
5. Hambatan mobilitas fisik berhubungan dengan nyeri/ketidak nyamanan, terapi
pembatasan aktivitas, dan penurunan kekuatan/tahanan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
C. INTERVENSI DAN IMPLEMENTASI</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Intervensi adalah penyusunan rencana tindakan keperawatan yang akan
dilaksanakan untuk menanggulangi masalah sesuai dengan diagnosa keperawatan
(Boedihartono, 1994).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Implementasi adalah pengelolaan dan perwujudan dari rencana keperawatan yang
telah disusun pada tahap perencanaan (Effendi, 1995).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Intervensi dan implementasi keperawatan yang muncul pada pasien dengan trauma
abdomen (Wilkinson, 2006) meliputi :</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
1. Kerusakan integritas kulit adalah keadaan kulit seseorang yang mengalami
perubahan secara tidak diinginkan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Tujuan : Mencapai penyembuhan luka pada waktu yang sesuai.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Kriteria Hasil : - tidak ada tanda-tanda infeksi seperti pus.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
- luka bersih tidak lembab dan tidak kotor.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
- Tanda-tanda vital dalam batas normal atau dapat ditoleransi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Intervensi dan Implementasi :</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
a. Kaji kulit dan identifikasi pada tahap perkembangan luka.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ mengetahui sejauh mana perkembangan luka mempermudah dalam melakukan
tindakan yang tepat.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
b. Kaji lokasi, ukuran, warna, bau, serta jumlah dan tipe cairan luka.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ mengidentifikasi tingkat keparahan luka akan mempermudah intervensi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
c. Pantau peningkatan suhu tubuh.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ suhu tubuh yang meningkat dapat diidentifikasikan sebagai adanya proses
peradangan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
d. Berikan perawatan luka dengan tehnik aseptik. Balut luka dengan kasa kering
dan steril, gunakan plester kertas.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ tehnik aseptik membantu mempercepat penyembuhan luka dan mencegah terjadinya
infeksi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
e. Jika pemulihan tidak terjadi kolaborasi tindakan lanjutan, misalnya
debridement.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ agar benda asing atau jaringan yang terinfeksi tidak menyebar luas pada area
kulit normal lainnya.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
f. Setelah debridement, ganti balutan sesuai kebutuhan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ balutan dapat diganti satu atau dua kali sehari tergantung kondisi parah/
tidak nya luka, agar tidak terjadi infeksi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
g. Kolaborasi pemberian antibiotik sesuai indikasi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R / antibiotik berguna untuk mematikan mikroorganisme pathogen pada daerah yang
berisiko terjadi infeksi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
2. Risiko infeksi berhubungan dengan tidak adekuatnya pertahanan perifer,
perubahan sirkulasi, kadar gula darah yang tinggi, prosedur invasif dan
kerusakan kulit.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Tujuan : infeksi tidak terjadi / terkontrol.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Kriteria hasil : - tidak ada tanda-tanda infeksi seperti pus.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
- luka bersih tidak lembab dan tidak kotor.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
- Tanda-tanda vital dalam batas normal atau dapat ditoleransi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Intervensi dan Implementasi :</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
a. Pantau tanda-tanda vital.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ mengidentifikasi tanda-tanda peradangan terutama bila suhu tubuh meningkat.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
b. Lakukan perawatan luka dengan teknik aseptik.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ mengendalikan penyebaran mikroorganisme patogen.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
c. Lakukan perawatan terhadap prosedur invasif seperti infus, kateter, drainase
luka, dll.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ untuk mengurangi risiko infeksi nosokomial.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
d. Jika ditemukan tanda infeksi kolaborasi untuk pemeriksaan darah, seperti Hb
dan leukosit.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ penurunan Hb dan peningkatan jumlah leukosit dari normal bisa terjadi akibat
terjadinya proses infeksi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
e. Kolaborasi untuk pemberian antibiotik.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ antibiotik mencegah perkembangan mikroorganisme patogen.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
3. Nyeri adalah pengalaman sensori serta emosi yang tidak menyenangkan dan
meningkat akibat adanya kerusakan jaringan aktual atau potensial, digambarkan
dalam istilah seperti kerusakan ; awitan yang tiba-tiba atau perlahan dari
intensitas ringan samapai berat dengan akhir yang dapat di antisipasi atau
dapat diramalkan dan durasinya kurang dari enam bulan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Tujuan : nyeri dapat berkurang atau hilang.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Kriteria Hasil : - Nyeri berkurang atau hilang</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
