tag:blogger.com,1999:blog-45117323202991088712024-02-20T11:42:13.485-08:00Contoh Askepgunakanlah blog ini selayakx orang yang berjiwa besarsinggih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.comBlogger35125tag:blogger.com,1999:blog-4511732320299108871.post-18556566987089910802015-05-11T05:47:00.001-07:002015-05-11T05:47:48.147-07:00PANDUAN PENULISAN NASKAH PUBLIKASI JURNAL METABOLISME – LPPM<!--[if gte mso 9]><xml>
<o:OfficeDocumentSettings>
<o:TargetScreenSize>800x600</o:TargetScreenSize>
</o:OfficeDocumentSettings>
</xml><![endif]--><br />
<!--[if gte mso 9]><xml>
<w:WordDocument>
<w:View>Normal</w:View>
<w:Zoom>0</w:Zoom>
<w:TrackMoves/>
<w:TrackFormatting/>
<w:PunctuationKerning/>
<w:ValidateAgainstSchemas/>
<w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid>
<w:IgnoreMixedContent>false</w:IgnoreMixedContent>
<w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText>
<w:DoNotPromoteQF/>
<w:LidThemeOther>EN-US</w:LidThemeOther>
<w:LidThemeAsian>X-NONE</w:LidThemeAsian>
<w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript>
<w:Compatibility>
<w:BreakWrappedTables/>
<w:SnapToGridInCell/>
<w:WrapTextWithPunct/>
<w:UseAsianBreakRules/>
<w:DontGrowAutofit/>
<w:SplitPgBreakAndParaMark/>
<w:EnableOpenTypeKerning/>
<w:DontFlipMirrorIndents/>
<w:OverrideTableStyleHps/>
</w:Compatibility>
<w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel>
<m:mathPr>
<m:mathFont m:val="Cambria Math"/>
<m:brkBin m:val="before"/>
<m:brkBinSub m:val="--"/>
<m:smallFrac m:val="off"/>
<m:dispDef/>
<m:lMargin m:val="0"/>
<m:rMargin m:val="0"/>
<m:defJc m:val="centerGroup"/>
<m:wrapIndent m:val="1440"/>
<m:intLim m:val="subSup"/>
<m:naryLim m:val="undOvr"/>
</m:mathPr></w:WordDocument>
</xml><![endif]--><!--[if gte mso 9]><xml>
<w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="false"
DefSemiHidden="false" DefQFormat="false" DefPriority="99"
LatentStyleCount="371">
<w:LsdException Locked="false" Priority="0" QFormat="true" Name="Normal"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 1"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="heading 2"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="heading 3"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="heading 4"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="heading 5"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="heading 6"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="heading 7"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="heading 8"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="heading 9"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="index 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="index 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="index 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="index 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="index 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="index 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="index 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="index 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="index 9"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" Name="toc 1"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" Name="toc 2"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" Name="toc 3"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" Name="toc 4"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" Name="toc 5"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" Name="toc 6"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" Name="toc 7"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" Name="toc 8"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" Name="toc 9"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="footnote text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="header"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="footer"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="index heading"/>
<w:LsdException Locked="false" Priority="35" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="caption"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="table of figures"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="envelope address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="envelope return"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="footnote reference"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation reference"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="line number"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="page number"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="endnote reference"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="endnote text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="table of authorities"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="macro"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="toa heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 5"/>
<w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Closing"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Signature"/>
<w:LsdException Locked="false" Priority="1" SemiHidden="true"
UnhideWhenUsed="true" Name="Default Paragraph Font"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Message Header"/>
<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Salutation"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Date"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" QFormat="true" Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 6"/>
</w:LatentStyles>
</xml><![endif]--><!--[if gte mso 10]>
<style>
/* Style Definitions */
table.MsoNormalTable
{mso-style-name:"Table Normal";
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
mso-style-noshow:yes;
mso-style-priority:99;
mso-style-parent:"";
mso-padding-alt:0cm 5.4pt 0cm 5.4pt;
mso-para-margin:0cm;
mso-para-margin-bottom:.0001pt;
mso-pagination:widow-orphan;
font-size:10.0pt;
font-family:"Calibri","sans-serif";}
</style>
<![endif]-->
<br />
<div align="center" class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; text-align: center; text-autospace: none;">
<b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-size: 13.0pt; line-height: 115%; mso-ansi-language: IN; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;">PANDUAN </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;">PENULISAN NASKAH PUBLIKASI</span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-size: 13.0pt; line-height: 115%; mso-ansi-language: IN; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;"></span></b></div>
<div align="center" class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; text-align: center; text-autospace: none;">
<b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-size: 13.0pt; line-height: 115%; mso-ansi-language: IN; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;">JURNAL METABOLISME –</span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;"> </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;">LPPM – </span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-size: 13.0pt; line-height: 115%; mso-ansi-language: IN; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;">STIKES</span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;"> </span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-size: 13.0pt; line-height: 115%; mso-ansi-language: IN; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;">PEMKAB JOMBANG</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; text-autospace: none;">
<b style="mso-bidi-font-weight: normal;"><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">TIPOGRAFI</span></b></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level1 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">Jenis Font : </span><span style="mso-bidi-font-family: Arial;">Calibri</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level1 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">Besar Font</span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level2 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">Judul </span><span style="mso-bidi-font-family: Arial;"><span style="mso-tab-count: 3;"> </span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">: 12pt</span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level2 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">Penulis </span><span style="mso-bidi-font-family: Arial;"><span style="mso-tab-count: 3;"> </span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">: 10pt</span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level2 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">Abstrak </span><span style="mso-bidi-font-family: Arial;"><span style="mso-tab-count: 3;"> </span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">: 10pt</span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level2 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">Korespondensi </span><span style="mso-bidi-font-family: Arial;"><span style="mso-tab-count: 2;"> </span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">: 9pt</span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level2 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">Isi </span><span style="mso-bidi-font-family: Arial;">Naskah<span style="mso-tab-count: 3;"> </span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">: 10pt</span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level2 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">f.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Judul
tabel/gambar<span style="mso-tab-count: 2;"> </span>: 9pt</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level2 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">g.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Teks isi
dalam tabel<span style="mso-tab-count: 2;"> </span>: 8pt</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level2 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">h.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Keterangan
gambar/tabel<span style="mso-tab-count: 1;"> </span>: 8pt</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level1 lfo1; text-align: justify; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Ukuran
kertas A4, 1 spasi<span style="mso-spacerun: yes;"> </span>dengan margin atas
(top) 3cm, bawah (bottom) 3cm, kiri (left) 3cm dan kanan (right) 3cm dengan
format penyusunan menggunakan 2 kolom (columns) kecuali judul, penulis dan
afiliasinya, abstrak, abstract serta tabel/ gambar yang berukuran besar dapat menggunakan
format 1 kolom rata kanan-kiri (justify).</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level1 lfo1; text-align: justify; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Naskah
Publikasi terdiri dari MAKSIMAL 10 lembar (termasuk dengan COVER dan SURAT
PERNYATAAN).</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level1 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Karakteristik
penulisan:</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level2 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Judul
artikel:</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.0pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level3 lfo1; text-align: justify; text-autospace: none; text-indent: -15.3pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">Ditulis dalam </span><span style="mso-bidi-font-family: Arial;">dua bahasa (Indonesia</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> dan Inggris</span><span style="mso-bidi-font-family: Arial;">, dengan posisi bahasa</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> Indonesia </span><span style="mso-bidi-font-family: Arial;">di sebelah atas dan bahasa In</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">ggris</span><span lang="IN" style="mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">di sebelah bawah) </span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.0pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level3 lfo1; text-autospace: none; text-indent: -15.3pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Cetak
tebal, di tengah (<i style="mso-bidi-font-style: normal;">center</i>), kapital
tiap awal kata kecuali kata sambung </span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 62.95pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level3 lfo1; text-align: justify; text-autospace: none; text-indent: -15.3pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">Maksimal sebanyak </span><span style="mso-bidi-font-family: Arial;">1</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">5</span><span style="mso-bidi-font-family: Arial;"> kata dalam bahasa Indonesia
dan </span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">10</span><span style="mso-bidi-font-family: Arial;"> kata dalam bahasa Inggris</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level2 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Nama
penulis dan afiliasinya</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">:</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level3 lfo1; text-autospace: none; text-indent: -14.15pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Nama
lengkap</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> <span lang="IN">TANPA GELAR</span></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level3 lfo1; text-autospace: none; text-indent: -14.15pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Cetak
miring, tidak tebal, di tengah </span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level3 lfo1; text-autospace: none; text-indent: -14.15pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Diberi penanda
1,2,3, dan seterusnya untuk afiliasi penulis</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level3 lfo1; text-align: justify; text-autospace: none; text-indent: -14.15pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Urutan nama
berdasarkan kontribusi penulisan (penulis utama, penulis kedua,</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> dan
seterusnya)</span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level3 lfo1; text-align: justify; text-autospace: none; text-indent: -14.15pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">5)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Ditulis
dalam 1 atau 2 baris dengan afiliasi masing-masing penulis ditulis di bawah
nama-nama penulis dengan barisan kalimat yang</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">terpisah
untuk masing-masing afiliasi penulis dan disertai dengan alamat e-mail dengan
tata tulis seperti berik</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">ut :</span></div>
<div align="center" class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 12.0pt; mso-layout-grid-align: none; text-align: center; text-autospace: none;">
<i><span style="mso-bidi-font-family: Arial;">si Fulan<sup>1</sup>, Mulia Hakam<sup>2</sup>, Septi Fitrah Ningtyas<sup>3</sup></span></i></div>
<div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 92.15pt; margin-right: 0cm; margin-top: 12.0pt; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<i><sup><span style="font-size: 10.0pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;">1</span></sup></i><i><span style="font-size: 10.0pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;">
Program Studi D-3 Keperawatan STIKES Pemkab Jombang; fulan@yahoo.com</span></i></div>
<div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 92.15pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<i style="mso-bidi-font-style: normal;"><sup><span style="font-size: 10.0pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;">2</span></sup></i><i style="mso-bidi-font-style: normal;"><span style="font-size: 10.0pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;"> Program Studi S-1 Keperawatan STIKES Pemkab Jombang; hakam@yahoo.com</span></i></div>
<div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 92.15pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<i style="mso-bidi-font-style: normal;"><sup><span style="font-size: 10.0pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;">3</span></sup></i><i style="mso-bidi-font-style: normal;"><span style="font-size: 10.0pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt;"> Program Studi D-3 Kebidanan STIKES Pemkab Jombang; sayang@gmail.co.id</span></i></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level2 lfo1; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Abstrak:</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level3 lfo1; text-align: justify; text-autospace: none; text-indent: -14.15pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Judul <b>ABSTRAK/
<i>ABSTRACT </i></b>di tengah, kapital semua, cetak tebal (tegak untuk bahasa Indonesia
dan miring untuk bahasa Inggris)</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level3 lfo1; text-align: justify; text-autospace: none; text-indent: -14.15pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Maksimal
terdiri 250 kata yang mengandung (implisit): latar belakang, tujuan, metode
penelitian, hasil, dan kesimpulan dalam 1 paragraf</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">.</span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level3 lfo1; text-align: justify; text-autospace: none; text-indent: -14.15pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Tata paragraf
justify, isi abstrak dan abstract ditulis miring untuk bahasa inggris dan juga
bahasa Indonesia</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level3 lfo1; text-align: justify; text-autospace: none; text-indent: -14.2pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Untuk bahasa
inggris kata “<b><i>Keywords</i></b>” dicetak tebal miring, sementara isinya
dicetak miring saja, untuk bahasa indonesia kata “<b>Kata kunci</b>” hanya
dicetak tebal saja</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level2 lfo1; text-align: justify; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Subjudul
bab: dicetak tebal, tegak, dan kapital semua (<b>PENDAHULUAN, METODE PENELITIAN,
HASIL PENELITIAN, PEMBAHASAN, KESIMPULAN, DAFTAR PUSTAKA</b>).</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l3 level2 lfo1; text-align: justify; text-autospace: none; text-indent: -18.0pt;">
<span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-bidi-font-family: Arial;">Set
spasi paragraf untuk subjudul bab (before : 18pt dan after : 10pt); dan untuk
isi paragraf (before : 10pt dan after : 6pt).</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; text-autospace: none;">
<b><span style="mso-bidi-font-family: Arial;">ABSTRAK/</span></b><b><i><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span></i></b><b><i><span style="mso-bidi-font-family: Arial;">ABSTRACT</span></i></b></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l5 level1 lfo2; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Maksimal sebanyak 250 kata
yang mengandung (implisit): latar belakang, tujuan, metode,</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">hasil, dan kesimpulan dalam 1 paragraf
dan 1 kolom (column)</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l5 level1 lfo2; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Ditulis menggunakan bahasa Indonesia
dan bahasa Inggris (ada 2 abstrak)</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l5 level1 lfo2; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Tata paragraf justify, miring untuk
bahasa inggris dan tegak untuk bahasa Indonesia</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l5 level1 lfo2; text-align: justify; text-autospace: none;"><b><span style="mso-bidi-font-family: Arial;">Kata kunci/ <i style="mso-bidi-font-style: normal;">Keywords</i> </span></b><span style="mso-bidi-font-family: Arial;">memuat variabel-variabel yang penting
dan utama dalam penelitian dan maksimal 5 kata.</span></li>
</ol>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l8 level1 lfo9; text-autospace: none; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="mso-bidi-font-family: Arial;">PENDAHULUAN</span></b><span style="mso-bidi-font-family: Arial;">:</span></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l1 level1 lfo3; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Tata tulis 2 kolom rata kiri-kanan
(justify)</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l1 level1 lfo3; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Bahasa inggris dicetak miring</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l1 level1 lfo3; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Mengungkap latar belakang
masalah, pendekatan alternatif masalah yang sudah ada,</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">hipotesis, dan tujuan penelitian</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l1 level1 lfo3; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Tata tulisan berparagraf, tanpa ada
poin-poin</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l1 level1 lfo3; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Kaidah kutipan tetap
menggunakan Vancouver, dengan teknik penulisan sebagai berikut : .....<span style="mso-bidi-font-style: italic;">kalimat</span>..........<span style="mso-bidi-font-style: italic;"> kalimat </span><b style="mso-bidi-font-weight: normal;"><sup>1</sup></b>.</span></li>
</ol>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l8 level1 lfo9; text-autospace: none; text-indent: -18.0pt;">
<b><span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="mso-bidi-font-family: Arial;">METODE PENELITIAN</span></b></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l7 level1 lfo4; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Sebaiknya tidak ada
subjudul lagi dengan cara menampilkan dalam narasi paragraf, tetapi</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">jika terpaksa ada subjudul, boleh
ditambahkan subjudul TANPA penomeran dengan dicetak miring, tebal,</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">dan kapital di tiap awal kata kecuali
kata hubung (dengan spasi paragraf before : 10pt dan after : 6pt)</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l7 level1 lfo4; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Menampilkan : jenis
penelitian, bahan, alat, kriteria sampel/subjek, protocol/prosedur penelitian,
teknik analisis data,</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">serta
data-data lain yang utama saja.</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l7 level1 lfo4; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Tegaskan bahwa metode HARUS
dituliskan dalam kalimat lengkap BUKAN kalimat instruksi</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">seperti buku petunjuk laboratorium.</span></li>
</ol>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l8 level1 lfo9; text-autospace: none; text-indent: -18.0pt;">
<b><span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="mso-bidi-font-family: Arial;">HASIL PENELITIAN</span></b></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l2 level1 lfo5; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Menampilkan hasil
penelitian dalam bentuk narasi, yakni bagaimana hasil penelitiannya,</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">bagaimana interpretasi analisis
statistiknya, serta interpretasi hasil dalam kalimat yang</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">singkat dan jelas.</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l2 level1 lfo5; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Menampilkan data pendukung
yang penting saja, seperti tabel dan gambar dengan tampilan</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">yang ringkas, padat dan jelas. Jika
data tabel atau gambar dirasa terlalu banyak, yang</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">ditampilkan cukup 1 tabel yang
meringkas beberapa tabel yang berkaitan.</span></li>
</ol>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l2 level2 lfo5; text-align: justify; text-autospace: none; text-indent: -14.2pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Gambar dan tabel yang disajikan harus
mendukung isi, bersifat memperkuat dan tidak saling mengulang antara
tabel/gambar dan narasi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l2 level2 lfo5; text-align: justify; text-autospace: none; text-indent: -14.2pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Penulis harus memilih satu bentuk penyajian
yaitu tabel atau gambar ketika menyajikan satu hasil yang sama, misalnya
gambaran deskriptif atau rerata tidak perlu disajikan dalam tabel dan grafik.
Jika ada banyak variabel yang disajikan tidak perlu satu variabel satu tabel,
tetapi jika cara penyajian serupa maka semua variabel dapat disajikan dalam
satu tabel deskriptif.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l2 level2 lfo5; text-align: justify; text-autospace: none; text-indent: -14.2pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Tabel karakteristik responden atau subyek
penelitian tidak perlu disajikan kecuali menjadi tujuan penelitian. Fakta dalam
tabel karakteristik cukup diuraikan dalam narasi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l2 level2 lfo5; text-align: justify; text-autospace: none; text-indent: -14.2pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Setiap tabel dan gambar harus dibahas atau
diinterpretasikan dalam narasi hasil. Narasi tabel dan gambar dalam hasil tidak
boleh sekedar mengulang isi tabel dan gambar tetapi harus bersifat
interpretative atau memberikan makna dari isi tabel dan gambar.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l2 level2 lfo5; text-align: justify; text-autospace: none; text-indent: -14.2pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Hasil statistik jika bersifat satu baris
tidak harus disajikan dalam tabel, tetapi cukup dinarasikan. Hindari membaca
statistic secara teknis tetapi harus dijelaskan makna hasil statistik tersebut.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l2 level2 lfo5; text-align: justify; text-autospace: none; text-indent: -14.2pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">f.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Penulisan atau pembacaan hasil statistik dan
penyajiannya mengikuti manuskrip jurnal nasional terakreditasi (<i style="mso-bidi-font-style: normal;">lihat lampiran template</i>).</span></div>
<ol start="3" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l2 level1 lfo5; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Tata letak tabel yang
mempunyai kolom < 3 kolom, dan atau isinya tidak penuh melebar, maka
sebaiknya dibuat di satu kolom saja (dengan rata kiri-kanan paragraf),
sedangkan jika > 3 kolom, dan atau isinya penuh melebar, maka sebaiknya
diletakkan di tengah halaman dengan rata kiri-kanan halaman.</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l2 level1 lfo5; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Garis tabel hanya ada 3
garis horisontal (2 garis di atas untuk mengurung subjudul tabel, dan</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">1 garis paling bawah untuk menutup
tabel) dengan tepi garis sejajar dengan tepi paragraph</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">.</span><span style="mso-bidi-font-family: Arial;"></span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l2 level1 lfo5; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Tata letak gambar dapat di
satu kolom saja bila mencukupi ruangnya, atau diletakkan di tengah halaman
bila memang dibutuhkan dengan judul gambar dicetak tebal dan di tengah</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">(lihat aturan di atas)</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">.</span><span style="mso-bidi-font-family: Arial;"></span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l2 level1 lfo5; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Gambar tidak boleh diberi
garis kotak, berlatarbelakang warna tertentu (terutama gambar grafik), dan
sebaiknya untuk grafik tidak diberi warna selain hitam atau gradasinya.</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l2 level1 lfo5; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Jarak antar paragraf dengan
judul tabel/gambar dan akhir keterangan gambar/tabel adalah 12pt,
sedangkan jarak antara judul tabel/gambar dengan tabel/gambar adalah 6pt.</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l2 level1 lfo5; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Jumlah maksimal
tabel/gambar dalam 1 artikel adalah 8 buah</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">.</span><span style="mso-bidi-font-family: Arial;"></span></li>
</ol>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l8 level1 lfo9; text-autospace: none; text-indent: -18.0pt;">
<b><span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="mso-bidi-font-family: Arial;">PEMBAHASAN</span></b></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l0 level1 lfo6; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Pada intinya mengandung
alur perumusan sintesis (pengolahan) hasil penelitian, analisis</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">penyebabnya, hingga menjadi
fakta/fenomena/kesimpulan baru atau berbeda dengan</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">menunjukkan kajian pustaka yang
relevan. Antara lain dengan</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">:</span></li>
</ol>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l0 level2 lfo6; text-align: justify; text-autospace: none; text-indent: -14.65pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Menjelaskan fenomena “hasil” yang didapatkan
dengan kajian teori, pustaka, atau hasil penelitian lain, baik yang selaras
maupun yang berlawanan dengan hasil penelitian.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l0 level2 lfo6; text-align: justify; text-autospace: none; text-indent: -14.65pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Mengungkap kemungkinan-kemungkinan penyebab
mengapa penelitian ini menghasilkan data-data yang sesuai atau tidak sesuai
dengan hipotesis.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l0 level2 lfo6; text-align: justify; text-autospace: none; text-indent: -14.65pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Pembahasan juga menyajikan implikasi hasil
penelitian secara praktis maupun teoritis sebagai bentuk ekstrapolasi hasil
penelitian.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l0 level2 lfo6; text-align: justify; text-autospace: none; text-indent: -14.65pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Pembahasan juga perlu mendiskusikan
keterbatasan penelitian, dampak dari keterbatasan tersebut dan bagaimana
mengelola keterbatasan tersebut</span><span lang="IN" style="mso-ansi-language: IN; mso-bidi-font-family: Arial;">.</span><span style="mso-bidi-font-family: Arial;"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l0 level2 lfo6; text-align: justify; text-autospace: none; text-indent: -14.65pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Mengakhiri pembahasan dengan ringkasan dan
ditutup dengan kesimpulan di paragraf terakhir atau dalam bab <b>KESIMPULAN </b>tersendiri.</span></div>
<ol start="2" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l0 level1 lfo6; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Kaidah kutipan tetap
menggunakan Vancouver, dengan teknik penulisan sebagai berikut : .....<span style="mso-bidi-font-style: italic;">kalimat</span>..........<span style="mso-bidi-font-style: italic;"> kalimat </span><b style="mso-bidi-font-weight: normal;"><sup>1</sup></b>.</span></li>
</ol>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l8 level1 lfo9; text-autospace: none; text-indent: -18.0pt;">
<b><span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="mso-bidi-font-family: Arial;">KESIMPULAN</span></b></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l6 level1 lfo7; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Dapat dimasukkan dalam paragraf
terakhir pada bab <b style="mso-bidi-font-weight: normal;">PEMBAHASAN</b>
atau ter-bab-kan sendiri dalam</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">bab <b>KESIMPULAN</b></span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l6 level1 lfo7; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Mengandung kesimpulan,
yakni kalimat yang menyatakan hubungan antar variabel yang</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">diteliti (hubungan antara variabel
bebas dan variabel tergantung).</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l6 level1 lfo7; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Dinarasikan dalam 1 paragraf,
tanpa bentuk poin-poin, ringkas, padat dan jelas.</span></li>
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l6 level1 lfo7; text-align: justify; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Boleh ditambahkan saran
atau kalimat yang mengandung saran</span></li>
</ol>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; text-autospace: none;">
<b><span style="mso-bidi-font-family: Arial;">UNGKAPAN
TERIMA KASIH</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; text-autospace: none;">
<span style="mso-bidi-font-family: Arial;">Boleh
dicantumkan atau tidak</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; text-autospace: none;">
<b><span style="mso-bidi-font-family: Arial;">DAFTAR
PUSTAKA</span></b></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l4 level1 lfo8; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Penulisan dan aspek substansi</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">:</span></li>
</ol>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l4 level2 lfo8; text-align: justify; text-autospace: none; text-indent: -14.2pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Penulisan daftar pustaka mengikuti teknik penulisan
Vancouver (sesuai urutan angka kemunculannya pada naskah publikasi dan BUKAN
sesuai abjad/ alfabetis)</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l4 level2 lfo8; text-align: justify; text-autospace: none; text-indent: -14.2pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Pustaka yang dikutip berjangka waktu MAKSIMAL
5 (LIMA) tahun terakhir dan berjumlah MINIMAL 5 rujukan dalam 1 Naskah
Publikasi.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l4 level2 lfo8; text-align: justify; text-autospace: none; text-indent: -14.2pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Proporsi pustaka primer minimal sebesar 80%
dari keseluruhan pustaka yang dikutip</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l4 level2 lfo8; text-align: justify; text-autospace: none; text-indent: -14.2pt;">
<span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-bidi-font-family: Arial;">Sumber-sumber pustaka yang tidak boleh
dikutip contohnya antara lain adalah:</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">majalah
umum, koran, brosur, maupun situs-situs blog pribadi atau situs nonlembaga</span><span style="mso-ansi-language: IN; mso-bidi-font-family: Arial;"> </span><span style="mso-bidi-font-family: Arial;">resmi yang sulit dipertanggungjawabkan aspek
keilmiahannya.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<ol start="2" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; mso-list: l4 level1 lfo8; text-autospace: none;"><span style="mso-bidi-font-family: Arial;">Contoh penulisan:</span></li>
</ol>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l4 level2 lfo8; text-autospace: none; text-indent: -14.2pt;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: Calibri;"><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="mso-bidi-font-family: Arial;">Jurnal:</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="mso-bidi-font-family: Arial;">Boddie AM,
Dedlow ES, Nakashi JA, Opalko FJ, Kouwell GP., 2000, <i>Folate Absorption In Women
With A History Of Neural Tube Defect-Affected Pregnancy</i>. Am. J. Clin. Nutr.<i>
</i>72: 154-158.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l4 level2 lfo8; text-autospace: none; text-indent: -14.2pt;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: Arial;">Buku:</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="mso-bidi-font-family: Arial;">Sargowo D.,
2006, <i>Atherosclerosis and Endothelial Dysfunction</i>. 3rd edition. Media
Pustaka, Malang; hal. 137-350.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l4 level2 lfo8; text-autospace: none; text-indent: -14.2pt;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: Arial;">Bab dalam buku/ Buku dalam Buku:</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="mso-bidi-font-family: Arial;">Katzung BG,
Chatterjee K., 2004, <i>Vasodilator dan Pengobatan Angina Pektoris</i>. Didalam:
B.G. Katzung (Ed), 2006, <span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">Farmakologi Dasar dan Klinik. </i>edisi 6. EGC,
Jakarta; hal. 184-201.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l4 level2 lfo8; text-autospace: none; text-indent: -14.2pt;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: Arial;">Prosiding:</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="mso-bidi-font-family: Arial;">Abdurrahman,
2003, <i>Pendekatan Multidisiplin pada Penanganan Patologi Muskuloskeletal</i>.
Proceeding Scientific Meeting & Workshop of Indonesian Musculoskeletal
Pathology. Surabaya, March 22-23; hal. 1-8.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l4 level2 lfo8; text-autospace: none; text-indent: -14.2pt;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: Arial;">KTI / Skripsi / Tesis / Disertasi:</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="mso-bidi-font-family: Arial;">Masyhur M.,
2011, <i>Uji Efektivitas Quercetin sebagai Penghambat Aktivasi NF-kB dan Kadar
MCP-1 pada Kultur Sel Endothel Manusia (HUVECs) yang Dipapar dengan Hiperleptin</i>.
[Thesis]. Fakultas Kedokteran, Universitas Brawijaya, Malang.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-list: l4 level2 lfo8; text-autospace: none; text-indent: -14.2pt;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">f.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: Arial;">Internet/ Jurnal Online:</span></b></div>
<span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-font-family: Arial; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;">Njoku OU, Ononogbu
IC, Nwachukwu DE., 2006, <i>Plasma Cholesterol, B-carotene and ascorbic acid
changes in Human Malaria. </i>Online [http://www.ncbi.nlm.nih.gov/entrez/PubMed.,
<span style="mso-spacerun: yes;"> </span>diakses tanggal 17 September 2011.</span>singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-7621412443172748282015-01-17T20:20:00.001-08:002015-01-17T20:20:21.164-08:00 LAPORAN PENDAHULUAN HERNIA<div class="MsoTitle">
<b><span lang="IN"> LAPORAN PENDAHULUAN<o:p></o:p></span></b></div>
<div class="MsoTitle">
<b><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 14.0pt;"> HERNIA<o:p></o:p></span></b></div>
<div class="MsoTitle">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l5 level1 lfo1; tab-stops: list .25in; text-align: justify; text-indent: -.5in;">
<!--[if !supportLists]--><b><span lang="IN">1.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">DEFINISI<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.0pt; mso-list: l5 level2 lfo1; tab-stops: list 30.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">a.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Hernia adalah suatu penonjolan isi suatu
rongga melalui defek atau bagian lemah dari dinding rongga bersangkutan (R.
Syamsuhidayat dan Win Dedjong, Buku Ajar Ilmu Bedah)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.0pt; mso-list: l5 level2 lfo1; tab-stops: list 30.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">b.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Hernia abdominalis adalah penonjolan isi
perut dari rongga yang normal melalui suatu defek fasia dan muskuloaponeuritik
dinding perut baik secara konginetal maupun didapat. (Kapita Selecta
Kedokteran)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.0pt; mso-list: l5 level2 lfo1; tab-stops: list 30.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">c.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Hernia inguinalis lateralis adalah hernia
yang melalui annulus inguinalis internus yang terletak di sebelah lateral vasa
epigastrika inferior menyusuri kanalis inguinalis dan keluar ke rongga perut
melalui annulus inguinalis eksternus (Kapita Selekta Kedokteran)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .25in;">
<b><i><span lang="IN">Menurut jenisnya hernia
dibagi menjadi<o:p></o:p></span></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l7 level1 lfo2; tab-stops: list 30.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><i><span lang="IN">a.<span style="font-size: 7pt; font-stretch: normal; font-style: normal; line-height: normal;"> </span></span></i><!--[endif]--><i><span lang="IN">Henia
indirekta<o:p></o:p></span></i></div>
<div class="MsoBodyTextIndent">
<span lang="IN"> Suatu kantong yang terbentuk dari selaput
peritoneum yanmg berisi bagian dari saluran pencernaan atau omentum. Hal ini
sering menjadi besar dan turun ke skrotum. Diakibatkan dari gagalnya prosesus
vaginalis untuk menutup setelah testis turun ke dalam skrotum.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l7 level1 lfo2; tab-stops: list 30.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><i><span lang="IN">b.<span style="font-size: 7pt; font-stretch: normal; font-style: normal; line-height: normal;"> </span></span></i><!--[endif]--><i><span lang="IN">Hernia
direkta<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.0pt; tab-stops: list 30.0pt; text-align: justify; text-indent: -12.0pt;">
<span lang="IN"> Hernia yang melalui dinding
inguinal posterior medial terhadap vasa epigastrika inferior di daerah yang
dibatasi oleh segitiga hasselbach.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l7 level1 lfo2; tab-stops: list 30.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><i><span lang="IN">c.<span style="font-size: 7pt; font-stretch: normal; font-style: normal; line-height: normal;">
</span></span></i><!--[endif]--><i><span lang="IN">Hernia femoralis<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.0pt; tab-stops: list 30.0pt; text-align: justify; text-indent: -12.0pt;">
<span lang="IN"> Hernia yang mana lengkung susu
keluar melalui cincin umbilicus yang gagal menutup.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l7 level1 lfo2; tab-stops: list 30.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><i><span lang="IN">d.<span style="font-size: 7pt; font-stretch: normal; font-style: normal; line-height: normal;"> </span></span></i><!--[endif]--><i><span lang="IN">Hernia
incisional<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.0pt; tab-stops: list 30.0pt; text-align: justify; text-indent: -12.0pt;">
<span lang="IN"> Akibat dari in adekuat dari penyembuhan
luka bedah dan sering terjadi pada luka bedah terinfeksi.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .25in;">
<b><span lang="IN">Menurut keadaannya hernia dibagi menjadi :<o:p></o:p></span></b></div>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo3; tab-stops: list .5in; text-align: justify;"><i><span lang="IN">Hernia reponibilis</span></i><span lang="IN"> :
Isi hernia bisa dimasukkan kembali<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo3; tab-stops: list .5in; text-align: justify;"><i><span lang="IN">Hernia irreponibilis</span></i><span lang="IN"> : Isi
hernia tidak bisa dimasukkan kembali<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo3; tab-stops: list .5in; text-align: justify;"><i><span lang="IN">Hernia incaserata</span></i><span lang="IN"> :
Hernia ireponibilis yang terdapat gangguan pada jalannya isi usus.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo3; tab-stops: list .5in; text-align: justify;"><i><span lang="IN">Hernia strangulasi</span></i><span lang="IN"> :
Hernia incarserata yang terdapat gangguan sirkulasi darah.<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo1; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">2.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">ETIOLOGI<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l7 level2 lfo2; tab-stops: list .5in 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">a.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Konginetal atau primer<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l7 level2 lfo2; tab-stops: list .5in 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">b.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Sekunder akibat peningkatan tekanan intra
abdomen, misal disebabkan karena batuk kronis, konstipasi, kehamilan, asites,
penyumbatan jalan keluar kandung kemih, masa abdomen yang terlalu besar, gerak
yang terlalu aktif.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: list 1.0in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo1; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">3.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">PATOFISIOLOGI<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 24.0pt; text-align: justify;">
<span lang="IN">Prosesus
inguinalis
Batuk kronis, konstipasi, kehamilan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1029" style='position:absolute;
left:0;text-align:left;z-index:251651072' from="318pt,18.9pt" to="318pt,36.9pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; left: 0px; margin-left: 418px; margin-top: 24px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251651072;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1029" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1026"
style='position:absolute;left:0;text-align:left;z-index:251648000' from="42pt,18.9pt"
to="42pt,36.9pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; left: 0px; margin-left: 50px; margin-top: 24px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251648000;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1026" width="12" /></span><!--[endif]--><span lang="IN">(duktus spermatikus)
Retensi urin, masa abdomen membesar<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1032" style='position:absolute;
left:0;text-align:left;flip:y;z-index:251654144' from="3in,7.2pt" to="276pt,7.2pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 287px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 83px; z-index: 251654144;"><img height="12" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1032" width="83" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1033"
style='position:absolute;left:0;text-align:left;z-index:251655168' from="3in,7.2pt"
to="3in,124.2pt"/><![endif]--><!--[if !vml]--><span style="height: 158px; left: 0px; margin-left: 287px; margin-top: 9px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251655168;"><img height="158" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image003.gif" v:shapes="_x0000_s1033" width="2" /></span><!--[endif]--><span lang="IN">Janin 8 bulan testis
Peningkatan TIK<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1030" style='position:absolute;
left:0;text-align:left;z-index:251652096' from="318pt,1.8pt" to="318pt,19.8pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; left: 0px; margin-left: 418px; margin-top: 1px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251652096;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1030" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1027"
style='position:absolute;left:0;text-align:left;z-index:251649024' from="42pt,19.8pt"
to="42pt,37.8pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; left: 0px; margin-left: 50px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251649024;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1027" width="12" /></span><!--[endif]--><span lang="IN">turun ke skrotum<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<span lang="IN"> Sirkulasi darah
terganggu<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<span lang="IN">Tidak dpt menutup<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<span lang="IN"> sempurna <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1028" style='position:absolute;
left:0;text-align:left;z-index:251650048' from="42pt,0" to="42pt,18pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251650048;"><span style="height: 27px; left: 0px; left: 50px; position: absolute; top: -1px; width: 12px;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1028" width="12" /></span></span><!--[endif]--><span lang="IN"> </span></div>
<br clear="ALL" />
<br />
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1031" style='position:absolute;
left:0;text-align:left;z-index:251653120' from="102pt,9.05pt" to="138pt,9.05pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 135px; margin-top: 6px; mso-ignore: vglayout; position: absolute; width: 51px; z-index: 251653120;"><img height="12" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1031" width="51" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1034"
style='position:absolute;left:0;text-align:left;z-index:251656192' from="3in,18.05pt"
to="3in,36.05pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; left: 0px; margin-left: 282px; margin-top: 23px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251656192;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1034" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1040"
style='position:absolute;left:0;text-align:left;flip:y;z-index:251662336'
from="384pt,6.3pt" to="384pt,171.05pt"/><![endif]--><!--[if !vml]--><span style="height: 222px; left: 0px; margin-left: 511px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251662336;"><img height="222" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1040" width="2" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1041"
style='position:absolute;left:0;text-align:left;z-index:251663360' from="366pt,6.3pt"
to="384pt,6.3pt"/><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 487px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 26px; z-index: 251663360;"><img height="2" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1041" width="26" /></span><!--[endif]--><span lang="IN"> Isi usus keluar Usus dan isinya, omentum terjepit
skrotum<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<span lang="IN"> Bendungan dari pembuluh
darah usus<o:p></o:p></span></div>
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="9" width="109"></td>
</tr>
<tr>
<td></td>
<td><img height="43" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image007.gif" v:shapes="_x0000_s1035 _x0000_s1036 _x0000_s1037" width="334" /></td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1035" style='position:absolute;
left:0;text-align:left;z-index:251657216' from="3in,7.2pt" to="3in,34.2pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1036" style='position:absolute;left:0;
text-align:left;flip:x;z-index:251658240' from="84pt,7.2pt" to="3in,34.2pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1037" style='position:absolute;left:0;
text-align:left;z-index:251659264' from="3in,7.2pt" to="330pt,34.2pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]-->
<!--[endif]--><span lang="IN"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<br /></div>
<br clear="ALL" />
<br />
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1038" style='position:absolute;
left:0;text-align:left;z-index:251660288' from="3in,19.85pt" to="3in,37.85pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; left: 0px; margin-left: 282px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251660288;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image008.gif" v:shapes="_x0000_s1038" width="12" /></span><!--[endif]--><span lang="IN"> Nyeri, mual, muntah Perdarahan Nekrose<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<span lang="IN"> Resti infeksi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1039" style='position:absolute;
left:0;text-align:left;flip:x y;z-index:251661312' from="294pt,5.45pt" to="384pt,5.45pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 390px; margin-top: 1px; mso-ignore: vglayout; position: absolute; width: 123px; z-index: 251661312;"><img height="12" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image009.gif" v:shapes="_x0000_s1039" width="123" /></span><!--[endif]--><span lang="IN">
Penonjolan peritoneum<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<span lang="IN">
(menekan peritoneum)<o:p></o:p></span></div>
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="4" width="87"></td>
</tr>
<tr>
<td></td>
<td><img height="59" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image010.gif" v:shapes="_x0000_s1042 _x0000_s1043 _x0000_s1044 _x0000_s1045" width="430" /></td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: 0in; text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1042" style='position:absolute;
left:0;text-align:left;flip:x;z-index:251664384' from="150pt,3.65pt" to="204pt,12.65pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1043" style='position:absolute;left:0;
text-align:left;z-index:251665408' from="204pt,3.65pt" to="264pt,12.65pt">
<v:stroke endarrow="block"/>
</v:line><v:rect id="_x0000_s1044" style='position:absolute;left:0;
text-align:left;margin-left:228pt;margin-top:18.05pt;width:156pt;height:27pt;
z-index:251666432' strokecolor="white">
<v:textbox style='mso-next-textbox:#_x0000_s1044'>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal>
<span lang=IN style='mso-ansi-language:IN'>Gangguan
mobilitas fisik</span></p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1045" style='position:absolute;left:0;
text-align:left;margin-left:66pt;margin-top:18.05pt;width:126pt;height:27pt;
z-index:251667456' strokecolor="white">
<v:textbox style='mso-next-textbox:#_x0000_s1045'>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal>
<span lang=IN style='mso-ansi-language:IN'>Gangguan body
image</span></p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><![endif]--><!--[if !vml]-->
<!--[endif]--><span lang="IN"> </span></div>
<br clear="ALL" />
<br />
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo1; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">4.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">TANDA DAN GEJALA<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l7 level4 lfo2; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><i><span lang="IN">1.<span style="font-size: 7pt; font-stretch: normal; font-style: normal; line-height: normal;">
</span></span></i><!--[endif]--><i><span lang="IN">Hernia inguinalis lateralis / indirekta<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l7 level6 lfo2; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Adanya benjolan di selakangan/ kemaluan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l7 level6 lfo2; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Benjolan bisa hilang atau timbul dan
mengecil<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l7 level6 lfo2; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Timbul bila menangis, mengejan saat
defekasi, mengangkat benda berat<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l7 level6 lfo2; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Dapat ditemukan rasa nyeri pada benjolan
atau mual muntah bila terjadi komplikasi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l7 level6 lfo2; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Pada bayi dan anak-anak sering gelisah,
banyak menangis dan kadang perut kembung<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l7 level4 lfo2; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><i><span lang="IN">2.<span style="font-size: 7pt; font-stretch: normal; font-style: normal; line-height: normal;">
</span></span></i><!--[endif]--><i><span lang="IN">Hernia inguinalis medialis / direkta<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l7 level6 lfo2; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Terlihat adanya masa yang bundar pada
annulus inguinalis eksterna yang mudah mengecil bila tiduran<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l7 level6 lfo2; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Tetap akan terdapat benjolan meskipun
tidak mengejan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l7 level6 lfo2; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Mudah kencing karena buli-buli ikut
membentuk dinding medial hernia <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l7 level6 lfo2; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Bila hernia ke skrotum maka hanya akan ke
bagian atas skrotum<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo1; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">5.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">MASALAH KEPERAWATAN<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 42.0pt; mso-list: l9 level3 lfo3; text-align: justify; text-indent: -24.0pt;">
<!--[if !supportLists]--><span lang="IN">1.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Nyeri
berhubungan dengan terjepitnya usus di daerah selakangan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 42.0pt; mso-list: l9 level3 lfo3; text-align: justify; text-indent: -24.0pt;">
<!--[if !supportLists]--><span lang="IN">2.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Intoleransi
aktifitas berhubungan dengan nyeri dan benjolan di lipatan paha<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 42.0pt; mso-list: l9 level3 lfo3; text-align: justify; text-indent: -24.0pt;">
<!--[if !supportLists]--><span lang="IN">3.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Inkontinensia
usus berhubungan dengan vesika urinaria tertekan oleh hernia<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 42.0pt; mso-list: l9 level3 lfo3; text-align: justify; text-indent: -24.0pt;">
<!--[if !supportLists]--><span lang="IN">4.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Resti
kurang pemenuhan kebutuhan nutrisi berhubungan dengan mual dan muntah<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 42.0pt; mso-list: l9 level3 lfo3; text-align: justify; text-indent: -24.0pt;">
<!--[if !supportLists]--><span lang="IN">5.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Ansietas
berhubungan dengan kurang pengetahuan kondisi kesehatan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo1; tab-stops: list .25in 24.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">6.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">PEMERIKSAAN PENUNJANG<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l5 level2 lfo1; tab-stops: list 24.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">a.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Radiografi abdomen : sejumlah gas terdapat
dalam usus, enema barium menunjukan tingkat obstruksi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l5 level2 lfo1; tab-stops: list 24.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">b.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Laboratorium<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; tab-stops: 48.0pt; text-align: justify;">
<span lang="IN">- Hb dan Ht meningkat karena hemokonsentrasi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l7 level6 lfo2; tab-stops: 48.0pt list .75in 225.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Sel darah putih meningkat pada hernia
strangulasi (<10.000 sel/mm)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l7 level6 lfo2; tab-stops: 48.0pt list .75in 225.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Defisiensi elektrolit, pasien akan
kehilangan kalium, hydrogen, klorida, yang akan mengakibatkan alkalis metabolic<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; tab-stops: 48.0pt list 225.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo1; tab-stops: list .25in 24.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">7.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">PENATALAKSANAAN<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: list .5in; text-align: justify;">
<span lang="IN"> Pada kasus hernia tindakan bedah adalah
tindakan satu-satunya untuk pengobatan, pembedahan ini disebut herniotomy dan
herniografi. Pada hernia inguinalis lateralis reponbilis maka dilakukan bedah
afektif karena terjadi komplikasi. Pada hernia irreponibilis diusahakan agar
penderita istirahat baring dan dipuasakan/ mendapat diet halus. Dilakukan
tekanan yang kontinyu pada benjolan missal dengan bantl pasir., baik juga
dilakukan kompres es untuk mengurangi pembengkakan lakukan berulang-ulang
sehingga isi hernia masuk untuk kemudian dilakukan pembedahan. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; tab-stops: list .5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 24.0pt; mso-list: l5 level1 lfo1; tab-stops: list .25in 24.0pt; text-align: justify; text-indent: -24.0pt;">
<!--[if !supportLists]--><b><span lang="IN">8.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">ASUHAN KEPERAWATAN<o:p></o:p></span></b></div>
<ol start="1" style="margin-top: 0in;" type="A">
<li class="MsoNormal" style="line-height: 150%; mso-list: l10 level1 lfo9; text-align: justify;"><b><span lang="IN">Pengkajian fokus<o:p></o:p></span></b></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l0 level1 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">1.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Aktifitas<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="margin-left: .75in; tab-stops: .5in; text-indent: -.25in;">
<span lang="IN"> Pembatasan aktifitas yang dapat
meningkatkan tekanan intra abdomen seperti bersin, mengangkat benda berat,
batuk mengejan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l0 level1 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">2.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Istirahat<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-align: justify; text-indent: -.25in;">
<span lang="IN"> Ansietas, nyeri sebagai manifestasi
obstruksi usus, pembatasan aktifitas kerja sehubungan dengan peningkatan
tekanan intra abdomen. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 24.0pt; tab-stops: 24.0pt; text-align: justify; text-indent: -12.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l0 level1 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">3.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Integritas ego<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-align: justify; text-indent: -.25in;">
<span lang="IN"> Ansietas, takut, emosi (kesal), perasaan
tidak berdaya<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l0 level1 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">4.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Sirkulasi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-align: justify; text-indent: -.25in;">
<span lang="IN"> Takikardi (akibat dari nyeri, infeksi,
dehidrasi), hipotensi, kulit atau membran mukosa pecah, sianosis, takipnea,
asidosis berhubungan dengan hilangnya cairan dan Na mengakibatkan syock
hipovolemik.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l0 level1 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">5.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Eliminasi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-align: justify; text-indent: -.25in;">
<span lang="IN"> Pada awalnya feses dapat keluar, fase
lanjut terjadi konstipasi, obstipasi, terjadi inkontinensia uri, kebiasaan
mengejan pada waktu BAB.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l0 level1 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">6.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Makanan dan Cairan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-align: justify; text-indent: -.25in;">
<span lang="IN"> Mual, muntah, anoreksia, obesitas
merupakan salah satu predisposisi hernia. Muntah peroral mengandung makanan tak
dicerna selanjutnya muntah air dan empedu hitam dan fekal.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l0 level1 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">7.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Higiene<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-align: justify; text-indent: -.25in;">
<span lang="IN"> Tidak mampu melakukan perawatan diri, bau
badan berhubungan dengan keterbataan aktifitas akibat nyeri.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l0 level1 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">8.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Nyeri /kenyamanan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-align: justify; text-indent: -.25in;">
<span lang="IN"> Nyeri pada lokasi, pada selakangan dan
daerah sekitarnya.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 24.0pt; tab-stops: 24.0pt; text-align: justify; text-indent: -12.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 171.0pt; mso-list: l0 level3 lfo4; tab-stops: 12.0pt list 171.0pt; text-align: justify; text-indent: -171.0pt;">
<!--[if !supportLists]--><b><span lang="IN">B.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><span lang="IN"> <b>Masalah
keperawatan pre operasi dan post operasi <o:p></o:p></b></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; mso-list: l6 level1 lfo5; tab-stops: 24.0pt list .5in; text-align: justify; text-indent: -42.0pt;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">F<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><b><span lang="IN">Pre operasi<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l5 level2 lfo1; tab-stops: 24.0pt list .5in; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">a.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Nyeri berhubungan dengan terjepitnya usus
di daerah selakangan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; tab-stops: 24.0pt; text-align: justify;">
<span lang="IN">Tujuan :
Setelah dilakukan tindakan keperawatan diharapkan nyeri dapat dikurangi <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; tab-stops: 24.0pt; text-align: justify;">
<span lang="IN">Kriteria
hasil :<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l2 level1 lfo10; tab-stops: 24.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Klien mengatakan nyeri berkurang <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l2 level1 lfo10; tab-stops: 24.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Wajah relaks<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l2 level1 lfo10; tab-stops: 24.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">TTV dalam batas normal : TD : 120/80 mmHg,
N : 80 x/mnt<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; tab-stops: 24.0pt; text-align: justify;">
<span lang="IN">Intervensi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; mso-list: l4 level1 lfo6; tab-stops: 48.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">1.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Kaji nyeri, catat lokasi, karakteristik,
skalanya (skala 1-10)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; tab-stops: 60.0pt; text-align: justify; text-indent: -12.0pt;">
<span lang="IN"> R/ : berguna dalam pengawasan keefektifan
obat, kemajuan penyembuhan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; mso-list: l4 level1 lfo6; tab-stops: 48.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">2.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Tetapkan hubungan antara flatus dan nyeri
mereda<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; tab-stops: 48.0pt; text-align: justify; text-indent: -12.0pt;">
<span lang="IN"> R/ : nyeri tidak hilang dengan flatus
merupakan tanda obstruksi usus<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; mso-list: l4 level1 lfo6; tab-stops: 48.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">3.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Monitor bising usus, TTV, perhatikan
peningkatan/ spasme dan nyeri<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; tab-stops: 48.0pt; text-align: justify; text-indent: -12.0pt;">
<span lang="IN"> R/ : mengetahui perkembangan kondisi pasien<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; mso-list: l4 level1 lfo6; tab-stops: 48.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">4.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Berikan kompres dingin pada hernia yang
membengkak<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; tab-stops: 48.0pt; text-align: justify; text-indent: -12.0pt;">
<span lang="IN"> R/ : kompres dingin menambah
vasokontriksi pembuluh darah dan mengurangi nyeri<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l5 level2 lfo1; tab-stops: 24.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">b.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Ansietas berhubungan dengan kurang
pengetahuan tentang kondisi kesehatan, proses inflamasi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; tab-stops: 24.0pt 48.0pt; text-align: justify;">
<span lang="IN">Tujuan
: setelah dilakukan tindakan keperawatan diharapkan klien tidak cemas<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; tab-stops: 24.0pt 48.0pt; text-align: justify;">
<span lang="IN">Kriteria
hasil<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l1 level1 lfo11; tab-stops: 24.0pt 48.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Klien mengatakan sudah siap untuk
dioperasi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l1 level1 lfo11; tab-stops: 24.0pt 48.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Klien tidak gelisah<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l1 level1 lfo11; tab-stops: 24.0pt 48.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Wajah rileks<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; tab-stops: 24.0pt 48.0pt; text-align: justify;">
<span lang="IN">Intervensi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l3 level1 lfo7; tab-stops: 24.0pt list 60.0pt; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]--><span lang="IN">1.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Catat petunjuk perilaku missal gelisah,
menolak<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; tab-stops: 24.0pt list 60.0pt; text-align: justify;">
<span lang="IN"> R/ :
indicator derajat ansietas<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l3 level1 lfo7; tab-stops: 24.0pt list 60.0pt; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]--><span lang="IN">2.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Berikan lingkungan tenang dan istirahat<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; tab-stops: 24.0pt list 60.0pt; text-align: justify;">
<span lang="IN"> R/ : meningkatkan relaksasi,membantu
menurunkan ansietas<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l3 level1 lfo7; tab-stops: 24.0pt list 60.0pt; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]--><span lang="IN">3.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Motivasi orang terdekat untuk menunjukan
perilaku perhatian<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; tab-stops: 24.0pt list 60.0pt; text-align: justify;">
<span lang="IN"> R/ :
membantu pasien merasa tenang<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; mso-list: l3 level1 lfo7; tab-stops: 24.0pt list 60.0pt; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]--><span lang="IN">4.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Bantu pasien belajar mekanisme koping baru<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; tab-stops: 24.0pt list 60.0pt; text-align: justify;">
<span lang="IN"> R/ :
membantu menurunkan stress, meningkatkan kontrol penyakit<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l6 level1 lfo5; tab-stops: 24.0pt list .5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">F<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><b><span lang="IN">Post operasi<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l3 level2 lfo7; tab-stops: 24.0pt list 42.0pt left 48.0pt; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]--><span lang="IN">a.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Nyeri berhubungan denganluka insisi bedah<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; tab-stops: 24.0pt; text-align: justify;">
<span lang="IN">Tujuan :
Setelah dilakukan tindakan keperawatan diharapkan nyeri dapat dikurangi <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; tab-stops: 24.0pt; text-align: justify;">
<span lang="IN">Kriteria
hasil :<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l2 level1 lfo10; tab-stops: 24.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Klien mengatakan nyeri hilang / berkurang <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l2 level1 lfo10; tab-stops: 24.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Wajah relaks<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l2 level1 lfo10; tab-stops: 24.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">TTV dalam batas normal : TD : 120/80 mmHg,
N : 80 x/mnt<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; tab-stops: 24.0pt; text-align: justify;">
<span lang="IN">Intervensi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; mso-list: l4 level2 lfo6; tab-stops: 24.0pt list 60.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">1.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Kaji nyeri, catat lokasi, skala nyeri
(skala 1-10)<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: 60.0pt; text-indent: -12.0pt;">
<span lang="IN"> R/
: berguna dalam pengawasan keefektifan obat, kemajuan penyembuhan <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; mso-list: l4 level2 lfo6; tab-stops: 24.0pt list 60.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">2.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Dorong ambulasi dini<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; tab-stops: 24.0pt list 60.0pt; text-align: justify; text-indent: -12.0pt;">
<span lang="IN"> R/:
menungkatkan normalisasi fungsi organ seperti merangsang periltastik dan
kelancaran flatus.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; mso-list: l4 level2 lfo6; tab-stops: 24.0pt list 60.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">3.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Ajarkan teknik relaksasi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; tab-stops: 24.0pt list 60.0pt; text-align: justify; text-indent: -12.0pt;">
<span lang="IN"> R/ :
mengalihkan perhatian dan mengurangi ketegangan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; mso-list: l4 level2 lfo6; tab-stops: 24.0pt list 60.0pt; text-align: justify; text-indent: -12.0pt;">
<!--[if !supportLists]--><span lang="IN">4.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Berikan analgesik sesuai indikasi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; tab-stops: 24.0pt list 60.0pt; text-align: justify; text-indent: -12.0pt;">
<span lang="IN"> R/ :
menghilangkan nyeri.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; tab-stops: 24.0pt; text-align: justify; text-indent: -12.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 0in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 0in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 0in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 0in; text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; tab-stops: 0in; text-align: center;">
<b><span lang="IN">DAFTAR PUSTAKA<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="line-height: 150%; tab-stops: 0in; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l8 level1 lfo8; tab-stops: 0in list .5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Dongoes,
E Marylin. Rencana Asuhan Keperawatan. Jakarta : EGC. 1992<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l8 level1 lfo8; tab-stops: 0in list .5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Mansjoer,
Arif dkk. Kapita Selekta Kedokteran Jilid 2. Jakarta : Media Aesculapius. 2000<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l8 level1 lfo8; tab-stops: 0in list .5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Sabiston,
David C. Buku Ajar Bedah I. Jakarta . EGC. 1992<o:p></o:p></span></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com3tag:blogger.com,1999:blog-4511732320299108871.post-22249970637961366292015-01-17T20:16:00.003-08:002015-01-17T20:16:51.220-08:00LAPORAN PENDAHULUAN BPH (BENIGNA PROSTAT HIPERTROPHY)<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span lang="IN">LAPORAN PENDAHULUAN<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span lang="IN">BPH (BENIGNA PROSTAT HIPERTROPHY)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l3 level1 lfo5; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">1.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">PENGERTIAN<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent" style="margin-left: .25in; text-indent: 0in;">
<span lang="IN">BPH adalah pembesaran jinak kelenjar
prostat, disebabkan oleh karena hiperplasi beberapa atau semua komponen prostat
meliputi jaringan kelenjar / jaringan fibromuskular yang menyebabkan penyumbatan
uretra pars prostatika.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l3 level1 lfo5; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">2.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">ETIOLOGI<o:p></o:p></span></b></div>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo1; tab-stops: list .5in; text-align: justify;"><span lang="IN">Perubahan
keseimbangan hormon testosteron dan estrogen pada laki-laki usia lanjut<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo1; tab-stops: list .5in; text-align: justify;"><span lang="IN">Peranan
dari growth factor sebagai pemicu pertumbuhan stroma kelenjar prostat<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo1; tab-stops: list .5in; text-align: justify;"><span lang="IN">Meningkatnya
lama hidup sel-sel prostat karena berkurangnya sel-sel yang mati<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo1; tab-stops: list .5in; text-align: justify;"><span lang="IN">Terjadinya
proliferasi abnormal sel stem sehingga menyebabkan produksi sel stoma dan
sel epitel kelenjar prostat menjadi berlebihan<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;">
<span lang="IN">Ada 2 stadium yang
mempengaruhi perubahan pada dinding kemih yaitu :<o:p></o:p></span></div>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-align: justify;"><span lang="IN">Stadium
dini<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">Hiperplasi prostat menyebabkan penyempitan
lumen uretra prostatika dan menyumbat aliran urine sehingga meningkatkan
tekanan intravesikel<o:p></o:p></span></div>
<ol start="2" style="margin-top: 0in;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-align: justify;"><span lang="IN">Stadium
lanjut<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">Terjadi dekompensasi karena penebalan
dinding vesika urinaria tidak bertambah lagi residu urine bertambah. Gejala
semakin menyolok ( retensi urine clonis ), tonus otot vesika urinaria menurun.