- Klien tampak tenang.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Intervensi dan Implementasi :</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
a. Lakukan pendekatan pada klien dan keluarga</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ hubungan yang baik membuat klien dan keluarga kooperatif</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
b. Kaji tingkat intensitas dan frekwensi nyeri</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ tingkat intensitas nyeri dan frekwensi menunjukkan skala nyeri</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
c. Jelaskan pada klien penyebab dari nyeri</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ memberikan penjelasan akan menambah pengetahuan klien tentang nyeri</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
d. Observasi tanda-tanda vital.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ untuk mengetahui perkembangan klien</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
e. Melakukan kolaborasi dengan tim medis dalam pemberian analgesik</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ merupakan tindakan dependent perawat, dimana analgesik berfungsi untuk
memblok stimulasi nyeri.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
4. Intoleransi aktivitas adalah suatu keadaaan seorang individu yang tidak
cukup mempunyai energi fisiologis atau psikologis untuk bertahan atau memenuhi
kebutuhan atau aktivitas sehari-hari yang diinginkan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Tujuan : pasien memiliki cukup energi untuk beraktivitas.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Kriteria hasil : - perilaku menampakan kemampuan untuk memenuhi kebutuhan diri.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
- pasien mengungkapkan mampu untuk melakukan beberapa aktivitas tanpa dibantu.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
- Koordinasi otot, tulang dan anggota gerak lainya baik.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Intervensi dan Implementasi :</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
a. Rencanakan periode istirahat yang cukup.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ mengurangi aktivitas yang tidak diperlukan, dan energi terkumpul dapat
digunakan untuk aktivitas seperlunya secar optimal.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
b. Berikan latihan aktivitas secara bertahap.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ tahapan-tahapan yang diberikan membantu proses aktivitas secara perlahan dengan
menghemat tenaga namun tujuan yang tepat, mobilisasi dini.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
c. Bantu pasien dalam memenuhi kebutuhan sesuai kebutuhan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ mengurangi pemakaian energi sampai kekuatan pasien pulih kembali.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
d. Setelah latihan dan aktivitas kaji respons pasien.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ menjaga kemungkinan adanya respons abnormal dari tubuh sebagai akibat dari
latihan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
5. Hambatan mobilitas fisik adalah suatu keterbatasan dalam kemandirian,
pergerakkan fisik yang bermanfaat dari tubuh atau satu ekstremitas atau lebih.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Tujuan : pasien akan menunjukkan tingkat mobilitas optimal.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Kriteria hasil : - penampilan yang seimbang..</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
- melakukan pergerakkan dan perpindahan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
- mempertahankan mobilitas optimal yang dapat di toleransi, dengan
karakteristik :</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">0 = mandiri penuh</span></span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;"><span style="font-family: "Times", "Times New Roman", serif;">ü</span></span></span><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: minor-latin; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: minor-latin;"><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">1 = memerlukan alat Bantu.</span></span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;"><span style="font-family: "Times", "Times New Roman", serif;">ü</span></span></span><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: minor-latin; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: minor-latin;"><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">2 = memerlukan bantuan dari orang lain
untuk bantuan, pengawasan, dan pengajaran.</span></span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;"><span style="font-family: "Times", "Times New Roman", serif;">ü</span></span></span><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: minor-latin; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: minor-latin;"><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">3 = membutuhkan bantuan dari orang lain
dan alat Bantu.</span></span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;"><span style="font-family: "Times", "Times New Roman", serif;">ü</span></span></span><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: minor-latin; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: minor-latin;"><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="mso-spacerun: yes;"><span style="font-family: "Times", "Times New Roman", serif;"> </span></span><span style="font-family: "Times", "Times New Roman", serif;">4 = ketergantungan; tidak berpartisipasi
dalam aktivitas.</span></span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;"><span style="font-family: "Times", "Times New Roman", serif;">ü</span></span></span><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: minor-latin; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: minor-latin;"><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Intervensi dan Implementasi :</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
a. Kaji kebutuhan akan pelayanan kesehatan dan kebutuhan akan peralatan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ mengidentifikasi masalah, memudahkan intervensi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
b. Tentukan tingkat motivasi pasien dalam melakukan aktivitas.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ mempengaruhi penilaian terhadap kemampuan aktivitas apakah karena
ketidakmampuan ataukah ketidakmauan.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
c. Ajarkan dan pantau pasien dalam hal penggunaan alat bantu.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ menilai batasan kemampuan aktivitas optimal.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
d. Ajarkan dan dukung pasien dalam latihan ROM aktif dan pasif.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ mempertahankan /meningkatkan kekuatan dan ketahanan otot.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
e. Kolaborasi dengan ahli terapi fisik atau okupasi.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
R/ sebagai suaatu sumber untuk mengembangkan perencanaan dan
mempertahankan/meningkatkan mobilitas pasien.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
D. EVALUASI</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Evaluasi addalah stadium pada proses keperawatan dimana taraf keberhasilan
dalam pencapaian tujuan keperawatan dinilai dan kebutuhan untuk memodifikasi
tujuan atau intervensi keperawatan ditetapkan (Brooker, 2001).</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Evaluasi yang diharapkan pada pasien dengan trauma abdomen adalah :</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
1. Mencapai penyembuhan luka pada waktu yang sesuai.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
2. Infeksi tidak terjadi / terkontrol.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
3. Nyeri dapat berkurang atau hilang.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
4. Pasien memiliki cukup energi untuk beraktivitas.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
5. Pasien akan menunjukkan tingkat mobilitas optimal.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
DAFTAR PUSTAKA</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Boedihartono, 1994, Proses Keperawatan di Rumah Sakit, Jakarta.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Brooker, Christine. 2001. Kamus Saku Keperawatan Ed.31. EGC : Jakarta.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Dorland, W. A. Newman. 2002. Kamus Kedokteran. EGC : Jakarta.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
FKUI. 1995. Kumpulan Kuliah Ilmu bedah. Binarupa Aksara : Jakarta</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Nasrul Effendi, 1995, Pengantar Proses Keperawatan, EGC, Jakarta.</span><span style="font-family: "Times", "Times New Roman", serif;"><br /></span><span style="font-family: "Times", "Times New Roman", serif;">
Smeltzer, Suzanne C. 2001. Keperawatan Medikal-Bedah Brunner and Suddarth Ed.8
Vol.3. EGC : Jakarta.</span></span>
<span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span><br />Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com0tag:blogger.com,1999:blog-1799099966681267159.post-12728107782467093282012-01-12T03:25:00.000-08:002012-08-08T05:08:47.278-07:00ASKEP RETENSIO URINE<div style="color: black;">
<br /></div>
<div align="center" style="color: black; line-height: 150%; text-align: center;">
<span style="mso-themecolor: background1;">RENTENSI URINE</span></div>
<div style="color: black; line-height: 150%; orphans: 2; widows: 2; word-spacing: 0px;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-themecolor: background1;">1. Definisi </span></b></div>
<div style="color: black; line-height: 150%;">
<span style="mso-themecolor: background1;">Retensio urine adalah kesulitan miksi karena kegagalan urine dari fesika urinaria. (Kapita Selekta Kedokteran). Retensio urine adalah tertahannya urine di dalam akndung kemih, dapat terjadi secara akut maupun kronis. (Depkes RI Pusdiknakes 1995).</span></div>
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<span style="mso-themecolor: background1;">Retensio urine adlah ketidakmampuan untuk melakukan urinasi meskipun terdapat keinginan atau dorongan terhadap hal tersebut. (Brunner & Suddarth). Retensio urine adalah sutau keadaan penumpukan urine di kandung kemih dan tidak punya kemampuan untuk mengosongkannya secara sempurna. (PSIK UNIBRAW).</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="mso-themecolor: background1;">2. Etiologi</span></b><span style="mso-themecolor: background1;"></span></div>
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<span style="mso-themecolor: background1;">Adapun penyebab dari penyakit retensio urine adalah sebagai berikut:</span></div>
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<span style="mso-themecolor: background1;">a. Supra vesikal berupa kerusakan pada pusat miksi di medulla spinallis S2 S4 setinggi T12 L1. Kerusakan saraf simpatis dan parasimpatis baik sebagian ataupun seluruhnya, misalnya pada operasi miles dan mesenterasi pelvis, kelainan medulla spinalis, misalnya miningokel, tabes doraslis, atau spasmus sfinkter yang ditandai dengan rasa sakit yang hebat.</span></div>
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<span style="mso-themecolor: background1;">b. Vesikal berupa kelemahan otot detrusor karena lama teregang, atoni pada pasien DM atau penyakit neurologist, divertikel yang besar.</span></div>