Persyarafan para simpatis melemah dan akhirnya terjadi kelumpuhan detsrusor dan
spinter uretra sehingga terjadi over flow incontinensia ( urine menetes sacara
periodik )<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l3 level1 lfo5; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">3.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">PATOFISIOLOGI<o:p></o:p></span></b></div>
<table cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td bgcolor="white" height="78" style="background: white; border: .75pt solid white; vertical-align: top;" width="142"><!--[endif]--><!--[if !mso]--><span style="left: 0pt; mso-ignore: vglayout; position: absolute; z-index: 251627008;">
<table cellpadding="0" cellspacing="0" style="width: 100%px;">
<tbody>
<tr>
<td><!--[endif]-->
<div class="shape" style="padding: 4.35pt 7.95pt 4.35pt 7.95pt;" v:shape="_x0000_s1027">
<div align="center" class="MsoNormal" style="text-align: center;">
Proliferasi
abnormal sel stem</div>
</div>
<!--[if !mso]--></td>
</tr>
</tbody></table>
</span><!--[endif]--><!--[if !mso & !vml]--> <!--[endif]--><!--[if !vml]--></td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<!--[if gte vml 1]><v:rect
id="_x0000_s1027" style='position:absolute;left:0;text-align:left;
margin-left:372pt;margin-top:6.3pt;width:102pt;height:54pt;z-index:251627008'
strokecolor="white"/><![endif]--><!--[if !vml]--><span style="height: 78px; left: 0px; margin-left: 495px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 142px; z-index: 251627008;">
</span><!--[endif]--><!--[if gte vml 1]><v:rect id="_x0000_s1026" style='position:absolute;
left:0;text-align:left;margin-left:-6pt;margin-top:6.3pt;width:120pt;height:54pt;
z-index:251625984' strokecolor="white"/><![endif]--><!--[if !vml]--></div>
<table cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td bgcolor="white" height="78" style="background: white; border: .75pt solid white; vertical-align: top;" width="166"><!--[endif]--><!--[if !mso]--><span style="left: 0pt; mso-ignore: vglayout; position: absolute; z-index: 251625984;">
<table cellpadding="0" cellspacing="0" style="width: 100%px;">
<tbody>
<tr>
<td><!--[endif]-->
<div class="shape" style="padding: 4.35pt 7.95pt 4.35pt 7.95pt;" v:shape="_x0000_s1026">
<div align="center" class="MsoNormal" style="text-align: center;">
Perubahan
estrogen, testosterone pada laki-laki usia lanjut</div>
</div>
<!--[if !mso]--></td>
</tr>
</tbody></table>
</span><!--[endif]--><!--[if !mso & !vml]--> <!--[endif]--><!--[if !vml]--></td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="height: 78px; left: 0px; margin-left: -9px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 166px; z-index: 251625984;">
</span><!--[endif]--><!--[if gte vml 1]><v:rect id="_x0000_s1028" style='position:absolute;
left:0;text-align:left;margin-left:252pt;margin-top:6.3pt;width:102pt;
height:36pt;z-index:251628032' strokecolor="white"/><![endif]--><!--[if !vml]--></div>
<table cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td bgcolor="white" height="54" style="background: white; border: .75pt solid white; vertical-align: top;" width="142"><!--[endif]--><!--[if !mso]--><span style="left: 0pt; mso-ignore: vglayout; position: absolute; z-index: 251628032;">
<table cellpadding="0" cellspacing="0" style="width: 100%px;">
<tbody>
<tr>
<td><!--[endif]-->
<div class="shape" style="padding: 4.35pt 7.95pt 4.35pt 7.95pt;" v:shape="_x0000_s1028">
<div align="center" class="MsoNormal" style="text-align: center;">
Lama hidup sel
prostat</div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</div>
<!--[if !mso]--></td>
</tr>
</tbody></table>
</span><!--[endif]--><!--[if !mso & !vml]--> <!--[endif]--><!--[if !vml]--></td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="height: 54px; left: 0px; margin-left: 335px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 142px; z-index: 251628032;">
</span><!--[endif]--><!--[if gte vml 1]><v:rect id="_x0000_s1029" style='position:absolute;
left:0;text-align:left;margin-left:132pt;margin-top:6.3pt;width:102pt;
height:36pt;z-index:251629056' strokecolor="white"/><![endif]--><!--[if !vml]--></div>
<table cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td bgcolor="white" height="54" style="background: white; border: .75pt solid white; vertical-align: top;" width="142"><!--[endif]--><!--[if !mso]--><span style="left: 0pt; mso-ignore: vglayout; position: absolute; z-index: 251629056;">
<table cellpadding="0" cellspacing="0" style="width: 100%px;">
<tbody>
<tr>
<td><!--[endif]-->
<div class="shape" style="padding: 4.35pt 7.95pt 4.35pt 7.95pt;" v:shape="_x0000_s1029">
<div align="center" class="MsoNormal" style="text-align: center;">
Peranan growth
hormon</div>
<div class="MsoNormal">
<br /></div>
</div>
<!--[if !mso]--></td>
</tr>
</tbody></table>
</span><!--[endif]--><!--[if !mso & !vml]--> <!--[endif]--><!--[if !vml]--></td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="height: 54px; left: 0px; margin-left: 175px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 142px; z-index: 251629056;">
</span><!--[endif]--><span lang="IN"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<!--[if gte vml 1]><v:rect
id="_x0000_s1030" style='position:absolute;left:0;text-align:left;
margin-left:204pt;margin-top:40.2pt;width:1in;height:27pt;z-index:251630080'>
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
<b
style='mso-bidi-font-weight:normal'>BPH<o:p></o:p></b></p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1031" style='position:absolute;left:0;
text-align:left;margin-left:2in;margin-top:76.05pt;width:189.75pt;height:27pt;
z-index:251631104' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Penyempitan lumen
uretra prostatik</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1032" style='position:absolute;left:0;
text-align:left;margin-left:140.25pt;margin-top:152.25pt;width:198pt;height:27pt;
z-index:251632128' strokecolor="white">
<v:textbox style='mso-next-textbox:#_x0000_s1032'>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Perubahan sekunder
kandung kemih</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1033" style='position:absolute;left:0;
text-align:left;margin-left:168pt;margin-top:114.15pt;width:2in;height:27pt;
z-index:251633152' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Aliran urine
terhambat</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:line id="_x0000_s1034" style='position:absolute;left:0;
text-align:left;z-index:251634176' from="186pt,.9pt" to="240pt,36.9pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1035" style='position:absolute;left:0;
text-align:left;flip:x;z-index:251635200' from="240pt,.9pt" to="306pt,36.9pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1036" style='position:absolute;left:0;
text-align:left;z-index:251636224' from="48pt,18.9pt" to="240pt,36.9pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1037" style='position:absolute;left:0;
text-align:left;flip:x;z-index:251637248' from="240pt,18.9pt" to="426pt,36.9pt">
<v:stroke endarrow="block"/>
</v:line><v:rect id="_x0000_s1038" style='position:absolute;left:0;
text-align:left;margin-left:42pt;margin-top:199.35pt;width:96pt;height:27pt;
z-index:251638272' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Stadium lanjut</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1039" style='position:absolute;left:0;
text-align:left;margin-left:6pt;margin-top:387.8pt;width:174pt;height:27pt;
z-index:251639296' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Kelemahan muscle
destrusor</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1040" style='position:absolute;left:0;
text-align:left;margin-left:6pt;margin-top:350.75pt;width:174pt;height:27pt;
z-index:251640320' strokecolor="white">
<v:textbox style='mso-next-textbox:#_x0000_s1040'>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Saraf
parasimpatis melemah</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1041" style='position:absolute;left:0;
text-align:left;margin-left:6pt;margin-top:312.65pt;width:174pt;height:27pt;
z-index:251641344' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Tonus vesika
urinaria menurun</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1042" style='position:absolute;left:0;
text-align:left;margin-left:42pt;margin-top:274.55pt;width:96pt;height:27pt;
z-index:251642368' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Residu urine</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1043" style='position:absolute;left:0;
text-align:left;margin-left:18pt;margin-top:236.4pt;width:2in;height:27pt;
z-index:251643392' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Dinding vesika
menurun</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1044" style='position:absolute;left:0;
text-align:left;margin-left:270pt;margin-top:350.75pt;width:96pt;height:27pt;
z-index:251644416' strokecolor="white">
<v:textbox style='mso-next-textbox:#_x0000_s1044'>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Sulit kencing</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1045" style='position:absolute;left:0;
text-align:left;margin-left:228pt;margin-top:312.65pt;width:180pt;height:27pt;
z-index:251645440' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Penebalan vesika
urinaria</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1046" style='position:absolute;left:0;
text-align:left;margin-left:228pt;margin-top:274.55pt;width:180pt;height:27pt;
z-index:251646464' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Kompensasi
musculus destrusor</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1047" style='position:absolute;left:0;
text-align:left;margin-left:228pt;margin-top:236.4pt;width:180pt;height:27pt;
z-index:251647488' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Tekanan
intravesika meningkat</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1048" style='position:absolute;left:0;
text-align:left;margin-left:270pt;margin-top:199.35pt;width:96pt;height:27pt;
z-index:251648512' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Stadium dini</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:line id="_x0000_s1049" style='position:absolute;left:0;
text-align:left;z-index:251649536' from="240pt,180.3pt" to="324pt,198.3pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1050" style='position:absolute;left:0;
text-align:left;flip:x;z-index:251650560' from="78pt,180.3pt" to="240pt,198.3pt">
<v:stroke endarrow="block"/>
</v:line><v:rect id="_x0000_s1051" style='position:absolute;left:0;
text-align:left;margin-left:132pt;margin-top:416.9pt;width:180pt;height:36pt;
z-index:251651584' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Keluhan LUTS</p>
<p class=MsoNormal align=center style='text-align:center'>
(Lower Urinary
Tract Symptom)</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1052" style='position:absolute;left:0;
text-align:left;margin-left:348pt;margin-top:416.9pt;width:132pt;height:27pt;
z-index:251652608' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Distensi vesika
urinaria</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1053" style='position:absolute;left:0;
text-align:left;margin-left:348pt;margin-top:511.1pt;width:132pt;height:36pt;
z-index:251653632'>
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Resiko ketidak
efektifan jalan nafas</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1054" style='position:absolute;left:0;
text-align:left;margin-left:348pt;margin-top:464pt;width:132pt;height:36pt;
z-index:251654656'>
<v:textbox style='mso-next-textbox:#_x0000_s1054'>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Gangguan rasa
nyaman nyeri</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1055" style='position:absolute;left:0;
text-align:left;margin-left:156pt;margin-top:464pt;width:132pt;height:27pt;
z-index:251655680' strokecolor="white">
<v:textbox style='mso-next-textbox:#_x0000_s1055'>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Pembedahan
(TUR-P)</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1056" style='position:absolute;left:0;
text-align:left;margin-left:252pt;margin-top:511.1pt;width:66pt;height:27pt;
z-index:251656704' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal>
Anastesi</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1057" style='position:absolute;left:0;
text-align:left;margin-left:120pt;margin-top:511.1pt;width:84pt;height:36pt;
z-index:251657728' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Pemasangan
kateter</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1058" style='position:absolute;left:0;
text-align:left;margin-left:252pt;margin-top:558.2pt;width:162pt;height:126pt;
z-index:251658752'>
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal style='margin-left:12.0pt;text-indent:-12.0pt;
mso-list:l9 level1 lfo10'>
<![if !supportLists]><span style='mso-list:Ignore'>-<span
style='font:7.0pt "Times New Roman"'> </span></span><![endif]>Nyeri
akut</p>
<p class=MsoNormal style='margin-left:12.0pt;text-indent:-12.0pt;
mso-list:l9 level1 lfo10'>
<![if !supportLists]><span style='mso-list:Ignore'>-<span
style='font:7.0pt "Times New Roman"'> </span></span><![endif]>Resiko
perdarahan</p>
<p class=MsoNormal style='margin-left:12.0pt;text-indent:-12.0pt;
mso-list:l9 level1 lfo10'>
<![if !supportLists]><span style='mso-list:Ignore'>-<span
style='font:7.0pt "Times New Roman"'> </span></span><![endif]>Resiko
kekurangan cairan</p>
<p class=MsoNormal style='margin-left:12.0pt;text-indent:-12.0pt;
mso-list:l9 level1 lfo10'>
<![if !supportLists]><span style='mso-list:Ignore'>-<span
style='font:7.0pt "Times New Roman"'> </span></span><![endif]>Penurunan
pengetahuan post operasi</p>
<p class=MsoNormal style='margin-left:12.0pt;text-indent:-12.0pt;
mso-list:l9 level1 lfo10'>
<![if !supportLists]><span style='mso-list:Ignore'>-<span
style='font:7.0pt "Times New Roman"'> </span></span><![endif]>Resiko
retensi urine pasca operasi</p>
<p class=MsoNormal style='margin-left:12.0pt;text-indent:-12.0pt;
mso-list:l9 level1 lfo10'>
<![if !supportLists]><span style='mso-list:Ignore'>-<span
style='font:7.0pt "Times New Roman"'> </span></span><![endif]>Resiko
disfungsi seksual</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1059" style='position:absolute;left:0;
text-align:left;margin-left:114pt;margin-top:568.25pt;width:108pt;height:1in;
z-index:251659776'>
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal style='margin-left:12.0pt;text-align:justify;text-indent:
-12.0pt;mso-list:l2 level1 lfo9'>
<![if !supportLists]><span
style='mso-list:Ignore'>-<span style='font:7.0pt "Times New Roman"'>
</span></span><![endif]>Resiko infeksi</p>
<p class=MsoNormal style='margin-left:12.0pt;text-align:justify;text-indent:
-12.0pt;mso-list:l2 level1 lfo9'>
<![if !supportLists]><span
style='mso-list:Ignore'>-<span style='font:7.0pt "Times New Roman"'>
</span></span><![endif]>Resiko inkontinensia pasca kateter</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1060" style='position:absolute;left:0;
text-align:left;margin-left:6pt;margin-top:473pt;width:78pt;height:36pt;
z-index:251660800' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Bertahan lama</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1061" style='position:absolute;left:0;
text-align:left;margin-left:-4.5pt;margin-top:568.25pt;width:96pt;height:27pt;
z-index:251661824'>
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Resiko infeksi</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:rect id="_x0000_s1062" style='position:absolute;left:0;
text-align:left;margin-left:-4.5pt;margin-top:526.4pt;width:96pt;height:27pt;
z-index:251662848' strokecolor="white">
<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
Mikroorganisme</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:rect><v:line id="_x0000_s1063" style='position:absolute;left:0;
text-align:left;z-index:251663872' from="240pt,99.35pt" to="240pt,117.35pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1064" style='position:absolute;left:0;
text-align:left;z-index:251664896' from="240pt,63.15pt" to="240pt,81.15pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1065" style='position:absolute;left:0;
text-align:left;z-index:251665920' from="240pt,136.05pt" to="240pt,154.05pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1066" style='position:absolute;left:0;
text-align:left;z-index:251666944' from="316.1pt,297.85pt" to="316.1pt,315.85pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1067" style='position:absolute;left:0;
text-align:left;z-index:251667968' from="316.1pt,263.2pt" to="316.1pt,281.2pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1068" style='position:absolute;left:0;
text-align:left;z-index:251668992' from="315.15pt,222.65pt" to="315.15pt,240.65pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1069" style='position:absolute;left:0;
text-align:left;z-index:251670016' from="84pt,227.4pt" to="84pt,245.4pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1070" style='position:absolute;left:0;
text-align:left;z-index:251671040' from="42pt,509.2pt" to="42pt,527.2pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1071" style='position:absolute;left:0;
text-align:left;z-index:251672064' from="42pt,549.2pt" to="42pt,567.2pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1072" style='position:absolute;left:0;
text-align:left;z-index:251673088' from="162pt,546.35pt" to="162pt,564.35pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1073" style='position:absolute;left:0;
text-align:left;z-index:251674112' from="415.25pt,442.1pt" to="415.25pt,460.1pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1074" style='position:absolute;left:0;
text-align:left;z-index:251675136' from="218.85pt,451.1pt" to="218.85pt,469.1pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1075" style='position:absolute;left:0;
text-align:left;z-index:251676160' from="84pt,375pt" to="84pt,393pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1076" style='position:absolute;left:0;
text-align:left;z-index:251677184' from="84pt,335.95pt" to="84pt,353.95pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1077" style='position:absolute;left:0;
text-align:left;z-index:251678208' from="83.7pt,297.85pt" to="83.7pt,315.85pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1078" style='position:absolute;left:0;
text-align:left;z-index:251679232' from="83.35pt,262.25pt" to="83.35pt,280.25pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1079" style='position:absolute;left:0;
text-align:left;z-index:251680256' from="316.1pt,335.95pt" to="316.1pt,353.95pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1080" style='position:absolute;left:0;
text-align:left;flip:x;z-index:251681280' from="3in,373.6pt" to="318pt,418.6pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1081" style='position:absolute;left:0;
text-align:left;z-index:251682304' from="318.95pt,373.6pt" to="414.95pt,418.6pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1082" style='position:absolute;left:0;
text-align:left;flip:x;z-index:251683328' from="160.1pt,486.85pt" to="220.1pt,513.85pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1083" style='position:absolute;left:0;
text-align:left;z-index:251684352' from="221.05pt,486.85pt" to="287.05pt,513.85pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1084" style='position:absolute;left:0;
text-align:left;z-index:251685376' from="221.05pt,487.3pt" to="245.05pt,577.3pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1085" style='position:absolute;left:0;
text-align:left;z-index:251686400' from="306pt,525.4pt" to="348pt,525.4pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1086" style='position:absolute;left:0;
text-align:left;z-index:251687424' from="0,289.8pt" to="0,478.8pt"/><v:line
id="_x0000_s1087" style='position:absolute;left:0;text-align:left;z-index:251688448'
from="-.6pt,488.25pt" to="23.4pt,488.25pt">
<v:stroke endarrow="block"/>
</v:line><v:line id="_x0000_s1088" style='position:absolute;left:0;
text-align:left;z-index:251689472' from="0,288.85pt" to="48pt,288.85pt"/><![endif]--><!--[if !vml]--><span style="height: 915px; left: -7px; mso-ignore: vglayout; position: relative; top: 0px; width: 652px; z-index: 251630080;"><img height="915" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1030 _x0000_s1031 _x0000_s1032 _x0000_s1033 _x0000_s1034 _x0000_s1035 _x0000_s1036 _x0000_s1037 _x0000_s1038 _x0000_s1039 _x0000_s1040 _x0000_s1041 _x0000_s1042 _x0000_s1043 _x0000_s1044 _x0000_s1045 _x0000_s1046 _x0000_s1047 _x0000_s1048 _x0000_s1049 _x0000_s1050 _x0000_s1051 _x0000_s1052 _x0000_s1053 _x0000_s1054 _x0000_s1055 _x0000_s1056 _x0000_s1057 _x0000_s1058 _x0000_s1059 _x0000_s1060 _x0000_s1061 _x0000_s1062 _x0000_s1063 _x0000_s1064 _x0000_s1065 _x0000_s1066 _x0000_s1067 _x0000_s1068 _x0000_s1069 _x0000_s1070 _x0000_s1071 _x0000_s1072 _x0000_s1073 _x0000_s1074 _x0000_s1075 _x0000_s1076 _x0000_s1077 _x0000_s1078 _x0000_s1079 _x0000_s1080 _x0000_s1081 _x0000_s1082 _x0000_s1083 _x0000_s1084 _x0000_s1085 _x0000_s1086 _x0000_s1087 _x0000_s1088" width="652" /></span><!--[endif]--><span lang="IN"> </span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<br clear="ALL" />
<br />
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l3 level1 lfo5; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">4.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">TANDA DAN GEJALA<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="IN"> Kumpulan
gejala pada BPH :<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l8 level1 lfo3; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">F<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Hesitasi (miksi menunggu lama )<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l8 level1 lfo3; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">F<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Pancaran urine melemah<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l8 level1 lfo3; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">F<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Intermitensi (kencing terputus-putus)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l8 level1 lfo3; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">F<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Urgensi (perasaan miksi sangat mendesak)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l8 level1 lfo3; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">F<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Disuria (nyeri miksi)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l8 level1 lfo3; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">F<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Terasa ada sisa setelah miksi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l3 level1 lfo5; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">5.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">MANIFESTASI KLINIS<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent2" style="margin-left: .5in; mso-list: l6 level2 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">1.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span lang="IN">IPPS
( International Prostat Symptoms Score ) adalah kumpulan pertanyaan yang
merupakan pedoman untuk mengevaluasi beratnya LUTS<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">a. Skor 0-7 : gejala ringan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">b. Skor 8-19 :gejala sedang<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">c. Skor 20-35 : gejala berat<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .5in; text-indent: -6.0pt;">
<span lang="IN">Gejala : <o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .75in; mso-list: l5 level1 lfo6; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span lang="IN">Obstruktif
: hesitansi, pancaran miksi lemah, intermitten miksi tak puas, menetes setelah
miksi<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .75in; mso-list: l5 level1 lfo6; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span lang="IN">Iritatif
: nocturna, urgensi & disuria.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="margin-left: .5in; mso-list: l6 level2 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">2.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span lang="IN">Rectal
grading<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .5in; text-indent: 0in;">
<span lang="IN">Didapatkan batas atas teraba, menonjal
> 1 cm (seperti ujung hidung )<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .5in; text-indent: 0in;">
<span lang="IN">Lobus kanan/kiri simetri & tidak
teraba nodul<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .5in; text-indent: 0in;">
<span lang="IN">a. Grade 0 : penonjolan 0-1 cm<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .5in; text-indent: 0in;">
<span lang="IN">b. Grade 1 : penonjolan 1-2 cm<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .5in; text-indent: 0in;">
<span lang="IN">c. Grade 2 : penonjolan 2-3 cm<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .5in; text-indent: 0in;">
<span lang="IN">d. Grade 3 : penonjolan 3-4 cm<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .5in; text-indent: 0in;">
<span lang="IN">e. Grade 4 : penonjolan >4 cm<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="margin-left: .5in; mso-list: l6 level2 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">3.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span lang="IN">Clinical
grading (berdasarkan residu urine)<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .75in; mso-list: l3 level2 lfo5; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">a.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span lang="IN">Grade
1<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .75in; text-indent: 0in;">
<span lang="IN">Sejak berbulan-bulan bahkan bertahun-tahun
pasien mengeluh kencing tidak puas, pancaran urine lemah, harus mengedan,
nocturia (belum terdapat sisa urine)<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .75in; text-indent: 0in;">
<br /></div>
<div class="MsoBodyTextIndent3" style="margin-left: .75in; text-indent: 0in;">
<br /></div>
<div class="MsoBodyTextIndent3" style="margin-left: .75in; mso-list: l3 level2 lfo5; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">b.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span lang="IN">Grade
2<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .75in; text-indent: 0in;">
<span lang="IN">Telah terdapat sisa urine (sistitis),
nocturia makin sering dan kadang disertai hematuri pada cyctoscopy dinding
vesika urinaria menebal karena trabekulasi (hipertropi musculus destrusor)<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .75in; mso-list: l3 level2 lfo5; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">c.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span lang="IN">Grade
3<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .75in; text-indent: 0in;">
<span lang="IN">Sisa urine mencapai 80-100 ml, infeksi
semakin hebat (hiperplexi, menggigil & nyeri pinggang karena cystitis).
Trabekulasi semakin banyak.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .75in; mso-list: l3 level2 lfo5; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">d.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span lang="IN">Grade
4<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: .75in; text-indent: 0in;">
<span lang="IN">Retensi urine total.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="margin-left: 0in; text-indent: 24.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l3 level1 lfo5; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">6.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">PEMERIKSAAN PENUNJANG<o:p></o:p></span></b></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo4; tab-stops: list .5in; text-align: justify;"><span lang="IN">Pemeriksaan
laboratorium<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">a. Darah lengkap<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; text-align: justify;">
<span lang="IN">- Untuk menilai kadar Hb, PCV
(hematokrit), trombosit, leukosit dan LED<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; text-align: justify;">
<span lang="IN">- Untuk menilai kemungkinan
inflasi akibat statis urine<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">b. Sedimentasi urine<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">- Untuk menilai
kemungkinan inflamasi saluran kemih<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">c. Kultur urine<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">- Untuk menentukan
jenis bakteri & terapi antibiotik yang tepat<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">d. Renal fungsi tes (BUN/ureum, creatitin)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">- Untuk menilai
gangguan fungsi ginjal akibat dari statis urine<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">e. PSA (Prostatik Spesifik Antigen)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">- Untuk
kewaspadaan adanya keganasan<o:p></o:p></span></div>
<ol start="2" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo4; tab-stops: list .5in; text-align: justify;"><span lang="IN">Pemeriksaan
radiology<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">a. Foto abdomen polos (BNA/ Blass Nier
Averzith)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">- Untuk melihat
adanya batu pada system kemih<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">b. Intravenus phielografi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">- Untuk menilai
kelainan ginjal dan ureter<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">- Untuk menilai
penyulit yang terjadi pada fundus uteri<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">c. USG (ultrasonografi)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">- Untuk memeriksa
konsistensi, volume dan besar prostat<o:p></o:p></span></div>
<ol start="3" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo4; tab-stops: list .5in; text-align: justify;"><span lang="IN">Pemeriksaan
penendoscopy<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; text-align: justify;">
<span lang="IN">- Untuk melihat derajat
pembesaran kelenjar prostat<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-align: justify;">
<br /></div>
<ol start="4" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo4; tab-stops: list .5in; text-align: justify;"><span lang="IN">Pemeriksaan
pancaran urine (uroflowmetri)<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l7 level2 lfo4; tab-stops: list 42.0pt; text-align: justify; text-indent: -.5in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN"> Flowrate maximal >15 ml/ dtk : non obstruktif<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">- Flowrate maximal 10-15 ml/ dtk : border
line<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">- Folwrate maximal <10 ml/ dtk :
obstruktif<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l3 level1 lfo5; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">7.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">PENATALAKSANAAN<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 42.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -24.0pt;">
<!--[if !supportLists]--><span lang="IN">1.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Farmakologi
untuk :<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l7 level2 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Mengurangi
retensi laher vesika urinaria dengan obat golongan penghambat androgen<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l7 level2 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Mengurangi
volume prostat<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 42.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -24.0pt;">
<!--[if !supportLists]--><span lang="IN">2.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Operatif
(operasi terbuka)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l7 level2 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Retrapubic
transvesikal prostatectomy yaitu melakukan sayatan section alfa melalui fossa
prostate anterior tatapi tidak membuka dinding vesika urinaria<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l7 level2 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Suprapubic
transvesikal prostatectomy (trayer) yaitu melakukan sayatan section alva
menembus vesika urinaria<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l7 level2 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Transperineal
prostatectomy yaitu melakukan sayatan melalui perineum, fossa ischi langsung ke
prostate.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 42.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -24.0pt;">
<!--[if !supportLists]--><span lang="IN">3.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Endorologi
transurethral<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l7 level2 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Transurethral
resection prostatectomy (TUR-P)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l7 level2 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Transurethral
laser prostatectomy (TUL-P)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l7 level2 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">Transutretral
incision of the prostate (TUP)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify; text-indent: .25in;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l3 level1 lfo5; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">8.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">ASUHAN KEPERAWATAN<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l3 level3 lfo5; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">A.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">Pengkajian fokus<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;">
<span lang="IN"> 1. Identitas klien<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; text-align: justify;">
<span lang="IN">Jenis kelamin laki-laki, umur
>50 thn, banyak dijumpai pada bangsa / ras caucasian <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;">
<span lang="IN"> 2. Keluhan utama<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; text-align: justify;">
<span lang="IN">Nyeri berhubungan denga spasme
buli-buli<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;">
<span lang="IN"> 3. riwayat penyakit sekarang<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; text-align: justify;">
<span lang="IN">LUTS (hesitansi, pancaran
urine lemah, intermitensi, terminal dribbing, terasa ada sisa setelah miksi,
urgensi, frekuensi dan disuria)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify; text-indent: .25in;">
<span lang="IN">4. Riwayat
penyakit dahulu<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; text-align: justify;">
<span lang="IN">DM (diabetes mellitus),
hipertensi, PPOM (penyakit paru obstruksi menahun), jantung koroner,
decompensasi cordis dan gangguan faal darah<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">5. Riwayat penyakit keluarga<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">penyakit keturunan
(hipertensi,DM, ashma)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">6. Riwayat psikososial<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">emosi, kecemasan,
gangguan konsep diri<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">7. Pola hidup sehari-hari<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">a. Pola nutrisi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; text-align: justify;">
<span lang="IN">Puasa sebelum operasi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">b. Pola eliminsi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 60.0pt; text-align: justify;">
<span lang="IN">Hematuri setelah tindakan TUR,
retensi urine karena bekuan darah pada kateter, inkontinensia urine setelah
kateter dilepas<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">c. Pola
istirahat/tidur<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 24.0pt;">
<span lang="IN">Hospitalisasi
mempengaruhi pola tidur<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 12.0pt;">
<span lang="IN">d. Pola aktivitas<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 24.0pt;">
<span lang="IN">Keterbatasan
aktivitas karena kelemahan, terpasang traksi kateter<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<span lang="IN">8. Pemeriksaan fisik<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l7 level3 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">a.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Keadaan umum.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: 30.0pt;">
<span lang="IN">Keadaan lemah,
kesadaran baik, perlu adanya observasi TTV<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l7 level3 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">b.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Sistem pernafasan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; text-align: justify; text-indent: .25in;">
<span lang="IN">SAB tidak
mempengaruhi pernafasan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l7 level3 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">c.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Sistem sirkulasi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; text-align: justify;">
<span lang="IN">Tekanan darah biasa meningkat
atau menurun, cek HB (adanya perdarahan animea), observasi balance cairan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l7 level3 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">d.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Sistem neurologi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; text-align: justify; text-indent: .25in;">
<span lang="IN">Daerah
caudal mengalami kelumpuhan dan mati rasa akibat SAB <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l7 level3 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">e.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">System gastrointestinal<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; text-align: justify;">
<span lang="IN">Pusing, mual, muntah akibat
SAB, bising usus menurun dan terdapat masa abdomen<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l7 level3 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">f.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">System urogenital<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; text-align: justify;">
<span lang="IN">Hematuri, retensi urine
(daerah supra sinisfer menonjol, terdapat ballottement jika dipalpasi dan klien
ingin kencing)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 66.0pt; mso-list: l7 level3 lfo4; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">g.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">system muskuluskeletal<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 48.0pt; text-align: justify; text-indent: .25in;">
<span lang="IN">Klien tidak
boleh fleksi selam traksi kateter masih diperlukan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l3 level3 lfo5; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">B.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">Diagnosa keperawatan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l1 level1 lfo8; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">1.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Nyeri akut b/d distensi kandung kencing<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l1 level1 lfo8; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">2.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Retens urine b/d pembesaran prostate<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l1 level1 lfo8; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">3.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Resiko kekurangan volume cairan b/d
ketidak seimbangan elektrolit<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l1 level1 lfo8; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">4.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Perubahan eliminasi urine b/d pemasangan
kateter<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l1 level1 lfo8; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">5.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Resiko infeksi b/d pemasangan kateter<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l1 level1 lfo8; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">6.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Resiko disfungsi seksual b/d keterlibatan
area genital<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l1 level1 lfo8; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">7.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Kurang penmgetahuan pasca operasi TURP b/d
kurang terpaparnya informasi.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: -48.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l3 level3 lfo5; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="IN">C.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="IN">Rencana keperawatan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">1.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="IN">Nyeri akut b/d distensi kandung kemih<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-align: justify;">
<span lang="IN">Tujuan : setelah dilakukan
tindakan keperawatan selama 2x24 jam klien dapat mengontrol nyeri<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 78.0pt; text-align: justify; text-indent: -24.0pt;">
<span lang="IN">Kriteria
hasil :<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l7 level2 lfo4; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">klien
mengatakan nyeri berkurang / nyeri dapat terkontrol<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l7 level2 lfo4; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">skala
nyeri 1-0<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l7 level2 lfo4; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">wajah
rileks<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l7 level2 lfo4; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">TTV
dalam batas normal<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-align: justify;">
<span lang="IN">Intervensi:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l7 level2 lfo4; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">pertahankan
klien untuk tirah baring<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l7 level2 lfo4; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">beriakn
tindakan kenyamanan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l7 level2 lfo4; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">pasang
kateter untuk kelancaran drainase<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l7 level2 lfo4; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span lang="IN">kolaborasi
medis dalam pemberian obat<o:p></o:p></span></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com1tag:blogger.com,1999:blog-4511732320299108871.post-61079647362899386222015-01-17T19:54:00.001-08:002015-01-17T19:54:33.611-08:00LAPORAN PENDAHULUAN MENINGITIS<div class="MsoTitle">
LAPORAN PENDAHULUAN MENINGITIS</div>
<div class="MsoTitle">
<br /></div>
<div class="MsoTitle">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Defenisi<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Meningitis
adalah radang dari selaput otak (arachnoid dan piamater). Bakteri dan virus
merupakan penyebab utama dari meningitis.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Patofisiologi<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Otak
dilapisi oleh tiga lapisan, yaitu : duramater, arachnoid, dan piamater. Cairan
otak dihasilkan di dalam pleksus choroid ventrikel bergerak / mengalir melalui
sub arachnoid dalam sistem ventrikuler dan seluruh otak dan sumsum tulang
belakang, direabsorbsi melalui villi arachnoid yang berstruktur seperti
jari-jari di dalam lapisan subarachnoid.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Organisme
(virus / bakteri) yang dapat menyebabkan meningitis, memasuki cairan otak
melaui aliran darah di dalam pembuluh darah otak. Cairan hidung (sekret hidung)
atau sekret telinga yang disebabkan oleh fraktur tulang tengkorak dapat
menyebabkan meningitis karena hubungan langsung antara cairan otak dengan
lingkungan (dunia luar), mikroorganisme yang masuk dapat berjalan ke cairan
otak melalui ruangan subarachnoid. Adanya mikroorganisme yang patologis
merupakan penyebab peradangan pada piamater, arachnoid, cairan otak dan
ventrikel. Eksudat yang dibentuk akan menyebar, baik ke kranial maupun ke saraf
spinal yang dapat menyebabkan kemunduran neurologis selanjutnya, dan eksudat
ini dapat menyebabkan sumbatan aliran normal cairan otak dan dapat menyebabkan
hydrocephalus.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Etiologi<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Meningitis
disebabkan oleh berbagai macam organisme, tetapi kebanyakan pasien dengan
meningitis mempunyai faktor predisposisi seperti fraktur tulang tengkorak,
infeksi, operasi otak atau sum-sum tulang belakang. Seperti disebutkan diatas
bahwa meningitis itu disebabkan oleh virus dan bakteri, maka meningitis dibagi
menjadi dua bagian besar yaitu : meningitis purulenta dan meningitis serosa.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningitis
Bakteri<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Bakteri
yang paling sering menyebabkan meningitis adalah haemofilus influenza,
Nersseria,Diplokokus pnemonia, Sterptokokus group A, Stapilokokus Aurens,
Eschericia colli, Klebsiela dan Pseudomonas. Tubuh akan berespon terhadap
bakteri sebagai benda asing dan berespon dengan terjadinya peradangan dengan adanya
neutrofil, monosit dan limfosit. Cairan eksudat yang terdiri dari bakteri,
fibrin dan lekosit terbentuk di ruangan subarahcnoid ini akan terkumpul di
dalam cairan otak sehingga dapat menyebabkan lapisan yang tadinya tipis menjadi
tebal. Dan pengumpulan cairan ini akan menyebabkan peningkatan intrakranial.
Hal ini akan menyebabkan jaringan otak akan mengalami infark.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningitis
Virus<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Tipe
dari meningitis ini sering disebut aseptik meningitis. Ini biasanya disebabkan
oleh berbagai jenis penyakit yang disebabkan oleh virus, seperti; gondok,
herpez simplek dan herpez zoster. Eksudat yang biasanya terjadi pada meningitis
bakteri tidak terjadi pada meningitis virus dan tidak ditemukan organisme pada
kultur cairan otak. Peradangan terjadi pada seluruh koteks cerebri dan lapisan
otak. Mekanisme atau respon dari jaringan otak terhadap virus bervariasi
tergantung pada jenis sel yang terlibat.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pencegahan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Meningitis
dapat dicegah dengan cara mengenali dan mengerti dengan baik faktor presdis
posisi seperti otitis media atau infeksi saluran napas (seperti TBC) dimana
dapat menyebabkan meningitis serosa. Dalam hal ini yang paling penting adalah
pengobatan tuntas (antibiotik) walaupun gejala-gejala infeksi tersebut telah
hilang.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Setelah terjadinya meningitis penanganan yang sesuai
harus cepat diatasi. Untuk mengidentifikasi faktor atau janis organisme
penyebab dan dengan cepat memberikan terapi sesuai dengan organisme penyebab
untuk melindungi komplikasi yang serius.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pengkajian
Pasien dengan meningitis<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Riwayat penyakit dan pengobatan<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Faktor
riwayat penyakit sangat penting diketahui karena untuk mengetahui jenis kuman
penyebab. Disini harus ditanya dengan jelas tentang gejala yang timbul seperti
kapan mulai serangan, sembuh atau bertambah buruk. Setelah itu yang perlu
diketahui adalah status kesehatan masa lalu untuk mengetahui adanya faktor
presdiposisi seperti infeksi saluran napas, atau fraktur tulang tengkorak, dll.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Manifestasi
Klinik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pada awal penyakit,
kelelahan, perubahan daya mengingat, perubahan tingkah laku.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sesuai dengan cepatnya
perjalanan penyakit pasien menjadi stupor.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sakit kepala<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sakit-sakit pada otot-otot<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Reaksi pupil terhadap
cahaya. Photofobia apabila cahaya diarahkan pada mata pasien<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Adanya disfungsi pada saraf
III, IV, dan VI<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pergerakan motorik pada masa
awal penyakit biasanya normal dan pada tahap lanjutan bisa terjadi hemiparese,
hemiplegia, dan penurunan tonus otot.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Refleks Brudzinski dan
refleks Kernig (+) pada bakterial meningitis dan tidak terdapat pada virus
meningitis.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Nausea<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Vomiting<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Demam<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Takikardia<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kejang yang bisa disebabkan
oleh iritasi dari korteks cerebri atau hiponatremia<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien merasa takut dan
cemas.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemeriksaan
Laboratorium<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Pemeriksaan
laboratorium yang khas pada meningitis adalah analisa cairan otak. Lumbal
punksi tidak bisa dikerjakan pada pasien dengan peningkatan tekanan tintra
kranial. Analisa cairan otak diperiksa untuk jumlah sel, protein, dan
konsentrasi glukosa.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemeriksaan darah ini terutama jumlah sel darah
merah yang biasanya meningkat diatas nilai normal.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Serum
elektrolit dan serum glukosa dinilai untuk mengidentifikasi adanya
ketidakseimbangan elektrolit terutama hiponatremi.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kadar glukosa darah dibandingkan dengan kadar
glukosa cairan otak. Normalnya kadar glukosa cairan otak adalah 2/3 dari nilai
serum glukosa dan pada pasien meningitis kadar glukosa cairan otaknya menurun
dari nilai normal.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemeriksaan
Radiografi<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> CT-Scan
dilakukan untuk menentukan adanya edema cerebral atau penyakit saraf lainnya.