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<span style="mso-themecolor: background1;">c. Intravesikal berupa pembesaran prostate, kekakuan leher vesika, striktur, batu kecil, tumor pada leher vesika, atau fimosis.</span></div>
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<span style="mso-themecolor: background1;">d. Dapat disebabkan oleh kecemasan, pembesaran porstat, kelainan patologi urethra (infeksi, tumor, kalkulus), trauma, disfungsi neurogenik kandung kemih.</span></div>
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<span style="mso-themecolor: background1;">e. Beberapa obat mencakup preparat antikolinergik antispasmotik (atropine), preparat antidepressant antipsikotik (Fenotiazin), preparat antihistamin (Pseudoefedrin hidroklorida = Sudafed), preparat penyekat β adrenergic (Propanolol), preparat antihipertensi (hidralasin).</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="mso-themecolor: background1;">3. Patofisiologi</span></b></div>
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<span style="mso-themecolor: background1;">Pada retensio urine, penderita tidak dapat miksi, buli-buli penuh disertai rasa sakit yang hebat di daerah suprapubik dan hasrat ingin miksi yang hebat disertai mengejan. Retensio urine dapat terjadi menurut lokasi, factor obat dan factor lainnya seperti ansietas, kelainan patologi urethra, trauma dan lain sebagainya. Berdasarkan lokasi bisa dibagi menjadi supra vesikal berupa kerusakan pusat miksi di medulla spinalsi menyebabkan kerusaan simpatis dan parasimpatis sebagian atau seluruhnya sehingga tidak terjadi koneksi dengan otot detrusor yang mengakibatkan tidak adanya atau menurunnya relaksasi otot spinkter internal, vesikal berupa kelemahan otot detrusor karena lama teregang, intravesikal berupa hipertrofi prostate, tumor atau kekakuan leher vesika, striktur, batu kecil menyebabkan obstruksi urethra sehingga urine sisa meningkat dan terjadi dilatasi bladder kemudian distensi abdomen. Factor obat dapat mempengaruhi proses BAK, menurunkan tekanan darah, menurunkan filtrasi glumerolus sehingga menyebabkan produksi urine menurun. Factor lain berupa kecemasan, kelainan patologi urethra, trauma dan lain sebagainya yang dapat meningkatkan tensi otot perut, peri anal, spinkter anal eksterna tidak dapat relaksasi dengan baik. Dari semua factor di atas menyebabkan urine mengalir labat kemudian terjadi poliuria karena pengosongan kandung kemih tidak efisien. Selanjutnya terjadi distensi bladder dan distensi abdomen sehingga memerlukan tindakan, salah satunya berupa kateterisasi urethra</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="mso-themecolor: background1;">4. Tanda dan gejala</span></b></div>
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<span style="mso-themecolor: background1;">Adapun tanda dan gejala atau menifestasi klinis pada penyakit ini adalah sebagai berikut:</span></div>
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<span style="mso-themecolor: background1;">a.Diawali dengan urine mengalir lambat.</span></div>
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<span style="mso-themecolor: background1;">b.Kemudian terjadi poliuria yang makin lama menjadi parah karena pengosongan kandung kemih tidak efisien.</span></div>
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<span style="mso-themecolor: background1;">c.Terjadi distensi abdomen akibat dilatasi kandung kemih.</span></div>
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<span style="mso-themecolor: background1;">d.Terasa ada tekanan, kadang terasa nyeri dan merasa ingin BAK. e.Pada retensi berat bisa mencapai 2000 -3000 cc.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="mso-themecolor: background1;">5. Pemeriksaan diagnostik</span></b></div>
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<span style="mso-themecolor: background1;">Adapun pemeriksaan diagnostic yang dapat dilakukan pada retensio urine adalah sebagai berikut: </span></div>
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<span style="mso-themecolor: background1;">Pemeriksaan specimen urine. </span></div>
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<span style="mso-themecolor: background1;">– Pengambilan: steril, random, midstream. </span></div>
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<span style="mso-themecolor: background1;">– Penagmbilan umum: pH, BJ, Kultur, Protein, Glukosa, Hb, KEton, Nitrit.</span></div>
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<span style="mso-themecolor: background1;"><span style="mso-spacerun: yes;"> </span>– Sistoskopy, IVP.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="mso-themecolor: background1;">6. Penatalaksanaan</span></b></div>
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<span style="mso-themecolor: background1;"><span style="mso-spacerun: yes;"> </span>Penatalaksanaan yang dapat dilakukan pada retensio urine adalah sebagai berikut:</span></div>
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<span style="mso-themecolor: background1;"><span style="mso-spacerun: yes;"> </span>a. Kateterisasi urethra.</span></div>
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<span style="mso-themecolor: background1;">b. Dilatasi urethra dengan boudy.</span></div>
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<span style="mso-themecolor: background1;">c. Drainage suprapubik.</span></div>
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<i style="mso-bidi-font-style: normal;"><span style="mso-themecolor: background1;">ASUHAN KEPERAWATAN PADA KLIEN DENGAN RETENSIO URINE </span></i></div>
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<b style="mso-bidi-font-weight: normal;"><span style="mso-themecolor: background1;">1. PENGKAJIAN</span></b></div>
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<span style="mso-themecolor: background1;">a. Identitas klien</span></div>
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<span style="mso-themecolor: background1;">b. Riwayat kesehatan umum - Riwayat kesehatan keluarga - Riwayat kesehatan klien</span></div>
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<span style="mso-themecolor: background1;">c. Riwayat kesehatan sekarang </span></div>
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<span style="mso-themecolor: background1;">- Bagaimana frekuensi miksinya </span></div>
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<span style="mso-themecolor: background1;">- Adakah kelainan waktu miksi </span></div>
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<span style="mso-themecolor: background1;">- Apakah rasa sakit terdapat pada daerah setempat atau secara umum </span></div>
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<span style="mso-themecolor: background1;">- Apakah penyakit timbul setelah adanya penyakit lain</span></div>
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<span style="mso-themecolor: background1;"><span style="mso-spacerun: yes;"> </span>- Apakah terdapat mual muntah atau oedema </span></div>
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<span style="mso-themecolor: background1;">- bagaimana keadaan urinya </span></div>
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<span style="mso-themecolor: background1;">- Adakah secret atau darah yang keluar </span></div>
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<span style="mso-themecolor: background1;">- Adakah hambatan seksual </span></div>
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<span style="mso-themecolor: background1;">- Bagaimana riwayat menstruasi </span></div>
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<span style="mso-themecolor: background1;">- Bagaimana riwayat kehamilan </span></div>
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<span style="mso-themecolor: background1;">-Rasa nyeri </span></div>
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<span style="mso-themecolor: background1;">d. Data fisik Inpeksi : seluruh tubuh dan daerah genital </span></div>
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<span style="mso-themecolor: background1;">Palpasi : pada daerah abdomen </span></div>
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<span style="mso-themecolor: background1;">Auskultasi : kuadran atas abdomen dilakukan untuk mendeteksi bruit </span></div>
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<span style="mso-themecolor: background1;">- Tingkat kesadaran</span></div>
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<span style="mso-themecolor: background1;"><span style="mso-spacerun: yes;"> </span>- TB, BB </span></div>
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<span style="mso-themecolor: background1;">- TTV </span></div>
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<span style="mso-themecolor: background1;">e. Data psikologis </span></div>
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<span style="mso-themecolor: background1;">Keluhan dan reaksi pasien terhadap penyakit</span></div>
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<span style="mso-themecolor: background1;">Tingkat adaptasi pasien terhadap penyakit </span></div>
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<span style="mso-themecolor: background1;">Persepsi pasien terhadap penyakit </span></div>
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<span style="mso-themecolor: background1;">f. Data social, budaya, spiritual Umum : hubungan dengan orang lain, kepercayaan yang dianut dan keaktifanya dalam kegiatan </span></div>
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<b style="mso-bidi-font-weight: normal;"><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"; mso-fareast-language: IN; mso-themecolor: background1;"> </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;">2. <span style="mso-bidi-font-weight: bold;">DIAGNOSA</span></span></b></div>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -18pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">1. Retensi urin b.d ketidakmampuan kandung kemih untuk berkontraksi dengan adekuat.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -18pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">2. Gangguan rasa nyaman: nyeri</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></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; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;">3. </span><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"; mso-fareast-language: IN; mso-themecolor: background1;">Intoleransi aktivitas</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></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; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;">4. </span><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"; mso-fareast-language: IN; mso-themecolor: background1;">Ansietas b.d krisis situasi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
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<br /></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;">3. PERENCANAAN</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -18pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">1. Retensi urin b.d ketidakmampuan kandung kemih untuk berkontraksi dengan adekuat.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></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; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"> Kriteria evaluasi : - Berkemih dengan jumlah yang cukup</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></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; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"> - Tidak teraba distensi kandung kemih</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