Hasilnya biasanya normal, kecuali pada penyakit yang sudah sangat parah.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pengobatan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pengobatab biasanya diberikan antibiotik yang paling
sesuai.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Untuk setiap
mikroorganisme penyebab meningitis :<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 110.7pt;" valign="top" width="148">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Antibiotik<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 110.7pt;" valign="top" width="148">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Organisme<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 110.7pt;" valign="top" width="148">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 110.7pt;" valign="top" width="148">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 110.7pt;" valign="top" width="148">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penicilin G<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gentamicyn<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Chlorampenikol<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 110.7pt;" valign="top" width="148">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumoccocci<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningoccocci<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Streptoccocci<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Klebsiella<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pseudomonas<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Proleus<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Haemofilus Influenza<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 110.7pt;" valign="top" width="148">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Terapi TBC<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Streptomicyn<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INH<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PAS<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 110.7pt;" valign="top" width="148">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Micobacterium Tuber culosis<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diagnosa
Keperawatan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diagnosa keperawatan yang mungkin timbul adalah :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><i><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan perfusi jaringan sehubungan dengan
peningkatan tekanan intrakranial</span></i></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tujuan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien kembali pada,keadaan
status neurologis sebelum sakit<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatnya kesadaran
pasien dan fungsi sensoris<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kriteria hasil<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tanda-tanda vital dalam
batas normal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasa sakit kepala berkurang<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kesadaran meningkat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Adanya peningkatan kognitif
dan tidak ada atau hilangnya tanda-tanda tekanan intrakranial yang meningkat.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rencana Tindakan<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI<o:p></o:p></span></b></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">RASIONALISASI<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien bed rest total dengan posisi tidur
terlentang tanpa bantal<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Perubahan pada tekanan intakranial akan dapat
meyebabkan resiko untuk terjadinya herniasi otak<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tanda-tanda status neurologis dengan GCS.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Dapat mengurangi kerusakan otak lebih lanjt<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tanda-tanda vital seperti TD, Nadi, Suhu,
Resoirasi dan hati-hati pada hipertensi sistolik<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pada keadaan normal autoregulasi mempertahankan
keadaan tekanan darah sistemik berubah secara fluktuasi. Kegagalan
autoreguler akan menyebabkan kerusakan vaskuler cerebral yang dapat
dimanifestasikan dengan peningkatan sistolik dan diiukuti oleh penurunan
tekanan diastolik. Sedangkan peningkatan suhu dapat menggambarkan perjalanan
infeksi.<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan output<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">hipertermi dapat menyebabkan peningkatan IWL dan
meningkatkan resiko dehidrasi terutama pada pasien yang tidak sadra, nausea
yang menurunkan intake per oral<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu pasien untuk membatasi muntah, batuk.
Anjurkan pasien untuk mengeluarkan napas apabila bergerak atau berbalik di
tempat tidur.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Aktifitas ini dapat meningkatkan tekanan
intrakranial dan intraabdomen. Mengeluarkan napas sewaktu bergerak atau
merubah posisi dapat melindungi diri dari efek valsava<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kolaborasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan cairan perinfus dengan perhatian ketat.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meminimalkan fluktuasi pada beban vaskuler dan
tekanan intrakranial, vetriksi cairan dan cairan dapat menurunkan edema
cerebral<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor AGD bila diperlukan pemberian oksigen<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Adanya kemungkinan asidosis disertai dengan
pelepasan oksigen pada tingkat sel dapat menyebabkan terjadinya iskhemik
serebral<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan terapi sesuai advis dokter seperti:
Steroid, Aminofel, Antibiotika.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Terapi yang diberikan dapat menurunkan
permeabilitas kapiler.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menurunkan edema serebri<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menurunka metabolik sel / konsumsi dan kejang.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><i><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sakit kepala sehubungan dengan adanya iritasi
lapisan otak</span></i></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tujuan<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien terlihat rasa sakitnya berkurang / rasa sakit
terkontrol<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kriteria evaluasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien dapat tidur dengan tenang<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Memverbalisasikan penurunan
rasa sakit.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rencana Tindakan <o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI<o:p></o:p></span></b></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">RASIONALISASI<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Independent<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usahakan membuat lingkungan yang aman dan tenang<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menurukan reaksi terhadap rangsangan ekternal atau
kesensitifan terhadap cahaya dan menganjurkan pasien untuk beristirahat<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kompres dingin (es) pada kepala dan kain dingin
pada mata<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Dapat menyebabkan vasokontriksi pembuluh darah
otak<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Lakukan latihan gerak aktif atau pasif sesuai
kondisi dengan lembut dan hati-hati<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Dapat membantu relaksasi otot-otot yang tegang dan
dapat menurunkan rasa sakit / disconfort<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kolaborasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat analgesik<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mungkin diperlukan untuk menurunkan rasa sakit.
Catatan : Narkotika merupakan kontraindikasi karena berdampak pada status
neurologis sehingga sukar untuk dikaji.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><i><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potensial terjadinya injuri sehubungan dengan adanya
kejang, perubahan status mental dan penurunan tingkat kesadaran</span></i></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tujuan:<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien bebas dari injuri yang disebabkan oleh kejang
dan penurunan kesadaran<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rencana Tindakan <o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI<o:p></o:p></span></b></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">RASIONALISASI<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Independent<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">monitor kejang pada tangan, kaki, mulut dan
otot-otot muka lainnya<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gambaran tribalitas sistem saraf pusat memerlukan
evaluasi yang sesuai dengan intervensi yang tepat untuk mencegah terjadinya
komplikasi.<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Persiapkan lingkungan yang aman seperti batasan ranjang,
papan pengaman, dan alat suction selalu berada dekat pasien.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Melindungi pasien bila kejang terjadi<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pertahankan bedrest total selama fae akut<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mengurangi resiko jatuh / terluka jika vertigo,
sincope, dan ataksia terjadi<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kolaborasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan terapi sesuai advis dokter seperti;
diazepam, phenobarbital, dll.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0in 5.4pt 0in 5.4pt; width: 243.0pt;" valign="top" width="324">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Untuk mencegah atau mengurangi kejang.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catatan : Phenobarbital dapat menyebabkan
respiratorius depresi dan sedasi.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><u><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">DAFTAR
KEPUSTAKAAN<o:p></o:p></span></u></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Donnad, Medical Surgical
Nursing, WB Saunders, 1991<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kapita Selekta Kedokteran
FKUI, Media Aesculapius, 1982<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin-left: .1in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.1in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Brunner / Suddarth, Medical
Surgical Nursing, JB Lippincot Company, Philadelphia, 1984<o:p></o:p></span></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-89679236484460721322015-01-17T19:14:00.000-08:002015-01-17T19:14:19.780-08:00CIDERA OTAK SEDANG (COR)<div class="MsoTitle">
<span style="font-size: 14.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 16.0pt;">LAPORAN
PENDAHULUAN<o:p></o:p></span></div>
<div class="MsoTitle">
<br /></div>
<div class="MsoTitle">
<span style="font-size: 14.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 16.0pt;">CEDERA OTAK
SEDANG <o:p></o:p></span></div>
<div class="MsoTitle">
<br /></div>
<div class="MsoTitle">
<br /></div>
<div class="MsoNormal" style="margin-left: 17.85pt; mso-list: l0 level1 lfo1; tab-stops: list .25in; text-indent: -17.85pt;">
<!--[if !supportLists]--><b>A.<span style="font-size: 7pt; font-stretch: normal; font-weight: normal;">
</span></b><!--[endif]--><b>Pengertian Cedera Kepala Sedang (COS):<o:p></o:p></b></div>
<div class="MsoNormal" style="text-indent: .5in;">
Cidera kepala adalah suatu gangguan
traumatik dari fungsi otak yang disertai atau tanpa disertai perdarahan
interstiil dalam substansi otak tanpa diikuti terputusnya kontinuitas otak.</div>
<div class="MsoNormal" style="text-indent: .5in;">
Cedera kepala yaitu adanya
deformitas berupa penyimpangan bentuk atau penyimpangan garis pada tulang
tengkorak, percepatan dan perlambatan (accelerasi – descelarasi) yang merupakan
perubahan bentuk dipengaruhi oleh perubahan peningkatan pada percepatan factor
dan penurunan percepatan, serta rotasi yaitu pergerakan pada kepala dirasakan
juga oleh otak sebagai akibat perputaran pada tindakan pencegahan.</div>
<div class="MsoNormal" style="text-indent: .5in;">
Cedera kepala pada dasarnya dikenal
dua macam mekanisme trauma yang mengenai kepala yakni benturan dan goncangan
(Gernardli and Meany, 1996).</div>
<div class="MsoNormal" style="text-indent: .5in;">
Berdasarkan GCS maka cidera kepala
dapat dibagi menjadi 3 gradasi yaitu cidera kepala derajat ringan, bila GCS :
13 – 15, Cidera kepala derajat sedang, bila GCS : 9 – 12, Cidera kepala berat,
bila GCS kuang atau sama dengan 8. Pada penderita yang tidak dapat dilakukan
pemeriksaan misal oleh karena aphasia, maka reaksi verbal diberi tanda “X”,
atau oleh karena kedua mata edema berat sehingga tidak dapat di nilai reaksi
membuka matanya maka reaksi membuka mata diberi nilai “X”, sedangkan jika
penderita dilakukan traheostomy ataupun dilakukan intubasi maka reaksi verbal
diberi nilai “T”.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>Cedera Kepala Sedang (COS):<o:p></o:p></b></div>
<div class="MsoNormal">
- GCS 9 – 12</div>
<div class="MsoNormal">
- Saturasi oksigen > 90 %</div>
<div class="MsoNormal">
- Tekanan darah systale > 100
mm Hg</div>
<br />
<div class="MsoNormal">
- Lama kejadian < 8 jam<b><o:p></o:p></b></div>
<div class="MsoNormal">
<b>PATOFISIOLOGI<o:p></o:p></b></div>
<div class="MsoNormal">
<!--[if gte vml 1]><v:line id="_x0000_s1028"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251663872'
from="3in,14.4pt" to="246pt,41.4pt">
<v:stroke dashstyle="1 1" endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 43px; left: 0px; margin-left: 283px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 46px; z-index: 251663872;"><img height="43" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1028" width="46" /></span><!--[endif]-->Cidera Kepala TIK - Oedem</div>
<div class="MsoNormal">
<!--[if gte vml 1]><v:line id="_x0000_s1031"
style='position:absolute;left:0;text-align:left;z-index:251666944' from="30pt,2.7pt"
to="30pt,74.7pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 99px; left: 0px; margin-left: 34px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251666944;"><img height="99" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1031" width="12" /></span><!--[endif]--> - Hematom</div>
<div class="MsoNormal">
<!--[if gte vml 1]><v:line
id="_x0000_s1053" style='position:absolute;left:0;text-align:left;z-index:251689472'
from="186pt,12.45pt" to="186pt,48.45pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 51px; left: 0px; margin-left: 242px; margin-top: 16px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251689472;"><img height="51" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image003.gif" v:shapes="_x0000_s1053" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1030"
style='position:absolute;left:0;text-align:left;flip:x y;z-index:251665920'
from="222pt,18pt" to="246pt,45pt">
<v:stroke dashstyle="1 1" endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 42px; left: 0px; margin-left: 291px; margin-top: 19px; mso-ignore: vglayout; position: absolute; width: 38px; z-index: 251665920;"><img height="42" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1030" width="38" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1029"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251664896'
from="3in,9pt" to="246pt,9pt">
<v:stroke dashstyle="1 1" endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 286px; margin-top: 6px; mso-ignore: vglayout; position: absolute; width: 43px; z-index: 251664896;"><img height="12" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1029" width="43" /></span><!--[endif]--> Respon
Biologi Hypoxemia</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Kelainan
Metabolisme</div>
<div class="MsoNormal">
<!--[if gte vml 1]><v:line id="_x0000_s1027"
style='position:absolute;left:0;text-align:left;z-index:251662848' from="3in,19.8pt"
to="3in,46.8pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 282px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251662848;"><img height="39" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1027" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1026"
style='position:absolute;left:0;text-align:left;z-index:251661824' from="96pt,9pt"
to="156pt,9pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 127px; margin-top: 6px; mso-ignore: vglayout; position: absolute; width: 83px; z-index: 251661824;"><img height="12" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image007.gif" v:shapes="_x0000_s1026" width="83" /></span><!--[endif]-->Cidera Otak Primer Cidera Otak Sekunder</div>
<div class="MsoNormal">
Komotio</div>
<div class="MsoNormal">
<!--[if gte vml 1]><v:line id="_x0000_s1052"
style='position:absolute;left:0;text-align:left;z-index:251688448' from="54pt,5.4pt"
to="150pt,5.4pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 71px; margin-top: 1px; mso-ignore: vglayout; position: absolute; width: 131px; z-index: 251688448;"><img height="12" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image008.gif" v:shapes="_x0000_s1052" width="131" /></span><!--[endif]-->Kontutio</div>
<div class="MsoNormal">
<!--[if gte vml 1]><v:line id="_x0000_s1034"
style='position:absolute;left:0;text-align:left;z-index:251670016' from="204pt,16.6pt"
to="318pt,52.6pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 55px; left: 0px; margin-left: 271px; margin-top: 21px; mso-ignore: vglayout; position: absolute; width: 156px; z-index: 251670016;"><img height="55" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image009.gif" v:shapes="_x0000_s1034" width="156" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1033"
style='position:absolute;left:0;text-align:left;z-index:251668992' from="204pt,16.6pt"
to="204pt,52.6pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 51px; left: 0px; margin-left: 266px; margin-top: 21px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251668992;"><img height="51" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image003.gif" v:shapes="_x0000_s1033" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1032"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251667968'
from="54pt,16.6pt" to="204pt,43.6pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 43px; left: 0px; margin-left: 69px; margin-top: 21px; mso-ignore: vglayout; position: absolute; width: 204px; z-index: 251667968;"><img height="43" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image010.gif" v:shapes="_x0000_s1032" width="204" /></span><!--[endif]-->Lateratio Kerusakan Sel Otak <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"></span></div>
<div class="MsoFooter">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<!--[if gte vml 1]><v:line
id="_x0000_s1037" style='position:absolute;left:0;text-align:left;z-index:251673088'
from="324pt,12.45pt" to="324pt,39.45pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 426px; margin-top: 16px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251673088;"><img height="39" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1037" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1036"
style='position:absolute;left:0;text-align:left;z-index:251672064' from="42pt,12.45pt"
to="42pt,39.45pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 50px; margin-top: 16px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251672064;"><img height="39" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1036" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1035"
style='position:absolute;left:0;text-align:left;z-index:251671040' from="204pt,12.45pt"
to="204pt,39.45pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 266px; margin-top: 16px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251671040;"><img height="39" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1035" width="12" /></span><!--[endif]-->Gangguan Autoregulasi <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"></span> Rangsangan Simpatis Stress</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<!--[if gte vml 1]><v:line
id="_x0000_s1038" style='position:absolute;left:0;text-align:left;z-index:251674112'
from="42pt,18.25pt" to="42pt,54.25pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 51px; left: 0px; margin-left: 50px; margin-top: 23px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251674112;"><img height="51" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image003.gif" v:shapes="_x0000_s1038" width="12" /></span><!--[endif]-->Aliran Darah Keotak <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">¯</span> <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"></span> Tahanan Vaskuler <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"></span> Katekolamin</div>
<div class="MsoNormal">
<!--[if gte vml 1]><v:line
id="_x0000_s1040" style='position:absolute;left:0;text-align:left;z-index:251676160'
from="330pt,16.05pt" to="330pt,34.05pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; left: 0px; margin-left: 434px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251676160;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image011.gif" v:shapes="_x0000_s1040" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1039"
style='position:absolute;left:0;text-align:left;z-index:251675136' from="204pt,16.05pt"
to="204pt,34.05pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; left: 0px; margin-left: 266px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251675136;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image011.gif" v:shapes="_x0000_s1039" width="12" /></span><!--[endif]--> Sistemik
& TD <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"></span> <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"></span> Sekresi Asam Lambung</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
O2 <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">¯</span> <span style="font-family: Wingdings; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Wingdings;">à</span> Ggan Metabolisme <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">¯</span> Tek. Pemb.Darah Mual, Muntah</div>
<div class="MsoNormal">
<!--[if gte vml 1]><v:line
id="_x0000_s1043" style='position:absolute;left:0;text-align:left;z-index:251679232'
from="330pt,1.65pt" to="330pt,28.65pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 434px; margin-top: 1px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251679232;"><img height="39" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1043" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1042"
style='position:absolute;left:0;text-align:left;z-index:251678208' from="204pt,10.65pt"
to="204pt,37.65pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 266px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251678208;"><img height="39" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1042" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1041"
style='position:absolute;left:0;text-align:left;z-index:251677184' from="42pt,1.65pt"
to="42pt,28.65pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 50px; margin-top: 1px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251677184;"><img height="39" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1041" width="12" /></span><!--[endif]--> Pulmonal</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<!--[if gte vml 1]><v:line
id="_x0000_s1046" style='position:absolute;left:0;text-align:left;z-index:251682304'
from="204pt,17.7pt" to="204pt,35.7pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; left: 0px; margin-left: 266px; margin-top: 23px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251682304;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image011.gif" v:shapes="_x0000_s1046" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1044"
style='position:absolute;left:0;text-align:left;z-index:251680256' from="36pt,17.7pt"
to="36pt,35.7pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; left: 0px; margin-left: 42px; margin-top: 23px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251680256;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image011.gif" v:shapes="_x0000_s1044" width="12" /></span><!--[endif]-->Asam Laktat <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"></span> <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"></span> Tek. Hidrostatik Asupan Nutrisi Kurang</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<!--[if gte vml 1]><v:line
id="_x0000_s1047" style='position:absolute;left:0;text-align:left;z-index:251683328'
from="204pt,14.5pt" to="204pt,32.5pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; left: 0px; margin-left: 266px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251683328;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image011.gif" v:shapes="_x0000_s1047" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1045"
style='position:absolute;left:0;text-align:left;z-index:251681280' from="36pt,14.5pt"
to="36pt,41.5pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 42px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251681280;"><img height="39" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1045" width="12" /></span><!--[endif]-->Oedem Otak Kebocoran Cairan Kapiler</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<!--[if gte vml 1]><v:line
id="_x0000_s1051" style='position:absolute;left:0;text-align:left;z-index:251687424'
from="5in,10.8pt" to="5in,37.8pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 474px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251687424;"><img height="39" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1051" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1050"
style='position:absolute;left:0;text-align:left;z-index:251686400' from="348pt,10.8pt"
to="5in,10.8pt"/><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 463px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 18px; z-index: 251686400;"><img height="2" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1050" width="18" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1048"
style='position:absolute;left:0;text-align:left;z-index:251684352' from="204pt,12.55pt"
to="204pt,30.55pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; left: 0px; margin-left: 266px; margin-top: 16px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251684352;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image011.gif" v:shapes="_x0000_s1048" width="12" /></span><!--[endif]-->Ggan Perfusi Jaringan Oedema Paru <span style="font-family: Wingdings; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Wingdings;">à</span>
Cardiac Out Put <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">¯</span>
</div>
<div class="MsoNormal">
Cerebral</div>
<div class="MsoNormal" style="margin-left: 168.0pt; tab-stops: 168.0pt 312.0pt;">
<!--[if gte vml 1]><v:line
id="_x0000_s1049" style='position:absolute;left:0;text-align:left;z-index:251685376'
from="204pt,18.35pt" to="204pt,36.35pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; left: 0px; margin-left: 266px; margin-top: 23px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251685376;"><img height="27" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1049" width="12" /></span><!--[endif]-->Difusi O2 Terhambat Ggan Perfusi Jaringan</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">Gangguan Pola Napas </span><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Wingdings;">à</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">
Hipoksemia, Hiperkapnea</span></div>
<div class="MsoNormal">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span></div>
<div class="MsoNormal">
<b>Perdarahan yang sering ditemukan:<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l1 level1 lfo2; tab-stops: list .25in left 3.5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><b>Epidural Hematom:<o:p></o:p></b></div>
<div class="MsoNormal">
Terdapat pengumpulan darah diantara tulang tengkorak dan
duramater akibat pecahnya pembuluh darah/cabang-cabang arteri meningeal media
yang terdapat di duramater, pembuluh darah ini tidak dapat menutup sendiri
karena itu sangat berbahaya. Dapat terjadi dalam beberapa jam sampai 1 – 2
hari. Lokasi yang paling sering yaitu dilobus temporalis dan parietalis.</div>
<div class="MsoNormal">
Tanda dan gejala: </div>
<div class="MsoNormal">
penurunan tingkat kesadaran, nyeri kepala, muntah,
hemiparesa. Dilatasi pupil ipsilateral, pernapasan dalam dan cepat kemudian
dangkal, irreguler, penurunan nadi, peningkatan suhu.</div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l1 level1 lfo2; tab-stops: list .25in left 3.5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><b>Subdural Hematoma<o:p></o:p></b></div>
<div class="MsoNormal">
Terkumpulnya darah antara duramater dan jaringan otak, dapat
terjadi akut dan kronik. Terjadi akibat pecahnya pembuluh darah vena/jembatan
vena yang biasanya terdapat diantara duramater, perdarahan lambat dan sedikit.
Periode akut terjadi dalam 48 jam – 2 hari atau 2 minggu dan kronik dapat
terjadi dalam 2 minggu atau beberapa bulan. </div>
<div class="MsoNormal">
Tanda dan gejala: </div>
<div class="MsoNormal">
Nyeri kepala, bingung, mengantuk, menarik diri, berfikir
lambat, kejang dan edema pupil.</div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l1 level1 lfo2; tab-stops: list .25in left 3.5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><b>Perdarahan Intraserebral <o:p></o:p></b></div>
<div class="MsoNormal">
Perdarahan di jaringan otak karena pecahnya pembuluh darah
arteri, kapiler, vena.</div>
<div class="MsoNormal">
Tanda dan gejala: </div>
<div class="MsoNormal">
Nyeri kepala, penurunan kesadaran, komplikasi pernapasan,
hemiplegi kontralateral, dilatasi pupil, perubahan tanda-tanda vital.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l1 level1 lfo2; tab-stops: list .25in left 3.5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><b>Perdarahan Subarachnoid:<o:p></o:p></b></div>
<div class="MsoNormal">
Perdarahan didalam rongga subarachnoid akibat robeknya
pembuluh darah dan permukaan otak, hampir selalu ada pada cedera kepala yang
hebat.</div>
<div class="MsoNormal">
Tanda dan gejala:</div>
<div class="MsoNormal" style="margin-left: .5in;">
Nyeri kepala, penurunan kesadaran,
hemiparese, dilatasi pupil ipsilateral dan kaku kuduk.</div>
<div class="MsoNormal">
<b>Penatalaksanaan: <o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: .25in; tab-stops: 3.5in;">
<b>Konservatif<o:p></o:p></b></div>
<div class="MsoNormal">
</div>
<ul style="margin-top: 0in;" type="disc">
<li class="MsoNormal">Bedrest
total </li>
<li class="MsoNormal">Pemberian
obat-obatan</li>
<li class="MsoNormal">Observasi
tanda-tanda vital dan tingkat kesadaran.</li>
</ul>
<div>
<div class="Section1">
<div class="MsoTitle">
Pengkajian</div>
<div class="MsoNormal">
<b>BREATHING<o:p></o:p></b></div>
<div class="MsoNormal">
Kompresi pada batang otak akan mengakibatkan gangguan irama
jantung, sehingga terjadi perubahan pada pola napas, kedalaman, frekuensi
maupun iramanya, bisa berupa Cheyne Stokes atau Ataxia breathing. Napas
berbunyi, stridor, ronkhi, wheezing ( kemungkinana karena aspirasi), cenderung
terjadi peningkatan produksi sputum pada jalan napas.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>BLOOD:<o:p></o:p></b></div>
<div class="MsoNormal">
Efek peningkatan tekanan intrakranial terhadap tekanan darah
bervariasi. Tekanan pada pusat vasomotor akan meningkatkan transmisi rangsangan
parasimpatik ke jantung yang akan mengakibatkan denyut nadi menjadi lambat,
merupakan tanda peningkatan tekanan intrakranial. Perubahan frekuensi jantung
(bradikardia, takikardia yang diselingi dengan bradikardia, disritmia).</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>BRAIN<o:p></o:p></b></div>
<div class="MsoNormal">
Gangguan kesadaran merupakan salah satu bentuk manifestasi
adanya gangguan otak akibat cidera kepala. Kehilangan kesadaran sementara,
amnesia seputar kejadian, vertigo, sinkope, tinitus, kehilangan pendengaran,
baal pada ekstrimitas. Bila perdarahan hebat/luas dan mengenai batang otak akan
terjadi gangguan pada nervus cranialis, maka dapat terjadi : </div>
<ul style="margin-top: 0in;" type="disc">
<li class="MsoNormal">Perubahan
status mental (orientasi, kewaspadaan, perhatian, konsentrasi, pemecahan
masalah, pengaruh emosi/tingkah laku dan memori).</li>
<li class="MsoNormal">Perubahan
dalam penglihatan, seperti ketajamannya, diplopia, kehilangan sebagian
lapang pandang, foto fobia. </li>
<li class="MsoNormal">Perubahan
pupil (respon terhadap cahaya, simetri), deviasi pada mata. </li>
<li class="MsoNormal">Terjadi
penurunan daya pendengaran, keseimbangan tubuh. </li>
<li class="MsoNormal">Sering
timbul hiccup/cegukan oleh karena kompresi pada nervus vagus menyebabkan
kompresi spasmodik diafragma. </li>
<li class="MsoNormal">Gangguan
nervus hipoglosus. Gangguan yang tampak lidah jatuh kesalah satu sisi,
disfagia, disatria, sehingga kesulitan menelan. </li>
</ul>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>BLADER<o:p></o:p></b></div>
<div class="MsoNormal">
Pada cidera kepala sering terjadi gangguan berupa retensi,
inkontinensia uri, ketidakmampuan menahan miksi.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>BOWEL<o:p></o:p></b></div>
<div class="MsoNormal">
Terjadi penurunan fungsi pencernaan: bising usus lemah,
mual, muntah (mungkin proyektil), kembung dan mengalami perubahan selera.
Gangguan menelan (disfagia) dan terganggunya proses eliminasi alvi.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>BONE<o:p></o:p></b></div>
<div class="MsoNormal">
Pasien cidera kepala sering datang dalam keadaan parese,
paraplegi. Pada kondisi yang lama dapat terjadi kontraktur karena imobilisasi
dan dapat pula terjadi spastisitas atau ketidakseimbangan antara otot-otot
antagonis yang terjadi karena rusak atau putusnya hubungan antara pusat saraf
di otak dengan refleks pada spinal selain itu dapat pula terjadi penurunan
tonus otot.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>Pemeriksaan Diagnostik</b>:</div>
<ul style="margin-top: 0in;" type="disc">
<li class="MsoNormal">CT
Scan: tanpa/dengan kontras) mengidentifikasi adanya hemoragik, menentukan
ukuran ventrikuler, pergeseran jaringan otak.</li>
<li class="MsoNormal">Angiografi
serebral: menunjukkan kelainan sirkulasi serebral, seperti pergeseran
jaringan otak akibat edema, perdarahan, trauma.</li>
<li class="MsoNormal">X-Ray:
mendeteksi perubahan struktur tulang (fraktur), perubahan struktur garis
(perdarahan / edema), fragmen tulang.</li>
<li class="MsoNormal">Analisa
Gas Darah: medeteksi ventilasi atau masalah pernapasan (oksigenasi) jika
terjadi peningkatan tekanan intrakranial.</li>
<li class="MsoNormal">Elektrolit:
untuk mengkoreksi keseimbangan elektrolit sebagai akibat peningkatan
tekanan intrakranial.</li>
</ul>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>Prioritas perawatan:<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l3 level1 lfo5; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->memaksimalkan perfusi/fungsi otak</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l3 level1 lfo5; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->mencegah komplikasi</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l3 level1 lfo5; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->pengaturan fungsi secara optimal/mengembalikan ke
fungsi normal.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l3 level1 lfo5; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->mendukung proses pemulihan koping klien/keluarga</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l3 level1 lfo5; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->pemberian informasi tentang proses penyakit, prognosis,
rencana pengobatan, dan rehabilitasi.</div>
</div>
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-family: Arial; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<div class="Section2">
<div class="MsoSubtitle">
DIAGNOSA KEPERAWATAN:</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l2 level1 lfo2; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->Perubahan perfusi jaringan serebral berhubungan dengan
penghentian aliran darah (hemoragi, hematoma); edema cerebral; penurunan TD
sistemik/hipoksia (hipovolemia, disritmia jantung)</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l2 level1 lfo2; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->Resiko tinggi pola napas tidak efektif berhubungan
dengan kerusakan neurovaskuler (cedera pada pusat pernapasan otak). Kerusakan
persepsi atau kognitif. Obstruksi trakeobronkhial.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l2 level1 lfo2; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->Perubahan persepsi sensori berhubungan dengan perubahan
transmisi dan/atau integrasi (trauma atau defisit neurologis).</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l2 level1 lfo2; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->Perubahan proses pikir berhubungan dengan perubahan
fisiologis; konflik psikologis.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l2 level1 lfo2; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->Kerusakan mobilitas fisik berhubungan dengan kerusakan
persepsi atau kognitif. Penurunan kekuatan/tahanan. Terapi pembatasan
/kewaspadaan keamanan, misal: tirah baring, imobilisasi.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l2 level1 lfo2; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->6.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->Resiko tinggi terhadap infeksi berhubungan dengan
jaringan trauma, kulit rusak, prosedur invasif. Penurunan kerja silia, stasis
cairan tubuh. Kekurangan nutrisi. Respon inflamasi tertekan (penggunaan
steroid). Perubahan integritas sistem tertutup (kebocoran CSS)</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l2 level1 lfo2; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->7.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->Resiko tinggi terhadap perubahan nutrisi kurang dari
kebutuhan tubuh berhubungan dengan perubahan kemampuan untuk mencerna nutrien
(penurunan tingkat kesadaran). Kelemahan otot yang diperlukan untuk mengunyah,
menelan. Status hipermetabolik.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l2 level1 lfo2; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->8.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->Perubahan proses keluarga berhubungan dengan transisi
dan krisis situasional. Ketidak pastian tentang hasil/harapan.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l2 level1 lfo2; tab-stops: list 21.85pt left 3.5in; text-indent: -21.85pt;">
<!--[if !supportLists]-->9.<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->Kurang pengetahuan mengenai kondisi dan kebutuhan
pengobatan berhubungan dengan kurang pemajanan, tidak mengenal informasi.
Kurang mengingat/keterbatasan kognitif.</div>
<div class="MsoSubtitle">
<br /></div>
</div>
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-family: Arial; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<div class="Section3">
<div class="MsoSubtitle">
RENCANA TINDAKAN KEPERAWATAN</div>
<div class="MsoNormal" style="margin-left: 0in; mso-list: l5 level1 lfo6; tab-stops: list .15pt left 3.5in; text-indent: -17.85pt;">
<!--[if !supportLists]-->1)<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->Perubahan perfusi jaringan serebral berhubungan dengan
penghentian aliran darah (hemoragi, hematoma); edema cerebral; penurunan TD
sistemik/hipoksia (hipovolemia, disritmia jantung)</div>
<div class="MsoNormal">
Tujuan: </div>
<ul style="margin-top: 0in;" type="disc">
<li class="MsoNormal">Mempertahankan
tingkat kesadaran biasa/perbaikan, kognisi, dan fungsi motorik/sensorik.</li>
</ul>
<div class="MsoNormal">
Kriteria hasil: </div>
<ul style="margin-top: 0in;" type="disc">
<li class="MsoNormal">Tanda
vital stabil dan tidak ada tanda-tanda peningkatan TIK</li>
</ul>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 179.4pt;" valign="top" width="239">
<div class="MsoTitle">
Intervensi</div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 242.45pt;" valign="top" width="323">
<div class="MsoTitle">
Rasional</div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 179.4pt;" valign="top" width="239">
<div class="MsoNormal">
Tentukan faktor-faktor yg menyebabkan koma/penurunan perfusi jaringan
otak dan potensial peningkatan TIK.</div>
<div class="MsoNormal" style="margin-left: 0.25in;">
<br /></div>
<div class="MsoNormal">
Pantau /catat
status neurologis secara teratur dan bandingkan dengan nilai standar GCS. </div>
<div class="MsoNormal" style="margin-left: 0.25in;">
<br /></div>
<div class="MsoNormal">
Evaluasi
keadaan pupil, ukuran, kesamaan antara kiri dan kanan, reaksi terhadap
cahaya.</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">
Pantau
tanda-tanda vital: TD, nadi, frekuensi nafas, suhu.</div>
<div class="MsoNormal" style="margin-left: 0.25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.25in;">
<br /></div>
<div class="MsoNormal">
Pantau intake
dan out put, turgor kulit dan membran mukosa.</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">
Turunkan
stimulasi eksternal dan berikan kenyamanan, seperti lingkungan yang tenang.</div>
<div class="MsoNormal" style="margin-left: 0.25in;">
<br /></div>
<div class="MsoNormal">
Bantu pasien
untuk menghindari /membatasi batuk, muntah, mengejan.</div>
<div class="MsoNormal">
Tinggikan
kepala pasien 15-45 derajad sesuai indikasi/yang dapat ditoleransi.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Batasi
pemberian cairan sesuai indikasi.</div>
<div class="MsoNormal" style="margin-left: 0.25in;">
<br /></div>
<div class="MsoNormal">
Berikan oksigen
tambahan sesuai indikasi.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Berikan obat
sesuai indikasi, misal: diuretik, steroid, antikonvulsan, analgetik, sedatif,
antipiretik.</div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 242.45pt;" valign="top" width="323">
<div class="MsoNormal">
Penurunan
tanda/gejala neurologis atau kegagalan dalam pemulihannya setelah serangan
awal, menunjukkan perlunya pasien dirawat di perawatan intensif.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Mengkaji
tingkat kesadaran dan potensial peningkatan TIK dan bermanfaat dalam
menentukan lokasi, perluasan dan perkembangan kerusakan SSP.</div>
<div class="MsoNormal">
Reaksi pupil
diatur oleh saraf cranial okulomotor (III) berguna untuk menentukan apakah batang
otak masih baik. Ukuran/ kesamaan ditentukan oleh keseimbangan antara
persarafan simpatis dan parasimpatis. Respon terhadap cahaya mencerminkan
fungsi yang terkombinasi dari saraf kranial optikus (II) dan okulomotor
(III).</div>
<div class="MsoNormal">
Peningkatan TD
sistemik yang diikuti oleh penurunan TD diastolik (nadi yang membesar)
merupakan tanda terjadinya peningkatan TIK, jika diikuti oleh penurunan
kesadaran. Hipovolemia/hipertensi dapat mengakibatkan kerusakan/iskhemia
cerebral. Demam dapat mencerminkan kerusakan pada hipotalamus. Peningkatan
kebutuhan metabolisme dan konsumsi oksigen terjadi (terutama saat demam dan
menggigil) yang selanjutnya menyebabkan peningkatan TIK.</div>
<div class="MsoNormal">
Bermanfaat
sebagai indikator dari cairan total tubuh yang terintegrasi dengan perfusi
jaringan. Iskemia/trauma serebral dapat mengakibatkan diabetes insipidus.
Gangguan ini dapat mengarahkan pada masalah hipotermia atau pelebaran
pembuluh darah yang akhirnya akan berpengaruh negatif terhadap tekanan
serebral.</div>
<div class="MsoNormal">
Memberikan efek
ketenangan, menurunkan reaksi fisiologis tubuh dan meningkatkan istirahat
untuk mempertahankan atau menurunkan TIK.</div>
<div class="MsoNormal">
Aktivitas ini
akan meningkatkan tekanan intrathorak dan intraabdomen yang dapat
meningkatkan TIK.</div>
<div class="MsoNormal">
Meningkatkan
aliran balik vena dari kepala sehingga akan mengurangi kongesti dan oedema
atau resiko terjadinya peningkatan TIK.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Pembatasan
cairan diperlukan untuk menurunkan edema serebral, meminimalkan fluktuasi
aliran vaskuler TD dan TIK.</div>
<div class="MsoNormal">
Menurunkan
hipoksemia, yang mana dapat meningkatkan vasodilatasi dan volume darah serebral
yang meningkatkan TIK.</div>
<div class="MsoNormal">
Diuretik
digunakan pada fase akut untuk menurunkan air dari sel otak, menurunkan edema
otak dan TIK,. Steroid menurunkan inflamasi, yang selanjutnya menurunkan
edema jaringan. Antikonvulsan untuk mengatasi dan mencegah terjadinya
aktifitas kejang. Analgesik untuk menghilangkan nyeri . Sedatif digunakan
untuk mengendalikan kegelisahan, agitasi. Antipiretik menurunkan atau
mengendalikan demam yang mempunyai pengaruh meningkatkan metabolisme serebral
atau peningkatan kebutuhan terhadap oksigen.</div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: -17.85pt; tab-stops: 3.5in;">
<br /></div>
</div>
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<div class="MsoNormal" style="margin-left: 0in; mso-list: l5 level1 lfo6; tab-stops: list .15pt left 3.5in; text-indent: -17.85pt;">
<!--[if !supportLists]-->2)<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->Resiko tinggi pola napas tidak efektif berhubungan
dengan kerusakan neurovaskuler (cedera pada pusat pernapasan otak). Kerusakan
persepsi atau kognitif. Obstruksi trakeobronkhial.</div>
<div class="MsoNormal">
Tujuan: </div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l4 level2 lfo3; tab-stops: list .75in left 3.5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->mempertahankan pola pernapasan efektif.</div>
<div class="MsoNormal">
Kriteria
evaluasi:</div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l4 level2 lfo3; tab-stops: list .75in left 3.5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->bebas sianosis, GDA dalam batas normal</div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 161.4pt;" valign="top" width="215">
<div class="MsoTitle">
Intervensi</div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 260.45pt;" valign="top" width="347">
<div class="MsoTitle">
Rasional</div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 161.4pt;" valign="top" width="215">
<div class="MsoNormal">
Pantau
frekuensi, irama, kedalaman pernapasan. Catat ketidakteraturan pernapasan.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Pantau dan
catat kompetensi reflek gag/menelan dan kemampuan pasien untuk melindungi
jalan napas sendiri. Pasang jalan napas sesuai indikasi.</div>
<div class="MsoNormal">
Angkat kepala
tempat tidur sesuai aturannya, posisi miirng sesuai indikasi.</div>
<div class="MsoNormal">
Anjurkan pasien
untuk melakukan napas dalam yang efektif bila pasien sadar.</div>
<div class="MsoNormal">
Lakukan
penghisapan dengan ekstra hati-hati, jangan lebih dari 10-15 detik. Catat
karakter, warna dan kekeruhan dari sekret.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Auskultasi
suara napas, perhatikan daerah hipoventilasi dan adanya suara tambahan yang
tidak normal misal: ronkhi, wheezing, krekel.</div>
<div class="MsoNormal">
Pantau analisa
gas darah, tekanan oksimetri</div>
<div class="MsoNormal">
Lakukan ronsen
thoraks ulang.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Berikan
oksigen.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Lakukan
fisioterapi dada jika ada indikasi.</div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 260.45pt;" valign="top" width="347">
<div class="MsoNormal">
Perubahan dapat
menandakan awitan komplikasi pulmonal atau menandakan lokasi/luasnya
keterlibatan otak. Pernapasan lambat, periode apnea dapat menandakan perlunya
ventilasi mekanis.</div>
<div class="MsoNormal">
Kemampuan
memobilisasi atau membersihkan sekresi penting untuk pemeliharaan jalan
napas. Kehilangan refleks menelan atau batuk menandakan perlunaya jalan napas
buatan atau intubasi.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Untuk
memudahkan ekspansi paru/ventilasi paru dan menurunkan adanya kemungkinan
lidah jatuh yang menyumbat jalan napas.</div>
<div class="MsoNormal">
Mencegah/menurunkan
atelektasis.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Penghisapan
biasanya dibutuhkan jika pasien koma atau dalam keadaan imobilisasi dan tidak
dapat membersihkan jalan napasnya sendiri. Penghisapan pada trakhea yang
lebih dalam harus dilakukan dengan ekstra hati-hati karena hal tersebut dapat
menyebabkan atau meningkatkan hipoksia yang menimbulkan vasokonstriksi yang
pada akhirnya akan berpengaruh cukup besar pada perfusi jaringan.</div>
<div class="MsoNormal">
Untuk
mengidentifikasi adanya masalah paru seperti atelektasis, kongesti, atau
obstruksi jalan napas yang membahayakan oksigenasi cerebral dan/atau
menandakan terjadinya infeksi paru.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Menentukan
kecukupan pernapasan, keseimbangan asam basa dan kebutuhan akan terapi.</div>
<div class="MsoNormal">
Melihat kembali
keadaan ventilasi dan tanda-tandakomplikasi yang berkembang misal: atelektasi
atau bronkopneumoni.</div>
<div class="MsoNormal">
Memaksimalkan
oksigen pada darah arteri dan membantu dalam pencegahan hipoksia. Jika pusat
pernapasan tertekan, mungkin diperlukan ventilasi mekanik.</div>
<div class="MsoNormal">
Walaupun merupakan
kontraindikasi pada pasien dengan peningkatan TIK fase akut tetapi tindakan
ini seringkali berguna pada fase akut rehabilitasi untuk memobilisasi dan
membersihkan jalan napas dan menurunkan resiko atelektasis/komplikasi paru
lainnya.</div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: -17.85pt; tab-stops: 3.5in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0in; mso-list: l5 level1 lfo6; tab-stops: list .15pt left 3.5in; text-indent: -17.85pt;">
<!--[if !supportLists]-->3)<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->Resiko tinggi terhadap infeksi berhubungan dengan
jaringan trauma, kulit rusak, prosedur invasif. Penurunan kerja silia, stasis
cairan tubuh. Kekurangan nutrisi. Respon inflamasi tertekan (penggunaan
steroid). Perubahan integritas sistem tertutup (kebocoran CSS)</div>
<div class="MsoNormal">
Tujuan: </div>
<div class="MsoNormal">
Mempertahankan normotermia, bebas tanda-tanda infeksi.</div>
<div class="MsoNormal">
Kriteria
evaluasi:</div>
<div class="MsoNormal">
Mencapai penyembuhan luka tepat waktu.</div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 210.9pt;" valign="top" width="281">
<div class="MsoTitle">
Intervensi</div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 210.95pt;" valign="top" width="281">
<div class="MsoTitle">
Rasional</div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 210.9pt;" valign="top" width="281">
<div class="MsoNormal">
Berikan perawatan aseptik dan
antiseptik, pertahankan tehnik cuci tangan yang baik.</div>
<div class="MsoNormal">
Observasi
daerah kulit yang mengalami kerusakan, daerah yang terpasang alat invasi,
catat karakteristik dari drainase dan adanya inflamasi.</div>
<div class="MsoNormal">
Pantau suhu
tubuh secara teratur, catat adanya demam, menggigil, diaforesis dan perubahan
fungsi mental (penurunan kesadaran).</div>
<div class="MsoNormal">
Anjurkan untuk
melakukan napas dalam, latihan pengeluaran sekret paru secara terus menerus.
Observasi karakteristik sputum.</div>
<div class="MsoNormal">
Berikan
antibiotik sesuai indikasi</div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 210.95pt;" valign="top" width="281">
<div class="MsoNormal">
Cara pertama untuk menghindari
terjadinya infeksi nosokomial.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Deteksi dini
perkembangan infeksi memungkinkan untuk melakukan tindakan dengan segera dan
pencegahan terhadap komplikasi selanjutnya.</div>
<div class="MsoNormal">
Dapat
mengindikasikan perkembangan sepsis yang selanjutnya memerlukan evaluasi atau
tindakan dengan segera.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Peningkatan
mobilisasi dan pembersihan sekresi paru untuk menurunkan resiko terjadinya
pneumonia, atelektasis.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Terapi
profilatik dapat digunakan pada pasien yang mengalami trauma, kebocoran CSS
atau setelah dilakukan pembedahan untuk menurunkan resiko terjadinya infeksi
nosokomial.</div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<b><span style="font-family: "Times New Roman","serif"; font-size: 16.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Arial; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-font-kerning: 14.0pt;"><br clear="all" style="page-break-before: always;" />
</span></b>
<div class="MsoTitle">
Daftar Pustaka<o:p></o:p></div>
<div class="MsoTitle">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Abdul Hafid (1989), <b>Strategi Dasar Penanganan Cidera Otak</b>. PKB
Ilmu Bedah XI – Traumatologi , Surabaya.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Asikin Z. (1991). <b>Simposium Keperawatan Penderita Cidera kepala
Penatalaksanaan Penderita dengan Alat Bantu Napas</b>. (Jakarta).</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Carpenito, L.J. (1997). <b>Diagnosa
Keperawatan</b>. Jakarta : EGC.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Depkes. RI. (1989). <b>Perawatan
Pasien Yang Merupakan Kasus-Kasus Bedah.</b> Jakarta : Pusdiknakes.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Doenges, M. E. (1999). <b>R</b><b>encana
Asuhan Keperawatan</b>. Jakarta : EGC.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Harsono. (1993) <b>Kapita Selekta Neurologi</b>. Gajah Mada University
Press. Yogyakarta.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Hudak, C.M. (1999) <b>Keperawatan
Kritis.</b> Jakarta : EGC. </div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Kariasa I Made. (1997). <b>Asuhan Keperawatan Pada Klien Dengan Cedera
Kepala</b>. Fakultas Ilmu Keperawatan Universitas Indonesia. Jakarta.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Long; BC and Phipps WJ. (1985). <b>Essensial of Medical Surgical
Nursing</b> : A Nursing process Approach St. CV. Mosby Company.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Luckman, Sorensen, (1992), <b>Medical Surgical Nursing; a
Psychophysiologic Aproach, (3 rd Ed)</b>. Philadelphia: W.B. Saunders Company.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Potter, P.A., & Perry, A.G. (1993), <b>Fundamental of Nursing;
Concept, Proces, and Practice (3 rd Ed.)</b>. St. Louis : Mosby Year Book.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Pusponegoro, A.D.(1995). <b>Ilmu
Bedah</b>. Jakarta : Fakultas Kedokteran Universitas Indonesia.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Sjamsuhidajat, R. Wim de Jong (1997), <b>Buku Ajar Ilmu Bedah</b>.
Edisi Revisi. EGC, Jakarta.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.75in;">
Tabrani. (1998). <b>Agenda Gawat Darurat</b>. Penerbit Alumni. Bandung.</div>
</div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-13155952119085032882013-01-24T00:35:00.001-08:002013-01-24T00:35:08.526-08:00LAPORAN PENDAHULUAN DENGAN PASIEN STROKE<br />
<div class="MsoTitle">
<span lang="EN-US">BAB II</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span lang="EN-US">TINJAUAN
PUSTAKA</span></b></div>
<div class="MsoNormal">
<br /></div>
<h1>
<!--[if !supportLists]--><span lang="EN-US">I.<span style="font-size: 7pt; font-weight: normal;">
</span></span><!--[endif]--><span lang="EN-US">Konsep Dasar</span></h1>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l14 level2 lfo1; tab-stops: list 32.2pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US">1<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pengertian</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US"> Menurut WHO stroke adalah adanya
tanda-tanda klinik yang berkembang cepat akibat gangguan fungsi otak fokal
(atau global) dengan gejala-gejala yang berlangsung selama 24 jam atau lebih
yang menyebabkan kematian tanpa adanya penyebab lain yang jelas selain
vaskuler. (Hendro Susilo, 2000)</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US"> Stroke hemoragik adalah disfungsi
neurologi fokal yang akut dan disebabkan oleh perdarahan primer substansi otak
yang terjadi secara spontan bukan oleh karena trauma kapitis, disebabkan oleh
karena pecahnya pembuluh arteri, vena dan kapiler. (Djoenaidi Widjaja et. al,
1994)</span></div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l14 level2 lfo1; tab-stops: list 32.2pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US">2<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Anatomi fisiologi</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l14 level3 lfo1; tab-stops: list 49.2pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Otak </span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; tab-stops: 54.0pt;">
<span lang="EN-US"> Berat otak manusia
sekitar 1400 gram dan tersusun oleh kurang lebih 100 triliun neuron. Otak terdiri dari empat bagian besar
yaitu serebrum (otak besar), serebelum (otak kecil), brainstem (batang otak),
dan diensefalon. (Satyanegara, 1998)</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; tab-stops: 54.0pt; text-indent: 18.0pt;">
<span lang="EN-US"> Serebrum terdiri dari dua
hemisfer serebri, korpus kolosum dan korteks serebri. Masing-masing hemisfer
serebri terdiri dari lobus frontalis yang merupakan area motorik primer yang
bertanggung jawab untuk gerakan-gerakan voluntar, lobur parietalis yang
berperanan pada kegiatan memproses dan mengintegrasi informasi sensorik yang
lebih tinggi tingkatnya, lobus temporalis yang merupakan area sensorik untuk
impuls pendengaran dan lobus oksipitalis yang mengandung korteks penglihatan
primer, menerima informasi penglihatan dan menyadari sensasi warna.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; tab-stops: 54.0pt; text-indent: 7.2pt;">
<span lang="EN-US"> Serebelum terletak di
dalam fosa kranii posterior dan ditutupi oleh duramater yang menyerupai atap
tenda yaitu tentorium, yang memisahkannya dari bagian posterior serebrum.
Fungsi utamanya adalah sebagai pusat refleks yang mengkoordinasi dan
memperhalus gerakan otot, serta mengubah tonus dan kekuatan kontraksi untuk
mempertahankan keseimbangan sikap tubuh.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; tab-stops: 54.0pt;">
<span lang="EN-US"> Bagian-bagian batang
otak dari bawak ke atas adalah medula oblongata, pons dan mesensefalon (otak
tengah). Medula oblongata merupakan pusat refleks yang penting untuk jantung,
vasokonstriktor, pernafasan, bersin, batuk, menelan, pengeluaran air liur dan
muntah. Pons merupakan mata rantai penghubung yang penting pada jaras
kortikosereberalis yang menyatukan hemisfer serebri dan serebelum. Mesensefalon
merupakan bagian pendek dari batang otak yang berisi aquedikus sylvius,
beberapa traktus serabut saraf asenden dan desenden dan pusat stimulus saraf
pendengaran dan penglihatan.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; tab-stops: 54.0pt;">
<span lang="EN-US"> Diensefalon di bagi
empat wilayah yaitu talamus, subtalamus, epitalamus dan hipotalamus. Talamus
merupakan stasiun penerima dan pengintegrasi subkortikal yang penting.
Subtalamus fungsinya belum dapat dimengerti sepenuhnya, tetapi lesi pada
subtalamus akan menimbulkan hemibalismus yang ditandai dengan gerakan kaki atau
tangan yang terhempas kuat pada satu sisi tubuh. Epitalamus berperanan pada beberapa dorongan emosi dasar
seseorang. Hipotalamus berkaitan dengan pengaturan rangsangan dari sistem
susunan saraf otonom perifer yang menyertai ekspresi tingkah dan emosi. (Sylvia
A. Price, 1995)</span></div>
<div class="MsoNormal" style="margin-left: 31.2pt; mso-list: l14 level3 lfo1; tab-stops: list 49.2pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Sirkulasi darah otak</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US"> Otak menerima 17 % curah jantung dan
menggunakan 20 % konsumsi oksigen total tubuh manusia untuk metabolisme
aerobiknya. Otak diperdarahi oleh dua pasang arteri yaitu arteri karotis
interna dan arteri vertebralis. Da dalam rongga kranium, keempat arteri ini
saling berhubungan dan membentuk sistem anastomosis, yaitu sirkulus Willisi.(Satyanegara, 1998)</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; tab-stops: 54.0pt 72.0pt; text-indent: 27.0pt;">
<span lang="EN-US"> Arteri karotis interna dan
eksterna bercabang dari arteria karotis komunis kira-kira setinggi rawan
tiroidea. Arteri karotis interna masuk ke dalam tengkorak dan bercabang
kira-kira setinggi kiasma optikum, menjadi arteri serebri anterior dan media.
Arteri serebri anterior memberi suplai darah pada struktur-struktur seperti
nukleus kaudatus dan putamen basal ganglia, kapsula interna, korpus kolosum dan
bagian-bagian (terutama medial) lobus frontalis dan parietalis serebri, termasuk
korteks somestetik dan korteks motorik. Arteri serebri media mensuplai darah
untuk lobus temporalis, parietalis dan frontalis korteks serebri.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US"> Arteria vertebralis kiri dan kanan
berasal dari arteria subklavia sisi yang sama. Arteri vertebralis memasuki
tengkorak melalui foramen magnum, setinggi perbatasan pons dan medula
oblongata. Kedua arteri ini bersatu membentuk arteri basilaris, arteri
basilaris terus berjalan sampai setinggi otak tengah, dan di sini bercabang
menjadi dua membentuk sepasang arteri serebri posterior. Cabang-cabang sistem
vertebrobasilaris </span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US">ini memperdarahi
medula oblongata, pons, serebelum, otak tengah dan sebagian diensefalon.
Arteri serebri posterior dan
cabang-cabangnya memperdarahi sebagian diensefalon, sebagian lobus oksipitalis
dan temporalis, aparatus koklearis dan organ-organ vestibular. (Sylvia A.
Price, 1995)</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; tab-stops: 72.0pt;">
<span lang="EN-US"> Darah vena dialirkan dari
otak melalui dua sistem : kelompok vena interna, yang mengumpulkan darah ke
Vena galen dan sinus rektus, dan kelompok vena eksterna yang terletak di
permukaan hemisfer otak, dan mencurahkan darah, ke sinus sagitalis superior dan
sinus-sinus basalis lateralis, dan seterusnya ke vena-vena jugularis,
dicurahkan menuju ke jantung. (Harsono, 2000)</span></div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l14 level2 lfo1; tab-stops: list 32.2pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US">3<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Patofisiologi</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-indent: 3.6pt;">
<span lang="EN-US"> Hipertensi kronik
menyebabkan pembuluh arteriola yang berdiameter 100-400 mcmeter mengalami
perubahan patologik pada dinding pembuluh darah tersebut berupa hipohialinosis,
nekrosis fibrinoid serta timbulnya aneurisma tipe Bouchard. Arteriol-arteriol
dari cabang-cabang lentikulostriata, cabang tembus arterio talamus (talamo perforate arteries)
dan cabang-cabang paramedian arteria vertebro-basilaris mengalami
perubahan-perubahan degenaratif yang sama. Kenaikan darah yang “abrupt” atau
kenaikan dalam jumlah yang secara mencolok dapat menginduksi pecahnya pembuluh
darah terutama pada pagi hari dan sore hari.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US"> Jika pembuluh darah tersebut pecah, maka
perdarahan dapat berlanjut sampai dengan 6 jam dan jika volumenya besarakan
merusak struktur anatomi otak dan menimbulkan gejala klinik.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-indent: 3.6pt;">
<span lang="EN-US"> Jika perdarahan yang
timbul kecil ukurannya, maka massa darah hanya dapat merasuk dan menyela di
antara selaput akson massa putih tanpa merusaknya. Pada keadaan ini absorbsi
darah akan diikutioleh pulihnya fungsi-</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-indent: 3.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-indent: 3.6pt;">
<span lang="EN-US">fungsi neurologi. Sedangkan pada perdarahan yang luas terjadi
destruksi massa otak, peninggian tekanan intrakranial dan yang lebih berat
dapat menyebabkan herniasi otak pada falk serebri atau lewat foramen magnum.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-indent: 3.6pt;">
<span lang="EN-US"> Kematian dapat
disebabkan oleh kompresi batang otak, hemisfer otak, dan perdarahan batang otak
sekunder atau ekstensi perdarahan ke batang otak. Perembesan darah ke ventrikel
otak terjadi pada sepertiga kasus perdarahan otak di nukleus kaudatus, talamus
dan pons.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US"> Selain kerusakan parenkim otak, akibat
volume perdarahan yang relatif banyak akan mengakibatkan peninggian tekanan
intrakranial dan menyebabkan menurunnya tekanan perfusi otak serta terganggunya
drainase otak.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-indent: 3.6pt;">
<span lang="EN-US"> Elemen-elemen vasoaktif
darah yang keluar serta kaskade iskemik akibat menurunnya tekanan perfusi,
menyebabkan neuron-neuron di daerah yang terkena darah dan sekitarnya tertekan
lagi. Jumlah darah yang keluar menentukan prognosis. Apabila volume darah lebih
dari 60 cc maka resiko kematian sebesar 93 % pada perdarahan dalam dan 71 %
pada perdarahan lobar. Sedangkan bila terjadi perdarahan serebelar dengan
volume antara 30-60 cc diperkirakan kemungkinan kematian sebesar 75 % tetapi
volume darah 5 cc dan terdapat di pons sudah berakibat fatal. (Jusuf Misbach,
1999)</span></div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l14 level2 lfo1; tab-stops: list 32.2pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US">4<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Dampak masalah</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 31.2pt; mso-list: l14 level3 lfo1; tab-stops: list 49.2pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pada individu</span></div>
<div class="MsoNormal" style="margin-left: 65.2pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan perfusi jaringan otak</span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -9.0pt;">
<span lang="EN-US"> Akibat adanya
sumbatan pembuluh darah otak, perdarahan otak, vasospasme serebral, edema otak</span></div>
<div class="MsoNormal" style="margin-left: 65.2pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan mobilitas fisik</span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -11.3pt;">
<span lang="EN-US"> Terjadi karena
adanya kelemahan, kelumpuhan dan menurunnya persepsi / kognitif</span></div>
<div class="MsoNormal" style="margin-left: 65.2pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan komunikasi verbal</span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -9.0pt;">
<span lang="EN-US"> Akibat menurunnya/
terhambatnya sirkulasi serebral, kerusakan neuromuskuler, kelemahan otot wajah</span></div>
<div class="MsoNormal" style="margin-left: 65.2pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan nutrisi</span></div>
<div class="MsoNormal" style="margin-left: 63.0pt;">
<span lang="EN-US"> Akibat adanya kesulitan menelan,
kehilangan sensasi (rasa kecap) pada lidah, nafsu makan yang menurun</span></div>
<div class="MsoNormal" style="margin-left: 65.2pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="EN-US">5)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan eliminasi uri dan alvi</span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -9.0pt;">
<span lang="EN-US"> Dapat terjadi
akibat klien tidak sadar, dehidrasi, imobilisasi dan hilangnya kontrol miksi</span></div>
<div class="MsoNormal" style="margin-left: 65.2pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="EN-US">6)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Ketidakmampuan perawatan diri</span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -9.0pt;">
<span lang="EN-US"> Akibat adanya kelemahan pada salah satu sisi
tubuh, kehilangan koordinasi / kontrol otot, menurunnya persepsi kognitif.</span></div>
<div class="MsoNormal" style="margin-left: 65.2pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="EN-US">7)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan psikologis</span></div>
<div class="MsoNormal" style="margin-left: 63.0pt;">
<span lang="EN-US"> Dapat berupa ketakutan, perasaan
tidak berdaya dan putus asa.emosi labil, mudah marah, kehilangan kontrol diri, </span></div>
<div class="MsoNormal" style="margin-left: 65.2pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="EN-US">8)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan penglihatan</span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -9.0pt;">
<span lang="EN-US"> Dapat terjadi
karena penurunan ketajaman penglihatan dan gangguan lapang pandang.</span></div>
<div class="MsoNormal" style="margin-left: 31.2pt; mso-list: l14 level3 lfo1; tab-stops: list 49.2pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pada keluarga</span></div>
<div class="MsoNormal" style="margin-left: 65.2pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Terjadi kecemasan</span></div>
<div class="MsoNormal" style="margin-left: 65.2pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Masalah biaya</span></div>
<div class="MsoNormal" style="margin-left: 65.2pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan dalam pekerjaan </span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l14 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span lang="EN-US">B.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-US"> <b>Asuhan Keperawatan<o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l14 level2 lfo1; tab-stops: list 45.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">1<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pengkajian</span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; tab-stops: list 45.0pt; text-indent: -18.0pt;">
<span lang="EN-US">
Pengkajian merupakan tahap awal dan landasan proses keperawatan untuk
mengenal masalah klien, agar dapat memberi arah kepada tindakan keperawatan.
Tahap pengkajian terdiri dari tiga kegiatan, yaitu pengumpulan data,
pengelompokkan data dan perumusan diagnosis keperawatan. (Lismidar, 1990)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level3 lfo1; tab-stops: list 72.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pengumpulan data</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; tab-stops: list 72.0pt;">
<span lang="EN-US"> Pengumpulan data adalah
mengumpulkan informasi tentang status kesehatan klien yang menyeluruh mengenai
fisik, psikologis, sosial budaya, spiritual, kognitif, tingkat perkembangan, status
ekonomi, kemampuan fungsi dan gaya hidup klien. (Marilynn E. Doenges et al,
1998)</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Identitas klien</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; tab-stops: 99.0pt;">
<span lang="EN-US"> Meliputi nama, umur
(kebanyakan terjadi pada usia tua), jenis kelamin, pendidikan, alamat,
pekerjaan, agama, suku bangsa, tanggal dan jam MRS, nomor register, diagnose
medis.</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Keluhan utama</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; tab-stops: list 99.0pt;">
<span lang="EN-US"> Biasanya didapatkan
kelemahan anggota gerak sebelah badan, bicara pelo, dan tidak dapat
berkomunikasi. (Jusuf Misbach, 1999)</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Riwayat penyakit sekarang</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; tab-stops: list 99.0pt;">
<span lang="EN-US"> Serangan stroke
hemoragik seringkali berlangsung
sangat </span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; tab-stops: list 99.0pt;">
<span lang="EN-US">mendadak, pada saat klien sedang melakukan aktivitas. Biasanya
terjadi nyeri kepala, mual, muntah bahkan kejang sampai tidak sadar, disamping
gejala kelumpuhan separoh badan atau gangguan fungsi otak yang lain. (Siti
Rochani, 2000) </span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Riwayat penyakit dahulu</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; tab-stops: list 99.0pt;">
<span lang="EN-US"> Adanya riwayat
hipertensi, diabetes militus, penyakit jantung, anemia, riwayat trauma kepala,
kontrasepsi oral yang lama, penggunaan obat-obat anti koagulan, aspirin,
vasodilator, obat-obat adiktif, kegemukan. (Donna D. Ignativicius, 1995)</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">5)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Riwayat penyakit keluarga</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; tab-stops: list 99.0pt;">
<span lang="EN-US"> Biasanya ada riwayat
keluarga yang menderita hipertensi ataupun diabetes militus. (Hendro Susilo,
2000)</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">6)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Riwayat psikososial</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; tab-stops: list 99.0pt;">
<span lang="EN-US"> Stroke memang suatu
penyakit yang sangat mahal. Biaya untuk pemeriksaan, pengobatan dan perawatan
dapat mengacaukan keuangan keluarga sehingga faktor biaya ini dapat
mempengaruhi stabilitas emosi dan pikiran klien dan keluarga.(Harsono, 1996)</span></div>
<div class="MsoNormal" style="margin-left: 65.2pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt left 99.0pt; text-indent: 6.8pt;">
<!--[if !supportLists]--><span lang="EN-US">7)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pola-pola fungsi kesehatan</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level5 lfo1; tab-stops: 99.0pt list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)</span><!--[endif]--><span lang="EN-US">Pola persepsi dan tata laksana hidup sehat</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 108.0pt;">
<span lang="EN-US"> Biasanya ada riwayat
perokok, penggunaan alkohol, penggunaan obat kontrasepsi oral.</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level5 lfo1; tab-stops: list 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pola nutrisi dan metabolisme</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 117.0pt;">
<span lang="EN-US"> Adanya keluhan
kesulitan menelan, nafsu
makan </span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 117.0pt;">
<span lang="EN-US">menurun, mual muntah pada fase akut.</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level5 lfo1; tab-stops: list 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pola eliminasi</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 117.0pt;">
<span lang="EN-US"> Biasanya terjadi
inkontinensia urine dan pada pola defekasi biasanya terjadi konstipasi akibat
penurunan peristaltik usus.</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level5 lfo1; tab-stops: list 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pola aktivitas dan latihan</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 117.0pt;">
<span lang="EN-US"> Adanya kesukaran untuk
beraktivitas karena kelemahan, kehilangan sensori atau paralise/ hemiplegi, mudah
lelah</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level5 lfo1; tab-stops: list 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pola tidur dan istirahat</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 117.0pt; text-indent: 18.0pt;">
<span lang="EN-US">Biasanya klien mengalami kesukaran untuk
istirahat karena kejang otot/nyeri otot</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level5 lfo1; tab-stops: list 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pola hubungan dan peran</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 117.0pt;">
<span lang="EN-US"> Adanya perubahan
hubungan dan peran karena klien mengalami kesukaran untuk berkomunikasi akibat
gangguan bicara.</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level5 lfo1; tab-stops: list 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">g)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pola persepsi dan konsep diri</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 117.0pt;">
<span lang="EN-US"> Klien merasa tidak
berdaya, tidak ada harapan, mudah marah, tidak kooperatif.</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level5 lfo1; tab-stops: list 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">h)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pola sensori dan kognitif</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 117.0pt;">
<span lang="EN-US"> Pada pola sensori klien
mengalami gangguan penglihatan/kekaburan pandangan, perabaan/sentuhan menurun
pada muka dan ekstremitas yang sakit. Pada pola kognitif biasanya terjadi
penurunan memori dan proses berpikir.</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level5 lfo1; tab-stops: list 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">i)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pola reproduksi seksual</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 117.0pt;">
<span lang="EN-US"> Biasanya terjadi
penurunan gairah seksual akibat dari beberapa pengobatan stroke, seperti obat
anti kejang, anti hipertensi, antagonis histamin.</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level5 lfo1; tab-stops: list 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">j)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pola penanggulangan stress</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 117.0pt;">
<span lang="EN-US"> Klien biasanya
mengalami kesulitan untuk memecahkan masalah karena gangguan proses berpikir
dan kesulitan berkomunikasi.</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level5 lfo1; tab-stops: list 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">k)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pola tata nilai dan kepercayaan</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 117.0pt;">
<span lang="EN-US"> Klien biasanya jarang
melakukan ibadah karena tingkah laku yang tidak stabil, kelemahan/kelumpuhan
pada salah satu sisi tubuh. (Marilynn E. Doenges, 2000)</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l14 level4 lfo1; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="EN-US">8)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan fisik</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l14 level5 lfo1; tab-stops: 81.0pt 117.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Keadaan umum</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level6 lfo1; tab-stops: list 3.0cm 117.0pt left 135.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">(1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kesadaran : umumnya mengelami
penurunan kesadaran</span></div>
<div class="MsoNormal" style="margin-left: 135.0pt; mso-list: l14 level6 lfo1; tab-stops: list 3.0cm 108.0pt 135.0pt 144.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Suara bicara : kadang mengalami
gangguan yaitu sukar dimengerti, kadang tidak bisa bicara</span></div>
<div class="MsoNormal" style="margin-left: 135.0pt; mso-list: l14 level6 lfo1; tab-stops: list 3.0cm 108.0pt 135.0pt 144.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tanda-tanda vital : tekanan
darah meningkat, denyut nadi bervariasi</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level5 lfo1; tab-stops: list 90.0pt left 117.0pt 135.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan integumen</span></div>
<div class="MsoNormal" style="margin-left: 135.0pt; mso-list: l14 level6 lfo1; tab-stops: list 108.0pt left 135.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kulit : jika klien kekurangan
O2 kulit akan tampak pucat dan jika kekurangan cairan maka turgor kulit kan
jelek. Di samping itu perlu juga dikaji tanda-tanda dekubitus terutama pada
daerah yang menonjol
karena klien stroke hemoragik harus bed rest 2-3 minggu</span></div>
<div class="MsoNormal" style="margin-left: 135.0pt; mso-list: l14 level6 lfo1; tab-stops: list 108.0pt left 135.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kuku : perlu dilihat adanya
clubbing finger, cyanosis</span></div>
<div class="MsoNormal" style="margin-left: 135.0pt; mso-list: l14 level6 lfo1; tab-stops: list 108.0pt left 135.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rambut : umumnya tidak ada
kelainan</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l14 level5 lfo1; tab-stops: list 69.05pt left 90.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan kepala dan leher</span></div>
<div class="MsoNormal" style="margin-left: 135.0pt; mso-list: l14 level6 lfo1; tab-stops: list 90.0pt left 135.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kepala : bentuk normocephalik</span></div>
<div class="MsoNormal" style="margin-left: 134.95pt; mso-list: l14 level6 lfo1; tab-stops: list 90.0pt left 135.0pt; text-indent: -17.85pt;">
<!--[if !supportLists]--><span lang="EN-US">(2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Muka : umumnya tidak simetris
yaitu mencong ke salah satu sisi</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 134.95pt; margin-right: 0cm; margin-top: 12.0pt; mso-list: l14 level6 lfo1; tab-stops: list 90.0pt left 135.0pt; text-indent: -17.85pt;">
<!--[if !supportLists]--><span lang="EN-US">(3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Leher : kaku kuduk jarang
terjadi (Satyanegara, 1998)</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l14 level5 lfo1; tab-stops: 117.0pt list 126.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan dada</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 126.0pt;">
<span lang="EN-US"> Pada pernafasan kadang
didapatkan suara nafas terdengar ronchi, wheezing ataupun suara nafas tambahan,
pernafasan tidak teratur akibat penurunan refleks batuk dan menelan.</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l14 level5 lfo1; tab-stops: list 117.0pt left 135.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan abdomen</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 117.0pt left 135.0pt;">
<span lang="EN-US"> Didapatkan penurunan
peristaltik usus akibat bed rest yang lama, dan kadang terdapat kembung.</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l14 level5 lfo1; tab-stops: 117.0pt list 126.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan inguinal,
genetalia, anus</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; tab-stops: 117.0pt list 126.0pt;">
<span lang="EN-US"> Kadang terdapat incontinensia
atau retensio urine</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l14 level5 lfo1; tab-stops: 117.0pt list 126.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">g)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan ekstremitas</span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; tab-stops: list 126.0pt left 144.0pt; text-indent: -18.0pt;">
<span lang="EN-US"> Sering didapatkan kelumpuhan
pada salah satu sisi tubuh.</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l14 level5 lfo1; tab-stops: list 117.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">h)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan neurologi</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l14 level6 lfo1; tab-stops: list 126.0pt; text-indent: -9.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan nervus cranialis</span></div>
<div class="MsoNormal" style="margin-left: 144.0pt;">
<span lang="EN-US"> Umumnya terdapat gangguan nervus
cranialis VII dan XII central. </span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l14 level6 lfo1; tab-stops: list 126.0pt; text-indent: -9.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan motorik</span></div>
<div class="MsoNormal" style="margin-left: 144.0pt; tab-stops: list 117.0pt 144.0pt;">
<span lang="EN-US"> Hampir selalu terjadi
kelumpuhan/kelemahan pada salah satu sisi tubuh.</span></div>
<div class="MsoNormal" style="margin-left: 144.0pt; mso-list: l14 level6 lfo1; tab-stops: list 144.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan sensorik</span></div>
<div class="MsoNormal" style="margin-left: 162.0pt; tab-stops: 162.0pt; text-indent: -18.0pt;">
<span lang="EN-US"> Dapat
terjadi hemihipestesi.</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: l14 level6 lfo1; tab-stops: list 126.0pt; text-indent: -9.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan refleks</span></div>
<div class="MsoNormal" style="margin-left: 144.0pt; tab-stops: list 108.0pt 144.0pt; text-indent: -9.0pt;">
<span lang="EN-US">
Pada fase akut reflek fisiologis sisi yang lumpuh akan menghilang.
Setelah beberapa hari refleks fisiologis akan muncul kembali didahuli dengan
refleks patologis.(Jusuf Misbach, 1999)</span></div>
<div class="MsoNormal" style="margin-left: 65.2pt; mso-list: l14 level4 lfo1; tab-stops: list 65.2pt; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="EN-US">9)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan penunjang</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level5 lfo1; tab-stops: list 69.05pt left 81.0pt; text-indent: -9.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)</span><!--[endif]--><span lang="EN-US">Pemeriksaan
radiologi</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l14 level6 lfo1; tab-stops: 90.0pt list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">CT scan : didapatkan hiperdens
fokal, kadang-kadang masuk ventrikel, atau menyebar ke permukaan otak. (Linardi
Widjaja, 1993)</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l14 level6 lfo1; tab-stops: 90.0pt list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">MRI : untuk menunjukkan area
yang mengalami hemoragik. (Marilynn E. Doenges, 2000)</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l14 level6 lfo1; tab-stops: 90.0pt list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Angiografi serebral : untuk
mencari sumber perdarahan seperti aneurisma atau malformasi vaskuler.
(Satyanegara, 1998)</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l14 level6 lfo1; tab-stops: 90.0pt list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan foto thorax : dapat
memperlihatkan keadaan jantung, apakah terdapat pembesaran ventrikel kiri yang
merupakan salah satu tanda hipertensi kronis
pada penderita </span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; tab-stops: 90.0pt;">
<span lang="EN-US">stroke. (Jusuf Misbach, 1999)</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l14 level5 lfo1; tab-stops: 72.0pt 81.0pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan laboratorium</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l14 level6 lfo1; tab-stops: list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pungsi lumbal : pemeriksaan
likuor yang merah biasanya dijumpai pada perdarahan yang masif, sedangkan
perdarahan yang kecil biasanya warna likuor masih normal (xantokhrom) sewaktu
hari-hari pertama. (Satyanegara, 1998)</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l14 level6 lfo1; tab-stops: list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan darah rutin</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l14 level6 lfo1; tab-stops: list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan kimia darah : pada
stroke akut dapat terjadi hiperglikemia. Gula darah dapat mencapai 250 mg dalam
serum dan kemudian berangsur-angsur turun kembali. (Jusuf Misbach, 1999)</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l14 level6 lfo1; tab-stops: list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">(4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan darah lengkap :
unutk mencari kelainan pada darah itu sendiri. (Linardi Widjaja, 1993)</span></div>
<div class="MsoNormal" style="margin-left: 31.2pt; mso-list: l14 level3 lfo1; tab-stops: list 49.2pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Analisa data</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US"> Analisa data adalah kemampuan
mengkaitkan data dan menghubungkan data tersebut dengan konsep, teori dan
prinsip yang relevan untuk membuat kesimpulan dalam menentukan masalah
kesehatan dan keperawatan klien. (Nasrul Effendy, 1995)</span></div>
<div class="MsoNormal" style="margin-left: 31.2pt; mso-list: l14 level3 lfo1; tab-stops: list 49.2pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">c.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Diagnosa keperawatan</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; text-indent: 7.2pt;">
<span lang="EN-US"> Diagnosa keperawatan
ditetapkan berdasarkan analisa dan interpretasi data yang diperoleh dari
pengkajian keperawatan klien. Diagnosa keperawatan memberikan gambaran tentang
masalah atau status kesehatan klien yang nyata (aktual) dan kemungkinan akan
terjadi (potensial) di mana pemecahannya dapat dilakukan dalam batas wewenang </span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; tab-stops: 54.0pt;">
<span lang="EN-US">perawat. (Nasrul Effendy, 1995)</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; tab-stops: 54.0pt;">
<span lang="EN-US"> Adapun diagnosa yang
mungkin muncul adalah : </span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan perfusi jaringan otak
yang berhubungan dengan perdarahan intracerebral. (Marilynn E. Doenges, 2000)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan mobilitas fisik
berhubungan dengan hemiparese/hemiplagia (Donna D. Ignativicius, 1995)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan persepsi sensori :
perabaan yang berhubungan dengan penekanan pada saraf sensori, penurunan
penglihatan (Marilynn E. Doenges, 2000)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan komunikasi verbal
berhubungan dengan penurunan sirkulasi darah otak (Donna D. Ignativicius, 1995)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">5)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan eliminasi
alvi(konstipasi) berhubungan dengan imobilisasi, intake cairan yang tidak
adekuat (Donna D. Ignativicius, 1995)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">6)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Resiko gangguan nutrisi
berhubungan dengan kelemahan otot mengunyah dan menelan ( Barbara Engram, 1998)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">7)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kurangnya pemenuhan perawatan
diri yang berhubungan dengan hemiparese/hemiplegi (Donna D. Ignativicius, 1995)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">8)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Resiko gangguan integritas
kulit yang berhubungan tirah baring lama (Barbara Engram, 1998)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">9)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Resiko ketidakefektifan
bersihan jalan nafas yang berhubungan dengan penurunan refleks batuk dan
menelan.(Lynda Juall Carpenito, 1998)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l14 level4 lfo1; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">10)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span lang="EN-US">Gangguan eliminasi uri (inkontinensia uri) yang berhubungan dengan
penurunan sensasi, disfungsi kognitif, ketidakmampuan untuk berkomunikasi
(Donna D. Ignatavicius, 1995) </span></div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l14 level2 lfo1; tab-stops: list 32.2pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US">2<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Perencanaan</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-indent: 3.6pt;">
<span lang="EN-US"> Rencana asuhan
keperawatan merupakan mata rantai antara penetapan kebutuhan klien
dan pelaksanaan keperawatan.
Dengan demikian rencana </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-indent: 3.6pt;">
<span lang="EN-US">asuhan keperawatan adalah petunjuk tertulis yang menggambarkan
secara tepat mengenai rencana tindakan yang dilakukan terhadap klien sesuai dengan kebutuhannya berdasarkan
diagnosa keperawatan.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-indent: 3.6pt;">
<span lang="EN-US"> Rencana asuhan
keperawatan disusun dengan melibatkan klien secara optimal agar dalam
pelaksanaan asuhan keperawatan terjalin suatu kerjasama yang saling membantu
dalam proses pencapaian tujuan keperawatan dalam memenuhi kebutuhan klien.
(Nasrul Effendy, 1995) </span></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<span lang="EN-US"> Rencana keperawatan dari diagnosa
keperawatan diatas adalah :</span></div>
<div class="MsoNormal" style="margin-left: 61.2pt; mso-list: l9 level3 lfo2; tab-stops: list 61.2pt; text-indent: -25.2pt;">
<!--[if !supportLists]--><span lang="EN-US">a<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan perfusi jaringan otak
yang berhubungan dengan perdarahan intra cerebral</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l9 level4 lfo2; tab-stops: list 86.4pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tujuan :</span></div>
<div class="MsoNormal" style="margin-left: 75.6pt; text-indent: 14.4pt;">
<span lang="EN-US">Perfusi jaringan otak dapat tercapai secara optimal</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l2 level4 lfo9; tab-stops: list 86.4pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kriteria hasil :</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l12 level1 lfo3; tab-stops: list 90.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien tidak gelisah</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l12 level1 lfo3; tab-stops: list 90.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tidak ada keluhan nyeri kepala</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l12 level1 lfo3; tab-stops: list 90.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">GCS 456</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l12 level1 lfo3; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tanda-tanda vital normal(nadi :
60-100 kali permenit, suhu: 36-36,7 C, pernafasan 16-20 kali permenit)</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l2 level4 lfo9; tab-stops: list 86.4pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rencana tindakan </span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l9 level5 lfo2; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan penjelasan kepada
keluarga klien tentang sebab-sebab gangguan perfusi jaringan otak dan akibatnya</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l9 level5 lfo2; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Anjurkan kepada klien untuk bed
rest total</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l9 level5 lfo2; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Observasi dan catat tanda-tanda
vital dan kelainan tekanan intrakranial tiap dua jam</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l9 level5 lfo2; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan posisi kepala lebih
tinggi 15-30 dengan letak jantung (beri
bantal tipis)</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l9 level5 lfo2; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Anjurkan klien untuk
menghindari batuk dan mengejan berlebihan</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l9 level5 lfo2; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Ciptakan lingkungan yang tenang
dan batasi pengunjung</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l9 level5 lfo2; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">g)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kolaborasi dengan tim dokter
dalam pemberian obat neuroprotektor</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l8 level4 lfo10; tab-stops: list 86.4pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rasional </span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l6 level5 lfo4; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Keluarga lebih berpartisipasi
dalam proses penyembuhan </span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l6 level5 lfo4; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Untuk mencegah perdarahan ulang</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l6 level5 lfo4; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Mengetahui setiap perubahan
yang terjadi pada klien secara dini dan untuk penetapan tindakan yang tepat</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l6 level5 lfo4; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Mengurangi tekanan arteri
dengan meningkatkan draimage vena dan memperbaiki sirkulasi serebral</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l6 level5 lfo4; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Batuk dan mengejan dapat
meningkatkan tekanan intra kranial dan potensial terjadi perdarahan ulang</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l6 level5 lfo4; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rangsangan aktivitas yang
meningkat dapat meningkatkan kenaikan TIK. Istirahat total dan ketenangan
mungkin diperlukan untuk pencegahan terhadap perdarahan dalam kasus stroke
hemoragik / perdarahan lainnya</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l6 level5 lfo4; tab-stops: list 111.6pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">g)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Memperbaiki sel yang masih
viabel</span></div>
<div class="MsoNormal" style="margin-left: 61.2pt; mso-list: l6 level3 lfo4; tab-stops: list 61.2pt; text-indent: -25.2pt;">
<!--[if !supportLists]--><span lang="EN-US">b<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan mobilitas fisik
berhubungan dengan hemiparese/hemiplegia</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l6 level4 lfo4; tab-stops: list 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tujuan :</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; tab-stops: 90.0pt;">
<span lang="EN-US">Klien mampu melaksanakan aktivitas fisik sesuai dengan kemampuannya</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l18 level4 lfo11; tab-stops: list 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kriteria hasil</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l20 level1 lfo5; tab-stops: list 90.0pt 108.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tidak terjadi kontraktur sendi</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l20 level1 lfo5; tab-stops: list 90.0pt 108.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Bertambahnya kekuatan otot</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l20 level1 lfo5; tab-stops: list 90.0pt 108.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien menunjukkan tindakan
untuk meningkatkan mobilitas</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l18 level4 lfo11; tab-stops: list 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rencana tindakan </span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l10 level5 lfo6; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Ubah posisi klien tiap 2 jam</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l10 level5 lfo6; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Ajarkan klien untuk melakukan
latihan gerak aktif pada ekstrimitas yang tidak sakit</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l10 level5 lfo6; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Lakukan gerak pasif pada
ekstrimitas yang sakit</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l10 level5 lfo6; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan papan kaki pada
ekstrimitas dalam posisi fungsionalnya</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l10 level5 lfo6; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tinggikan kepala dan tangan </span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l10 level5 lfo6; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kolaborasi dengan ahli
fisioterapi untuk latihan fisik klien</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l13 level4 lfo12; tab-stops: list 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rasional</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l3 level5 lfo7; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><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: 108.0pt; mso-list: l3 level5 lfo7; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><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: 108.0pt; mso-list: l3 level5 lfo7; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Otot volunter akan kehilangan
tonus dan kekuatannya bila tidak dilatih untuk digerakkan</span></div>
<div class="MsoNormal" style="margin-left: 61.2pt; mso-list: l15 level3 lfo8; tab-stops: list 61.2pt; text-indent: -25.2pt;">
<!--[if !supportLists]--><span lang="EN-US">c<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan persepsi sensori :
perabaan yang berhubungan dengan penekanan pada saraf sensori </span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l15 level4 lfo8; tab-stops: list 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tujuan :</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; tab-stops: list 90.0pt;">
<span lang="EN-US">Meningkatnya persepsi sensorik : perabaan secara optimal.</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l15 level4 lfo8; tab-stops: list 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kriteria hasil :</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l4 level1 lfo13; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien dapat mempertahankan
tingakat kesadaran dan fungsi
persepsi</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l4 level1 lfo13; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien mengakui perubahan dalam
kemampuan untuk meraba dan merasa</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l4 level1 lfo13; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien dapat menunjukkan
perilaku untuk mengkompensasi terhadap perubahan sensori</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l15 level4 lfo8; tab-stops: list 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rencana tindakan</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tentukan kondisi patologis
klien</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kaji kesadaran sensori, seperti
membedakan panas/dingin, tajam/tumpul, posisi bagian tubuh/otot, rasa
persendian</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan stimulasi terhadap rasa
sentuhan, seperti memberikan klien suatu benda untuk menyentuh, meraba. Biarkan
klien menyentuh dinding atau batas-batas lainnya.</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Lindungi klien dari suhu yang
berlebihan, kaji adanya lindungan yang berbahaya. Anjurkan pada klien dan
keluarga untuk melakukan pemeriksaan terhadap suhu air dengan tangan yang normal</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Anjurkan klien untuk mengamati
kaki dan tangannya bila perlu dan menyadari posisi bagian tubuh yang sakit.
Buatlah klien sadar akan semua bagian tubuh yang terabaikan seperti stimulasi
sensorik pada daerah yang sakit, latihan yang membawa area yang sakit melewati
garis tengah, ingatkan individu untuk merawata sisi yang sakit.</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Hilangkan kebisingan/stimulasi
eksternal yang berlebihan.</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">g)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Lakukan validasi terhadap
persepsi klien</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l15 level4 lfo8; tab-stops: list 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rasional </span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Untuk mengetahui tipe dan
lokasi yang mengalami gangguan, sebagai penetapan rencana tindakan</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Penurunan kesadaran terhadap
sensorik dan perasaan kinetik berpengaruh terhadap keseimbangan/posisi dan
kesesuaian dari gerakan yang mengganggu ambulasi, meningkatkan resiko
terjadinya trauma.</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Melatih kembali jaras sensorik
untuk mengintegrasikan persepsi dan intepretasi diri. Membantu klien untuk
mengorientasikan bagian dirinya dan kekuatan dari daerah yang terpengaruh.</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Meningkatkan keamanan klien dan
menurunkan resiko terjadinya trauma.</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Penggunaan stimulasi
penglihatan dan sentuhan membantu dalan mengintegrasikan sisi yang sakit.</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Menurunkan ansietas dan respon
emosi yang berlebihan/kebingungan yang berhubungan dengan sensori berlebih.</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">g)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Membantu klien untuk
mengidentifikasi ketidakkonsistenan dari persepsi dan integrasi stimulus.</span></div>
<div class="MsoNormal" style="margin-left: 61.2pt; mso-list: l15 level3 lfo8; tab-stops: list 61.2pt; text-indent: -25.2pt;">
<!--[if !supportLists]--><span lang="EN-US">d<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan komunikasi verbal yang
berhubungan dengan penurunan sirkulasi darah otak</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 86.4pt; text-indent: -32.4pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tujuan </span></div>
<div class="MsoNormal" style="margin-left: 86.4pt;">
<span lang="EN-US">Proses
komunikasi klien dapat berfungsi secara optimal</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 86.4pt; text-indent: -32.4pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kriteria hasil</span></div>
<div class="MsoNormal" style="margin-left: 100.55pt; mso-list: l11 level1 lfo14; tab-stops: list 104.4pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Terciptanya suatu komunikasi
dimana kebutuhan klien dapat dipenuhi</span></div>
<div class="MsoNormal" style="margin-left: 100.55pt; mso-list: l11 level1 lfo14; tab-stops: list 104.4pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien mampu merespon setiap
berkomunikasi secara verbal maupun isarat</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 86.4pt; text-indent: -32.4pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rencana tindakan</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan metode alternatif
komunikasi, misal dengan bahasa isarat</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Antisipasi setiap kebutuhan
klien saat berkomunikasi</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Bicaralah dengan klien secara
pelan dan gunakan pertanyaan yang jawabannya “ya” atau “tidak”</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Anjurkan kepada keluarga untuk
tetap berkomunikasi dengan klien</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Hargai kemampuan klien dalam
berkomunikasi</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kolaborasi dengan fisioterapis
untuk latihan wicara</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l15 level4 lfo8; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rasional </span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Memenuhi kebutuhan komunikasi
sesuai dengan kemampuan klien</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Mencegah rasa putus asa dan
ketergantungan pada orang lain</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Mengurangi kecemasan dan
kebingungan pada saat </span></div>
<div class="MsoNormal" style="margin-left: 111.6pt;">
<span lang="EN-US">komunikasi</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Mengurangi isolasi sosial dan
meningkatkan komunikasi yang efektif</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Memberi semangat pada klien
agar lebih sering melakukan komunikasi</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Melatih klien belajar bicara
secara mandiri dengan baik dan benar</span></div>
<div class="MsoNormal" style="margin-left: 61.2pt; mso-list: l15 level3 lfo8; tab-stops: list 61.2pt; text-indent: -25.2pt;">
<!--[if !supportLists]--><span lang="EN-US">e<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kurangnya perawatan diri
berhubungan dengan hemiparese/hemiplegi</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 86.4pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tujuan</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt;">
<span lang="EN-US">Kebutuhan
perawatan diri klien terpenuhi</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 86.4pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kriteria hasil</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l0 level1 lfo15; tab-stops: 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien dapat melakukan aktivitas
perawatan diri sesuai dengan kemampuan klien</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l0 level1 lfo15; tab-stops: list 108.0pt; text-indent: -25.45pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien dapat mengidentifikasi
sumber pribadi/komunitas untuk memberikan bantuan sesuai kebutuhan</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 86.4pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rencana tindakan</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tentukan kemampuan dan tingkat
kekurangan dalam melakukan perawatan diri</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><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: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Hindari melakukan sesuatu untuk
klien yang dapat dilakukan klien sendiri, tetapi berikan bantuan sesuai
kebutuhan</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan umpan balik yang
positif untuk setiap usaha yang dilakukannya atau keberhasilannya</span></div>
<div class="MsoNormal" style="margin-left: 111.6pt; mso-list: l15 level5 lfo8; tab-stops: list 111.6pt; text-indent: -21.6pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kolaborasi dengan ahli
fisioterapi/okupasi </span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l15 level4 lfo8; tab-stops: list 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rasional </span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Membantu dalam
mengantisipasi/merencanakan pemenuhan kebutuhan secara individual</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Meningkatkan harga diri dan
semangat untuk berusaha terus-menerus</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><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 mempertahankan harga diri dan meningkatkan
pemulihan</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><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: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><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-left: 61.2pt; mso-list: l15 level3 lfo8; tab-stops: list 61.2pt; text-indent: -25.2pt;">
<!--[if !supportLists]--><span lang="EN-US">f<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Resiko gangguan nutrisi kurang
dari kebutuhan tubuh berhubungan dengan kelemahan otot mengunyah dan menelan</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tujuan</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; tab-stops: list 81.0pt; text-indent: -9.0pt;">
<span lang="EN-US">Tidak terjadi gangguan nutrisi</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level4 lfo8; tab-stops: list 72.0pt left 81.0pt; text-indent: -9.0pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kriteria hasil</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l5 level1 lfo16; tab-stops: list 90.0pt 104.4pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berat badan dapat
dipertahankan/ditingkatkan</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l5 level1 lfo16; tab-stops: list 90.0pt 104.4pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Hb dan albumin dalam batas
normal</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level4 lfo8; tab-stops: list 72.0pt left 81.0pt; text-indent: -9.0pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rencana tindakan</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tentukan kemampuan klien dalam
mengunyah, menelan dan reflek batuk</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Letakkan posisi kepala lebih
tinggi pada waktu, selama dan sesudah makan </span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Stimulasi bibir untuk menutup
dan membuka mulut secara manual dengan menekan ringan diatas bibir/dibawah dagu
jika dibutuhkan </span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Letakkan makanan pada daerah
mulut yang tidak terganggu </span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan makan dengan berlahan
pada lingkungan yang tenang</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Mulailah untuk memberikan makan
peroral setengah cair, makan lunak ketika klien dapat menelan air</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">g)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Anjurkan klien menggunakan
sedotan meminum cairan</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">h)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Anjurkan klien untuk
berpartisipasidalam program latihan/kegiatan</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">i)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kolaborasi dengan tim dokter
untuk memberikan ciran melalui iv atau
makanan melalui selang </span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -9.0pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rasional </span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 81.0pt 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)</span><!--[endif]--><span lang="EN-US">Untuk menetapkan jenis makanan yang akan diberikan pada klien</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 81.0pt 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Untuk klien lebih mudah untuk
menelan karena gaya gravitasi </span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 81.0pt 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)</span><!--[endif]--><span lang="EN-US">Membantu dalam melatih kembali sensori dan meningkatkan kontrol
muskuler</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 81.0pt 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Memberikan stimulasi sensori
(termasuk rasa kecap) yang dapat mencetuskan usaha untuk menelan dan
meningkatkan masukan</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 81.0pt 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)</span><!--[endif]--><span lang="EN-US">Klien dapat berkonsentrasi pada mekanisme makan tanpa adanya
distraksi/gangguan dari luar</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 81.0pt 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Makan lunak/cairan kental mudah
untuk mengendalikannya didalam mulut, menurunkan terjadinya aspirasi</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 81.0pt 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">g)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Menguatkan otot fasial dan dan
otot menelan dan menurunkan resiko terjadinya tersedak</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 81.0pt 90.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">h)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Dapat meningkatkan pelepasan
endorfin dalam otak yang meningkatkan nafsu makan</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">i)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Mungkin diperlukan untuk
memberikan cairan pengganti dan juga makanan jika klien tidak mampu untuk
memasukkan segala sesuatu melalui mulut</span></div>
<div class="MsoNormal" style="margin-left: 61.2pt; mso-list: l15 level3 lfo8; tab-stops: list 61.2pt; text-indent: -25.2pt;">
<!--[if !supportLists]--><span lang="EN-US">g<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan eliminasi alvi
(konstipasi) berhubngan dengan imobilisasi, intake cairan yang tidak adekuat</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tujuan</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; tab-stops: list 81.0pt;">
<span lang="EN-US">Klien tidak mengalami kopnstipasi</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kriteria hasil</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l16 level1 lfo17; tab-stops: list 81.0pt 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien dapat defekasi secara
spontan dan lancar tanpa menggunakan obat</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l16 level1 lfo17; tab-stops: list 81.0pt 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Konsistensi feses lunak</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l16 level1 lfo17; tab-stops: list 81.0pt 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tidak teraba masa pada kolon (
scibala )</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l16 level1 lfo17; tab-stops: list 81.0pt 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Bising usus normal ( 7-12 kali per menit )</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rencana tindakan</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan penjelasan pada klien
dan keluarga tentang penyebab konstipasi</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Auskultasi bising usus </span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Anjurkan pada klien untuk makan
makanan yang mengandung serat</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan intake cairan yang
cukup (2 liter perhari) jika tidak ada kontraindikasi </span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Lakukan mobilisasi sesuai
dengan keadaan klien </span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt 111.6pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kolaborasi dengan tim dokter
dalam pemberian pelunak feses (laxatif, suppositoria, enema)</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rasional </span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 81.0pt 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien dan keluarga akan
mengerti tentang penyebab obstipasi</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 81.0pt 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Bising usus menandakan sifat
aktivitas peristaltik</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 81.0pt 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Diit seimbang tinggi kandungan
serat merangsang peristaltik dan eliminasi reguler</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><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: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><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: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pelunak feses meningkatkan
efisiensi pembasahan air usus, yang melunakkan massa feses dan membantu
eliminasi</span></div>
<div class="MsoNormal" style="margin-left: 61.2pt; mso-list: l15 level3 lfo8; tab-stops: list 61.2pt; text-indent: -25.2pt;">
<!--[if !supportLists]--><span lang="EN-US">h<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Resiko gangguan integritas
kulit berhubungan dengan tirah baring lama</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 63.0pt left 81.0pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tujuan</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; tab-stops: list 63.0pt left 81.0pt; text-indent: -5.4pt;">
<span lang="EN-US">Klien mampu mempertahankan keutuhan kulit</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 63.0pt left 81.0pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kriteria hasil</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l1 level1 lfo18; tab-stops: list 63.0pt left 81.0pt list 104.4pt; text-indent: -5.4pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien mau berpartisipasi
terhadap pencegahan luka</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l1 level1 lfo18; tab-stops: list 63.0pt left 81.0pt list 104.4pt; text-indent: -5.4pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien mengetahui penyebab dan
cara pencegahan luka</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l1 level1 lfo18; tab-stops: list 63.0pt left 81.0pt list 104.4pt; text-indent: -5.4pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tidak ada tanda-tanda kemerahan
atau luka</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 63.0pt left 81.0pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rencana tindakan</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 63.0pt left 99.0pt list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Anjurkan untuk melakukan
latihan ROM (range of motion) dan mobilisasi jika mungkin</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 63.0pt left 99.0pt list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rubah posisi tiap 2 jam </span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 63.0pt left 99.0pt list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><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: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 63.0pt left 99.0pt list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Lakukan masase pada daerah yang
menonjol yang baru mengalami tekanan pada waktu berubah posisi</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 63.0pt left 99.0pt list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Observasi terhadap eritema dan
kepucatan dan palpasi area sekitar terhadap kehangatan dan pelunakan jaringan
tiap merubah posisi</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 63.0pt left 99.0pt list 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Jaga kebersihan kulit dan
seminimal mungkin hindari trauma, panas terhadap kulit</span></div>
<div class="MsoNormal" style="margin-left: 86.4pt; mso-list: l15 level4 lfo8; tab-stops: list 63.0pt left 81.0pt; text-indent: -23.4pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rasional </span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 63.0pt left 81.0pt list 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Meningkatkan aliran darah
kesemua daerah</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 63.0pt left 81.0pt list 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Menghindari tekanan dan
meningkatkan aliran darah</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 63.0pt left 81.0pt list 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Menghindari tekanan yang berlebih
pada daerah yang menonjol</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 63.0pt left 81.0pt list 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Menghindari kerusakan-kerusakan
kapiler-kapiler</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 63.0pt left 81.0pt list 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Hangat dan pelunakan adalah
tanda kerusakan jaringan</span></div>
<div class="MsoNormal" style="margin-left: 99.0pt; mso-list: l15 level5 lfo8; tab-stops: list 63.0pt left 81.0pt list 99.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Mempertahankan keutuhan kulit</span></div>
<div class="MsoNormal" style="margin-left: 61.2pt; mso-list: l15 level3 lfo8; tab-stops: list 61.2pt; text-indent: -25.2pt;">
<!--[if !supportLists]--><span lang="EN-US">i<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Resiko terjadinya
ketidakefektifan bersihan jalan nafas yang berhubungan dengan menurunnya
refleks batuk dan menelan, imobilisasi</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tujuan :</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; tab-stops: list 81.0pt;">
<span lang="EN-US">Jalan nafas tetap efektif.</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kriteria hasil :</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l19 level1 lfo19; tab-stops: list 81.0pt 104.4pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien tidak sesak nafas</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l19 level1 lfo19; tab-stops: list 81.0pt 104.4pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tidak terdapat ronchi, wheezing
ataupun suara nafas tambahan</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l19 level1 lfo19; tab-stops: list 81.0pt 104.4pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tidak retraksi otot bantu
pernafasan</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l19 level1 lfo19; tab-stops: list 81.0pt 104.4pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pernafasan teratur, RR 16-20 x
per menit</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rencana tindakan :</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan penjelasan kepada klien
dan keluarga tentang sebab dan akibat ketidakefektifan jalan nafas</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rubah posisi tiap 2 jam sekali</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan intake yang adekuat
(2000 cc per hari)</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Observasi pola dan frekuensi
nafas</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Auskultasi suara nafas</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Lakukan fisioterapi nafas
sesuai dengan keadaan umum klien</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rasional :</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien dan keluarga mau
berpartisipasi dalam mencegah terjadinya ketidakefektifan bersihan jalan nafas</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Perubahan posisi dapat
melepaskan sekret dari saluran pernafasan</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Air yang cukup dapat
mengencerkan sekret</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Untuk mengetahui ada tidaknya
ketidakefektifan jalan nafas</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Untuk mengetahui adanya
kelainan suara nafas</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">f)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Agar dapat melepaskan sekret
dan mengembangkan paru-paru</span></div>
<div class="MsoNormal" style="margin-left: 61.2pt; mso-list: l15 level3 lfo8; tab-stops: list 61.2pt; text-indent: -25.2pt;">
<!--[if !supportLists]--><span lang="EN-US">j<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan eliminasi uri
(incontinensia uri) yang berhubungan dengan penurunan sensasi, disfungsi
kognitif, ketidakmampuan untuk berkomunikasi</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tujuan :</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; tab-stops: list 81.0pt;">
<span lang="EN-US">Klien mampu mengontrol eliminasi urinya</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kriteria hasil :</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l7 level1 lfo20; tab-stops: list 81.0pt 104.4pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Klien akan melaporkan penurunan
atau hilangnya inkontinensia</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l7 level1 lfo20; tab-stops: list 81.0pt 104.4pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tidak ada distensi bladder</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rencana tindakan :</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Identifikasi pola berkemih dan
kembangkan jadwal berkemih sering</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l15 level5 lfo8; tab-stops: list 81.0pt left 108.0pt list 111.6pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Ajarkan untuk membatasi masukan
cairan selama malam hari</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Ajarkan teknik untuk
mencetuskan refleks berkemih (rangsangan kutaneus dengan penepukan suprapubik,
manuver regangan anal)</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: 108.0pt list 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Bila masih terjadi
inkontinensia, kurangi waktu antara berkemih pada jadwal yang telah
direncanakan</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt 111.6pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan penjelasan tentang
pentingnya hidrasi optimal (sedikitnya 2000 cc per hari bila tidak ada
kontraindikasi)</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l15 level4 lfo8; tab-stops: list 81.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Rasional :</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berkemih yang sering dapat
mengurangi dorongan dari distensi kandung kemih yang berlebih</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pembatasan cairan pada malam
hari dapat membantu mencegah enuresis</span></div>
<div class="MsoNormal" style="margin-left: 81.0pt; mso-list: l15 level5 lfo8; tab-stops: list 81.0pt 108.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US">c)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Untuk melatih dan membantu
pengosongan kandung kemih</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">d)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kapasitas kandung kemih mungkin
tidak cukup untuk menampung volume urine sehingga memerlukan untuk lebih sering
berkemih</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l15 level5 lfo8; tab-stops: list 108.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span lang="EN-US">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Hidrasi optimal diperlukan
untuk mencegah infeksi saluran perkemihan dan batu ginjal.</span></div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l14 level2 lfo1; tab-stops: list 32.2pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US">3<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pelaksanaan</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US"> Pada tahap ini dilakukan pelaksanaan
dari perencanaan keperawatan yang telah ditentukan dengan tujuan untuk memenuhi
kebutuhan klien secara optimal. Pelaksanaan adalah pengelolaan dan perwujudan
dari rencana keperawatan yang telah di susun pada tahap pencanaan. (Nasrul
Effendy, 1995)</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l14 level2 lfo1; tab-stops: list 32.2pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US">4<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Evaluasi</span></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<span lang="EN-US"> Evaluasi merupakan langkah akhir dalam
proses keperawatan. Evaluasi adalah kegiatan yang di sengaja dan terus-menerus
dengan melibatkan klien, perawat, dan anggota tim kesehatan lainnya. Dalam hal
ini diperlukan pengetahuan tentang kesehatan, patofisiologi, dan strategi
evaluasi. Tujuan evaluasi adalah untuk menilai apakah tujuan dalam rencana
keperawatan tercapai atau tidak dan untuk melakukan pengkajian ulang.