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<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><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"; mso-fareast-language: IN; mso-themecolor: background1;">Intervensi</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> <td style="border-left: none; border: solid windowtext 1.0pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><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"; mso-fareast-language: IN; mso-themecolor: background1;">Rasional</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
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<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">1. Dorong pasien utnuk berkemih tiap 2-4 jam dan bila tiba-tiba dirasakan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">2. Tanyakan pasien tentang inkontinensia stres.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">3. </span><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"; mso-fareast-language: IN; mso-themecolor: background1;">Observasi aliran urin, perhatikan ukuran dan ketakutan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">4. Awasi dan catat waktu dan jumlah tiap berkemih..</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">5. Perkusi/palpasi area suprapubik</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<br /></div>
</td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">1. Meminimalkan retensi urin distensi berlebihan pada kandung kemih.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">2. </span><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"; mso-fareast-language: IN; mso-themecolor: background1;">Tekanan ureteral tinggi menghambat pengosongan kandung kemih.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">3. Berguna untuk mengevaluasi obsrtuksi dan pilihan intervensi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">4. Retensi urin meningkatkan tekanan dalam saluran perkemihan atas.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">5. Distensi kandung kemih dapat dirasakan diarea suprapubik.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> </tr>
</tbody></table>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -18pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">2. Gangguan rasa nyaman: nyeri</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -18pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">Kriteria evaluasi : - Menyatakan nyeri hilang/ terkontrol</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -18pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;"> </span><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"; mso-fareast-language: IN; mso-themecolor: background1;">- Menunjukkan rileks, istirahat dan peningkatan aktivitas dengan tepat</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; color: black;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><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"; mso-fareast-language: IN; mso-themecolor: background1;">Intervensi</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> <td style="border-left: none; border: solid windowtext 1.0pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><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"; mso-fareast-language: IN; mso-themecolor: background1;">Rasional</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">1. </span><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"; mso-fareast-language: IN; mso-themecolor: background1;">Kaji nyeri, perhatikan lokasi, intensitas nyeri.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">2. Plester selang drainase pada paha dan kateter pada abdomen.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">3. Pertahankan tirah baring bila diindikasikan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">4. Berikan tindakan kenyamanan</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">5. Dorong menggunakan rendam duduk, sabun hangat untuk perineum.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">1. Memberikan informasi untuk membantu dalam menetukan intervensi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">2. Mencegah penarikan kandung kemih dan erosi pertemuan penis-skrotal.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<span lang="IT" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IT; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;">3. Tirah baring mungkin diperlukan pada awal selama fase retensi akut.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">4. Meningktakan relaksasi dan mekanisme koping.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">5. Meningkatkan relaksasi otot.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> </tr>
</tbody></table>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -18pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">3. Intoleransi aktivitas</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -18pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">Kriteria evaluasi : - Menunjukkan peningkatan toleransi terhadap aktivitas yang dapat diukur dengan tidak adanya dispnea, kelemahan, tanda vital dalam rentang normal.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; color: black;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><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"; mso-fareast-language: IN; mso-themecolor: background1;">Intervensi</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> <td style="border-left: none; border: solid windowtext 1.0pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><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"; mso-fareast-language: IN; mso-themecolor: background1;">Rasional</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">1. Evaluasi respon klien terhadap aktivitas.