(Lismidar, 1990)</span><o:p></o:p></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span lang="SV">DAFTAR PUSTAKA<o:p></o:p></span></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 45.0pt; text-indent: -45.0pt;">
<span lang="SV">Muda, Ahmad A.K., 2003. <i>”Kamus Lengkap
Kedokteran Edisi Refisi” </i>Gita Press; Jakarta. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; text-indent: -45.0pt;">
<span lang="SV">Diagnosa Keperawatan NANDA 2005- 2006,
Prima Medika; Jakarta.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; text-indent: -45.0pt;">
<span lang="SV">Hidayat, Aziz Alimul. 2004. “<i>Buku Saku
Praktikum Kebutuhan Dasar Manusia”</i>
EGC; Jakarta.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; text-indent: -45.0pt;">
<span lang="EN-US">McKesson Health Solution LLC; Stroke; www.medcohealth.com</span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; text-indent: -45.0pt;">
<span lang="SV">Harian Kompas; Penderita Stroke Harus
Segera Ditangani; www.kompas.com<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; text-indent: -45.0pt;">
<span lang="SV">Vitahealth; Stroke; Gramedia Pustaka Utama<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 39.6pt;">
<br /></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com6tag:blogger.com,1999:blog-4511732320299108871.post-8885382155333449972013-01-24T00:27:00.000-08:002013-01-24T00:27:02.005-08:00CIDERA KEPALA (COB)<br />
<div align="center" class="MsoNormal" style="text-align: center;">
<b><u><span lang="EN-US">CIDERA KEPALA<o:p></o:p></span></u></b></div>
<h1 style="margin-left: 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="EN-US">I.<span style="font-size: 7pt; font-weight: normal;">
</span></span><!--[endif]--><span lang="EN-US">PENGERTIAN</span></h1>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US">Cidera kepala
adalah suatu gangguan traumatik dari fungsi otak yang disertai atau tanpa
disertai perdarahan interstiil dalam substansi otak tanpa diikuti terputusnya
kontinuitas otak.</span></div>
<div class="MsoNormal">
<span lang="EN-US">Cidera otak
primer:</span></div>
<div class="MsoNormal">
<span lang="EN-US">Adalah kelainan patologi otak yang timbul
segera akibat langsung dari trauma. Pada cidera primer dapat terjadi: memar
otak, laserasi.</span></div>
<div class="MsoNormal">
<span lang="EN-US">Cidera otak
sekunder:</span></div>
<div class="MsoNormal">
<span lang="EN-US">Adalah kelainan patologi otak disebabkan
kelainan biokimia, metabolisme, fisiologi yang timbul setelah trauma.</span></div>
<div class="MsoNormal">
<span lang="EN-US">Proses-proses
fisiologi yang abnormal:</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l5 level1 lfo3; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kejang-kejang</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l5 level1 lfo3; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Gangguan saluran nafas</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l5 level1 lfo3; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tekanan intrakranial meningkat
yang dapat disebabkan oleh karena:</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l5 level2 lfo3; tab-stops: list 72.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">edema fokal atau difusi</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l5 level2 lfo3; tab-stops: list 72.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">hematoma epidural</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l5 level2 lfo3; tab-stops: list 72.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">hematoma subdural</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l5 level2 lfo3; tab-stops: list 72.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">hematoma intraserebral</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l5 level2 lfo3; tab-stops: list 72.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">over hidrasi</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l5 level1 lfo3; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Sepsis/septik syok</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l5 level1 lfo3; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Anemia</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l5 level1 lfo3; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Shock</span></div>
<div class="MsoNormal">
<span lang="EN-US">Proses fisiologis
yang abnormal ini lebih memperberat kerusakan cidera otak dan sangat
mempengaruhi morbiditas dan mortalitas.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><span lang="EN-US">Perdarahan
yang sering ditemukan:<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo8; tab-stops: list 18.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Epidural hematom:</span></div>
<div class="MsoNormal">
<span lang="EN-US">Terdapat pengumpulan darah diantara tulang
tengkorak dan duramater akibat pecahnya pembuluh darah/cabang-cabang arteri
meningeal media yang terdapat di duramater, pembuluh darah ini tidak dapat
menutup sendiri karena itu sangat berbahaya. Dapat terjadi dalam beberapa jam
sampai 1 – 2 hari. Lokasi yang paling sering yaitu dilobus temporalis dan
parietalis.</span></div>
<div class="MsoNormal">
<span lang="EN-US">Tanda dan gejala: </span></div>
<div class="MsoNormal">
<span lang="EN-US">penurunan tingkat kesadaran, nyeri kepala,
muntah, hemiparesa. Dilatasi pupil ipsilateral, pernapasan dalam dan cepat
kemudian dangkal, irreguler, penurunan nadi, peningkatan suhu.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo8; tab-stops: list 18.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Subdural hematoma</span></div>
<div class="MsoNormal">
<span lang="EN-US">Terkumpulnya darah antara duramater dan
jaringan otak, dapat terjadi akut dan kronik. Terjadi akibat pecahnya pembuluh
darah vena/jembatan vena yang biasanya terdapat diantara duramater, perdarahan
lambat dan sedikit. Periode akut terjadi dalam 48 jam – 2 hari atau 2 minggu dan
kronik dapat terjadi dalam 2 minggu atau beberapa bulan. </span></div>
<div class="MsoNormal">
<span lang="EN-US">Tanda dan gejala: </span></div>
<div class="MsoNormal">
<span lang="EN-US">Nyeri kepala, bingung, mengantuk, menarik
diri, berfikir lambat, kejang dan edema pupil.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo8; tab-stops: list 18.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Perdarahan intraserebral </span></div>
<div class="MsoNormal">
<span lang="EN-US">Perdarahan di jaringan otak karena pecahnya
pembuluh darah arteri, kapiler, vena.</span></div>
<div class="MsoNormal">
<span lang="EN-US">Tanda dan gejala: </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US">Nyeri kepala,
penurunan kesadaran, komplikasi pernapasan, hemiplegi kontralateral, dilatasi
pupil, perubahan tanda-tanda vital.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo8; tab-stops: list 18.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Perdarahan subarachnoid:</span></div>
<div class="MsoNormal">
<span lang="EN-US">Perdarahan didalam rongga subarachnoid
akibat robeknya pembuluh darah dan permukaan otak, hampir selalu ada pada
cedera kepala yang hebat.</span></div>
<div class="MsoNormal">
<span lang="EN-US">Tanda dan gejala:</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="EN-US">Nyeri kepala,
penurunan kesadaran, hemiparese, dilatasi pupil ipsilateral dan kaku kuduk.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><span lang="EN-US">Penatalaksanaan:
<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; tab-stops: 252.0pt;">
<span lang="EN-US">Konservatif</span></div>
<ul style="margin-top: 0cm;" type="disc">
<li class="MsoNormal"><span lang="EN-US">Bedrest total </span></li>
<li class="MsoNormal"><span lang="EN-US">Pemberian obat-obatan</span></li>
<li class="MsoNormal"><span lang="EN-US">Observasi tanda-tanda vital dan tingkat kesadaran.</span></li>
</ul>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><span lang="EN-US">Pengkajian<o:p></o:p></span></b></div>
<div class="MsoNormal">
<span lang="EN-US">BREATHING</span></div>
<div class="MsoNormal">
<span lang="EN-US">Kompresi pada batang otak akan
mengakibatkan gangguan irama jantung, sehingga terjadi perubahan pada pola
napas, kedalaman, frekuensi maupun iramanya, bisa berupa Cheyne Stokes atau
Ataxia breathing. Napas berbunyi, stridor, ronkhi, wheezing ( kemungkinana
karena aspirasi), cenderung terjadi peningkatan produksi sputum pada jalan
napas.</span></div>
<div class="MsoNormal">
<span lang="EN-US">BLOOD:</span></div>
<div class="MsoNormal">
<span lang="EN-US">Efek peningkatan tekanan intrakranial
terhadap tekanan darah bervariasi. Tekanan pada pusat vasomotor akan
meningkatkan transmisi rangsangan parasimpatik ke jantung yang akan
mengakibatkan denyut nadi menjadi lambat, merupakan tanda peningkatan tekanan
intrakranial. Perubahan frekuensi jantung (bradikardia, takikardia yang
diselingi dengan bradikardia, disritmia).</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">BRAIN</span></div>
<div class="MsoNormal">
<span lang="EN-US">Gangguan kesadaran merupakan salah satu
bentuk manifestasi adanya gangguan otak akibat cidera kepala. Kehilangan
kesadaran sementara, amnesia seputar kejadian, vertigo, sinkope, tinitus,
kehilangan pendengaran, baal pada ekstrimitas. Bila perdarahan hebat/luas dan
mengenai batang otak akan terjadi gangguan pada nervus cranialis, maka dapat
terjadi : </span></div>
<ul style="margin-top: 0cm;" type="disc">
<li class="MsoNormal"><span lang="EN-US">Perubahan status mental (orientasi, kewaspadaan, perhatian,
konsentrasi, pemecahan masalah, pengaruh emosi/tingkah laku dan memori).</span></li>
<li class="MsoNormal"><span lang="EN-US">Perubahan dalam penglihatan, seperti ketajamannya, diplopia,
kehilangan sebagian lapang pandang, foto fobia. </span></li>
<li class="MsoNormal"><span lang="EN-US">Perubahan pupil (respon terhadap cahaya, simetri), deviasi pada
mata. </span></li>
<li class="MsoNormal"><span lang="EN-US">Terjadi penurunan daya pendengaran, keseimbangan tubuh. </span></li>
<li class="MsoNormal"><span lang="EN-US">Sering timbul hiccup/cegukan oleh karena kompresi pada nervus
vagus menyebabkan kompresi spasmodik diafragma. </span></li>
<li class="MsoNormal"><span lang="EN-US">Gangguan nervus hipoglosus. Gangguan yang tampak lidah jatuh
kesalah satu sisi, disfagia, disatria, sehingga kesulitan menelan. </span></li>
</ul>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">BLADER</span></div>
<div class="MsoNormal">
<span lang="EN-US">Pada cidera kepala sering terjadi gangguan
berupa retensi, inkontinensia uri, ketidakmampuan menahan miksi.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">BOWEL</span></div>
<div class="MsoNormal">
<span lang="EN-US">Terjadi penurunan fungsi pencernaan: bising
usus lemah, mual, muntah (mungkin proyektil), kembung dan mengalami perubahan
selera. Gangguan menelan (disfagia) dan terganggunya proses eliminasi alvi.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">BONE</span></div>
<div class="MsoNormal">
<span lang="EN-US">Pasien cidera kepala sering datang dalam
keadaan parese, paraplegi. Pada kondisi yang lama dapat terjadi kontraktur
karena imobilisasi dan dapat pula terjadi spastisitas atau ketidakseimbangan
antara otot-otot antagonis yang terjadi karena rusak atau putusnya hubungan
antara pusat saraf di otak dengan refleks pada spinal selain itu dapat pula
terjadi penurunan tonus otot.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><span lang="EN-US">Pemeriksaan Diagnostik</span></b><span lang="EN-US">:</span></div>
<ul style="margin-top: 0cm;" type="disc">
<li class="MsoNormal"><span lang="EN-US">CT Scan: tanpa/dengan kontras) mengidentifikasi adanya
hemoragik, menentukan ukuran ventrikuler, pergeseran jaringan otak.</span></li>
<li class="MsoNormal"><span lang="EN-US">Angiografi serebral: menunjukkan kelainan sirkulasi serebral,
seperti pergeseran jaringan otak akibat edema, perdarahan, trauma.</span></li>
<li class="MsoNormal"><span lang="EN-US">X-Ray: mendeteksi perubahan struktur tulang (fraktur),
perubahan struktur garis (perdarahan / edema), fragmen tulang.</span></li>
<li class="MsoNormal"><span lang="EN-US">Analisa Gas Darah: medeteksi ventilasi atau masalah pernapasan
(oksigenasi) jika terjadi peningkatan tekanan intrakranial.</span></li>
<li class="MsoNormal"><span lang="EN-US">Elektrolit: untuk mengkoreksi keseimbangan elektrolit sebagai
akibat peningkatan tekanan intrakranial.</span></li>
</ul>
<div class="MsoNormal">
<b><span lang="EN-US">Prioritas
perawatan:<o:p></o:p></span></b></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal"><span lang="EN-US">memaksimalkan perfusi/fungsi otak</span></li>
<li class="MsoNormal"><span lang="EN-US">mencegah komplikasi</span></li>
<li class="MsoNormal"><span lang="EN-US">pengaturan fungsi secara optimal/mengembalikan ke fungsi
normal.</span></li>
<li class="MsoNormal"><span lang="EN-US">mendukung proses pemulihan koping klien/keluarga</span></li>
<li class="MsoNormal"><span lang="EN-US">pemberian informasi tentang proses penyakit, prognosis, rencana
pengobatan, dan rehabilitasi.</span></li>
</ol>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><span lang="EN-US">DIAGNOSA
KEPERAWATAN</span></b><span lang="EN-US">:</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Perubahan perfusi jaringan
serebral berhubungan dengan penghentian aliran darah (hemoragi, hematoma);
edema cerebral; penurunan TD sistemik/hipoksia (hipovolemia, disritmia jantung)</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Resiko tinggi pola napas tidak
efektif berhubungan dengan kerusakan neurovaskuler (cedera pada pusat
pernapasan otak). Kerusakan persepsi atau kognitif. Obstruksi trakeobronkhial.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Perubahan persepsi sensori
berhubungan dengan perubahan transmisi
dan/atau integrasi (trauma atau defisit neurologis).</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Perubahan proses pikir b. d
perubahan fisiologis; konflik psikologis.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">5)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kerusakan mobilitas fisik
berhubungan dengan kerusakan persepsi atau kognitif. Penurunan
kekuatan/tahanan. Terapi pembatasan /kewaspadaan keamanan, misal: tirah baring,
imobilisasi.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">6)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Resiko tinggi terhadap infeksi
berhubungan dengan jaringan trauma,
kulit rusak, prosedur invasif. Penurunan kerja silia, stasis cairan tubuh.
Kekurangan nutrisi. Respon inflamasi tertekan (penggunaan steroid). Perubahan
integritas sistem tertutup (kebocoran CSS)</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">7)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Resiko tinggi terhadap
perubahan nutrisi kurang dari kebutuhan tubuh berhubungan dengan perubahan
kemampuan untuk mencerna nutrien (penurunan tingkat kesadaran). Kelemahan otot
yang diperlukan untuk mengunyah, menelan. Status hipermetabolik.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">8)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Perubahan proses keluarga
berhubungan dengan transisi dan krisis
situasional. Ketidak pastian tentang hasil/harapan.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">9)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kurang pengetahuan mengenai
kondisi dan kebutuhan pengobatan berhubungan dengan kurang pemajanan, tidak
mengenal informasi. Kurang mengingat/keterbatasan kognitif.</span></div>
<h1 style="margin-left: 0cm; mso-list: none; tab-stops: 21.85pt; text-indent: 0cm;">
<span lang="EN-US"> </span></h1>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<h1>
<!--[if !supportLists]--><span lang="EN-US">II.<span style="font-size: 7pt; font-weight: normal;"> </span></span><!--[endif]--><span lang="EN-US">RENCANA TINDAKAN KEPERAWATAN</span></h1>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l9 level1 lfo9; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Perubahan perfusi jaringan
serebral berhubungan dengan penghentian aliran darah (hemoragi, hematoma);
edema cerebral; penurunan TD sistemik/hipoksia (hipovolemia, disritmia jantung)</span></div>
<div class="MsoNormal">
<span lang="EN-US">Tujuan: </span></div>
<ul style="margin-top: 0cm;" type="disc">
<li class="MsoNormal"><span lang="EN-US">Mempertahankan tingkat kesadaran biasa/perbaikan, kognisi, dan
fungsi motorik/sensorik.</span></li>
</ul>
<div class="MsoNormal">
<span lang="EN-US">Kriteria hasil: </span></div>
<ul style="margin-top: 0cm;" type="disc">
<li class="MsoNormal"><span lang="EN-US">Tanda vital stabil dan tidak ada tanda-tanda peningkatan TIK</span></li>
</ul>
<div class="MsoNormal" style="margin-left: 18.0pt; tab-stops: 252.0pt;">
<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;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 179.4pt;" valign="top" width="239">
<div align="center" class="MsoNormal" style="tab-stops: 252.0pt; 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: 242.45pt;" valign="top" width="323">
<div align="center" class="MsoNormal" style="tab-stops: 252.0pt; text-align: center;">
<span lang="EN-US">Rasional</span></div>
</td>
</tr>
<tr>
<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: 179.4pt;" valign="top" width="239">
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Tentukan faktor-faktor
yg menyebabkan koma/penurunan perfusi
jaringan otak dan potensial peningkatan TIK.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Pantau /catat
status neurologis secara teratur dan bandingkan dengan nilai standar GCS. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Evaluasi
keadaan pupil, ukuran, kesamaan antara kiri dan kanan, reaksi terhadap
cahaya.<o:p></o:p></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">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Pantau
tanda-tanda vital: TD, nadi, frekuensi nafas, suhu.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Pantau intake
dan out put, turgor kulit dan membran mukosa.<o:p></o:p></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">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Turunkan
stimulasi eksternal dan berikan kenyamanan, seperti lingkungan yang tenang.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Bantu pasien
untuk menghindari /membatasi batuk, muntah, mengejan.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Tinggikan
kepala pasien 15-45 derajad sesuai indikasi/yang dapat ditoleransi.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Batasi
pemberian cairan sesuai indikasi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Berikan oksigen
tambahan sesuai indikasi.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Berikan obat
sesuai indikasi, misal: diuretik, steroid, antikonvulsan, analgetik, sedatif,
antipiretik.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<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: 242.45pt;" valign="top" width="323">
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Penurunan
tanda/gejala neurologis atau kegagalan dalam pemulihannya setelah serangan
awal, menunjukkan perlunya pasien dirawat di perawatan intensif.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Mengkaji
tingkat kesadaran dan potensial peningkatan TIK dan bermanfaat dalam menentukan
lokasi, perluasan dan perkembangan kerusakan SSP.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Reaksi pupil
diatur oleh saraf cranial okulomotor (III) berguna untuk menentukan apakah
batang otak masih baik. Ukuran/ kesamaan ditentukan oleh keseimbangan antara
persarafan simpatis dan parasimpatis. Respon terhadap cahaya mencerminkan
fungsi yang terkombinasi dari saraf kranial optikus (II) dan okulomotor
(III).<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Peningkatan TD
sistemik yang diikuti oleh penurunan TD diastolik (nadi yang membesar)
merupakan tanda terjadinya peningkatan TIK, jika diikuti oleh penurunan
kesadaran. Hipovolemia/hipertensi dapat mengakibatkan kerusakan/iskhemia
cerebral. Demam dapat mencerminkan kerusakan pada hipotalamus. Peningkatan
kebutuhan metabolisme dan konsumsi oksigen terjadi (terutama saat demam dan
menggigil) yang selanjutnya menyebabkan peningkatan TIK.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Bermanfaat
sebagai ndikator dari cairan total tubuh yang terintegrasi dengan perfusi
jaringan. Iskemia/trauma serebral dapat mengakibatkan diabetes insipidus.
Gangguan ini dapat mengarahkan pada masalah hipotermia atau pelebaran
pembuluh darah yang akhirnya akan berpengaruh negatif terhadap tekanan
serebral.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Memberikan efek
ketenangan, menurunkan reaksi fisiologis tubuh dan meningkatkan istirahat
untuk mempertahankan atau menurunkan TIK.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Aktivitas ini
akan meningkatkan tekanan intrathorak dan intraabdomen yang dapat
meningkatkan TIK.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Meningkatkan
aliran balik vena dari kepala sehingga akan mengurangi kongesti dan oedema
atau resiko terjadinya peningkatan TIK.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Pembatasan
cairan diperlukan untuk menurunkan edema serebral, meminimalkan fluktuasi
aliran vaskuler TD dan TIK.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Menurunkan
hipoksemia, yang mana dapat meningkatkan vasodilatasi dan volume darah
serebral yang meningkatkan TIK.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Diuretik
digunakan pada fase akut untuk menurunkan air dari sel otak, menurunkan edema
otak dan TIK,. Steroid menurunkan inflamasi, yang selanjutnya menurunkan
edema jaringan. Antikonvulsan untuk mengatasi dan mencegah terjadinya
aktifitas kejang. Analgesik untuk menghilangkan nyeri . Sedatif digunakan
untuk mengendalikan kegelisahan, agitasi. Antipiretik menurunkan atau
mengendalikan demam yang mempunyai pengaruh meningkatkan metabolisme serebral
atau peningkatan kebutuhan terhadap oksigen.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l9 level1 lfo9; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Resiko tinggi pola napas tidak
efektif berhubungan dengan kerusakan neurovaskuler (cedera pada pusat
pernapasan otak). Kerusakan persepsi atau kognitif. Obstruksi trakeobronkhial.</span></div>
<div class="MsoNormal">
<span lang="EN-US">Tujuan: </span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l4 level2 lfo4; tab-stops: list 54.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">mempertahankan pola pernapasan
efektif.</span></div>
<div class="MsoNormal">
<span lang="EN-US">
Kriteria evaluasi:</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l4 level2 lfo4; tab-stops: list 54.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">bebas sianosis, GDA dalam batas
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;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 161.4pt;" valign="top" width="215">
<div align="center" class="MsoNormal" style="tab-stops: 252.0pt; text-align: center;">
<span lang="EN-US" style="font-size: 11.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Intervensi<o:p></o:p></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: 260.45pt;" valign="top" width="347">
<div align="center" class="MsoNormal" style="tab-stops: 252.0pt; text-align: center;">
<span lang="EN-US" style="font-size: 11.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Rasional<o:p></o:p></span></div>
</td>
</tr>
<tr>
<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: 161.4pt;" valign="top" width="215">
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Pantau
frekuensi, irama, kedalaman pernapasan. Catat ketidakteraturan pernapasan.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Pantau dan
catat kompetensi reflek gag/menelan dan kemampuan pasien untuk melindungi
jalan napas sendiri. Pasang jalan napas sesuai indikasi.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Angkat kepala
tempat tidur sesuai aturannya, posisi miirng sesuai indikasi.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Anjurkan pasien
untuk melakukan napas dalam yang efektif bila pasien sadar.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Lakukan
penghisapan dengan ekstra hati-hati, jangan lebih dari 10-15 detik. Catat
karakter, warna dan kekeruhan dari sekret.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Auskultasi
suara napas, perhatikan daerah hipoventilasi dan adanya suara tambahan yang
tidak normal misal: ronkhi, wheezing, krekel.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Pantau analisa
gas darah, tekanan oksimetri<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Lakukan ronsen
thoraks ulang.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Berikan
oksigen.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Lakukan
fisioterapi dada jika ada indikasi.<o:p></o:p></span></div>
<div class="MsoNormal">
<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: 260.45pt;" valign="top" width="347">
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Perubahan dapat
menandakan awitan komplikasi pulmonal atau menandakan lokasi/luasnya
keterlibatan otak. Pernapasan lambat, periode apnea dapat menandakan perlunya
ventilasi mekanis.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Kemampuan
memobilisasi atau membersihkan sekresi penting untuk pemeliharaan jalan
napas. Kehilangan refleks menelan atau batuk menandakan perlunaya jalan napas
buatan atau intubasi.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Untuk
memudahkan ekspansi paru/ventilasi paru dan menurunkan adanya kemungkinan
lidah jatuh yang menyumbat jalan napas.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Mencegah/menurunkan
atelektasis.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Penghisapan
biasanya dibutuhkan jika pasien koma atau dalam keadaan imobilisasi dan tidak
dapat membersihkan jalan napasnya sendiri. Penghisapan pada trakhea yang
lebih dalam harus dilakukan dengan ekstra hati-hati karena hal tersebut dapat
menyebabkan atau meningkatkan hipoksia yang menimbulkan vasokonstriksi yang
pada akhirnya akan berpengaruh cukup besar pada perfusi jaringan.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Untuk
mengidentifikasi adanya masalah paru seperti atelektasis, kongesti, atau
obstruksi jalan napas yang membahayakan oksigenasi cerebral dan/atau
menandakan terjadinya infeksi paru.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Menentukan
kecukupan pernapasan, keseimbangan asam basa dan kebutuhan akan terapi.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Melihat kembali
keadaan ventilasi dan tanda-tandakomplikasi yang berkembang misal: atelektasi
atau bronkopneumoni.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Memaksimalkan
oksigen pada darah arteri dan membantu dalam pencegahan hipoksia. Jika pusat
pernapasan tertekan, mungkin diperlukan ventilasi mekanik.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Walaupun
merupakan kontraindikasi pada pasien dengan peningkatan TIK fase akut tetapi
tindakan ini seringkali berguna pada fase akut rehabilitasi untuk
memobilisasi dan membersihkan jalan napas dan menurunkan resiko
atelektasis/komplikasi paru lainnya.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l9 level1 lfo9; tab-stops: list 36.0pt left 252.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Resiko tinggi terhadap infeksi
b.d jaringan trauma, kulit rusak, prosedur invasif. Penurunan kerja silia,
stasis cairan tubuh. Kekurangan nutrisi. Respon inflamasi tertekan (penggunaan
steroid). Perubahan integritas sistem tertutup (kebocoran CSS)</span></div>
<div class="MsoNormal">
<span lang="EN-US">Tujuan: </span></div>
<div class="MsoNormal">
<span lang="EN-US">Mempertahankan normotermia, bebas
tanda-tanda infeksi.</span></div>
<div class="MsoNormal">
<span lang="EN-US">
Kriteria evaluasi:</span></div>
<div class="MsoNormal">
<span lang="EN-US">Mencapai penyembuhan luka tepat waktu.</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: 210.9pt;" valign="top" width="281">
<div align="center" class="MsoNormal" style="tab-stops: 252.0pt; text-align: center;">
<span lang="EN-US" style="font-size: 11.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Intervensi<o:p></o:p></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: 210.95pt;" valign="top" width="281">
<div align="center" class="MsoNormal" style="tab-stops: 252.0pt; text-align: center;">
<span lang="EN-US" style="font-size: 11.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Rasional<o:p></o:p></span></div>
</td>
</tr>
<tr>
<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: 210.9pt;" valign="top" width="281">
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Berikan perawatan aseptik
dan antiseptik, pertahankan tehnik cuci tangan yang baik.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Observasi
daerah kulit yang mengalami kerusakan, daerah yang terpasang alat invasi,
catat karakteristik dari drainase dan adanya inflamasi.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Pantau suhu
tubuh secara teratur, catat adanya demam, menggigil, diaforesis dan perubahan
fungsi mental (penurunan kesadaran).<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Anjurkan untuk
melakukan napas dalam, latihan pengeluaran sekret paru secara terus menerus.
Observasi karakteristik sputum.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Berikan
antibiotik sesuai indikasi<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<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: 210.95pt;" valign="top" width="281">
<div class="MsoNormal">
<span lang="EN-US">Cara pertama
untuk menghindari terjadinya infeksi nosokomial.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Deteksi dini
perkembangan infeksi memungkinkan untuk melakukan tindakan dengan segera dan
pencegahan terhadap komplikasi selanjutnya.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Dapat
mengindikasikan perkembangan sepsis yang selanjutnya memerlukan evaluasi atau
tindakan dengan segera.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Peningkatan
mobilisasi dan pembersihan sekresi paru untuk menurunkan resiko terjadinya
pneumonia, atelektasis.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">Terapi
profilatik dapat digunakan pada pasien yang mengalami trauma, kebocoran CSS
atau setelah dilakukan pembedahan untuk menurunkan resiko terjadinya infeksi
nosokomial.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span>
<br clear="all" style="page-break-before: always;" />
</span>
<div align="center" class="MsoNormal" style="margin-left: 18.0pt; text-align: center;">
<span lang="EN-US">Daftar pustaka</span></div>
<div align="center" class="MsoNormal" style="margin-left: 18.0pt; text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US">Abdul Hafid
(1989), <u>Strategi Dasar Penanganan Cidera Otak</u>. PKB Ilmu Bedah XI –
Traumatologi , Surabaya.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US">Doenges M.E.
(2000), <u>Rencana Asuhan Keperawatan: Pedoman Untuk Perencanaan dan
Pendokumentasian Perawatan Pasien</u>. Edisi 3 . EGC. Jakarta.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<br /></div>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">Sjamsuhidajat, R. Wim de Jong (1997), <u>Buku
Ajar Ilmu Bedah</u>. Edisi Revisi. EGC, Jakarta.</span>singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-91430670969465166462013-01-24T00:18:00.001-08:002013-01-24T00:18:08.962-08:00LAPORAN PENDAHULUAN KLIEN DENGAN GANGGUAN ALAM PERASAAN DEPRESI<br />
<div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">LAPORAN PENDAHULUAN<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<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; mso-list: l1 level1 lfo10; text-align: justify; text-indent: -21.3pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN; mso-fareast-font-family: "Times New Roman";">1.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">Kasus (masalah utama)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">Gangguan alam perasaan :Depresi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<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; mso-list: l1 level1 lfo10; text-align: justify; text-indent: -21.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">2.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">P</span><span lang="EN-US" style="font-family: "Times New Roman","serif";">roses
terjadinya masalah<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">2.1 D</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">efinisi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">
Gangguan alam perasaan adalah suatu keadaan atau suasana hati yang
mempengaruhi seseorang dalam jangka waktu yang lama dan di gunakan untuk
komunikasi social, menggerakan fisik, kesadaran diri, pertahanan psikodinamik.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">
Depresi adalah suatu jenis alam
perasaan atau emosi yang disertai komponen
Psikologik ; rasa susah,murung,sedih, putus asa dan tidak bahagia serta
komponen somatic : anoreksia,konstipasi,kulit lembab.(rasa dingin) tekanan
darah dan denyut nadi sedikit menurun.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">
Depresi adalah suatu gangguan alam perasaan yang ditandai perasaan sedih
dan berduka berlebihan dan berkepanjangan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">2.2 rentang respon</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<!--[if gte vml 1]><v:shapetype id="_x0000_t32"
coordsize="21600,21600" o:spt="32" o:oned="t" path="m,l21600,21600e" filled="f">
<v:path arrowok="t" fillok="f" o:connecttype="none"/>
<o:lock v:ext="edit" shapetype="t"/>
</v:shapetype><v:shape id="_x0000_s1026" type="#_x0000_t32" style='position:absolute;
left:0;text-align:left;margin-left:66.6pt;margin-top:8.1pt;width:264pt;
height:0;z-index:251656704' o:connectortype="straight">
<v:stroke startarrow="block" endarrow="block"/>
</v:shape><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="5" width="87"></td>
</tr>
<tr>
<td></td>
<td><img height="12" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1026" width="356" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span></div>
<br clear="ALL" />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Respon adaptif Respon</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">maladaptif<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 26.7pt; 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>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 3.0cm;" valign="top" width="113">
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></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: 92.15pt;" valign="top" width="123">
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></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: 101.9pt;" valign="top" width="136">
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></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: 101.9pt;" valign="top" width="136">
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Kepekaan
emosional Reaksi berduka Supresi
Penundaan </span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span style="font-family: "Times New Roman","serif";"> <span lang="EN-US">Depresi<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";"> Tak
terkomplikasi emosi reaksi berduka</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">1.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Kepekaan
emosional<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;">Termasuk di pengaruhi oleh dan berperan aktiv dalam dunia internal dan
external.</span><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;">Tersirat bahwa orang tersebut berduka dan sadar akan
perasaan dirinya.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">2.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Reaksi
berduka tak berkomplikasi<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Terjadi
sebagai respon terhadap kehilangan dan tersirat bahwa seseorang sedang
menghadapi suatu kehilangan yang nyata serta terbenam dalam proses berduka.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">3.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Supresi
emosi<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Mungkin
tampak sebagi penyangkalan ( denial ) terhadap perasaan sendiri, pelepasan dari
keterikatan dengan emosi, atau penalaran terhadap semua aspek dari dunia
afektif seseorang.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">4.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Penndaan
reaksi berduka tau berkabung.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;">Adalah ketidak adaan yang persistem respon emosional terhadap kehilangan.
Ini dapat terjadi pada proses awal berkabung dan menjadi proses nyata pada kemunduran proses, mulai terjadi atau
keduanya. </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">Penundaan
dan penolakan proses berduka kadang terjadi bertaun-taun.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">5.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Depresi<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Ad</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">a</span><span lang="EN-US" style="font-family: "Times New Roman","serif";">lah suatu kesedihan
atau perasaan berduka yang berkepanjangan dapat digunakan untuk menunjukkan
berbagi fenomena, tanda gejala, sindrom, keadaan emosional, reaksi, penyakit
atau klinik.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">2.3 Fraktor predisposisi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 49.6pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Berbagai
teori telah di ajukan untuk menjelaskan gangguan alam persaan alam yang parah. Teori ini menunjukkan tentang
factor-faktor penhyebab yang mungkin bekerja sendiri atau dalam kombinasi.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Faktor
genetic <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Dianggap
mempengaruhi transmisi gangguan afektif melalui riwayat keluarga atau
keturunan.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">b.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Teori
agresi-menyerang kedalam<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Menunjukkan
bahwa depresi terjadi karena perasaan marah yang ditunjukkan kepada diri
sendiri.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">c.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Teori
kehilangan objek<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Merujuk
kepada perpisahan traumatic individu dengan benda atau yang sangat berarti.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">d.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Teori
organisasi kepribadian<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Menguraikan
bagaimana konsep diri yang negative dan harga diri rendah mempengaruhi system
keyakinan dan penilaian seseorang terhadap stressor.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">e.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Model
kognitif<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Menyatakan
bahwa depresi merupakan masalah kognitif yang didominasi oleh evaluasi negative
seseorang terhadap diri seseorang, dunia seseorang dan masa depan seseorang.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">f.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Model
ketidakberdayaan yang dipelajari<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Menunjukkan
bahwa bukan semata-mata trauma menyebabkan depresi tetapi keyakinan bahwa
seseorang tidak mempunyai kendali terhadap hasil yang penting terhadap
kehidupannya, oleh karna itu ia mengulang respon adaptif.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">g.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Model
perilaku<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Berkembang
dati kerangka teori belajar social yang mengasumsi penyebab depresi terletak
pada kurnagnya keinginan positif dalam berinteraksi dengan lingkungan,<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">h.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Model
biologic<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify; text-indent: 34.9pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Menguraikan perubahan
kimia dalam tubuh yang terjadi selam masa depresi termasuk devisiansi
katekolamin,disfungsi endokrin,hipersekresi kortisol, dan variasi periodic
dalam irama biologis<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">2.4 Stresor
prespitasi<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Ada empat sumberdaya utama yang
dapat mencetuskan gangguan alam perasaan :<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Kehilangan
keterikatan<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 38.15pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Yang nyata atau yang di
bayangkan,termasukan kehilang cinta seseorang, fungsi fisik, kedudukan atau
harga diri.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Peristiwa
besar dalam kehidupan<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 38.15pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Sering di laporkan sebagai pendahuluan
episode depresi dan mempunyai dampak terhadap masalah - masalah
yang di hadapi sekarang dan
kemampuan menyelesaikan masaalah<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Peran
dan ketegangan peran<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;">Telah di laporkan mempengaruhi perkembangan depresi
terutama pada wanita.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">4)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Perubahan
fisiologik<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 38.15pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Diakibatkan oleh obat-obatan atau
berbagai penyakit fisik seperti infeksi, neoplasma dan gangguan keseimbangaan
metabolik, kehilangan kasih sayang, kehilanggan harga diri,dll<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">5)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Sumber
koping<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 38.15pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Sumber-sumber koping meliputi
status sosioekonomik,</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">keluarga,</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">jaringan
interpersonal,dan organisasi sekunder yang dilindungi oleh lingkungan social
yang lebih luas. </span><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;">Kurangnya sumber personal tersebut menambah stress bagi
individu<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;">Faktor – faktor
resiko pada depresi adalah :<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Episode
depresi sebelumnya<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Riwayat
keluarga tentang depresi<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Percobaan
bunuh diri sebelumnya<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Jenis
kelamin wanita<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Usia
saat awitan depresi < 40 tahun<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Masa
post partum<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Morbiditas
medic<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Kurangnya
dukungan social<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Peristiwa
kehidupan yang penuh stress<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Riwayat
personal tentang penganiayaan seksual<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">6)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Mekanisme
koping<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 38.15pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Reaksi berduka yang tertunda
mencerminkan penggunaan eksagresasi dari mekanisme pertahanan penyangkalan
(denial) dan supresi yang berlebihan
dalam upayanya untuk menghindari stress yang hebat berhubungan dengan duka.Depresi
yaitu perasaan berduka yang belum
terselesaikan.mekanisme koping yang di gunakaan
adalah represi,supresi,denial dan
disosiasi<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="FI" style="font-family: "Times New Roman","serif"; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">7)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="FI" style="font-family: "Times New Roman","serif"; mso-ansi-language: FI;">Kriteria
Untuk Penentu Keparahan Episode Depresi<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">a)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Ringan<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 92.15pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 15.85pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Jika ada gejala yang melebihi
dari yang di perlukan untuk membuat diagnosis</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> dan </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">gejala menyebabkan hanya gangguan
ringan dalam fungsi perkerjaan atau
dalam aktivitas social yang biasanya hubungan dengan orang lain<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">b)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Sedang
<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Gejala
atau gangguan fungsional berada diantara ringan dan parah<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">c)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">Berat</span><span lang="EN-US" style="font-family: "Times New Roman","serif";"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level5 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Tanpa
ciri psikotik<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 92.15pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 15.85pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Beberapa gejala adalah melebihi
yang diperlukan untuk membuat diagnosis
dan gejala dengan jelas menggangu fungsi
pekerjaan atau aktivitas social yang biasanya atau hubungan dengan orang
lain</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level5 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Dengan
ciri psikotik<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 92.15pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 15.85pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Waham atau halusinasi, jika
mungkin sejalan dengan mood atau tidak sejalan dengan mood</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 92.15pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 15.85pt;">
<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; mso-list: l1 level1 lfo10; text-align: justify; text-indent: -21.3pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN; mso-fareast-font-family: "Times New Roman";">3.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Pohon
masalah</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 20.7pt;">
<!--[if gte vml 1]><v:shape id="_x0000_s1027"
type="#_x0000_t32" style='position:absolute;left:0;text-align:left;
margin-left:117.6pt;margin-top:18.65pt;width:0;height:18.75pt;flip:y;
z-index:251657728' o:connectortype="straight">
<v:stroke endarrow="block"/>
</v:shape><![endif]--><!--[if !vml]--><span style="height: 28px; left: 0px; margin-left: 151px; margin-top: 23px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251657728;"><img height="28" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1027" width="12" /></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Kerusakaan komunikasi verba</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">L </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">(akibat)</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 20.7pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 20.7pt;">
<!--[if gte vml 1]><v:shape id="_x0000_s1028"
type="#_x0000_t32" style='position:absolute;left:0;text-align:left;
margin-left:118.35pt;margin-top:17.75pt;width:0;height:18.75pt;flip:y;
z-index:251658752' o:connectortype="straight">
<v:stroke endarrow="block"/>
</v:shape><![endif]--><!--[if !vml]--><span style="height: 28px; left: 0px; margin-left: 152px; margin-top: 22px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251658752;"><img height="28" src="file:///C:/Users/BAYUKH~1/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1028" width="12" /></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Gangguan alam perasaan :depres</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">I </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">(care problem)</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 20.7pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 20.7pt;">
<span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">Ketidak berdayaan : mengambil keputusan (penyebab)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<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; mso-list: l1 level1 lfo10; text-align: justify; text-indent: -21.3pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN; mso-fareast-font-family: "Times New Roman";">4.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">Data yang perlu di
kaji dan masalah keperawatan <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l1 level2 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">4.1<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;">Data yang dik</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">a</span><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;">ji dan tanda gejalanya<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">Data Subyektif:<o:p></o:p></span></div>
<div style="margin-left: 35.45pt; text-align: justify;">
<span lang="EN-US">Tidak mampu mengutarakan pendapat dan malas
berbicara.Sering mengemukakan keluhan somatic seperti ; nyeri abdomen dan dada,
anoreksia, sakit punggung,pusing. Merasa dirinya sudah tidak berguna lagi,
tidak berarti, tidak ada tujuan hidup, merasa putus asa dan cenderung bunuh
diri. Pasien mudah tersinggung dan ketidakmampuan untuk konsentrasi. </span><span lang="EN-US" style="color: #aabbcc;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">Data
Obyektif:</span><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level4 lfo6; text-align: justify; text-indent: -14.2pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Afektif</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> :</span><span style="font-family: "Times New Roman","serif";"> <span lang="EN-US">-</span></span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">kemaraha</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">n </span><span lang="EN-US" style="font-family: "Times New Roman","serif";"> -</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">harga dir<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 85.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 6.5pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">ansietas</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">rasa tidak berharga </span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 85.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 6.5pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">penyangkalan perasaan</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">keputusasaan</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 85.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 6.5pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">- kemurungan</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level4 lfo6; text-align: justify; text-indent: -14.2pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Fisiolog</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">i : - </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">insomnia<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 85.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 13.6pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">ganggu</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">an<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 85.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 13.6pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">kelesuan</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 85.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 13.6pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">keletihan<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level4 lfo6; text-align: justify; text-indent: -14.2pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Kognitif</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> : - </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">kebingungan<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 85.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 13.6pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">ketidak mampuan
konsentrasi</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 85.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 13.6pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">tidak dapat mengambil
keputusan</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 85.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 13.6pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">kehilangan minat dan
motivasi</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 85.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 13.6pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">mencela diri sendiri</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 85.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 13.6pt;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 49.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level4 lfo6; text-align: justify; text-indent: -14.2pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Perilaku</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> : </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">Perubahan tingkat
aktivita<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 85.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 13.6pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">sangat tergantung</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 85.65pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: 13.6pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">-</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> </span><span lang="EN-US" style="font-family: "Times New Roman","serif";">kebersihan diri kerang<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l1 level2 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">4.2<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Masalah keperawatan<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level6 lfo6; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">1.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Kerusakaan
komunikasi verbal<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level6 lfo6; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">2.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Gangguan
alam perasaan :depresi<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level6 lfo6; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">3.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Ketidak
berdayaan mengambil keputusa<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<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; mso-list: l1 level1 lfo10; text-align: justify; text-indent: -21.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">5.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Diagnosa
keperawatan<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">1.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Kerusakan
komunikasi verbal<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">2.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Gangguan
alam persaan : depresi<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">3.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Ketidak
berdayaan mengambil keputusan<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;">
<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; mso-list: l1 level1 lfo10; text-align: justify; text-indent: -21.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">6.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">Rencana
tindakan keperawatan<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify; text-indent: -50.7pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Diagnosa keperwatan : kerusakaan
komunikasi verbal<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l7 level4 lfo8; text-align: justify; text-indent: -50.7pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;">TUM :</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;"> Klien</span><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;">
dapat berkomunikasi dengan orang lain
secara maksimal<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l7 level4 lfo8; text-align: justify; text-indent: -50.7pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US" style="font-family: "Times New Roman","serif";">TUK :<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo9; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">1.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;">K</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">lien</span><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;"> dapat membina hubungan saling percaya <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo9; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">2.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">Klie</span><span lang="SV" style="font-family: "Times New Roman","serif"; mso-ansi-language: SV;">n dapat mengidentifikasi komponen yang dimiliki<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo9; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="FI" style="font-family: "Times New Roman","serif"; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">3.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="FI" style="font-family: "Times New Roman","serif"; mso-ansi-language: FI;">K</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">lien</span><span lang="FI" style="font-family: "Times New Roman","serif"; mso-ansi-language: FI;"> dapat menilai kemampuan yang di gunakan <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo9; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";">4.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: IN;">Klien</span><span lang="EN-US" style="font-family: "Times New Roman","serif";">
dapat melakukan komunikasi sesuai kondisinya<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div align="center" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: center;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">DAFTAR PUSTAKA<o:p></o:p></span></div>
<div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Aziz R, dkk. 2003. <i>Pedoman
Asuhan Keperawatan Jiwa Semarang</i>. RSJP Dr.Amina : Gondo Utama</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="EN-US" style="font-family: "Times New Roman","serif";">Carpenito,
Lynda Juall. 2006. <i>Buku Saku Diagnosa
Keperawatan</i>. Jakarta : EGC http://www.scribd.com/<i>LP-perilaku-kekerasan</i> diakses pada Senin 06 Juni 2011<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span lang="FI" style="font-family: "Times New Roman","serif"; mso-ansi-language: FI;">Keliat, BA. 1998. <i>Proses Keperawatan
Kesehatan Jiwa</i>. Jakarta : EGC<o:p></o:p></span></div>
<div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -36.0pt;">
<span lang="FI">Materi Kuliah Keperawatan Jiwa Akademi
Keperawatan Pamenang Pare Kediri<o:p></o:p></span></div>
<div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -36.0pt;">
<span lang="FI">Stuard G. W dan L.J Sundeen. </span><span lang="EN-US">1991. <i>Principles and Practice
of Phsychiatric Nursing</i>. St. Louis : Mosby Year Book</span></div>
<div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Tim Direktorat Keswa. 2001. <i>Standart
Asuhan Keperawatan Jiwa Edisi I</i>. Bandung : RSJP Bandung</span></div>
<div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm;">
<br /></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-18952754895862860932013-01-20T22:18:00.001-08:002013-01-20T22:18:18.093-08:00LAPORAN PENDAHULUAN DAN ASKEP TEORI PADA ANAK DENGAN THIPOID<br />
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span lang="EN-US">ASUHAN KEPERAWATAN KLIEN
ANAK DENGAN THIPOID<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b><span lang="EN-US">A. PENGERTIAN<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<span lang="EN-US">Demam
tifoid adalah penyakit menular yang bersifat akut, yang ditandai dengan
bakterimia, perubahan pada sistem retikuloendotelial yang bersifat difus,
pembentukan mikroabses dan ulserasi Nodus peyer di distal ileum. (Soegeng
Soegijanto, 2002)</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify; text-indent: 35.45pt;">
<span lang="EN-US">Tifus abdominalis adalah suatu
infeksi sistem yang ditandai demam, sakit kepala, kelesuan, anoreksia,
bradikardi relatif, kadang-kadang pembesaran dari limpa/hati/kedua-duanya.
(Samsuridjal D dan heru S, 2003)</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<h2 style="line-height: 150%;">
<span lang="EN-US">B. PENYEBAB </span></h2>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<span lang="EN-US">Salmonella
typhi yang menyebabkan infeksi invasif yang ditandai oleh demam, toksemia,
nyeri perut, konstipasi/diare. Komplikasi yang dapat terjadi antara lain:
perforasi usus, perdarahan, toksemia dan kematian. (Ranuh, Hariyono, dan dkk.
2001)</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<span lang="EN-US">Etiologi
demam tifoid dan demam paratipoid adalah S.typhi, S.paratyphi A, S.paratyphi b
dan S.paratyphi C. (Arjatmo Tjokronegoro, 1997) </span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 0cm;">
<br /></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 0cm;">
<b><span lang="EN-US">C. PATOFISIOLOGIS<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<span lang="EN-US">Transmisi
terjadi melalui makanan dan minuman yang terkontaminasi urin/feses dari
penderita tifus akut dan para pembawa kuman/karier.</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<span lang="EN-US">Empat F
(Finger, Files, Fomites dan fluids) dapat menyebarkan kuman ke makanan, susu,
buah dan sayuran yang sering dimakan tanpa dicuci/dimasak sehingga dapat
terjadi penularan penyakit terutama terdapat dinegara-negara yang sedang
berkembang dengan kesulitan pengadaan pembuangan kotoran (sanitasi) yang andal.
(Samsuridjal D dan heru S, 2003)</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<span lang="EN-US">Masa
inkubasi demam tifoid berlangsung selama 7-14 hari (bervariasi antara 3-60
hari) bergantung jumlah dan strain kuman yang tertelan. Selama masa inkubasi
penderita tetap dalam keadaan asimtomatis. (Soegeng soegijanto, 2002)</span></div>
<div align="center" class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<br /></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 0cm;">
<b><span lang="EN-US">D. GEJALA KLINIS<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<span lang="EN-US">Gejala
klinis pada anak umumnya lebih ringan dan lebih bervariasi dibandingkan dengan
orang dewasa. Walaupun gejala demam tifoid pada anak lebih bervariasi, tetapi
secara garis besar terdiri dari demam satu minggu/lebih, terdapat gangguan
saluran pencernaan dan gangguan kesadaran. Dalam minggu pertama, keluhan dan
gejala menyerupai penyakit infeksi akut pada umumnya seperti demam, nyeri
kepala, anoreksia, mual, muntah, diare, konstipasi, serta suhu badan yang
meningkat.</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<span lang="EN-US">Pada
minggu kedua maka gejala/tanda klinis menjadi makin jelas, berupa demam
remiten, lidah tifoid, pembesaran hati dan limpa, perut kembung, bisa disertai
gangguan kesadaran dari ringan sampai berat. Lidah tifoid dan tampak kering,
dilapisi selaput kecoklatan yang tebal, di bagian ujung tepi tampak lebih
kemerahan. (Ranuh, Hariyono, dan dkk. 2001)</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<span lang="EN-US">Sejalan
dengan perkembangan penyakit, suhu tubuh
meningkat dengan gambaran ‘anak tangga’. Menjelang akhir minggu pertama, pasien
menjadi bertambah toksik. (Vanda Joss & Stephen Rose, 1997)</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 13.65pt; text-indent: 36.0pt;">
<span lang="EN-US">Gambaran klinik tifus abdominalis</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 14.2pt;">
<span lang="EN-US">Keluhan:</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 14.2pt;">
<span lang="EN-US">- Nyeri kepala (frontal) 100%</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 14.2pt;">
<span lang="EN-US">- Kurang enak di perut </span><span lang="EN-US" style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">³</span><span lang="EN-US">50%</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 14.2pt;">
<span lang="EN-US">- Nyeri tulang, persendian, dan otot </span><span lang="EN-US" style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">³</span><span lang="EN-US">50%</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 14.2pt;">
<span lang="EN-US">- Berak-berak </span><span lang="EN-US" style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">£</span><span lang="EN-US">50%</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 14.2pt;">
<span lang="EN-US">- Muntah </span><span lang="EN-US" style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">£</span><span lang="EN-US">50%</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 14.2pt;">
<span lang="EN-US">Gejala:</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 14.2pt;">
<span lang="EN-US">- Demam 100%</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 14.2pt;">
<span lang="EN-US">- Nyeri tekan perut 75%</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 14.2pt;">
<span lang="EN-US">- Bronkitis 75%</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 14.2pt;">
<span lang="EN-US">- Toksik </span><span lang="EN-US" style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">></span><span lang="EN-US">60%</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 14.2pt;">
<span lang="EN-US">- Letargik </span><span lang="EN-US" style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">></span><span lang="EN-US">60%</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0cm; text-indent: 14.2pt;">
<span lang="EN-US">- Lidah tifus (“kotor”) 40%</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<span lang="EN-US"> (Sjamsuhidayat,1998)</span></div>
<div class="MsoBodyTextIndent2" style="text-indent: 0cm;">
<b><span lang="EN-US">E. PEMERIKSAAN PENUNJANG<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent2" style="margin-left: 32.2pt; mso-list: l7 level1 lfo5; tab-stops: list 32.2pt left 155.95pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan Darah Perifer
Lengkap</span></div>
<div class="MsoBodyTextIndent2" style="margin-left: 32.2pt; text-indent: 0cm;">
<span lang="EN-US">Dapat ditemukan leukopeni, dapat pula leukositosis atau kadar
leukosit normal. Leukositosis dapat terjadi walaupun tanpa disertai infeksi
sekunder. </span></div>
<div class="MsoBodyTextIndent2" style="margin-left: 32.2pt; mso-list: l7 level1 lfo5; tab-stops: list 32.2pt left 155.95pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan SGOT dan SGPT</span></div>
<div class="MsoBodyTextIndent2" style="margin-left: 32.2pt; text-indent: 0cm;">
<span lang="EN-US">SGOT dan SGPT sering meningkat, tetapi akan kembali normal setelah
sembuh. Peningkatan SGOT dan SGPT ini tidak memerlukan penanganan khusus</span></div>
<div class="MsoBodyTextIndent2" style="margin-left: 32.2pt; mso-list: l7 level1 lfo5; tab-stops: list 32.2pt left 155.95pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">3.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemeriksaan Uji Widal</span></div>
<div class="MsoBodyTextIndent2" style="margin-left: 32.2pt; tab-stops: 35.45pt 155.95pt; text-indent: 0cm;">
<span lang="EN-US">Uji Widal dilakukan untuk
mendeteksi adanya antibodi terhadap bakteri Salmonella typhi. Uji Widal
dimaksudkan untuk menentukan adanya aglutinin dalam serum penderita Demam
Tifoid. Akibat adanya infeksi oleh Salmonella typhi maka penderita membuat
antibodi (aglutinin) yaitu:</span></div>
<div class="MsoBodyTextIndent2" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 49.65pt left 120.5pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Aglutinin O: karena rangsangan
antigen O yang berasal dari tubuh bakteri</span></div>
<div class="MsoBodyTextIndent2" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 49.65pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Aglutinin H: karena rangsangan
antigen H yang berasal dari flagela bakteri</span></div>
<div class="MsoBodyTextIndent2" style="margin-left: 127.6pt; mso-list: l1 level1 lfo4; tab-stops: 49.65pt 120.5pt; text-indent: -92.15pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Aglutinin Vi: karena rangsangan
antigen Vi yang berasal dari simpai bakter.</span></div>
<div class="MsoBodyTextIndent2" style="margin-left: 35.45pt; tab-stops: 49.65pt 120.5pt; text-indent: 0cm;">
<span lang="EN-US">Dari ketiga aglutinin tersebut
hanya aglitinin O dan H yang digunakan untuk diagnosis Demam Tifoid. Semakin
tinggi titernya semakin besar kemungkinan menderita Demam Tifoid. (Widiastuti
Samekto, 2001)</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; text-indent: -14.2pt;">
<br /></div>
<h2 style="line-height: 150%;">
<span lang="EN-US">F. TERAPI</span></h2>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l6 level1 lfo2; tab-stops: list 35.45pt; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="EN-US">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Kloramfenikol. Dosis yang
diberikan adalah 4 x 500 mg perhari, dapat diberikan secara oral atau
intravena, sampai 7 hari bebas panas</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l6 level1 lfo2; tab-stops: list 35.45pt; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="EN-US">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US"> Tiamfenikol. Dosis yang diberikan 4 x 500 mg
per hari. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l6 level1 lfo2; tab-stops: list 35.45pt; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="EN-US">3.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Kortimoksazol. Dosis 2 x 2
tablet (satu tablet mengandung 400 mg sulfametoksazol dan 80 mg trimetoprim)</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l6 level1 lfo2; tab-stops: list 35.45pt; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="EN-US">4.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Ampisilin dan amoksilin. Dosis
berkisar 50-150 mg/kg BB, selama 2 minggu</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l6 level1 lfo2; tab-stops: list 35.45pt; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="EN-US">5.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Sefalosporin Generasi Ketiga.
dosis 3-4 gram dalam dekstrosa 100 cc, diberikan selama ½ jam per-infus sekali
sehari, selama 3-5 hari</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l6 level1 lfo2; tab-stops: list 35.45pt; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="EN-US">6.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Golongan Fluorokuinolon</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: list 53.45pt left 155.95pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Norfloksasin : dosis 2 x 400 mg/hari selama 14
hari</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: list 53.45pt left 155.95pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Siprofloksasin : dosis 2 x 500 mg/hari selama 6
hari</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: list 53.45pt left 155.95pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Ofloksasin : dosis 2 x 400 mg/hari selama
7 hari</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: list 53.45pt left 155.95pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Pefloksasin : dosis 1 x 400 mg/hari selama 7
hari</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: list 53.45pt left 155.95pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Fleroksasin : dosis 1 x 400 mg/hari selama 7
hari</span></div>
<div class="MsoBodyTextIndent2" style="margin-left: 18.0pt; mso-list: l6 level1 lfo2; tab-stops: list 18.0pt left 155.95pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">7.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kombinasi obat antibiotik.
Hanya diindikasikan pada keadaan tertentu seperti: Tifoid toksik, peritonitis
atau perforasi, syok septik, karena telah terbukti sering ditemukan dua macam
organisme dalam kultur darah selain kuman Salmonella typhi. (Widiastuti S,
2001)</span></div>
<div class="MsoBodyTextIndent2" style="margin-left: 32.2pt; tab-stops: 35.45pt 155.95pt; text-indent: 0cm;">
<br /></div>
<h2 style="line-height: 150%; tab-stops: 155.95pt;">
<span lang="EN-US">G. KOMPLIKASI</span></h2>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-indent: 35.45pt;">
<span lang="EN-US">Perdarahan usus, peritonitis, meningitis, kolesistitis,
ensefalopati, bronkopneumonia, hepatitis. (Arif mansjoer & Suprohaitan
2000)</span></div>
<div class="MsoBodyTextIndent3" style="margin-left: 14.2pt; text-indent: 35.45pt;">
<span lang="EN-US">Perforasi usus terjadi pada 0,5-3% dan perdarahan berat pada 1-10%
penderita demam tifoid. Kebanyakan komplikasi terjadi selama stadium ke-2
penyakit dan umumnya didahului oleh penurunan suhu tubuh dan tekanan darah
serta kenaikan denyut jantung.Pneumonia sering ditemukan selama stadium ke-2
penyakit, tetapi seringkali sebagai akibat superinfeksi oleh organisme lain
selain Salmonella. Pielonefritis, endokarditis, meningitis, osteomielitis dan
arthritis septik jarang terjadi pada hospes normal. Arthritis septik dan
osteomielitis lebih sering terjadi pada penderita hemoglobinopati. (Behrman
Richard, 1992)</span></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 155.95pt; text-align: justify; text-indent: 21.3pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 216.0pt;">
<br /></div>
<b><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-size: 10.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="page-break-before: always;" />
</span></b>
<div class="MsoBodyText">
<b><span lang="EN-US">H.
ASUHAN KEPERAWATAN PADA ANAK DENGAN DEMAM TIPOID<o:p></o:p></span></b></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText" style="margin-left: 18.0pt; mso-list: l2 level1 lfo6; tab-stops: 35.45pt 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><b><span lang="EN-US">A.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-US">PENGKAJIAN<o:p></o:p></span></b></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l0 level1 lfo7; tab-stops: 35.45pt 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Riwayat keperawatan</span></div>
<div class="MsoBodyText" style="margin-left: 2.0cm; mso-list: l0 level1 lfo7; tab-stops: 35.45pt 2.0cm; text-indent: -17.4pt;">
<!--[if !supportLists]--><span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kaji adanya gejala dan tanda
meningkatnya suhu tubuh terutama pada malam hari, nyeri kepala, lidah kotor,
tidak nafsu makan, epistaksis, penurunan kesadaran</span></div>
<div class="MsoBodyText" style="margin-left: 18.0pt; tab-stops: 35.45pt 2.0cm; text-indent: 3.3pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 18.0pt; mso-list: l2 level1 lfo6; tab-stops: 35.45pt 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><b><span lang="EN-US">B.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-US">DIAGNOSA KEPERAWATAN<o:p></o:p></span></b></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l8 level1 lfo8; tab-stops: 35.45pt 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Hipertermi berhubungan dengan
proses infeksi</span></div>
<div class="MsoBodyText" style="margin-left: 2.0cm; mso-list: l8 level1 lfo8; tab-stops: 35.45pt 2.0cm; text-indent: -17.4pt;">
<!--[if !supportLists]--><span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Perubahan nutrisi kurang dari
kebutuhan tubuh berhubungan dengan tidak ada nafsu makan, mual, dan kembung</span></div>
<div class="MsoBodyText" style="margin-left: 2.0cm; mso-list: l8 level1 lfo8; tab-stops: 35.45pt 2.0cm; text-indent: -17.4pt;">
<!--[if !supportLists]--><span lang="EN-US">3.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Risiko kurangnya volume cairan
berhubungan dengan kurangnya intake cairan, dan peningkatan suhu tubuh</span></div>
<div class="MsoBodyText" style="margin-left: 18.0pt; tab-stops: 35.45pt 2.0cm; text-indent: 3.3pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 18.0pt; mso-list: l2 level1 lfo6; tab-stops: 35.45pt 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><b><span lang="EN-US">C.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-US">PERENCANAAN<o:p></o:p></span></b></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l3 level1 lfo9; tab-stops: 35.45pt 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><b><span lang="EN-US">1.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-US">Mempertahankan suhu dalam
batas normal<o:p></o:p></span></b></div>
<div class="MsoBodyText" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 53.45pt left 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kaji pengetahuan klien dan
keluarga tentang hipertermia</span></div>
<div class="MsoBodyText" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 53.45pt left 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Observasi suhu, nadi, tekanan
darah, pernafasan</span></div>
<div class="MsoBodyText" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 53.45pt left 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berri minum yang cukup</span></div>
<div class="MsoBodyText" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 53.45pt left 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan kompres air biasa</span></div>
<div class="MsoBodyText" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 53.45pt left 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Lakukan tepid sponge (seka)</span></div>
<div class="MsoBodyText" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 53.45pt left 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pakaian (baju) yang tipis dan
menyerap keringat</span></div>
<div class="MsoBodyText" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 53.45pt left 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemberian obat antipireksia</span></div>
<div class="MsoBodyText" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 53.45pt left 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Pemberian cairan parenteral
(IV) yang adekuat</span></div>
<div class="MsoBodyText" style="tab-stops: 35.45pt 2.0cm; text-indent: 3.3pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l3 level1 lfo9; tab-stops: 35.45pt 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><b><span lang="EN-US">2.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-US">Meningkatkan kebutuhan
nutrisi dan cairan<o:p></o:p></span></b></div>
<div class="MsoBodyText" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 53.45pt left 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Menilai status nutrisi anak</span></div>
<div class="MsoBodyText" style="margin-left: 70.9pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt 70.9pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Ijinkan anak untuk memakan
makanan yang dapat ditoleransi anak, rencanakan untuk memperbaiki kualitas gizi
pada saat selera makan anak meningkat.</span></div>
<div class="MsoBodyText" style="margin-left: 70.9pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt 70.9pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan makanan yang disertai
dengan suplemen nutrisi untuk meningkatkan kualitas intake nutrisi</span></div>
<div class="MsoBodyText" style="margin-left: 70.9pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt 70.9pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Menganjurkan kepada orang tua
untuk memberikan makanan dengan teknik porsi kecil tetapi sering</span></div>
<div class="MsoBodyText" style="margin-left: 70.9pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt 70.9pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Menimbang berat badan setiap
hari pada waktu yang sama, dan dengan skala yang sama</span></div>
<div class="MsoBodyText" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 53.45pt left 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Mempertahankan kebersihan mulut
anak</span></div>
<div class="MsoBodyText" style="margin-left: 70.9pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt 70.9pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Menjelaskan pentingnya intake
nutrisi yang adekuat untuk penyembuhan penyakit</span></div>
<div class="MsoBodyText" style="margin-left: 70.9pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt 70.9pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Kolaborasi untuk pemberian
makanan melalui parenteral jika pemberian makanan melalui oral tidak memenuhi
kebutuhan gizi anak</span></div>
<div class="MsoBodyText" style="margin-left: 35.45pt; text-indent: 3.3pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l3 level1 lfo9; tab-stops: 35.45pt 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><b><span lang="EN-US">3.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-US">Mencegah kurangnya volume
cairan<o:p></o:p></span></b></div>
<div class="MsoBodyText" style="margin-left: 70.9pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt 70.9pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Mengobservasi tanda-tanda vital
(suhu tubuh) paling sedikit setiap 4 jam</span></div>
<div class="MsoBodyText" style="margin-left: 70.9pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt 70.9pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Monitor tanda-tanda
meningkatnya kekurangan cairan: turgor tidak elastis, ubun-ubun cekung, produksi urin menurun,
memberan mukosa kering, bibir pecah-pecah</span></div>
<div class="MsoBodyText" style="margin-left: 70.9pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt 70.9pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Mengobservasi dan mencatat
berat badan pada waktu yang sama dan dengan skala yang sama </span></div>
<div class="MsoBodyText" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 53.45pt left 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Memonitor pemberian cairan
melalui intravena setiap jam</span></div>
<div class="MsoBodyText" style="margin-left: 70.9pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt 70.9pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Mengurangi kehilangan cairan
yang tidak terlihat (Insensible Water Loss/IWL) dengan memberikan kompres
dingin atau dengan tepid sponge</span></div>
<div class="MsoBodyText" style="margin-left: 53.45pt; mso-list: l1 level1 lfo4; tab-stops: 35.45pt list 53.45pt left 2.0cm; text-indent: 3.3pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Memberikan antibiotik sesuai
program</span></div>
<div class="MsoBodyText" style="margin-left: 252.0pt; tab-stops: 35.45pt 2.0cm; text-indent: 3.3pt;">
<span lang="EN-US">(Suriadi & Rita Y, 2001)</span></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText">
<br /></div>
<b><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-size: 10.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="page-break-before: always;" />
</span></b>
<div class="MsoBodyText">
<b><span lang="EN-US">I.
DISCHARGE PLANNING<o:p></o:p></span></b></div>
<div class="MsoBodyText" style="margin-left: 32.2pt; mso-list: l5 level1 lfo1; tab-stops: list 32.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Penderita harus dapat
diyakinkan cuci tangan dengan sabun setelah defekasi</span></div>
<div class="MsoBodyText" style="margin-left: 32.2pt; mso-list: l5 level1 lfo1; tab-stops: list 32.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Mereka yang diketahui sebagai
karier dihindari untuk mengelola makanan</span></div>
<div class="MsoBodyText" style="margin-left: 32.2pt; mso-list: l5 level1 lfo1; tab-stops: list 32.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">3.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Lalat perlu dicegah
menghinggapi makanan dan minuman.</span></div>
<div class="MsoBodyText" style="margin-left: 32.2pt; mso-list: l5 level1 lfo1; tab-stops: list 32.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">4.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Penderita memerlukan istirahat </span></div>
<div class="MsoBodyText" style="margin-left: 32.2pt; mso-list: l5 level1 lfo1; tab-stops: list 32.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">5.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Diit lunak yang tidak
merangsang dan rendah serat</span></div>
<div class="MsoBodyText" style="margin-left: 216.0pt;">
<span lang="EN-US">(Samsuridjal
D dan Heru S, 2003)</span></div>
<div class="MsoBodyText" style="margin-left: 32.2pt; mso-list: l5 level1 lfo1; tab-stops: list 32.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">6.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Berikan informasi tentang
kebutuhan melakukan aktivitas sesuai dengan tingkat perkembangan dan kondisi
fisik anak</span></div>
<div class="MsoBodyText" style="margin-left: 32.2pt; mso-list: l5 level1 lfo1; tab-stops: list 32.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">7.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Jelaskan terapi yang diberikan:
dosis, dan efek samping</span></div>
<div class="MsoBodyText" style="margin-left: 32.2pt; mso-list: l5 level1 lfo1; tab-stops: list 32.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">8.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Menjelaskan gejala-gejala
kekambuhan penyakit dan hal yang harus dilakukan untuk mengatasi gejala
tersebut</span></div>
<div class="MsoBodyText" style="margin-left: 32.2pt; mso-list: l5 level1 lfo1; tab-stops: list 32.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">9.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-US">Tekankan untuk melakukan
kontrol sesuai waktu yang ditentukan.</span></div>
<div class="MsoBodyText" style="margin-left: 216.0pt;">
<span lang="EN-US">(Suriadi
& Rita Y, 2001) </span></div>
<div class="MsoBodyText">
<br /></div>
<b><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-size: 10.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="page-break-before: always;" />
</span></b>
<div align="center" class="MsoBodyText" style="text-align: center;">
<b><span lang="EN-US">DAFTAR PUSTAKA<o:p></o:p></span></b></div>
<div align="center" class="MsoBodyText" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.75pt; mso-list: l4 level1 lfo3; tab-stops: list 30.75pt; text-align: justify; text-indent: -30.75pt;">
<!--[if !supportLists]--><span lang="EN-US">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Arif Mansjoer, Suprohaitan,
Wahyu Ika W, Wiwiek S. <b><i>Kapita Selekta Kedokteran</i></b>. Penerbit
Media Aesculapius. FKUI <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>.
2000.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.75pt; mso-list: l4 level1 lfo3; tab-stops: list 30.75pt; text-align: justify; text-indent: -30.75pt;">
<!--[if !supportLists]--><span lang="EN-US">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Arjatmo Tjokronegoro &
Hendra Utama. <b><i>Buku Ajar Ilmu Penyakit Dalam</i></b>. Jilid I. Edisi ke Tiga. FKUI. <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>. 1997.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.75pt; mso-list: l4 level1 lfo3; tab-stops: list 30.75pt; text-align: justify; text-indent: -30.75pt;">
<!--[if !supportLists]--><span lang="EN-US">3.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Behrman Richard. <b><i>Ilmu
Kesehatan Anak</i></b>. Alih bahasa: Moelia Radja Siregar & Manulang.
Editor: Peter Anugrah. EGC. <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>.
1992.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.75pt; mso-list: l4 level1 lfo3; tab-stops: list 30.75pt; text-align: justify; text-indent: -30.75pt;">
<!--[if !supportLists]--><span lang="EN-US">4.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Joss, Vanda dan Rose, Stephan. <b><i>Penyajian
Kasus pada Pediatri</i></b>. Alih bahasa Agnes Kartini. Hipokrates. <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>. 1997. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.75pt; mso-list: l4 level1 lfo3; tab-stops: list 30.75pt; text-align: justify; text-indent: -30.75pt;">
<!--[if !supportLists]--><span lang="EN-US">5.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Ranuh, Hariyono dan Soeyitno,
dkk. <b><i>Buku
Imunisasi Di Indonesia</i></b>, edisi pertama. Satgas Imunisasi Ikatan Dokter
Anak <st1:country-region w:st="on"><st1:place w:st="on">Indonesia</st1:place></st1:country-region>.
<st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>. 2001.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.75pt; mso-list: l4 level1 lfo3; tab-stops: list 30.75pt; text-align: justify; text-indent: -30.75pt;">
<!--[if !supportLists]--><span lang="EN-US">6.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Samsuridjal Djauzi dan Heru
Sundaru. <b><i>Imunisasi Dewasa</i></b>. FKUI. <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>.
2003.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.75pt; mso-list: l4 level1 lfo3; tab-stops: list 30.75pt; text-align: justify; text-indent: -30.75pt;">
<!--[if !supportLists]--><span lang="EN-US">7.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Sjamsuhidayat. <b><i>Buku
Ajar Ilmu Bedah</i></b>. Edisi revisi. EGC. <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>. 1998.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 30.75pt; mso-list: l4 level1 lfo3; tab-stops: list 30.75pt; text-align: justify; text-indent: -30.75pt;">
<!--[if !supportLists]--><span lang="EN-US">8.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Soegeng Soegijanto. <b><i>Ilmu
Penyakit Anak, Diagnosa dan Penatalaksanaan</i></b>. Salemba Medika. <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>. 2002.</span></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-9821397197943974302013-01-20T22:09:00.000-08:002013-01-20T22:09:02.051-08:00ASUHAN KEPERAWATAN PASIEN DENGAN SIROSIS HEPATIS<!--[if !mso]>
<style>
v\:* {behavior:url(#default#VML);}
o\:* {behavior:url(#default#VML);}
w\:* {behavior:url(#default#VML);}
.shape {behavior:url(#default#VML);}
</style>
<![endif]--><!--[if gte mso 9]><xml>
<w:WordDocument>
<w:View>Normal</w:View>
<w:Zoom>0</w:Zoom>
<w:TrackMoves/>
<w:TrackFormatting/>
<w:PunctuationKerning/>
<w:ValidateAgainstSchemas/>
<w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid>
<w:IgnoreMixedContent>false</w:IgnoreMixedContent>
<w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText>
<w:DoNotPromoteQF/>
<w:LidThemeOther>IN</w:LidThemeOther>
<w:LidThemeAsian>X-NONE</w:LidThemeAsian>
<w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript>
<w:Compatibility>
<w:BreakWrappedTables/>
<w:SnapToGridInCell/>
<w:WrapTextWithPunct/>
<w:UseAsianBreakRules/>
<w:DontGrowAutofit/>
<w:SplitPgBreakAndParaMark/>
<w:DontVertAlignCellWithSp/>
<w:DontBreakConstrainedForcedTables/>
<w:DontVertAlignInTxbx/>
<w:Word11KerningPairs/>
<w:CachedColBalance/>
</w:Compatibility>
<w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel>
<m:mathPr>
<m:mathFont m:val="Cambria Math"/>
<m:brkBin m:val="before"/>
<m:brkBinSub m:val="--"/>
<m:smallFrac m:val="off"/>
<m:dispDef/>
<m:lMargin m:val="0"/>
<m:rMargin m:val="0"/>
<m:defJc m:val="centerGroup"/>
<m:wrapIndent m:val="1440"/>
<m:intLim m:val="subSup"/>
<m:naryLim m:val="undOvr"/>
</m:mathPr></w:WordDocument>
</xml><![endif]--><!--[if gte mso 9]><xml>
<w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true"
DefSemiHidden="true" DefQFormat="false" DefPriority="99"
LatentStyleCount="267">
<w:LsdException Locked="false" Priority="0" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Normal"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="heading 1"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 2"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 3"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 4"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 5"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 6"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 7"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 8"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 9"/>
<w:LsdException Locked="false" Priority="39" Name="toc 1"/>
<w:LsdException Locked="false" Priority="39" Name="toc 2"/>
<w:LsdException Locked="false" Priority="39" Name="toc 3"/>
<w:LsdException Locked="false" Priority="39" Name="toc 4"/>
<w:LsdException Locked="false" Priority="39" Name="toc 5"/>
<w:LsdException Locked="false" Priority="39" Name="toc 6"/>
<w:LsdException Locked="false" Priority="39" Name="toc 7"/>
<w:LsdException Locked="false" Priority="39" Name="toc 8"/>
<w:LsdException Locked="false" Priority="39" Name="toc 9"/>
<w:LsdException Locked="false" Priority="35" QFormat="true" Name="caption"/>
<w:LsdException Locked="false" Priority="0" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" Priority="1" Name="Default Paragraph Font"/>
<w:LsdException Locked="false" Priority="0" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" Priority="22" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" Priority="59" SemiHidden="false"
UnhideWhenUsed="false" Name="Table Grid"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading"/>
</w:LatentStyles>
</xml><![endif]--><!--[if gte mso 10]>
<style>
/* Style Definitions */
table.MsoNormalTable
{mso-style-name:"Table Normal";
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
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:0cm;
mso-para-margin-bottom:.0001pt;
mso-pagination:widow-orphan;
font-size:10.0pt;
font-family:"Times New Roman","serif";}
</style>
<![endif]--><!--[if gte mso 9]><xml>
<o:shapedefaults v:ext="edit" spidmax="1071"/>
</xml><![endif]--><!--[if gte mso 9]><xml>
<o:shapelayout v:ext="edit">
<o:idmap v:ext="edit" data="1"/>
</o:shapelayout></xml><![endif]-->
<br />
<div class="Section1">
<div class="MsoTitle">
<div style="text-align: center;">
<span lang="EN-US">ASUHAN KEPERAWATAN</span></div>
</div>
<div class="MsoTitle">
<div style="text-align: center;">
<span lang="EN-US">PASIEN DENGAN SIROSIS HEPATIS</span></div>
</div>
<div class="MsoTitle">
<div style="text-align: center;">
<br /></div>
</div>
<div class="MsoTitle">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo4; tab-stops: list -36.0pt; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><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" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">LANDASAN TEORI</span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l6 level2 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">KONSEP PENYAKIT</span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l6 level3 lfo4; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><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" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pengertian</span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US">Sirosis hepatis
adalah stadium akhir penyakit hati menahun dimana secara anatomis didapatkan
proses fibrosis dengan pembentukan nodul regenerasi dan nekrosis.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l6 level3 lfo4; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Penyebab</span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Beberapa penyebab dari
sirosis hepatic yang sering adalah:</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -27.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Post nekrotic
cirrhosis (viral hepatits)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -27.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Proses
autoimmune:</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l6 level5 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">a)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Cronic active
hepatitis.</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l6 level5 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">b)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Biliary cirhosis</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -27.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Alkoholisme</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l6 level3 lfo4; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Gambaran Klinis</span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Mual-mual, nafsu
makan menurun</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Cepat lelah</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kelemahan otot</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Penurunan berat
badan</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">5)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Air kencing
berwarna gelap</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">6)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kadang-kadang
hati teraba keras</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">7)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Ikterus, spider
naevi, erytema palmaris</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">8)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Asites</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">9)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Hematemesis,
melena</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">10)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Ensefalopati</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l6 level3 lfo4; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pemeriksaan Laboratorium</span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">1) Urine<span style="mso-tab-count: 1;"> </span>: bila ada ikterus, urobilin dan bilirubin
menjadi positif.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">2) Feses<span style="mso-tab-count: 1;"> </span>: ada perdarahan maka test benzidin
positif.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3) Darah<span style="mso-tab-count: 1;"> </span>: dapat timbul anemia, hipoalbumin,
hiponatrium.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">4) Test faal hati.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l6 level3 lfo4; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">f.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Prognosis Yang Jelek</span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Adanya ikterus yang jelek.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pengobatan sudah satu bulan tanpa perbaikan.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Asites.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Hati yang mengecil.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">5)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Ada komplikasi yang neurologist.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">6)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Ensefalopati.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">7)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Perdarahan.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l6 level3 lfo4; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">g.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pengobatan</span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Istirahat yang cukup.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Makanan tinggi kalori dan protein.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Vitamin yang cukup.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pengobatan terhadap penyulit.</span></div>
<div class="MsoNormal" style="margin-left: 126.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l6 level2 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">KONSEP ASUHAN
KEPERAWATAN</span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l6 level3 lfo4; tab-stops: list -108.0pt; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><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" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Data Fokus</span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Data Subyektif</span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l6 level5 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">a)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Keluhan perut
tidak enak, mual dan nafsu makan menurun.</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l6 level5 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">b)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Mengeluh cepat
lelah.</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l6 level5 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">c)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Mengeluh sesak
nafas</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Data Obyektif</span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l6 level5 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">a)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Penurunan berat
badan</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l6 level5 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">b)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Ikterus.</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l6 level5 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">c)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Spider naevi.</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l6 level5 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">d)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Anemia.Air
kencing berwarna gelap.</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l6 level5 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">e)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kadang-kadang
hati teraba keras.</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l6 level5 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">f)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kadar cholesterol
rendah, albumin rendah.</span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l6 level5 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">g)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Hematemesis dan
melena.</span></div>
<div class="MsoNormal" style="margin-left: 162.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l6 level3 lfo4; tab-stops: list -108.0pt; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Diagnosa
Keperawatan</span></b></div>
<div class="MsoNormal">
<span lang="EN-US">Diagnosa keperawatan yang mungkin timbul
adalah:</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Perubahan
nutrisi: kurang dari kebutuhan tubuh b/d anoreksia.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Intolerans
aktifitas b/d kelemahan otot.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Gangguan
keseimbangan cairan dan elektrolit b/d hipertensi portal.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Gangguan perfusi
jaringan b/d hematemesis dan melena.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">5)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Cemas b/d
hematemesis dan melena.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">6)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Gangguan pola
nafas b/d ekspansi paru menurun</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">7)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kerusakan
komunikasi verbal b/d gangguan persarafan bicara.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">8)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Resiko tinggi
cedera b/d gerakan yang tidak terkontrol.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">9)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kerusakan
mobilitas fisik b/d efek kekakuan otot.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l6 level4 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">10)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Defisit perawatan
diri b/d keadaan koma.</span></div>
<div align="left" class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level3 lfo4; tab-stops: list -108.0pt; text-align: left; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Rencana Tindakan</span></b></div>
<div align="left" class="MsoNormal" style="margin-left: 36.0pt; mso-list: l6 level4 lfo4; tab-stops: list -90.0pt; text-align: left; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Perubahan nutrisi: kurang dari kebutuhan tubuh b/d
anoreksia.</span></b></div>
<div align="left" class="MsoNormal" style="margin-left: 36.0pt; text-align: left;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Tujuan:</span></i><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"> kebutuhan nutrisi terpenuhi.</span></div>
<div align="left" class="MsoNormal" style="margin-left: 36.0pt; text-align: left;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kriteria hasil:</span></i><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"> menunjukkan peningkatan
nafsu makan.</span></div>
<div align="left" class="MsoNormal" style="margin-left: 36.0pt; text-align: left;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Rencana tindakan:</span></i></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid windowtext .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: 189.0pt;" valign="top" width="252"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">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: 225.0pt;" valign="top" width="300"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Rasional</span></b></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: 189.0pt;" valign="top" width="252"><div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l5 level1 lfo5; tab-stops: list -176.4pt; text-indent: -12.6pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Diskusikan tentang pentingnya nutrisi bagi klien.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l5 level1 lfo5; tab-stops: list -176.4pt; text-indent: -12.6pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Anjurkan makan sedikit tapi sering.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l5 level1 lfo5; tab-stops: list -176.4pt; text-indent: -12.6pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Batasi cairan 1 jam sebelum dan sesudah makan.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l5 level1 lfo5; tab-stops: list -176.4pt; text-indent: -12.6pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pertahankan kebersihan mulut.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l5 level1 lfo5; tab-stops: list -176.4pt; text-indent: -12.6pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Batasi makanan dan cairan yang tinggi lemak.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l5 level1 lfo5; tab-stops: list -176.4pt; text-indent: -12.6pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">pantau intake sesuai dengan diet yang telah
disediakan.</span></div>
<div class="MsoNormal" style="margin-left: 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; 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: 225.0pt;" valign="top" width="300"><div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Nutrisi yang baik dapat mempercepat proses penyembuhan.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Peningkatan tekanan intra abdominal akibat asites menekan
saluran GI dan menurunkan kapasitasnya.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Cairan dapat menurunkan nafsu makan dan masukan.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Akumulasi partikel makanan di mulut dapat menambah bau dan
rasa tak sedap yang menurunkan nafsu makan.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kerusakan aliran empedu mengakibatkan malabsorbsi lemak.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Untuk mencukupi nutrisi intake harus adekuat.</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 72.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 27.0pt; mso-list: l6 level4 lfo4; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Intolerans
aktifitas b/d kelemahan otot.</span></b></div>
<div class="MsoNormal" style="margin-left: 27.0pt; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Tujuan:</span></i><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"> Klien dapat beraktifitas sesuai dengan batas
toleransi.</span></div>
<div class="MsoNormal" style="margin-left: 27.0pt; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kriteria hasil:</span></i><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"> menunjukkan peningkatan
dalam beraktifitas.</span></div>
<div class="MsoNormal" style="margin-left: 27.0pt; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Rencana tindakan:</span></i></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid windowtext .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: 225.0pt;" valign="top" width="300"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">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: 189.0pt;" valign="top" width="252"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Rasional</span></b></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: 225.0pt;" valign="top" width="300"><div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l4 level1 lfo6; text-indent: -12.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kaji kesiapan
untuk meningkatkan aktifitas contoh: apakah tekanan darah stabil, perhatian
terhadap aktifitas dan perawatan diri.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l4 level1 lfo6; text-indent: -12.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">jelaskan pola
peningkatan bertahap dari aktifitas contoh: posisi duduk di tempat tidur,
bangun dari tempat tidur, belajar berdiri dst.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l4 level1 lfo6; text-indent: -12.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Berikan bantuan
sesuai dengan kebutuhan (makan, minum, mandi, berpakaian dan eleminasi).</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: 189.0pt;" valign="top" width="252"><div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Stabilitas fisiologis penting untuk menunjukkan tingkat
aktifitas individu.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kemajuan aktifitas bertahap mencegah peningkatan tiba-tiba
pada kerja jantung.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Teknik penghematan energi menurunkan penggunaan energi.</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="tab-stops: 108.75pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">DAFTAR
PUSTAKA<span style="mso-tab-count: 1;"> </span></span></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo9; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Arthur C. Guyton and John E. Hal (1997), <i style="mso-bidi-font-style: normal;">Buku Ajar Fisiologi Kedokteran, Edisi 9</i>, EGC, Jakarta.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo9; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Marylin E. Doengoes (2000), <i style="mso-bidi-font-style: normal;">Rencana Asuhan Keperawatan, Edisi 3,</i> EGC, Jakarta.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo9; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Carpenito, Lynda Juall (2001), <i style="mso-bidi-font-style: normal;">Diagnosa Keperawatan Edisi 8</i>, EGC, Jakarta.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo9; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Soeparman (1987), <i style="mso-bidi-font-style: normal;">Ilmu
Penyakit Dalam I</i>, FKUI, Jakarta.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo9; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Stefan Silbernagl, Florian Lang (2000), <i style="mso-bidi-font-style: normal;">Pathophysiology,</i> Thieme, Struttgart New York.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo9; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Sarjadi (1999), <i style="mso-bidi-font-style: normal;">Patologi
Umum<span style="mso-spacerun: yes;"> </span>dan Sistemik, Edisi 2</i>, EGC,
Jakarta.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo9; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Aji Dharma (1991), <i style="mso-bidi-font-style: normal;">Patofisiologi
Konsep Klinik Proses-proses Penyakit</i>, EGC, Jakarta.</span></div>
</div>
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span></b>
<br />
<div class="Section2">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo4; tab-stops: list -36.0pt; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">ASUHAN
KEPERAWATAN</span></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoSubtitle">
<span lang="EN-US">PENGKAJIAN</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pengkajian dilaksanakan pada tanggal 14 Oktober 2002 pada
pukul 10.00 WIB.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">1. <b>Identitas</b></span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Nama<span style="mso-tab-count: 2;"> </span>: Tn.