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">2. Berikan lingkungan tenang dan batasi pengunjung selama fase akut sesuai indikasi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">3. Jelaskna pentingnya istirahat dalam rencana pengobatan dan perlunya keseimbangan aktivitas dan istirahat.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">4. Bantu aktivitas perawatan diri yang diperlukan. Berikan kemajuan peningkatan aktivitas selama fase penyembuhan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">1. Menetapkan kemampuan/kebutuhan pasien dan memudahkan pilihan intervensi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">2. Menurunkan stres dan rangsangan berlebihan, meningkatkan istirahat.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">3. Tirah baring dapat menurunkan kebutuhan metabolik, menghemat energi untuk penyembuhan. Pembatasan aktivitas ditentukan dengan respons individual pasien terhadap aktivitas dan perbaikan kegagalan pernapasan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">4. Meminimalkan kelelahan dan membantu keseimbangan suplai dan kebutuhan oksigen.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> </tr>
</tbody></table>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -18pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">4. Ansietas b.d krisis situasi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -18pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">Kriteria evaluasi : - Mengakui dan mendiskusikan takut/masalah</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -144pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;"> - Menunjukkan rentang perasaan yang tepat dan penampilan wajah tampak rileks/istirahat</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -144pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; color: black;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><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"; mso-fareast-language: IN; mso-themecolor: background1;">Intervensi</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> <td style="border-left: none; border: solid windowtext 1.0pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><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"; mso-fareast-language: IN; mso-themecolor: background1;">Rasional</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<span lang="IT" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IT; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;">1. Identifikasi persepsi pasien tentang ancaman yang ada dari situasi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<span lang="IT" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IT; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;">2. Observasi respon fisik,seperti gelisah, tanda vital, gerakan berulang.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<span lang="IT" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IT; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;">3. Dorong pasien/orang terdekat untuk mengakui dan menyatakan rasa takut.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.0pt;">
<span lang="IT" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IT; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;">4. Identifikasi pencegahan keamanan yang diambil, seperti marah dan suplai oksigen. </span><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"; mso-fareast-language: IN; mso-themecolor: background1;">Diskusikan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.55pt;" valign="top" width="299"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">1. Mendefinisikan lingkup masalah individu dan mempengaruhi pilihan intervensi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">2. Berguna dalam evaluasi derajat masalah khususnya bila dibandingkan dengan pernyataan verbal.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">3. Memberikan kesempatan untuk menerima masalah, memperjelas kenyataan takut dan menurunkan ansietas.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-indent: -18.45pt;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">4. Memberikan kayakinan untuk membantu ansietas yang tak perlu.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
</td> </tr>
</tbody></table>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -27pt;">
<br /></div>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -27pt;">
<br /></div>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm; text-indent: -27pt;">
<b><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"; mso-fareast-language: IN; mso-themecolor: background1;">VII.</span></b><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"; mso-fareast-language: IN; mso-themecolor: background1;"> <b>Daftar Pustaka</b></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">Brunner & Suddarth. (2002). <i>Keperawatan medikal bedah.</i> Jakarta: EGC.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
<div class="MsoNormal" style="color: black; line-height: 150%; margin-bottom: 0cm;">
<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"; mso-fareast-language: IN; mso-themecolor: background1;">Doenges. M. E. (2000). </span><i><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"; mso-fareast-language: IN; mso-themecolor: background1;">Rencana asuhan keperawatan.</span></i><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"; mso-fareast-language: IN; mso-themecolor: background1;"> Jakarta: EGC.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-themecolor: background1;"></span></div>
Elsahttp://www.blogger.com/profile/14585217785407870236noreply@blogger.com3