A..A.<span style="mso-tab-count: 2;"> </span>Tgl MRS<span style="mso-tab-count: 1;"> </span>14-10- 2002</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Umur<span style="mso-tab-count: 2;"> </span>: 62
tahun<span style="mso-tab-count: 2;"> </span>Register<span style="mso-tab-count: 1;"> </span>: 711844</span></div>
<div align="left" class="MsoNormal" style="text-align: left;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Jenis kelamin<span style="mso-tab-count: 1;"> </span>: Laki-laki<span style="mso-tab-count: 3;"> </span>Diagnose<span style="mso-tab-count: 1;"> </span>: sirosis hepatis + sepsis</span></div>
<div align="left" class="MsoNormal" style="text-align: left;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Suku Bangsa<span style="mso-tab-count: 2;"> </span>: Jawa<span style="mso-spacerun: yes;"> </span>Jawa / Indonesia</span></div>
<div align="left" class="MsoNormal" style="text-align: left;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Agama<span style="mso-tab-count: 3;"> </span>: Islam</span></div>
<div align="left" class="MsoNormal" style="text-align: left;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pekerjaan<span style="mso-tab-count: 2;"> </span>: Pensiunan </span></div>
<div align="left" class="MsoNormal" style="text-align: left;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pendidikan<span style="mso-tab-count: 2;"> </span>: SMA</span></div>
<div align="left" class="MsoNormal" style="text-align: left;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Alamat<span style="mso-tab-count: 3;"> </span>: Puncang
Gang 3/05 C.</span></div>
<div align="left" class="MsoNormal" style="text-align: left;">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Keluhan utama</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-tab-count: 1;"> </span>: Sakit perut.</span></div>
<div align="left" class="MsoNormal" style="text-align: left;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"></span></div>
<div align="left" class="MsoNormal" style="text-align: left;">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">II Riwayat Keperawatan</span></b></div>
<div align="left" class="MsoNormal" style="text-align: left;">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">2.1 Riwayat penyakit
sebelumnya</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">: Penderita pernah Batu ginjal dilakukan laser dan pernah
dioperasi batu buli di RSUD. Dr Soetomo Surabaya tahun 1987<span style="mso-spacerun: yes;"> </span>.</span></div>
<div align="left" class="MsoNormal" style="text-align: left;">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">2.2 Riwayat penyakit
sekarang </span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">: Penderita muntah-muntahsejak 6 september 2002 kemudian tanggal
12 September 2002 perut semakin besar dan tegang di IRD pada tanggal 14 oktober
2002 dapat muntah air sekali, mual-mual, perut kembung, perut sakit badan lemah
</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">2.3 Riwayat kesehatan keluarga </span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">: Keluarga tidak ada yang
sakit seperti ini, </span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">2.4 Keadaan kesehatan lingkungan </span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">: Menurut keluarga,
lingkunagn rumah cukup bersih karena kebiasaan keluarga dan masyarakat sekitar
membersihkan rumah dan lingkunagn sekitar setiap minggu sekali.</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">2.5 Riwayat kesehatan lainnya</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-tab-count: 1;"> </span>: taa</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">2.6 Alat bantu yang dipakai</span></b></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Gigi palsu<span style="mso-tab-count: 1;"> </span>: --</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kaca mata<span style="mso-tab-count: 1;"> </span>:--</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pendengaran<span style="mso-tab-count: 1;"> </span>:taa</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Lain-lain<span style="mso-tab-count: 1;"> </span>:taa</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">III. Observasi dan
Pemeriksaan Fisik</span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">1. Keadaan umum</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-tab-count: 1;"> </span>:kondisi umum terlihat lemah.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">2. Tanda vital<span style="mso-tab-count: 1;"> </span></span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">:S: 36,5 <sup>0</sup>C
axilla, N: 100 x/mnt teratur dan kuat, TD: 100/70 mmHg lengan kiri dalam posisi
berbaring, RR: 24 x/mnt.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3. Body System</span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3.1 Pernafasan</span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Hidung<span style="mso-tab-count: 4;"> </span>:
taa.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Trachea<span style="mso-tab-count: 3;"> </span>:
taa</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Dada<span style="mso-tab-count: 4;"> </span>:
Tidak ada kelainan</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Bentuk<span style="mso-tab-count: 3;"> </span>:
simetris</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Gerakan<span style="mso-tab-count: 3;"> </span>:
simetris, nyeri dada (-).</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Suara nafas dan lokasi<span style="mso-tab-count: 1;"> </span>: vesikuler +/+</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Jenis nafas<span style="mso-tab-count: 3;"> </span>: hidung</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Batuk<span style="mso-tab-count: 4;"> </span>:
(-).</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Sputum<span style="mso-tab-count: 3;"> </span>: tidak ada</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Cyanosis<span style="mso-tab-count: 3;"> </span>: tidak ada</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Frekwensi nafas<span style="mso-tab-count: 2;"> </span>: 24 x/mnt.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"></span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3.2 Kardiovaskuler</span></b></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Nyeri dada<span style="mso-tab-count: 2;"> </span>: tidak ada</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Pusing<span style="mso-tab-count: 3;"> </span>: tidak ada.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Kram kaki<span style="mso-tab-count: 2;"> </span>: tidak ada</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Palpitasi<span style="mso-tab-count: 2;"> </span>: --</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Clubing finger<span style="mso-tab-count: 2;"> </span>:--</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Suara jantung<span style="mso-tab-count: 2;"> </span>: S1 S2 tunggal.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Edema<span style="mso-tab-count: 3;"> </span>: asites</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Kapilari refill
Time<span style="mso-tab-count: 1;"> </span>: 2 dtk.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Lainnya<span style="mso-tab-count: 3;"> </span>: --</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"></span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3.3 Persarafan</span></b></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Kesadaran<span style="mso-tab-count: 2;"> </span>: CM</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>GCS<span style="mso-tab-count: 3;"> </span>: E4V5M6</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Kepala dan wajah<span style="mso-tab-count: 1;"> </span>: dbn</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Mata<span style="mso-tab-count: 2;"> </span>: anemis (+),</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Sklera<span style="mso-tab-count: 2;"> </span>: ikterus</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Konjunctiva<span style="mso-tab-count: 1;"> </span>: merah muda.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Pupil<span style="mso-tab-count: 2;"> </span>: isokor</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Leher<span style="mso-tab-count: 2;"> </span>: DVJ (-).</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Reflek fisiologis<span style="mso-tab-count: 1;"> </span>: dbn</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Reflek patologis<span style="mso-tab-count: 1;"> </span>: taa</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Pendengaran<span style="mso-tab-count: 1;"> </span>: dbn</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Penciuman<span style="mso-tab-count: 2;"> </span>: dbn</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Pengecapan<span style="mso-tab-count: 1;"> </span>: dbn</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Penglihatan<span style="mso-tab-count: 2;"> </span>: dbn</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Perabaan<span style="mso-tab-count: 2;"> </span>: dbn</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Lainnya<span style="mso-tab-count: 2;"> </span>: --</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"></span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3.4 Perkemihan –Eliminasi Urine</span></b></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Produksi urine<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>600 – 800 cc /hari.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Warna urine<span style="mso-tab-count: 2;"> </span>: seperti teh.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Gangguan saat
kencing<span style="mso-tab-count: 1;"> </span>: taa.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">.<span style="mso-spacerun: yes;"> </span>Lainnya<span style="mso-tab-count: 3;"> </span>: --</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3.5 Pencernaan -<span style="mso-spacerun: yes;">
</span>Eliminasi Alvi</span></b></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Mulut<span style="mso-tab-count: 2;"> </span>: bersih, gigi lengkap, mukosa
bibir lembab.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Tenggorokan<span style="mso-tab-count: 1;"> </span>: sakit menelan (-).</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Abdomen<span style="mso-tab-count: 1;"> </span>: distensi (-), peristaltik usus
baik.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Rectum<span style="mso-tab-count: 2;"> </span>: dbn</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Bab<span style="mso-tab-count: 2;"> </span>: Lancar *(1 x sehari)-</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Obat
pencahar<span style="mso-tab-count: 1;"> </span>: --</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Lavement<span style="mso-tab-count: 1;"> </span>: --</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Lain-lain<span style="mso-tab-count: 1;"> </span>: --</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3.6 Tulang – Otot – Integumen</span></b></div>
<div class="MsoNormal">
<span style="height: 2px; left: 0px; margin-left: 251px; margin-top: 16px; mso-ignore: vglayout; position: absolute; width: 74px; z-index: 251635200;"><img height="2" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image023.gif" width="74" /></span><span style="height: 38px; left: 0px; margin-left: 287px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251636224;"><img height="38" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image024.gif" width="2" /></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;">
</span>Kemampuan pergerakan sendi:<span style="mso-spacerun: yes;">
</span>555<span style="mso-spacerun: yes;"> </span>555</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;">
</span>55 5<span style="mso-spacerun: yes;"> </span>555</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Extremitas<span style="mso-tab-count: 1;"> </span>: </span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>- Atas<span style="mso-tab-count: 2;"> </span>: pergerakan baik, kekuatan otot
baik.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>- Bawah<span style="mso-tab-count: 2;"> </span>: pergerakan baik, kekuatan otot
baik. Ada edema</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>- Tulang
belakang<span style="mso-tab-count: 1;"> </span>:dbn</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Kulit:</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-indent: -108.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>- Warna kulit<span style="mso-tab-count: 1;"> </span>:sawo matang, agak ikterik.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>- Akral<span style="mso-tab-count: 2;"> </span>:hangat, </span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>- Turgor<span style="mso-tab-count: 2;"> </span>: baik</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3.7 Sistem Endokrin</span></b></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Terapi hormon<span style="mso-tab-count: 1;"> </span>:
--</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Karakteristik
seks sekunder: dbn</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Riwayat
pertumbuhan dan perkembnagan fisik: taa</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3.8 Sistem Hematopoietik</span></b></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Diagnosis
penyakit hematopoietik yang lalu: --</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Type darah: O</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3.9 Reproduksi</span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-indent: -72.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Laki – laki: tidak ada masalah.</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">4.0 Psikososial</span></b></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Konsep diri: --</span></b></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Citra diri:</span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Tanggapan tentang tubuh: taa</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Bagian tubuh yang disukai: taa</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Bagian tubuh yang tidak disukai:<span style="mso-spacerun: yes;"> </span>taa</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Persepsi thd kehilangan bagian tubuh: taa</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Lainnya, sebutkan: taa</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Identitas:</span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Status klien dalam keluarga: ayah, seorang suami, kepala
rumah tangga</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kepuasan klien thd status dan posisi dlm keluarga: puas</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kepuasan klie thd jenis kelamin: puas</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Lainnya, sebutkan: taa</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Peran:</span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">tanggapan klien thd perannya: cukup puas.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kemampuan/kesanggupan klien melaksanakan perannya: sanggup
melaksanakan peran.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kepuasan klien melaksanakan perannya: puas.</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Ideal
diri/harapan:</span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">harapan klien thd:</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-indent: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">= Tubuh: suapaya
cepat sembuh.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-indent: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">= Posisi (dlm
pekerjaan): taa</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-indent: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">= Status dlm
keluarga: taa</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">= Tugas/pekerjaan: tidak ada masalah.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Harapan klien thd lingkungan: lingkungan tetap sehat</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Harapan klien thd penyakit yg diderita: penyakitnya dapat
segera disembuhkan.</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Harga diri:</span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Tanggapan klien thd harga dirinya: tinggi</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Lainnya, sebutkan: taa</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Sosial/interaksi:</span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Hubungan dengan klien:kenal baik.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Dukungan keluarga:<span style="mso-spacerun: yes;">
</span>aktif</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Dukungan kelompok/teman/masyarakat:<span style="mso-spacerun: yes;"> </span>aktif.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Reaksi saat interaksi: kooperatif, komunikasi lancar dan
jelas.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Konflik yang terjadi terhadap: taa</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>3.11 Spiritual:</span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Konsep tentang penguasa kehidupan: Kepada Tuhan.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Sumber kekuatan/harapan saat sakit: Tuhan, tenaga dokter dan
perawat serta dukungan keluarga.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Ritual agama yg berarti/diharapkan saat ini: dapat
melaksanakan tuntunan dari pendeta dengan baik (selama dirawat).</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Sarana/peralatan/orang yg diperlukan dlm melaksanakan ritual
agama yg diharapkan saat ini:<span style="mso-spacerun: yes;"> </span>lewat
ibadah.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Upaya kesehatan yang bertentangan dgn keyakinan agama: taa</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Keyakinan/kepercayaan bahwa Tuhan akan menolong dlm
menghadapi situasi sakit saat ini: sangat yakin Tuhan akan membantu kesembuhan.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Keyakinan/kepercayaan bahwa penyakit dapat disembuhkan:
sangat yakin.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Persepsi thd penyebab penyakit: karena kelelahan.</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pemeriksaan penunjang:</span></b></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;">Tgl 14-10-2002</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l8 level2 lfo7; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;">Hb<span style="mso-tab-count: 1;"> </span>: 14 gr%<span style="mso-tab-count: 2;"> </span>Bill. Direk : 0,5 mg/dl</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l8 level2 lfo7; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;">GDA<span style="mso-tab-count: 1;"> </span>: 79 mg/dl<span style="mso-tab-count: 2;"> </span>Bill Total : 1,37 mg/dl</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l8 level2 lfo7; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;">SGOT<span style="mso-tab-count: 1;"> </span>:46,7 U/L<span style="mso-tab-count: 2;"> </span>SGPT : 35,9 u/l</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l8 level2 lfo7; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;">BUN<span style="mso-tab-count: 1;"> </span>: 16 mg/dl<span style="mso-tab-count: 2;"> </span>Leukosit : 10,8</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l8 level2 lfo7; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;">SC<span style="mso-tab-count: 1;"> </span>: 1,1mg/dl<span style="mso-tab-count: 2;"> </span>Trombo : 76</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l8 level2 lfo7; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;"><span style="mso-list: Ignore;">f.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;">K<sup>+<span style="mso-tab-count: 1;"> </span></sup>: 4,53
mEg/dl<span style="mso-tab-count: 2;"> </span>Albumin<span style="mso-tab-count: 1;"> </span>: 6,89 g/dl</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l8 level2 lfo7; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;"><span style="mso-list: Ignore;">g.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;">Na<sup>+<span style="mso-tab-count: 1;"> </span></sup>: 147mEg/dl<span style="mso-tab-count: 2;"> </span>Globulin<span style="mso-tab-count: 1;"> </span>: 3,62 g/dl</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l8 level2 lfo7; tab-stops: list -54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;"><span style="mso-list: Ignore;">h.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic;">PCV<sup>-<span style="mso-tab-count: 1;"> </span></sup>: 0,41</span></div>
<div class="MsoNormal">
<b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Terapi:</span></b></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Tgl 14-10-2002</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l7 level2 lfo8; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Oksigen Nasal 3 L
/menit</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l7 level2 lfo8; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Infus PZ 0,9 </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l7 level2 lfo8; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Mefetran 3x1</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l7 level2 lfo8; tab-stops: list -99.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Ranitidin 2x1</span></div>
<div class="MsoNormal">
<br /></div>
</div>
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span></b>
<br />
<div class="Section3">
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">ANALISA DATA:</span></b></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid windowtext .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: 225.0pt;" valign="top" width="300"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Data</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: 126.0pt;" valign="top" width="168"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Penyebab</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: 135.0pt;" valign="top" width="180"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Masalah</span></b></div>
</td>
</tr>
<tr>
<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: 225.0pt;" valign="top" width="300"><div class="MsoNormal" style="margin-left: 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">S: Klien
mengatakan tidak ada selera makan dan perutnya mual.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">O: Mukosa bibir
kering, Muntah air, albumin 3,27 gr/dl.</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: 126.0pt;" valign="top" width="168"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Anoreksia.</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: 135.0pt;" valign="top" width="180"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Ggn Pemenuhan nutrisi
kurang dari kebutuhan.</span></div>
</td>
</tr>
<tr>
<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: 225.0pt;" valign="top" width="300"><div class="MsoNormal" style="margin-left: 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">S: Klien
mengeluh perutnya terasa penuh.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">O: Asites (+),
albumin 3,27 gr/dl, oedema ekstremitas bawah (+).</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: 126.0pt;" valign="top" width="168"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Penurunan tekanan osmotik
plasma</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: 135.0pt;" valign="top" width="180"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kelebihan volume cairan.</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: 225.0pt;" valign="top" width="300"><div class="MsoNormal" style="margin-left: 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">S: Klien dan
keluarga banyak bertanya tentang pengobatan dan perawatan.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">O: Wajah klien
tampak murung, skala HARS: 7-8.</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: 126.0pt;" valign="top" width="168"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kurangnya informasi
mengenai regimen pengobatan dan perawatan.</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: 135.0pt;" valign="top" width="180"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Ansietas.</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">DIAGNOSA KEPERAWATAN:</span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; tab-stops: list -81.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Resiko pemenuhan
nutrisi: kurang kebutuhan tubuh b/d anoreksia.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Data penunjang: </span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">S: Klien mengatakan tidak
ada selera makan dan perutnya mual.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">O: Mukosa bibir
kering, Muntah air ,Muka agak pucat, albumin 3,27 gr/dl.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; tab-stops: list -81.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kelebihan volume
cairan b/d penurunan tekanan osmotik plasma.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Data penunjang: </span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">S: Klien mengeluh perutnya
terasa penuh.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">O: Asites (+), albumin 3,27
gr/dl, oedema ekstremitas bawah (+).</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; tab-stops: list -81.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Ansietas b/d
kurangnya informasi tentang regimen pengobatan dan perawatan.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Data penunjang: </span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">S: Klien dan keluarga banyak
bertanya tentang pengobatan dan perawatan.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">O: Wajah klien tampak
murung, skala HARS: 7-8.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<br /></div>
</div>
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span></b>
<br />
<div class="Section4">
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">RENCANA INTERVENSI:</span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo3; tab-stops: list -81.0pt; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Resiko pemenuhan
nutrisi: kurang kebutuhan tubuh b/d anoreksia.</span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Data
penunjang</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">: </span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">S: Klien mengatakan tidak
ada selera makan dan perutnya mual.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">O: Mukosa bibir
kering, muntah air,wajah agak pucat, albumin 3,27 gr/dl.</span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -45.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Tujuan</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">: Setelah diberikan askep selama 3 hari, kebutuhan
nutrisi klien terpenuhi.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kriteria
hasil</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">: Klien dapat mengkonsumsi 1 porsi makanan yang disediakan.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Rencana
tindakan</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">:</span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 23.4pt; 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: 36.0pt;" valign="top" width="48"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">No</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: 189.0pt;" valign="top" width="252"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">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: 246.9pt;" valign="top" width="329"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Rasional</span></b></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: 36.0pt;" valign="top" width="48"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">1.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">2.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">4.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">5.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 189.0pt;" valign="top" width="252"><div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Diskusikan tentang pentingnya nutrisi bagi klien.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Anjurkan makan sedikit tapi sering.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Batasi cairan 1 jam sebelum dan sesudah makan.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pertahankan kebersihan mulut.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pantau intake sesuai dengan diet yang telah disediakan: </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: 246.9pt;" valign="top" width="329"><div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Nutrisi yang baik dapat mempercepat proses penyembuhan.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Peningkatan tekanan intra abdominal akibat asites menekan
saluran GI dan menurunkan kapasitasnya.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Cairan dapat menurunkan nafsu makan dan masukan.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Akumulasi partikel makanan di mulut dapat menambah bau dan
rasa tak sedap yang menurunkan nafsu makan.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Untuk mencukupi nutrisi intake harus adekuat.</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo3; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kelebihan volume cairan b/d penurunan tekanan osmotik plasma.</span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Data
penunjang: </span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">S: Klien mengeluh perutnya
terasa penuh.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">O: Asites (+), albumin 3,27
gr/dl, oedema ekstremitas bawah (+).</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Tujuan</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">: Setelah
diberikan askep selama 3 hari, volume cairan stabil.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kriteria
hasil</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">: tidak terdapat perluasan oedema.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Rencana
tindakan</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">:</span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 23.4pt; 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: 36.0pt;" valign="top" width="48"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">No</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: 189.0pt;" valign="top" width="252"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">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: 246.9pt;" valign="top" width="329"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Rasional</span></b></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: 36.0pt;" valign="top" width="48"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">1.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">2.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">4.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">5.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">6.</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: 189.0pt;" valign="top" width="252"><div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Ukur intake dan output.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Awasi tekanan darah setiap 3 jam sekali.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Pantau derajat oedema.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Berikan perawatan mulut.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Batasi natrium dan air: diet TKRP RG dan minum ± 700 cc/24
jam.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kolaborasi therapi diuretik.</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: 246.9pt;" valign="top" width="329"><div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Mengetahui status volume sirkulasi.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Tekanan darah yang meningkat berhubungan dengan kelebihan
cairan.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Perpindahan cairan pada jaringan akibat dari retensi
natrium dan air.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Menurunkan rasa haus.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Meminimalkan retensi cairan dalam area ekstravaskular.
Pembatasan cairan untuk memperbaiki pengenceran hiponatremia.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Mengontrol oedema dan asites.</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo3; tab-stops: list -81.0pt; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Ansietas b/d
kurang pengetahuan tentang regimen pengobatan dan perawatan.</span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Data
penunjang: </span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">S: Klien dan keluarga banyak
bertanya tentang pengobatan dan perawatan.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">O: Wajah klien tampak
murung, skala HARS: 7-8.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Tujuan</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">: Setelah
diberikan askep selama 30 menit, klien dan keluarga dapat mengontrol cemas.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kriteria
hasil</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">: Klien dan keluarga mengerti tentang penjelasan yang diberikan, klien
kooperatif terhadap tindakan perawatan yang diberikan.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Rencana
Tindakan</span></b><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">:</span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 23.4pt; 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: 36.0pt;" valign="top" width="48"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">No</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: 189.0pt;" valign="top" width="252"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">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: 246.9pt;" valign="top" width="329"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Rasional</span></b></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: 36.0pt;" valign="top" width="48"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">1.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">2.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">4.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 189.0pt;" valign="top" width="252"><div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Informasikan tentang regimen pengobatan dan perawatan.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Jelaskan tujuan dan persiapan tindakan yang akan dilakukan.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Jawab pertanyaan dengan jujur dan nyata.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kaji tersedianya dukungan pada klien yaitu istri dan
anak-anaknya.</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: 246.9pt;" valign="top" width="329"><div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Memberikan dasar pengetahuan pada klien dan keluarga.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Penjelasan tentang prosedur akan dapat mengurangi
kecemasan.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Informasi yang tepat dapat menurunkan kecemasan.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Menjadi sumber yang membantu mengurangi kecemasan.</span></div>
</td>
</tr>
</tbody></table>
</div>
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span></b>
<br />
<div class="Section5">
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">IMPLEMENTASI:</span></b></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid windowtext .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: 63.0pt;" valign="top" width="84"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Tanggal</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: 81.0pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">No Dx. Kep</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: 342.0pt;" valign="top" width="456"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Implementasi</span></b></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: 63.0pt;" valign="top" width="84"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">14-10-2002</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">10.00</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">10.30</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">10.40</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 81.0pt;" valign="top" width="108"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Dx.No. 1</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Dx No. 2</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Dx. No 3</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: 342.0pt;" valign="top" width="456"><div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Mendiskusikan tentang pentingnya nutrisi bagi klien.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Menganjurkan makan sedikit tapi sering.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Menganjurkan tidak minum banyak sebelum dan sesudah
makan.Menganjurkan kumur-kumur sebelum makan.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Memantau seberapa banyak makanan yang dikonsumsi
klien: ¼ porsi, minum ½ gelas (100 cc).</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Membantu saat klien makan, habis ½ porsi dan minum ½
gelas (100 cc).</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Memberikan obat oral: lactulose 2 sendok.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Membantu saat klien makan: diet TKRP RG habis 1
porsi dengan dimakan 3x tahapan.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Menganjurkan keluarga untuk mencatat jumlah minum
dan jumlah kencing selama 24 jam.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Memasang cairan infus PZ. 0,9% 14 tts/mnt.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Melakukan obs gejala cardinal: T: 100/70 mmHg, N;
100 x/mnt; RR: 24 x/mnt; S: 36<sup>0</sup>C.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Memantau oedema: oedema perifer </span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Memantau intake minum 0 cc, infus 300 cc, jumlah
urine 300 cc.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Melakukan obs gejala cardinal: T: 100/70 mmHg, N:
100 x/mnt, RR; 40 x/mnt; S: 36<sup>0</sup>C.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Menjelaskan tentang prosedur pengobatan dan
perawatan klien.Menjawab pertanyaan dengan jelas.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list -203.4pt; text-indent: -9.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Mengkaji dukungan: istri dan anaknya sangat
memberikan dukungan selama klien sakit.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Melakukan evaluasi verbal
dan non verbal. </span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
</div>
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span></b>
<br />
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">EVALUASI KEPERAWATAN:</span></b></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid windowtext .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: 63.0pt;" valign="top" width="84"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Tanggal </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: 135.0pt;" valign="top" width="180"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Diagnosa Keperawatan</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: 291.9pt;" valign="top" width="389"><div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Evaluasi</span></b></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: 63.0pt;" valign="top" width="84"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">1.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">2.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">3.</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: 135.0pt;" valign="top" width="180"><div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Resiko pemenuhan nutrisi: kurang kebutuhan tubuh b/d
anoreksia.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Kelebihan volume cairan b/d penurunan tekanan osmotik
plasma.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Ansietas b/d kurangnya informasi tentang regimen pengobatan
dan perawatan</span></div>
<div class="MsoNormal">
<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: 291.9pt;" valign="top" width="389"><div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">S; Klien mengatakan sudah mau makan.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">O; Mukosa bibir
lembab, muntah tidak ada</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">A; Masalah teratasi.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">P; Intervensi dilanjutkan</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>Pasien Pindah ke
RPI</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">S; Klien mengeluh perutnya kembung.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">O; Asites (+),
oedema perifer (+), T: 100/70 mmHg; S: 36<sup>0</sup>C; RR: 24 x/mnt; N: 100
x/mnt, intake 300 cc, output 300 cc.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">A; Masalah teratasi sebagian.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">P; Intervensi dilanjutkan semua.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">S; Klien
menyatakan mengerti tentang penjelasan yang diberikan.</span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">O; Wajah tampak
tenang, klien kooperatif terhadap tindakan yang diberikan.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">A; Masalah teratasi.</span></div>
<div class="MsoNormal">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 11.0pt;">P; Intervensi dihentikan.</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com2tag:blogger.com,1999:blog-4511732320299108871.post-43407624346320769712013-01-20T22:05:00.007-08:002013-01-20T22:05:53.827-08:00Dermatitis Kontak<br />
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span lang="EN-US" style="font-size: 20.0pt; line-height: 150%; mso-ansi-language: EN-US;">Dermatitis Kontak<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b><span lang="EN-US">Definisi<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Dermatitis kontak adalah
dermatitis yang disebabkan oleh bahan (substansi) yang menempel pada kulit.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b><span lang="EN-US">Jenis <o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Dikenal dua macam jenis
dermatitis kontak yaitu dermatitis kontak iritan dan dermatitis kontak alergik,
keduanya dapat bersifat akut maupun kronis.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span lang="EN-US">A.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="EN-US">Dermatitis kontak iritan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Epidemologi <o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.15pt;">
<span lang="EN-US">Dermatitis
kontak iritan dapat diderita oleh semua orang dari berbagai golongan umur, ras,
dan jenis kelamin.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.15pt;">
<span lang="EN-US">Jumlah
penderita dermatitis kontak iritan diperkirakan cukup banyak, namun angkanya
secara tepat sulit diketahui. Hal ini disebabkan antara lain oleh banyak
penderita dengan kelainan ringan tidak datang berobat.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Etiologi<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Penyebab
munculnya dermatitis jenis ini ialah bahan yang bersifat iritan misalkan bahan
pelarut, detergen, minyak pelumas, asam, alkali, dan serbuk kayu. Kelainan
kulit yang terjadi selain ditentukan oleh ukuran molekul, daya larut,
kosentrasi, vehikulum, serta suhu badan iritan tersebut juga dipengaruhi oleh
factor lain. Factor yang dimaksut yaitu : lama kontak, kekerapan (terus menerus
atau berselang), adanya oklusi menyebabkan kulit lebih permeable, demikian pula
gesekan, dan trauma fisis. Suhu dan kelembapan lingkungan juga ikut berperan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Factor
individu juga berpengaruh pada dermatitis kontak iritan, misalnya perbedaan
ketebalan kulit diberbagai tempat menyebabkan perbedaan permeabilitas
diberbagai tempat menyebabkan perbedaan permeabilitas; usia (anak dibawah 8
tahun lebih mudah teriritasi); ras (kulit hitam lebih tahan dari pada kulit
putih); jenis kelamin (insisden dermatitis kontak iritan lebih tinggi pada
wanita); penyakit kulit yang pernah atau sedang dialami (ambang rangsang
terhadap bahan iritan turun) misalnya dermatitis atopik.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Patogenis<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Kelainan
kulit timbul akibat kerusakan sel yang disebabkan oleh bahan iritan melalui
kerja kimiawi maupun fisik. Bahan iritan merusak lapisan tanduk, denaturasi
keratin, menyingkirkan lemak lapisan tanduk, dan mengubah daya ikat air kulit.
Keadaan ini akan merusak sel epidermis. <st1:place w:st="on"><st1:city w:st="on">Ada</st1:city></st1:place>
dua jenis bahan iritan yaitu : iritan kuat dan iritan lemah. Iritan kuat akan
menimbulkan kelainan kulit pada pajanan pertama pada hampir semua orang, sedang
iritan lemah hanya pada mereka yang paling rawan atau mengalami kontak
berulang-ulang. Factor kontribusi, misalkan kelembapan udara, tekanan gesekan
dan oklusi mempunyai andil pada terjadinya kerusakan tersebut.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Gejala klinis<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Sebagaimana
disebutkan diatas bahwa ada dua jenis bahan iritan, maka dermatitis kontak
iritan juga ada dua macam yaitu dermatitis kontak iritan akut dan dermatitis kontak
iritan kronis.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify;">
<b><i><span lang="EN-US">Dermatitis kontak
iritan akut<o:p></o:p></span></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Penyebabnya
iritan kuat, biasanya karena kecelakaan. Kulit terasa pedih dan panas, eritema,
vesikel, atau bula. Luas kelaianan umunya sebatas daerah yang terkena berbatas
tegas.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Pada
umumnya kelainan kulit muncul segera, tetapi ada sejumlah bahan kimia yang
menimbulkan reaksi akut lambat misalnya podofilin, antralin, asam
fluorohidrogenat, sehingga dermatitis iritan akut lambat. Kelainan kulit baru
terlihat setelah 12-24 jam atau lebih. Contohnya ialah dermatitis yang
desebabkan oleh bulu serangga yang terbang dimalam hari (dermatitis venenata);
penderita baru merasa merasa pedih setelah esok harinya, pada awalnya terlihat
eritema dan sorenya sudah menjadi vesikel atau bahkan nekrosis.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify;">
<b><i><span lang="EN-US">Dermatitis kontak iritan
kronis<o:p></o:p></span></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Nama
lain ialah dermaitits iritan komulatif disebabkan oleh kontak dengan iritan
lemah yang berulang-ulang (oleh factor fisik, misalnya gesekan, trauma mikro,
kelembapan rendah, panas atau dingin; juga bahan, contohnya detergen, sabun,
pelarut, tanah, bahkan juga air). Dermatitis kontak iritan kronis mungkin
terjadi oleh karena kerja sama berbagai factor. Bisa jadi suatu bahan secara
sendiri tidak cukup kuat menyebabkan dermatitis
iritan, tetapi bila bergabung dengan factor lain baru mampu. Kelainan baru
nyata setelah berhari-hari, berminggu atau bulan, bahkan biasa bertahun-tahun
kemudian.sehingga waktu dan rentetan kontak merupakan factor paling penting.
Dermatitis iritan kumulatif ini merupakan dermatitis kontak iritan yang paling
sering detemukan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Gejala
klasik berupa kulit kering, eritema, skuama, lambat laun kulit tebal
(hyperkeratosis) dan likensifikasi, batas kelainan tidak tegas. Bila kontak
terus berlangsung akhirnya kulit dapat retak seperti luka iris (fisur),
midalnya pada kulit tumit tukang cuci yang mengalami kontak terus menerus
dengan deterjen. <st1:place w:st="on"><st1:city w:st="on">Ada</st1:city></st1:place>
kalanya kelainan hanya berupa kulit
kering atau skuama tanpa eritema, sehingga diabaikan oleh penderita. Setelah
kelaianan dirasahan mengganggu, baru mendapat perhatian. Banyak perkerjaan yang
berisiko tinggi yang memungkinkan terjadinya dermatitis kontak iritan
kumulatif, misalnya; mencuci, memasak, membersihkan lantai, kerja bangunan,
kerja di bengkel, dan berkebun.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Diagnosis<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US"> Diagnosis dermatitis kontak iritan didasarkan
atas anamnesis yang cermat dan pengamatan gambaran klinis. Dermatitis kontak
iritan akut lebih mudah diketahui karena munculnya lebih cepat sehingga
penderita pada umumnya masih ingat yang menjadi penyebabnya. Sebaliknya,
dermatitis kontak iritan kronis timbulnya lambat serta mempunyai fariasi
gambaran klinis yang luas, sehingga ada kalanya sulit dibedakan dengan
dermatitis kontak alergi. Untuk itu diperlukan uji tempel dengan bahan yang dicurigai.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Pengobatan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Upaya
pengobatan dermatitis kontak iritan yang paling terpenting adalah menyingkirkan
pajanan bahan iritan, baik yang bersifat mekanik, fisik maupun kimiawi. Bila
hala ini dapat dilakasanakan dengan sempurna, dan tidak terjadi komplikasi,
maka dermatitis iritan tersebut akan sembuh dengan sedirinya tanpa pengobatan
topical, mungkin cukup dengan pelembab untuk memperbaikai kulit yang kering.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Apabila
diperlukan, untuk mengatasi peradangan dapat diberikan, untuk mengatasi
peradangan dapat diberikan kortikosteroid topical, misalnya hidrokortison, atau
untuk kelainan yang kronis bisa diawali dengan kortikosteroid yang lebih kuat.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Pemakaian
alat pelindung yang adekuat diperlukan bagi mereka yang bekerja dengan bahan
iritan, untuk mencegah kontak dengan bahan tersebut.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Progonosis<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Bila
bahan iritan penyebab dermatitis tersebut tidak dapat disingkirkan dengan
sempurna, maka prognosisnya kurang baik. Keadaan ini sering terjadi pada
dermatitis kontak iritan kronis yang penyebabnya multi factor.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span lang="EN-US">B.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="EN-US">Dermatitis Kontak Alergik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Epidemologi <o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Bila
dibandingkan dengan dermatitis kontak iritan, jumlah penderita dermatitis
kontak alergi lebih sedikit, karena hanya mengenai orang yang kulitnya sangat
peka (hipersensitif). Namun sedikit sekali informasi mengenai prevalensi
dermatitis ini dimasyarakat.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Etiologi <o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Penyebab
dermatitis kontak alergik adalah allergen, paling sering berupa bahan kimia
dengan berat molekul kutang dari 500-1000 Da, yang disebut juga bahan kima
sederhana. Dermatitis yang timbul dipengaruhi oleh potensi sensitisasi allergen, derajat pejanan, dan luasnya, dan
luasnya penetrasi dikulit.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Patogenesis<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Mekanisme terjadinya
kelainan kulit pada dermatitis kontak alergi adalah mengikuti respons
imun yang diperantarai oleh sel (cell- mediated immune respons) atau reaksi
tipe IV. Reaksi hipersensitifitas dikulit timbulnya lambat (delayed
hipersensitifity), umumnya dalam waktu 24 jama setelah perpajan dengan
allergen.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Sebelum
seseorang pertama kali menderita dermatitis kontak alergik, terlebih dahulu
mendapatkan perubahan spesifik reaktifitas pada kulitnya. Perubahan ini terjadi
karena adanya kontak dengan bahan kimia
sederhana yang disebut dengan hapten
yang akan terikat dengan protein, membentuk antigen lengakap. Antigen ini
ditangkap dan diproses oleh makrofag dan sel langerhans, selanjutnya
dipresentasikan ke sel T. setelah kontak dengan allergen yang telah diproses
ini, sel T menuju ke kelenjar getah bening regional untuk berdiferensiasi dan
berploriferasi membentuk sel T efektor
yang tersensititasi secara spesifik dan
sel memori. Sel-sel ini kemudian tersebar melalui sirkulasi keseluruh tubuh,
juga system limfoid, sehingga menyebabkan keadaan sensitivitas yang sama
diseluruh kulit tubuh. Fase saat kontak pertama allergen sampai kulit menjadi
sensitive disebut fase induksi atau sensitisasi. Fase ini berlangsung selama
2-3 minggu. Pada umunya reaksi sensitisasi ini dipengaruhi oleh derajat
kepekaan individu, sifat sensitisasi allergen (sensitizer), jumlah allergen dan
kosentrasi. Sensitizer kuat mempunyai
fase yang lebih pendek, sebaliknya sentisizer lemah seperti bahan-bahan yang
dijumpai pada kehidupan sehari-hari pada umumnya kelaianan kulit pertama muncul
setelah lama kontak dengan bahan tersebut, bulanan atau tahunan. Sedangkan periode saat
terjadinya pejanan ulang dengan allergen yang sama atau serupa sampai timbulnya
gejala klinis disebut fase elisitasi, umumnya berlangsung antara 24-48 jam.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Gejala klinis <o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Penderita
umumnya mengeluh gatal. Kelainan kulit bergantung pada keparahan dermatitis.
Pada yang akut ada bercak eritema berbatas jelas, kemdian diikuti edema, papula
vesikel, vesikel atau bula. Vesikel atau
bula dapat pecah menimbulkan erosi dan
eksudasi. Pada yang kronis kulit terlihat kering, berskuama, papul,
likenifikasi dan mungkin juga fisur, batas yang tidak jelas. Kelainan ini sulit
dibedakan dengan dermatitis kontak iritan kronis, penyebabnya juga campuran.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><i><span lang="EN-US">Berbagai lokalisasi
terjadinya dermatitis kontak <o:p></o:p></span></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<b><span lang="EN-US">Tangan</span></b><span lang="EN-US">. Kejasian dermatitis kontak baik iritan maupun
alergik paling sering ditangan, misalnua pada ibu rumah tangga. Demikian pula
kebanyakan dermatitis kontak akibat kerja ditemukan ditangan. Debagian besar
memegang oleh karena bahan iritan. Bahan penyebabnya misalnya deterjen,
antiseptic, getah sayuran/tanaman, semen dan petisida.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<b><span lang="EN-US">Lengan</span></b><span lang="EN-US">. Allergen umumnya sama dengan pada tangan
misalnya oleh jam tangan (nikel), sarung tangan karet, debu semen, dan tanaman.
Dan aksila umumnya oleh bahan pengharum.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<b><span lang="EN-US">Wajah</span></b><span lang="EN-US">. Dermatitis kontak pada wajah dapat disebkan
oleh bahan kosmetik, obat toikal, allergen yang ada diudara, nikel (tangkai
kacamata), oleh lipstick, pasta gigi, getah buah-buahan. Dermatitis dikelopak
mata dapat disebabkan oleh cat kuku, cat rambut, eyeshadows, dan obat mata.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<b><span lang="EN-US">Telinga</span></b><span lang="EN-US">. Anting atau jepit telinga terbuat dari nikel,
penyebab dermatitis dermatitis kontak pada cuping telinga. Penyebab lain,
misalnya obat topical, tangkai kacamata, cat rambut, hearing aids.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<b><span lang="EN-US">Leher.</span></b><span lang="EN-US"> Penyebabnya adalah kalung dari nikel, cat kuku
(yang berasal dari ujung jari), parfum, allergen diudara, zat warna pakean.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<b><span lang="EN-US">Badan.</span></b><span lang="EN-US"> Dermatitis kontak dibadan dapat disebabkan oleh
pakean, zar warna, kancing logam, karet (elastis, busa), plastic, dan detergen.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<b><span lang="EN-US">Genitalia</span></b><span lang="EN-US">. Penyebabnya adalah dapat
antiseptic, obat topical, nilon, kondom, pembalut wanita, dan allergen yang
berada ditangan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<b><span lang="EN-US">Paha dan tungkai bawah</span></b><span lang="EN-US">. Dermatitis ditempat ini dapat
disebabkan oleh pakaian, dompet, kunci (nikel) berada disaku, kaos kaki nilon,
obat topical (misalnya anastesi local, neomisin, etilendiamin), semen dan
sepatu.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Diagnosis <o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Diagnosis
didasarkan atas hasil anamnesis yang cermat dan pemeriksaan klinis yang teliti.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Pernyataan
terhadap kontaktan yang dicurigai berdasarkan kelainan kulit yang ditemukan.
Misalnya ada kelianan kulit lesi numuler disekitas umbilicus berupa
hiperpigmentasi, likenifikasi, dengan papul dan erosi, maka perlu ditanyakan
apakah penderita memakai kancing celana atau kepala ikat pinggang yang terbut
dari logam (nikel). Data yang berasal dari anamnesis juga meliputi riwayat
pekerjaan, hobi, obat topical, yang pernah digunakan, obat sistemik, kosmetika,
bahan-bahan yang diketahui menimbulkan alergi, penyakit kulit yang pernah
dialami, serta penyakit kulit pada keluarganya (misalnya dermatitis atopik,
psoriasis).<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Pemeriksaan
fisis sangat penting, karena dengan melihat lokalisasi dan pola kelainan sering
kali dapat diketahui kemungkinan penyebabnya. Misalnya, diketiak oleh
deodorant, dipergelangan tangan oleh jam tangan, dan di kedua kaki oleh sepatu.
Pemriksaan hendaknya dilakukan pada seluruh permukaan kulit untuk melihat
kemugkinan kelianan kulit lain karena sebab-sebab endogen.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Diagnosis banding<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Kelainan
kulit dermatitis kontak alergik sering tidak menjunjukan gambaran morfologik
yang khas, dapat menyerupai dermatitis atopik, dermatitis numularis, dermatitis
seboroik, atau psoriasis. Diagnosis banding yang terutama ialah dengan dermatitis
kontak iritan dalam keadaan ini pemeriksaan uji tempel perlu dipertimbangkan
utuk menentukan, apakah dermatitis tersebut karena kontak alergi.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Uji tempel <o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Pelaksanaan
uji tempel dilakukan setelah dermatitisnya sembuh (tenang), bila mungkin
setelah 3 minggu. Tempat melakukan uji tempel biasanya dipunggung, dapat pula
dibagian luar lengan atas. Bahan uji diletakkan pada sepotong kain atau kertas
ditempelkan pada kulit yang utuh, ditutup dengan bahan impermeable, kemudian
direkat dengan plester. Setelah 48 jam dibuka. Reaksi dibaca setelah 48 jam
(waktu dibuka), 72 jam atau 96 jam. Untuk bahan tertentu bahkan baru memberi
reaksi setelah satu minggu. Hasil positif dapat berupa eritema dengan urtika
sampai vesikel atau bula. Penting dibedakan, apakah reaksi karena alergi kontak
atau karena iritasi, sehubungan dengan konsentrasi bahan uji yang terlalu
tinggi. Bila oleh karena iritasi, reaksi akan menurun setelah 48 jam (reaksi
tipe decrescendo) sedangkan reaksi alergi kontak makin meningkat (reaksi tipe
crescendo).<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Pengobatan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Hasil
yang perlu diperhatikan pada pengbatan dermatitis kontak adalah upaya
pencegahan terulangnya kontak kembali dengan allergen penyebab dan menekan
kelainan kulit yang timbul.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<span lang="EN-US">Kortikosteroid dapat
diberikan dalam jangka pendek untuk mengatasi peradangan pada dermatitis kontak
alergi akut yang ditandai dengan eritema, edema, bula atau vesikel, serta
eksukatif (medidans), misalnya predison 30mg/hari. Umumnya kelainan kulit akan
mereda setelah beberapa hari. Kelainan kulit cukup dikompres dengan larutan
garam faal.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<span lang="EN-US">Untuk dermatitis kontak
alergik yang ringan atau dermatitis akut yang telah mereda (setelah mendapat
pengobatan kortikosteroid sistemik) cukup diberikan kortikosteroid topical.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<b><span lang="EN-US">Pronognosis <o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Prognosis
dermatitis kontak alergi umunya baik, sejauh bahan kontaknya dapat
disingkirkan. Prognosis kurang baik dan menjadi kronis bila bersamaan dengan
dermatitis oleh factor endogen (dermatitis atopik, dermatitis numularis, atau
psoriasis) atau pejanan dengan bahan iritan yang tidak mungkin dihindari.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-41724353340050861802013-01-19T04:30:00.000-08:002013-01-19T04:30:03.008-08:00LP TONSILITIS AKUT<!--[if gte mso 9]><xml>
<w:WordDocument>
<w:View>Normal</w:View>
<w:Zoom>0</w:Zoom>
<w:TrackMoves/>
<w:TrackFormatting/>
<w:PunctuationKerning/>
<w:ValidateAgainstSchemas/>
<w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid>
<w:IgnoreMixedContent>false</w:IgnoreMixedContent>
<w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText>
<w:DoNotPromoteQF/>
<w:LidThemeOther>IN</w:LidThemeOther>
<w:LidThemeAsian>X-NONE</w:LidThemeAsian>
<w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript>
<w:Compatibility>
<w:BreakWrappedTables/>
<w:SnapToGridInCell/>
<w:WrapTextWithPunct/>
<w:UseAsianBreakRules/>
<w:DontGrowAutofit/>
<w:SplitPgBreakAndParaMark/>
<w:DontVertAlignCellWithSp/>
<w:DontBreakConstrainedForcedTables/>
<w:DontVertAlignInTxbx/>
<w:Word11KerningPairs/>
<w:CachedColBalance/>
</w:Compatibility>
<w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel>
<m:mathPr>
<m:mathFont m:val="Cambria Math"/>
<m:brkBin m:val="before"/>
<m:brkBinSub m:val="--"/>
<m:smallFrac m:val="off"/>
<m:dispDef/>
<m:lMargin m:val="0"/>
<m:rMargin m:val="0"/>
<m:defJc m:val="centerGroup"/>
<m:wrapIndent m:val="1440"/>
<m:intLim m:val="subSup"/>
<m:naryLim m:val="undOvr"/>
</m:mathPr></w:WordDocument>
</xml><![endif]--><!--[if gte mso 9]><xml>
<w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true"
DefSemiHidden="true" DefQFormat="false" DefPriority="99"
LatentStyleCount="267">
<w:LsdException Locked="false" Priority="0" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Normal"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="heading 1"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 2"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 3"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 4"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 5"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 6"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 7"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 8"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 9"/>
<w:LsdException Locked="false" Priority="39" Name="toc 1"/>
<w:LsdException Locked="false" Priority="39" Name="toc 2"/>
<w:LsdException Locked="false" Priority="39" Name="toc 3"/>
<w:LsdException Locked="false" Priority="39" Name="toc 4"/>
<w:LsdException Locked="false" Priority="39" Name="toc 5"/>
<w:LsdException Locked="false" Priority="39" Name="toc 6"/>
<w:LsdException Locked="false" Priority="39" Name="toc 7"/>
<w:LsdException Locked="false" Priority="39" Name="toc 8"/>
<w:LsdException Locked="false" Priority="39" Name="toc 9"/>
<w:LsdException Locked="false" Priority="35" QFormat="true" Name="caption"/>
<w:LsdException Locked="false" Priority="10" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" Priority="1" Name="Default Paragraph Font"/>
<w:LsdException Locked="false" Priority="11" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" Priority="22" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" Priority="59" SemiHidden="false"
UnhideWhenUsed="false" Name="Table Grid"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading"/>
</w:LatentStyles>
</xml><![endif]--><!--[if gte mso 10]>
<style>
/* Style Definitions */
table.MsoNormalTable
{mso-style-name:"Table Normal";
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
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:0cm;
mso-para-margin-bottom:.0001pt;
mso-pagination:widow-orphan;
font-size:10.0pt;
font-family:"Times New Roman","serif";}
</style>
<![endif]-->
<br />
<div class="Section1">
<div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">TONSILITIS AKUT </span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">(TONSILEKTOMI)</span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l2 level1 lfo1; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Pengertian</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<span lang="EN-US">Tonsilitis
adalah terdapatnya peradangan umum dan pembengkakan dari jaringan tonsil dengan
pengumpulan lekosit, el-sel epitel mati dan bakteri patogen dalam kripta (Adam
Boeis, 1994: 330).</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<span lang="EN-US">Tonsilektomi
adalah suatu tindakan invasif yang dilakukan untuk mengambil tonsil dengan atau
tanpa adenoid (Adam Boeis, 1994: 337). </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l2 level1 lfo1; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Etiologi </span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l18 level1 lfo2; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Streptokokus hemolitikus grup
A.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l18 level1 lfo2; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Pneumokokus.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l18 level1 lfo2; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Stafilokokus.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l18 level1 lfo2; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Haemofilus influezae.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l2 level1 lfo1; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Pathofisiologi </span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l13 level1 lfo20; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Terjadinya peradangan pada
daerah tonsila akibat virus.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l13 level1 lfo20; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Mengakibatkan terjadinya
pembentukan eksudat.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l13 level1 lfo20; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Terjadi selulitis tonsila dan
daerah sekitarnya.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l13 level1 lfo20; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Pembentukan abses peritonsilar.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l13 level1 lfo20; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Nekrosis jaringan.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l2 level1 lfo1; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Gejala-gejala </span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l15 level1 lfo15; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Sakit tenggorokan dan disfagia.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l15 level1 lfo15; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Penderita tidak mau makan atau
minum.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l15 level1 lfo15; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Malaise.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l15 level1 lfo15; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Demam.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l15 level1 lfo15; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Nafas bau.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l15 level1 lfo15; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Otitis media merupakan salah
satu faktor pencetusnya. </span></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l2 level1 lfo1; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Penatalaksanaan</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l0 level1 lfo16; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Tirah baring.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l0 level1 lfo16; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Pemberian cairan adekuat dan
diet ringan.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l0 level1 lfo16; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Pemberian obat-obat (analgesik
dan antibiotik).</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l0 level1 lfo16; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Apabila tidak ada kemajuan maka
alternatif tindakan yang dapat di lakukan adalah pembedahan.</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l2 level1 lfo1; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Indikasi tindakan pembedahan </span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l9 level1 lfo3; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Indikasi absolut</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l5 level1 lfo17; tab-stops: 42.55pt; text-indent: -14.2pt;">
<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">Timbulnya kor pulmonale akibat
adanya obstruksi jalan nafas yang kronis.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l5 level1 lfo17; tab-stops: 42.55pt; text-indent: -14.2pt;">
<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">Hipertrofi tonsil atau adenoid
dengan sindroma apnea pada waktu tidur.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l5 level1 lfo17; tab-stops: 42.55pt; text-indent: -14.2pt;">
<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">Hipertrofi yang berlebihan yang
mengakibatkan disfagia dan penurunan berat badan sebagai penyertanya.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l5 level1 lfo17; tab-stops: 42.55pt; text-indent: -14.2pt;">
<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">Biopsi eksisi yang di curigai
sebagai keganasan (limfoma).</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l5 level1 lfo17; tab-stops: 42.55pt; text-indent: -14.2pt;">
<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">Abses peritonsilaris berulang
atau abses yang meluas pada jaringan sekitarnya.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l9 level1 lfo3; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Indikasi relatif</span></div>
<div class="MsoNormal" style="margin-left: 1.0cm;">
<span lang="EN-US">Seluruh indikasi
lain untuk tindakan tonsilektomi di anggap sebagai indikasi relatif.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l9 level1 lfo3; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Indikasi lain yang paling dapat
di terima adalah</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l7 level1 lfo18; tab-stops: 42.55pt; text-indent: -14.2pt;">
<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">Serangan tonsilitis yang
berulang.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l7 level1 lfo18; tab-stops: 42.55pt; text-indent: -14.2pt;">
<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">Hiperplasia tonsil dengan
gangguan fungsional (disfagia).</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l7 level1 lfo18; tab-stops: 42.55pt; text-indent: -14.2pt;">
<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">Hiperplasia dan obstruksi yang
menetap selama 6 bulan.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l7 level1 lfo18; tab-stops: 42.55pt; text-indent: -14.2pt;">
<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">Tidak memberikan respons
terhadap penatalaksanaan dan terapi.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l2 level1 lfo1; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">G.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Kontraindikasi </span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l19 level1 lfo19; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Demam yang tidak di ketahui
penyebabnya.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l19 level1 lfo19; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Asma.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l19 level1 lfo19; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Infeksi sistemik atau kronis.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l19 level1 lfo19; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Sinusitis.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l2 level1 lfo1; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">H.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Persiapan operasi yang mungkin di lakukan</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l17 level1 lfo21; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Pemeriksaan laboratorium (Hb,
leko, waktu perdarahan).</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l17 level1 lfo21; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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 penjelasan kepada klien
tindakan dan perawatan setelah operasi.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l17 level1 lfo21; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Puasa 6-8 jam sebelum operasi.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l17 level1 lfo21; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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 antibiotik sebagai
propilaksis.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l17 level1 lfo21; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Berikan premedikasi ½ jam
sebelum operasi.</span></div>
</div>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<div class="Section2">
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l2 level1 lfo1; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pengkajian</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l16 level1 lfo4; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Riwayat kesehatan yang
bergubungan dengan faktor pendukung terjadinya tonsilitis serta bio- psiko-
sosio- spiritual.</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l16 level1 lfo4; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Peredaradan darah</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<span lang="EN-US">Palpitasi, sakit
kepala pada saat melakukan perubahan posisi, penurunan tekanan darah,
bradikardi, tubuh teraba dingin, ekstrimitas tampak pucat.</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l16 level1 lfo4; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Eliminasi</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<span lang="EN-US">Perubahan pola eliminasi
(inkontinensia uri/ alvi), distensi abdomen, menghilangnya bising usus.</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l16 level1 lfo4; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Aktivitas/ istirahat</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<span lang="EN-US">Terdapat
penurunan aktivitas karena kelemahan tubuh, kehilangan sensasi atau parese/
plegia, mudah lelah, sulit dalam beristirahat karena kejang otot atau spasme
dan nyeri. Menurunnya tingkat kesadaran, menurunnya kekuatan otot, kelemahan
tubuh secara umum. </span></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l16 level1 lfo4; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Nutrisi dan cairan</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<span lang="EN-US">Anoreksia, mual
muntah akibat peningkatan TIK (tekanan intra kranial), gangguan menelan, dan
kehilangan sensasi pada lidah. </span></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l16 level1 lfo4; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Persarafan</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<span lang="EN-US">Pusing/ syncope,
nyeri kepala, menurunnya luas lapang pandang/ pandangan kabur, menurunnya
sensasi raba terutama pada daerah muka dan ekstrimitas. Status mental koma,
kelmahan pada ekstrimitas, paralise otot wajah, afasia, pupil dilatasi,
penurunan pendengaran.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l16 level1 lfo4; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kenyamanan</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<span lang="EN-US">Ekspresi wajah
yang tegang, nyeri kepala, gelisah.</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l16 level1 lfo4; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pernafasan</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<span lang="EN-US">Nafas yang
memendek, ketidakmampuan dalam bernafas, apnea, timbulnya periode apnea dalam
pola nafas.</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l16 level1 lfo4; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Keamanan </span></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<span lang="EN-US">Fluktuasi dari
suhu dalam ruangan. </span></div>
<div class="MsoNormal" style="margin-left: 21.25pt; mso-list: l16 level1 lfo4; tab-stops: list 21.25pt; text-indent: -21.25pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">10.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Psikolgis</span></div>
<div class="MsoNormal" style="margin-left: 14.2pt;">
<span lang="EN-US">Denial, tidak
percaya, kesedihan yang mendalam, takut, cemas. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 14.2pt; mso-list: l2 level1 lfo1; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">J.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Masalah<span style="mso-spacerun: yes;"> </span>dan rencana tindakan keperawatan</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l1 level1 lfo5; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Ketidakefektifan pola nafas
berhubungan dengan kerusakan jaringan atau trauma pada pusat pernafasan</span></div>
<div class="MsoNormal" style="margin-left: 69.45pt; text-indent: -41.1pt;">
<span lang="EN-US">Tujuan: Pasien menunjukkan kemampuan dalam melakukan pernafasan
secara adekuat dengan memperlihatkan hasil blood gas yang stabil dan baik serta
hilangnya tanda-tanda distress pernafasan.</span></div>
<div class="MsoNormal" style="margin-left: 69.45pt; text-indent: -41.1pt;">
<span lang="EN-US">Rencana tindakan:</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l3 level1 lfo12; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Bebaskan jalan nafas secara
paten (pertahankan posisi kepala dalam keadaan sejajar dengan tulang belakang/
sesuai indikasi). </span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l3 level1 lfo12; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Lakukan suction jika di
perlukan.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l3 level1 lfo12; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Kaji fungsi sistem pernafasan.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l3 level1 lfo12; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Kaji kemampuan pasien dalam
melakukan batuk/ usaha mengeluarkan sekret.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l3 level1 lfo12; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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 tanda-tanda vital
sebelum dan sesudah melakukan tindakan.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l3 level1 lfo12; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Observasi tanda-tanda adanya
ditress pernafasan (kulit menjadi pucat/ cyanosis).</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l3 level1 lfo12; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">g.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kolaborasi dengan terapist
dalam pemberian fisoterapi.</span></div>
<div class="MsoNormal" style="margin-left: 1.0cm;">
<br /></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l1 level1 lfo5; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Kerusakan mobilitas fisik
berhubungan dengan kelemahan neuromuskuler pada ekstrimitas.</span></div>
<div class="MsoNormal" style="margin-left: 68.05pt; text-indent: -39.7pt;">
<span lang="EN-US">Tujuan: Pasien menunjukan adanya peningkatan kemampuan dalam
melakukan aktivitas fisik.</span></div>
<div class="MsoNormal" style="margin-left: 68.05pt; text-indent: -39.7pt;">
<span lang="EN-US">Rencana tindakan:</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l12 level1 lfo6; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Kaji kemampuan pasien dalam
melakukan aktivitas.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l12 level1 lfo6; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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 pada pasien tentang
rentang gerak yang masih dapat di lakukan.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l12 level1 lfo6; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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 latihan secara aktif
dan pasif pada akstrimitas untuk mencegah kekakuan otot dan atrofi.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l12 level1 lfo6; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Anjurkan pasien untuk mengambil
posisi yang lurus.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l12 level1 lfo6; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Bantu pasien secara bertahap
dalam melakukan ROM sesuai kemampuan.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l12 level1 lfo6; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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 dalam pemberian
antispamodic atau relaxant jika di perlukan.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l12 level1 lfo6; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">g.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Observasi kemampuan pasien
dalam melakukan aktivitas<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-left: 1.0cm;">
<br /></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l1 level1 lfo5; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Penurunan perfusi jaringan otak
berhubungan dengan edema cerebri, perdarahan pada otak.</span></div>
<div class="MsoNormal" style="margin-left: 68.05pt; text-indent: -39.7pt;">
<span lang="EN-US">Tujuan: Pasien menunjukan adanya peningkatan kesadaran, kognitif dan
fungsi sensori.</span></div>
<div class="MsoNormal" style="margin-left: 68.05pt; text-indent: -39.7pt;">
<span lang="EN-US">Rencana tindakan:</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l20 level1 lfo7; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Kaji status<span style="mso-spacerun: yes;"> </span>neurologis dan catat perubahannya.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l20 level1 lfo7; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Berikan pasien posisi terlentang.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l20 level1 lfo7; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Kolaborasi dalam pemberian O<sub>2.</sub></span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l20 level1 lfo7; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Observasi tingkat kesadaran,
tanda vital.</span></div>
<div class="MsoNormal" style="margin-left: 1.0cm;">
<br /></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l1 level1 lfo5; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Gangguan rasa nyaman nyeri
berhubungan dengan adanya trauma secara fisik </span></div>
<div class="MsoNormal" style="margin-left: 69.45pt; text-indent: -41.1pt;">
<span lang="EN-US">Tujuan: Pasien mengungkapkan nyeri sudah berkurang dan menunjukkan
suatu keadaan yang relaks dan tenang.</span></div>
<div class="MsoNormal" style="margin-left: 69.45pt; text-indent: -41.1pt;">
<span lang="EN-US">Rencana tindakan:</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l8 level1 lfo8; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Kaji tingkat atau derajat nyeri
yang di rasakan oleh pasien dengan menggunakan skala.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l8 level1 lfo8; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Bantu pasien dalam mencarai
faktor presipitasi dari nyeri yang di rasakan.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l8 level1 lfo8; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Ciptakan lingkungan yang
tenang.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l8 level1 lfo8; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Ajarkan dan demontrasikan ke
pasien tentang beberapa cara dalam melakukan tehnik relaksasi.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l8 level1 lfo8; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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 dalam pemberian
sesuai indikasi. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l1 level1 lfo5; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Kerusakan komunikasi verbal
berhubungan dengan efek dari kerusakan pada area bicara pada himisfer otak.</span></div>
<div class="MsoNormal" style="margin-left: 68.05pt; text-indent: -39.7pt;">
<span lang="EN-US">Tujuan: Pasien mampu melakukan komunikasi untuk memenuhi kebutuhan
dasarnya dan menunjukan peningkatan kemampuan dalam melakukan komunikasi.</span></div>
<div class="MsoNormal" style="margin-left: 68.05pt; text-indent: -39.7pt;">
<span lang="EN-US">Rencana tindakan:</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l10 level1 lfo9; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Lakukan komunkasi dengan pasien
(sering tetapi pendek serta<span style="mso-spacerun: yes;"> </span>mudah di
pahami).</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l10 level1 lfo9; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Ciptakan suatu suasana
penerimaan terhadap perubahan yang dialami pasien.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l10 level1 lfo9; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Ajarkan pada pasien untuk
memperbaiki<span style="mso-spacerun: yes;"> </span>tehnik berkomunikasi.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l10 level1 lfo9; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Pergunakan tehnik komunikasi
non verbal.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l10 level1 lfo9; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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 dalam pelaksanaan
terapi wicara.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l10 level1 lfo9; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Observasi kemampuan pasien
dalam melakukan komunikasi baik verbal maupun non verbal.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l1 level1 lfo5; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<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">Perubahan konsep diri berhubungan
dengan perubahan persepsi.</span></div>
<div class="MsoNormal" style="margin-left: 68.05pt; text-indent: -39.7pt;">
<span lang="EN-US">Tujuan: Pasien menunjukan peningkatan kemampuan dalam menerima
keadaan nya.</span></div>
<div class="MsoNormal" style="margin-left: 68.05pt; text-indent: -39.7pt;">
<span lang="EN-US">Rencana tindakan:</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l11 level1 lfo11; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Kaji pasien terhadap derajat
perubahan konsep diri.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l11 level1 lfo11; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Dampingi dan dengarkan keluhan
pasien.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l11 level1 lfo11; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Beri dukungan terhadap tindakan
yang bersifat positif.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l11 level1 lfo11; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Kaji kemampuan pasien dalam
beristirahat (tidur).</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l11 level1 lfo11; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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 kemampuan pasien
dalam menerima keadaanya.</span></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l1 level1 lfo5; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Perubahan pola eliminasi
defekasi dan uri berhubungan dengan an inervasi pada bladder dan rectum.</span></div>
<div class="MsoNormal" style="margin-left: 73.7pt; text-indent: -45.35pt;">
<span lang="EN-US">Tujuan: Pasien menunjukkan kemampuan dalam melakukan eliminasi
(defekasi/ uri) secara normal sesuai dengan kebiasaan pasien.</span></div>
<div class="MsoNormal" style="margin-left: 1.0cm;">
<span lang="EN-US">Rencana tindakan:</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l4 level1 lfo13; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Kaji pola eliminasi pasien
sebelum dan saat di lakukan pengkajian.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l4 level1 lfo13; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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 dan
distensi abdomen.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l4 level1 lfo13; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Pertahankan porsi minum 2-3
liter perhari (sesuai indikasi).</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l4 level1 lfo13; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Kaji/ palpasi distensi dari
bladder.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l4 level1 lfo13; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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 bladder training sesuai
indikasi.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l4 level1 lfo13; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Bantu/ lakukan pengeluaran
feces secara manual.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l4 level1 lfo13; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">g.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kolaborasi dalam(pemberian
gliserin, pemasangan dower katheter dan<span style="mso-spacerun: yes;">
</span>pemberian obat sesuai indikasi).</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l1 level1 lfo5; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Resiko terjadinya kerusakan
integritas kulit berhubungan dengan sirkulasi perifer yang tidak adekuat,
adanya edema, imobilisasi.</span></div>
<div class="MsoNormal" style="margin-left: 1.0cm;">
<span lang="EN-US">Tujuan: Tidak
terjadi kerusakan integritas kulit (dikubitus).</span></div>
<div class="MsoNormal" style="margin-left: 1.0cm;">
<span lang="EN-US">Rencana tindakan:</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l14 level1 lfo14; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Kaji keadaan kulit dan lokasi
yang biasanya terjadi luka atau lecet.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l14 level1 lfo14; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Anjurkan pada keluarga agar
menjaga keadan kulit tetap kering dan bersih.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l14 level1 lfo14; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Ganti posisi tiap 2 jam sekali.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l14 level1 lfo14; tab-stops: list 14.2pt; text-indent: -14.2pt;">
<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">Rapikan alas tidur agar tidak
terlipat. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 28.4pt; mso-list: l1 level1 lfo5; tab-stops: list 1.0cm; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Resiko terjadinya
ketidakpatuhan terhadap penatalaksanaan yang berhubungan dengan kurangnya
informasi.</span></div>
<div class="MsoNormal" style="margin-left: 70.9pt; text-indent: -42.55pt;">
<span lang="EN-US">Tujuan: Pasien menunjukan kemauan untuk melakukan kegiatan
penatalak- sanaan.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l6 level1 lfo10; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Identifikasi faktor yang dapat
menimbulkan ketidak patuhan terhadap penatalaksanaan.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l6 level1 lfo10; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Diskusikan dengan pasien
cara-cara untuk mengatasi faktor penghambat tersebut.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l6 level1 lfo10; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Jelaskan pada pasien akibat
dari ketidak patuhan terhadap penatalaksanaan.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l6 level1 lfo10; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Libatkan keluarga dalam
penyuluhan.</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; mso-list: l6 level1 lfo10; tab-stops: list 42.55pt; text-indent: -14.2pt;">
<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">Anjurkan pada pasien untuk
melakukan kontrol secara teratur.</span></div>
</div>
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span></b>
<div class="MsoNormal">
<span lang="EN-US">DAFTAR PUSTAKA</span></div>
<div class="MsoNormal" style="margin-left: 2.0cm; text-indent: -2.0cm;">
<br /></div>
<div class="MsoNormal" style="margin-left: 2.0cm; text-indent: -2.0cm;">
<span lang="EN-US">Boeis,Adam, 1994, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Buku Ajar Penyakit THT</i></b>, Jakarta:
EGC. </span></div>
<div class="MsoNormal" style="margin-left: 2.0cm; text-indent: -2.0cm;">
<br /></div>
<div class="MsoNormal" style="margin-left: 2.0cm; text-indent: -2.0cm;">
<span lang="EN-US">Junadi, Purnawan,<span style="mso-spacerun: yes;"> </span>1982, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Kapita
Selekta Kedokteran</i></b>, Jakarta: Media Aesculapius Fakultas Kedokteran
Universitas Indonesia.</span></div>
<div class="MsoNormal" style="margin-left: 2.0cm; text-indent: -2.0cm;">
<br /></div>
<div class="MsoNormal" style="margin-left: 2.0cm; text-indent: -2.0cm;">
<span lang="EN-US">Price, Sylvia Anderson, 1985, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Pathofisiologi Konsep klinik proses-proses
penyakit</i></b>, Jakarta: EGC.</span></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-5899876879687814432013-01-10T06:16:00.001-08:002013-01-10T06:16:46.609-08:00gagal ginjal kronik<!--[if !mso]>
<style>
v\:* {behavior:url(#default#VML);}
o\:* {behavior:url(#default#VML);}
w\:* {behavior:url(#default#VML);}
.shape {behavior:url(#default#VML);}
</style>
<![endif]--><!--[if gte mso 9]><xml>
<w:WordDocument>
<w:View>Normal</w:View>
<w:Zoom>0</w:Zoom>
<w:TrackMoves/>
<w:TrackFormatting/>
<w:PunctuationKerning/>
<w:ValidateAgainstSchemas/>
<w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid>
<w:IgnoreMixedContent>false</w:IgnoreMixedContent>
<w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText>
<w:DoNotPromoteQF/>
<w:LidThemeOther>IN</w:LidThemeOther>
<w:LidThemeAsian>X-NONE</w:LidThemeAsian>
<w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript>
<w:Compatibility>
<w:BreakWrappedTables/>
<w:SnapToGridInCell/>
<w:WrapTextWithPunct/>
<w:UseAsianBreakRules/>
<w:DontGrowAutofit/>
<w:SplitPgBreakAndParaMark/>
<w:DontVertAlignCellWithSp/>
<w:DontBreakConstrainedForcedTables/>
<w:DontVertAlignInTxbx/>
<w:Word11KerningPairs/>
<w:CachedColBalance/>
</w:Compatibility>
<w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel>
<m:mathPr>
<m:mathFont m:val="Cambria Math"/>
<m:brkBin m:val="before"/>
<m:brkBinSub m:val="--"/>
<m:smallFrac m:val="off"/>
<m:dispDef/>
<m:lMargin m:val="0"/>
<m:rMargin m:val="0"/>
<m:defJc m:val="centerGroup"/>
<m:wrapIndent m:val="1440"/>
<m:intLim m:val="subSup"/>
<m:naryLim m:val="undOvr"/>
</m:mathPr></w:WordDocument>
</xml><![endif]--><!--[if gte mso 9]><xml>
<w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true"
DefSemiHidden="true" DefQFormat="false" DefPriority="99"
LatentStyleCount="267">
<w:LsdException Locked="false" Priority="0" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Normal"/>
<w:LsdException Locked="false" Priority="0" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="heading 1"/>
<w:LsdException Locked="false" Priority="0" QFormat="true" Name="heading 2"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 3"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 4"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 5"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 6"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 7"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 8"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 9"/>
<w:LsdException Locked="false" Priority="39" Name="toc 1"/>
<w:LsdException Locked="false" Priority="39" Name="toc 2"/>
<w:LsdException Locked="false" Priority="39" Name="toc 3"/>
<w:LsdException Locked="false" Priority="39" Name="toc 4"/>
<w:LsdException Locked="false" Priority="39" Name="toc 5"/>
<w:LsdException Locked="false" Priority="39" Name="toc 6"/>
<w:LsdException Locked="false" Priority="39" Name="toc 7"/>
<w:LsdException Locked="false" Priority="39" Name="toc 8"/>
<w:LsdException Locked="false" Priority="39" Name="toc 9"/>
<w:LsdException Locked="false" Priority="35" QFormat="true" Name="caption"/>
<w:LsdException Locked="false" Priority="10" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" Priority="1" Name="Default Paragraph Font"/>
<w:LsdException Locked="false" Priority="11" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" Priority="0" Name="Body Text Indent 2"/>
<w:LsdException Locked="false" Priority="0" Name="Body Text Indent 3"/>
<w:LsdException Locked="false" Priority="22" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" Priority="59" SemiHidden="false"
UnhideWhenUsed="false" Name="Table Grid"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading"/>
</w:LatentStyles>
</xml><![endif]--><!--[if !mso]><img src="//img2.blogblog.com/img/video_object.png" style="background-color: #b2b2b2; " class="BLOGGER-object-element tr_noresize tr_placeholder" id="ieooui" data-original-id="ieooui" />
<style>
st1\:*{behavior:url(#ieooui) }
</style>
<![endif]--><!--[if gte mso 10]>
<style>
/* Style Definitions */
table.MsoNormalTable
{mso-style-name:"Table Normal";
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
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:0cm;
mso-para-margin-bottom:.0001pt;
mso-pagination:widow-orphan;
font-size:10.0pt;
font-family:"Times New Roman","serif";}
</style>
<![endif]--><!--[if gte mso 9]><xml>
<o:shapedefaults v:ext="edit" spidmax="1062"/>
</xml><![endif]--><!--[if gte mso 9]><xml>
<o:shapelayout v:ext="edit">
<o:idmap v:ext="edit" data="1"/>
</o:shapelayout></xml><![endif]-->
<br />
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span lang="EN-US">GAGAL GINJAL KRONIK</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; 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">PENGERTIAN</span></b></div>
<div class="MsoBodyTextIndent2" style="text-indent: 18.0pt;">
<span lang="EN-US">Gagal
Ginjal Kronik (GGK) adalah kemunduran fungsi ginjal yang menyebabkan
ketidakmampuan mempertahankan substansi tubuh dibawah kondisi normal (Betz
Sowden, 2002<span style="mso-spacerun: yes;"> </span>)</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 18.0pt;">
<span lang="EN-US">Gagal Ginjal Kronik adalah kerusakan
yang progresif pada nefron yang mengarah pada timbulnya uremia yang secara
perlahan-lahan meningkat ( Rosa M. Sacharin, 1996).</span></div>
<div class="MsoBodyTextIndent3">
<span lang="EN-US">Dari kedua pengertian tersebut
diatas dapat disimpulkan bahwa gagal ginjal kronis adalah adanya kerusakan
fungsi ginjal secara progresif sehingga tubuh akan mengalami gangguan karena
ginjal tidak mampu mempertahnkan substansi tubuh dalam keadaan nomal.</span></div>
<div class="MsoBodyTextIndent3">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">ETIOLOGI</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level2 lfo1; tab-stops: list 36.0pt 54.0pt; text-align: justify; 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">Glomerulonefritis</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level2 lfo1; tab-stops: list 36.0pt 54.0pt; text-align: justify; 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">Pielonefritis</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level2 lfo1; tab-stops: list 36.0pt 54.0pt; text-align: justify; 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">Nefrosklerosis</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level2 lfo1; tab-stops: list 36.0pt 54.0pt; text-align: justify; 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">Sindroma Nefrotik</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level2 lfo1; tab-stops: list 36.0pt 54.0pt; text-align: justify; 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">Tumor Ginjal</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">PATOFISIOLOGI</span></b></div>
<div class="MsoBodyTextIndent3">
<span lang="EN-US">Ginjal mempunyai kemampuan nyata
untuk mengkompensasi kehilangan nefron yang persisten yang terjadi pada gagal
ginjal kronik. Jika angka filtrasi glomerolus menurun menjadi 5-20
ml/menit/1,73 m2, kapasitas ini mulai gagal. Hal ini menimbulkan berbagai
masalah biokimia berhubungan dengan bahan utama yang ditangani ginjal.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.9pt; text-align: justify; text-indent: 18.9pt;">
<span lang="EN-US">Ketidakseimbangan natrium dan cairan
terjadi karena ketidakmampuan ginjal untuk memekatkan urin. Hiperkalemia
terjadi akibat penurunan sekresi kalium. Asidosis metabolik terjadi karena
kerusakan reabsorbsi bikarbonat dan produksi ammonia. Demineralisasi tulang dan
gangguan pertumbuhan terjadi akibat sekresi hormon paratiroid, peningkatan
fosfat plasma (penurunan kalsium serum, asidosis) menyebabkan pelepasan kalsium
dan fosfor ke dalam aliran darah dan gangguan penyerapan kalsium usus. Anemia
terjadi karena gangguan produksi sel darah merah, penurunan rentang hidup sel
darah merah, peningkatan kecenderungan perdarahan (akibat kerusakan fungsi
trombosit). Perubahan pertumbuhan berhubungan dengan perubahan nutrisi dan
berbagai proses biokimia</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.9pt; text-align: justify; text-indent: 18.9pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.9pt; text-align: justify; text-indent: 18.9pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.9pt; text-align: justify; text-indent: 18.9pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.9pt; text-align: justify; text-indent: 18.9pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.9pt; text-align: justify; text-indent: 18.9pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.9pt; text-align: justify; text-indent: 18.9pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.9pt; text-align: justify; text-indent: 18.9pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.9pt; text-align: justify; text-indent: 18.9pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.9pt; text-align: justify; text-indent: 18.9pt;">
<br /></div>
<div class="MsoBodyTextIndent3" style="text-indent: 0cm;">
<b><span lang="EN-US">PATHWAYS</span></b></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Glomerulonefritis</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Pielonefritis, Hidronefrosis</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Sindroma Nefrotik</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; text-align: center; text-indent: 0cm;">
<span style="height: 27px; left: 0px; margin-left: 270px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251639808;"><img height="27" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /></span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Tumur Ginjal</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; text-align: center; text-indent: 0cm;">
<br /></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; text-align: center; text-indent: 0cm;">
<span style="height: 27px; left: 0px; margin-left: 270px; margin-top: 11px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251640832;"><img height="27" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /></span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">GFR menurun</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; text-align: center; text-indent: 0cm;">
<br /></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; text-align: center; text-indent: 0cm;">
<span style="height: 26px; left: 0px; margin-left: 275px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251641856;"><img height="26" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="2" /></span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">GGK</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; text-align: center; text-indent: 0cm;">
<br /></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="0" width="90"><br /></td>
<td width="396"><br /></td>
<td width="24"><br /></td>
<td width="12"><br /></td>
</tr>
<tr>
<td height="15"><br /></td>
<td align="left" rowspan="2" valign="top"><img height="19" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image003.gif" width="396" /></td>
</tr>
<tr>
<td height="4"><br /></td>
<td><br /></td>
<td align="left" rowspan="2" valign="top"><img height="27" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /></td>
</tr>
<tr>
<td height="23"><br /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 18.0pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 132.6pt;" valign="top" width="177">
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Sekresi protein</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">terganggu</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="11" width="78"><br /></td>
</tr>
<tr>
<td><br /></td>
<td><img height="63" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" width="12" /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<br /></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<br /></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<br /></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<br /></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="height: 27px; left: 0px; margin-left: 66px; margin-top: 143px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251664384;"><img height="27" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /></span><span style="height: 2px; left: 0px; margin-left: 71px; margin-top: 130px; mso-ignore: vglayout; position: absolute; width: 194px; z-index: 251660288;"><img height="2" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" width="194" /></span><span style="height: 2px; left: 0px; margin-left: 71px; margin-top: 143px; mso-ignore: vglayout; position: absolute; width: 386px; z-index: 251662336;"><img height="2" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" width="386" /></span><span style="height: 110px; left: 0px; margin-left: 71px; margin-top: 23px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251661312;"><img height="110" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image007.gif" width="2" /></span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Sindrom uremik</span></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 129.4pt;" valign="top" width="173">
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Retensi natrium</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="4" width="77"><br /></td>
</tr>
<tr>
<td><br /></td>
<td><img height="27" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image008.gif" width="12" /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<br /></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout; position: relative; z-index: 251645952;"><span style="height: 18px; left: 0px; left: 106px; position: absolute; top: -5px; width: 18px;"><img height="18" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image009.gif" width="18" /></span></span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">CES </span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="1" width="77"><br /></td>
<td width="12"><br /></td>
<td width="41"><br /></td>
<td width="18"><br /></td>
</tr>
<tr>
<td height="8"><br /></td>
<td align="left" rowspan="2" valign="top"><img height="16" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image010.gif" width="12" /></td>
</tr>
<tr>
<td height="8"><br /></td>
<td><br /></td>
<td align="left" rowspan="2" valign="top"><img height="19" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image011.gif" width="18" /></td>
</tr>
<tr>
<td height="11"><br /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Tekanan kapiler</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="3" width="77"><br /></td>
</tr>
<tr>
<td><br /></td>
<td><img height="16" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" width="12" /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout; position: relative; z-index: 251654144;"><span style="height: 18px; left: 0px; left: 142px; position: absolute; top: -6px; width: 18px;"><img height="18" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" width="18" /></span></span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Volume interstisial</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="6" width="77"><br /></td>
</tr>
<tr>
<td><br /></td>
<td><img height="15" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image014.gif" width="12" /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Edema</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="8" width="77"><br /></td>
</tr>
<tr>
<td><br /></td>
<td><img height="27" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image015.gif" width="12" /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<div class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-indent: 0cm;">
<br /></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout; position: relative; z-index: 251651072;"><span style="height: 26px; left: -2px; left: 0px; position: absolute; top: -2px; width: 170px;"><img height="26" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image016.gif" width="170" /></span></span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Kelebihan voleme cairan </span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<br /></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="13" width="77"><br /></td>
</tr>
<tr>
<td><br /></td>
<td><img height="39" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image017.gif" width="12" /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<div class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-indent: 0cm;">
<br /></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 127.8pt;" valign="top" width="170"><br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Sekresi eritropoietin</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="4" width="76"><br /></td>
</tr>
<tr>
<td><br /></td>
<td><img height="15" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image014.gif" width="12" /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Produksi Hb turun</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="6" width="76"><br /></td>
</tr>
<tr>
<td><br /></td>
<td><img height="16" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image018.gif" width="12" /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="height: 27px; left: 0px; margin-left: 100px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251659264;"><img height="27" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image019.gif" width="12" /></span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Suplai oksigen ke jaringan</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="height: 78px; left: -4px; mso-ignore: vglayout; position: relative; top: 8px; width: 170px; z-index: 251655168;"><img height="70" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image020.gif" width="170" /></span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<br /></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="height: 27px; left: 0px; margin-left: 100px; margin-top: 126px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251675648;"><img height="27" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" width="12" /></span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Gangguan perfusi jaringan </span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;">
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 132.6pt;" valign="top" width="177">
<div class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-indent: 0cm;">
<br /></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Hiperphospatemia</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="5" width="85"><br /></td>
</tr>
<tr>
<td><br /></td>
<td><img height="16" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image022.gif" width="12" /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Pruritus</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="height: 58px; left: -1px; mso-ignore: vglayout; position: relative; top: 7px; width: 170px; z-index: 251667456;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="0" width="0"><br /></td>
<td width="79"><br /></td>
<td width="12"><br /></td>
<td width="79"><br /></td>
</tr>
<tr>
<td height="16"><br /></td>
<td><br /></td>
<td align="left" valign="top"><img height="16" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image010.gif" width="12" /></td>
</tr>
<tr>
<td height="9"><br /></td>
</tr>
<tr>
<td height="26"><br /></td>
<td align="left" colspan="3" valign="top"><img height="26" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image023.gif" width="170" /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<br /></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Gangguan integritas kulit</span></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 129.4pt;" valign="top" width="173">
<div class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-indent: 0cm;">
<br /></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Gangguan keseimbangan</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">asam basa</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="0" width="75"><br /></td>
<td width="12"><br /></td>
<td width="41"><br /></td>
<td width="18"><br /></td>
</tr>
<tr>
<td height="8"><br /></td>
<td align="left" rowspan="2" valign="top"><img height="16" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image018.gif" width="12" /></td>
</tr>
<tr>
<td height="8"><br /></td>
<td><br /></td>
<td align="left" rowspan="2" valign="top"><img height="18" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image024.gif" width="18" /></td>
</tr>
<tr>
<td height="10"><br /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Produksi asam</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="2" width="75"><br /></td>
</tr>
<tr>
<td><br /></td>
<td><img height="16" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" width="12" /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Asidosis metabolik</span></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 127.8pt;" valign="top" width="170">
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<br /></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Urokrom tertimbun di kulit</span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span style="mso-ignore: vglayout;">
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="1" width="64"><br /></td>
</tr>
<tr>
<td><br /></td>
<td><img height="28" src="file:///C:/Users/BAYUKH%7E1/AppData/Local/Temp/msohtmlclip1/01/clip_image025.gif" width="12" /></td>
</tr>
</tbody></table>
</span><span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;"> </span></div>
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<br /></div>
<br clear="ALL" style="mso-ignore: vglayout;" />
<div align="center" class="MsoBodyTextIndent3" style="line-height: normal; margin-left: 0cm; text-align: center; text-indent: 0cm;">
<span lang="EN-US" style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">Perubahan warna kulit</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoBodyTextIndent3" style="margin-left: 0cm; text-indent: 0cm;">
<br /></div>
<div class="MsoBodyTextIndent3" style="margin-left: 0cm; text-indent: 0cm;">
<br /></div>
<div class="MsoBodyTextIndent3" style="margin-left: 0cm; text-indent: 0cm;">
<br /></div>
<div class="MsoBodyTextIndent3" style="margin-left: 0cm; text-indent: 0cm;">
<br /></div>
<h1>
<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">MANIFESTASI KLINIK</span></h1>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.9pt; text-align: justify; text-indent: 17.1pt;">
<span lang="EN-US">Meskipun gejala yang dialami anak
bervariasi berdasarkan proses penyakit yang berbeda – beda, penyakit paling
umum yang berhubungan dengan GGK adalah sebagai berikut :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.0pt; mso-list: l3 level1 lfo2; tab-stops: list 35.0pt; text-align: justify; text-indent: -17.0pt;">
<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">Ketidakseimbangan cairan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Kelebihan cairan : edema,
oliguri, hipertensi, gagal jantung kongestif</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.9pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -19.9pt;">
<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">Penipisan volume vaskuler :
poliuria, penurunan asupan cairan,<span style="mso-spacerun: yes;">
</span>dehidrasi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.0pt; mso-list: l3 level1 lfo2; tab-stops: list 35.0pt; text-align: justify; text-indent: -17.0pt;">
<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">Ketidakseimbangan elektrolit</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.9pt; mso-list: l3 level2 lfo2; tab-stops: list 53.9pt; text-align: justify; text-indent: -19.6pt;">
<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">Hiperkalemia : gangguan irama
jantung, disfungsi miokardial</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.9pt; mso-list: l3 level2 lfo2; tab-stops: list 53.9pt; text-align: justify; text-indent: -19.6pt;">
<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">Hipernatremia : haus, stupor,
takikardia, membran kering, peningkatan refleks tendon profunda, penurunan
tingkat kesadaran</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.9pt; mso-list: l3 level2 lfo2; tab-stops: list 53.9pt; text-align: justify; text-indent: -19.6pt;">
<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">Hipokalemia dan hiperfosfatemia
: iritabilitas, depresi, kram otot, parastesia, psikosis, tetani</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.9pt; mso-list: l3 level2 lfo2; tab-stops: list 53.9pt; text-align: justify; text-indent: -19.6pt;">
<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">Hipokalemia : penurunan reflek
tendon profunda, hipotonia, perubahan EKG</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.0pt; mso-list: l3 level1 lfo2; tab-stops: list 35.0pt; text-align: justify; text-indent: -17.0pt;">
<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">Ensefalopati dan neuropati
uremik</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Gatal gatal</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Kram dan kelemahan otot</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Bicara tidak jelas</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Parastesia telapak tangan dan
telapak kaki</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Konsentrasi buruk</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Mengantuk</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">g.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Tanda tanda peningkatan tekanan
intrakranial</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">h.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Koma</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">i.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kejang</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.0pt; mso-list: l3 level1 lfo2; tab-stops: list 35.0pt; text-align: justify; text-indent: -17.0pt;">
<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">Asidosis : takipnea</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.0pt; mso-list: l3 level1 lfo2; tab-stops: list 35.0pt; text-align: justify; text-indent: -17.0pt;">
<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">Anemia dan disfungsi sel darah</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Pucat</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Kelemahan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Perdarahan ( stomatitis, feses
berdarah )</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.0pt; mso-list: l3 level1 lfo2; tab-stops: list 35.0pt; text-align: justify; text-indent: -17.0pt;">
<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">Disfungsi pertumbuhan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Pertumbuhan tulang yang
abnormal</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Perkembangan seksual yang
terhambat</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Malnutrisi dan pelisutan otot</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Selera makan buruk</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Nyeri tulang</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45.35pt; mso-list: l3 level2 lfo2; tab-stops: list 52.0pt; text-align: justify; text-indent: -11.35pt;">
<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">Ketidakteraturan menstruasi.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">PEMERIKSAAN DIAGNOSTIK</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level4 lfo1; tab-stops: list 36.0pt 126.0pt; text-align: justify; 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">Tes darah</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level1 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-font-kerning: 8.0pt;"><span style="mso-list: Ignore;">Ó<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">BUN dan kreatinin serum meningkat</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level1 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-font-kerning: 8.0pt;"><span style="mso-list: Ignore;">Ó<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Kalium serum meningkat</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level1 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-font-kerning: 8.0pt;"><span style="mso-list: Ignore;">Ó<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Natrium serum meningkat</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level1 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-font-kerning: 8.0pt;"><span style="mso-list: Ignore;">Ó<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Kalsium serum menurun, fosfor serum meningkat, PH serum dan HCO3
menurun</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level1 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-font-kerning: 8.0pt;"><span style="mso-list: Ignore;">Ó<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Hb, Ht, trombosit menurun</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level1 lfo3; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-font-kerning: 8.0pt;"><span style="mso-list: Ignore;">Ó<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Asam urat meningkat, kultur darah positif</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level4 lfo1; tab-stops: list 36.0pt 126.0pt; text-align: justify; 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">Tes urin</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level5 lfo1; tab-stops: list 54.0pt 162.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-font-kerning: 8.0pt;"><span style="mso-list: Ignore;">Ó<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Urinalisis</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level5 lfo1; tab-stops: list 54.0pt 162.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-font-kerning: 8.0pt;"><span style="mso-list: Ignore;">Ó<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Elektrolit urin, osmolalitas dan berat jenis</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level5 lfo1; tab-stops: list 54.0pt 162.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-font-kerning: 8.0pt;"><span style="mso-list: Ignore;">Ó<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Urin 24 jam</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level4 lfo1; tab-stops: list 36.0pt 126.0pt; text-align: justify; 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">EKG</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level4 lfo1; tab-stops: list 36.0pt 126.0pt; text-align: justify; 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">Rontgen dada</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level4 lfo1; tab-stops: list 36.0pt 126.0pt; text-align: justify; 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">Biopsi Ginjal</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; tab-stops: list 126.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">F.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">PENATALAKSANAAN</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level4 lfo1; tab-stops: list 36.0pt 126.0pt; text-align: justify; 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">Stabilkan keseimbangan cairan
dan elektrolit</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level4 lfo1; tab-stops: list 36.0pt 126.0pt; text-align: justify; 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">Dukung fungsi kardiovaskuler</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level4 lfo1; tab-stops: list 36.0pt 126.0pt; text-align: justify; 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">Cegah infeksi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level4 lfo1; tab-stops: list 36.0pt 126.0pt; text-align: justify; 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">Tingkatkan status nutrisi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level4 lfo1; tab-stops: list 36.0pt 126.0pt; text-align: justify; 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"><span style="mso-spacerun: yes;"> </span>Kendalikan perdarahan dan anemia</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level4 lfo1; tab-stops: list 36.0pt 126.0pt; text-align: justify; 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">Lakukan dialisis</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level4 lfo1; tab-stops: list 36.0pt 126.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Transplantasi ginjal</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; tab-stops: list 126.0pt; text-align: justify;">
<br /></div>
<h1>
<span lang="EN-US"><span style="mso-list: Ignore;">G.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">ASUHAN KEPERAWATAN PADA ANAK DENGAN GGK</span></h1>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.0pt; mso-list: l1 level1 lfo4; tab-stops: list 35.0pt; text-align: justify; text-indent: -17.0pt;">
<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">PENGKAJIAN</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Kaji adanya tanda dan gejala
kelebihan volume cairan ( edema, kulit tegang dan mengilat, asupan lebih besar
daripada keluaran dan berat badan bertambah )</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Kaji adanya tanda dan gejala
penurunan curah jantung, kekurangan olume cairan dan pola nafas tak efektif</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Kaji adanya tanda dan gejala
masalah masalah kolaboratif potensial berikut ini : syok,infeksi, kelebihn
cairan, hipertensi, gagal jantung, edema pulmonal, ketidakseimbangan
elektrolit, koma, kejang</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Kaji adanya tanda dan gejala
infeksi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Kaji pertumbuhan dan
perkembangan biopsikososial dan spiritual anak</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Kaji tingkat aktivitas dan
respon koping anak</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">g.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kaji kemampuan keluarga untuk
penatalaksanaan dan melakukan koping terhadap perawatan jangka panjang dan
kebutuhan anak mereka.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.0pt; mso-list: l1 level1 lfo4; tab-stops: list 35.0pt; text-align: justify; text-indent: -17.0pt;">
<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">DIAGNOSA KEPERAWATAN</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Kelebihan volume cairan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Resiko tinggi kekurangan volume
cairan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Perubahan pola eliminasi urin</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Penurunan curah jantung</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Pola nafas tidak efektif</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Resiko tinggi kerusakan
integritas kulit</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">g.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Resiko tinggi cidera</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">h.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Resiko tinggi infeksi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">i.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Perubahan nutrisi : kurang dari
kebutuhan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">j.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Resiko tinggi penatalaksanaan
program terapeutik tidak efektif</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">k.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Resiko tinggi perubahan proses
keluarga</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">l.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Resiko tinggi perubahan tumbang</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.0pt; mso-list: l1 level1 lfo4; tab-stops: list 35.0pt; text-align: justify; text-indent: -17.0pt;">
<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">INTERVENSI KEPERAWATAN</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Pantau statua cairan dan
elektrolit</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Catat dengan akurat asupan dan keluaran</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Pertahankan pembatasan cairan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Pantau status hidrasi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Berikan diuretik dan pantau respon anak terhadapnya</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Berikan obat obatan untuk mempertahankan keseimbangan<span style="mso-spacerun: yes;"> </span>elktrolit</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Berikan terapi dialisis sesuai instruksi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Dukung fungsi kardiovaskuler
dan paru</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Pantau adanya kelebihan cairan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Pantau adanya tanda tanda dehidrasi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Pantau adanya perubahan EKG yang berhubungan dengan
ketidakseimbangan elktrolit</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Pantau tanda tanda vital, termasuk tekanan darah, pemberian
antihipertensi sesuai indikasi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Berikan produk darah sesuai instruksi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Pertahankan integritas kulit
dan cegah terjadinya infeksi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Mandikan pasien tiap hari dan berikan perawatan mulut dengan sering</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Bantu pasien untuk miring kiri dan kanan sesuai kebutuhan: cegah
terjadinya dekubitus</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Lakukan pencegahan perdarahan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Hindari kontak pasien dengan pengunjung infeksius</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Pertahankan sterilitas semua jalur jalur invasif dan lakukan
pengantian balutan serta perawatan jalur jalur tersebut seperlunya dan tepat
waktu</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Pantau adanya tanda tanda infeksi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 51.05pt; mso-list: l1 level2 lfo4; tab-stops: list 52.0pt; text-align: justify; text-indent: -17.05pt;">
<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">Tingkatkan pertumbuhan dan
nutrisi klien</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Bantu klien dalam memilih makanan yang disukainya dengan menyarankn
diet yang rendah kalium, rendah natrium, rendah fosfor, tinggi kalsium, tinggi
protein.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Pantau status pertumbuhan pasien dengan mengkaji kecenderungan
pertumbuhan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Berikan makanan enteral atau IV seperlunya</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Berikan vitamin, suplemen kalsium dan pengikat osfat</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 68.05pt; mso-list: l1 level3 lfo4; tab-stops: list 69.05pt; text-align: justify; text-indent: -17.0pt;">
<span lang="EN-US" style="font-family: Wingdings; 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 lang="EN-US">Berikan dukungn psikososial pada klien dan keluarga.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 34.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<h2>
<span lang="EN-US">DAFTAR PUSTAKA</span></h2>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo5; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">Betz Cecily L, Sowden Linda A.
(2002). <i style="mso-bidi-font-style: normal;">Buku Saku Keperawatan
Pediatri</i>. Jakarta
: EGC.</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo5; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">Sacharin Rosa M. (1996). <i style="mso-bidi-font-style: normal;">Prinsip Keperawatan Pediatrik</i>. Alih
bahasa : Maulanny R.F. Jakarta : EGC.</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo5; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">Price Sylvia A, Wilson Lorraine
McCarty. (1995). <i style="mso-bidi-font-style: normal;">Patofisiologi</i>. Jakarta : EGC.</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo5; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">Staf Pengajar Ilmu Kesehatan Anak
FK UI. (2000). <i style="mso-bidi-font-style: normal;">Ilmu Kesehatan Anak</i>.
Jilid<span style="mso-spacerun: yes;"> </span>2. Jakarta : Bagian Ilmu Kesehatan Anak FK
UI</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo5; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">……….,The Merck Manual of Diagnosis
and Therapy. <i>Chronic renal Failure</i>.Sec.17.Ch222.</span><span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 10.0pt;">http://www.vh.org/adult/provider/familymedicine.</span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<span lang="EN-US" style="line-height: 150%; mso-bidi-font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>html</span><span lang="EN-US" style="font-size: 10.0pt; line-height: 150%;"> </span></div>
<ol start="6" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo5; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">Nanny.S,(2001).Intisari online.<i style="mso-bidi-font-style: normal;">Disiplin Ketat Penderita Gagal Ginjal.</i>
www. Indomedia.com/intisari/2001/juni/Terapi_601.htm.</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo5; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US" style="mso-bidi-font-style: italic;">Agha,
I.A,(2003). Medical Encyclopedia. </span><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Chronic Renal Failure.</span></i><span lang="EN-US" style="mso-bidi-font-style: italic;">Departement of medicine,
renal division, St. Louis
University</span><i style="mso-bidi-font-style: normal;"><span lang="EN-US"></span></i></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo5; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US" style="color: black;">Horne M.M,
Swearingen P L,(2000).<i>Keseimbangan Cairan,Elektrolit Dan Asam Basa. </i>Jakarta
: EGC</span><i style="mso-bidi-font-style: normal;"><span lang="EN-US"></span></i></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo5; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US" style="color: black;">Wong and
whaley. (1996). <i>Clinical Manual of Pediatric Nursing</i></span><i style="mso-bidi-font-style: normal;"><span lang="EN-US"></span></i></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-43958622417017484232012-12-11T19:14:00.005-08:002012-12-11T19:14:52.668-08:00Paporan Pendahuluan Dengan HIV AIDS<br />
<div align="center" class="MsoNormal" style="text-align: center;">
<i><span lang="EN-US">Laporan Pendahuluan<o:p></o:p></span></i></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><u><span lang="EN-US">ASUHAN KEPERAWATAN
PASIEN DENGAN HIV-AIDS</span></u></b><b><span lang="EN-US"><o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b><span lang="EN-US">Konsep Dasar<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l2 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">I.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Pengertian<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<span lang="EN-US">AIDS adalah sindroma
yang menunjukkan defisiensi imun seluler pada seseorang tanpa adanya penyebab
yang diketahui untuk dapat menerangkan tejadinya defisiensi, tersebut seperti
keganasan, obat-obat supresi imun, penyakit infeksi yang sudah dikenal dan
sebagainya. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l2 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US">II.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Etiologi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 18.0pt;">
<span lang="EN-US">Penyebab
adalah golongan virus retro yang disebut human immunodeficiency virus (HIV).
HIV pertama kali ditemukan pada tahun 1983 sebagai retrovirus dan disebut
HIV-1. Pada tahun 1986 di Afrika ditemukan lagi retrovirus baru yang diberi
nama HIV-2. HIV-2 dianggap sebagai virus kurang pathogen dibandingkaan dengan
HIV-1. Maka untuk memudahkan keduanya disebut HIV.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 18.0pt;">
<span lang="EN-US">Transmisi
infeksi HIV dan AIDS terdiri dari lima fase yaitu :<o:p></o:p></span></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo3; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">Periode
jendela. Lamanya 4 minggu sampai 6 bulan setelah infeksi. Tidak ada
gejala.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo3; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">Fase
infeksi HIV primer akut. Lamanya 1-2 minggu dengan gejala flu likes
illness.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo3; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">Infeksi
asimtomatik. Lamanya 1-15 atau lebih tahun dengan gejala tidak ada.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo3; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">Supresi
imun simtomatik. Diatas 3 tahun dengan gejala demam, keringat malam hari,
B menurun, diare, neuropati, lemah, rash, limfadenopati, lesi mulut.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo3; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">AIDS.
Lamanya bervariasi antara 1-5 tahun dari kondisi AIDS pertama kali
ditegakkan. Didapatkan infeksi oportunis berat dan tumor pada berbagai
system tubuh, dan manifestasi neurologist.<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify; text-indent: 18.0pt;">
<span lang="EN-US">AIDS
dapat menyerang semua golongan umur, termasuk bayi, pria maupun wanita. Yang
termasuk kelompok resiko tinggi adalah :<o:p></o:p></span></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">Lelaki
homoseksual atau biseks. 5. Bayi dari ibu/bapak terinfeksi.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">Orang
yang ketagian obat intravena<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">Partner
seks dari penderita AIDS<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">Penerima
darah atau produk darah (transfusi).</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US" style="line-height: 150%; text-indent: -18pt;">I.<span style="font-size: 7pt; line-height: normal;"> </span></span><span lang="EN-US" style="line-height: 150%; text-indent: -18pt;">Pemeriksaan Diagnostik</span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify;"><span lang="EN-US">
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">1.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Tes untuk diagnosa infeksi HIV :<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">ELISA<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Western
blot<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">P24
antigen test<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Kultur
HIV<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">2.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Tes untuk deteksi gangguan system
imun.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Hematokrit.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">LED<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">CD4
limfosit<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Rasio
CD4/CD limfosit<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Serum
mikroglobulin B2<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="EN-US">Hemoglobulin
<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">II.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Penatalaksanaan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b>Asuhan Keperawatan<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">I.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Pengkajian.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">1.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Riwayat : tes HIV positif, riwayat
perilaku beresiko tinggi, menggunakan obat-obat.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">2.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Penampilan umum : pucat, kelaparan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">3.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Gejala subyektif : demam kronik,
dengan atau tanpa menggigil, keringat malam hari berulang kali, lemah, lelah,
anoreksia, BB menurun, nyeri, sulit tidur.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">4.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Psikososial : kehilangan pekerjaan
dan penghasilan, perubahan pola hidup, ungkapkan perasaan takut, cemas,
meringis.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">5.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Status mental : marah atau pasrah,
depresi, ide bunuh diri, apati, withdrawl, hilang interest pada lingkungan
sekitar, gangguan prooses piker, hilang memori, gangguan atensi dan
konsentrasi, halusinasi dan delusi.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">6.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">HEENT : nyeri periorbital,
fotophobia, sakit kepala, edem muka, tinitus, ulser pada bibir atau mulut,
mulut kering, suara berubah, disfagia, epsitaksis.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">7.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Neurologis :gangguan refleks pupil,
nystagmus, vertigo, ketidakseimbangan , kaku kuduk, kejang, paraplegia.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">8.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Muskuloskletal : focal motor
deifisit, lemah, tidak mampu melakukan ADL.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">9.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Kardiovaskuler ; takikardi,
sianosis, hipotensi, edem perifer, dizziness.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">10.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Pernapasan : dyspnea, takipnea,
sianosis, SOB, menggunakan otot Bantu pernapasan, batuk produktif atau non
produktif.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">11.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">GI : intake makan dan minum menurun,
mual, muntah, BB menurun, diare, inkontinensia, perut kram, hepatosplenomegali,
kuning.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">12.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Gu : lesi atau eksudat pada genital,<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">13.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Integument : kering, gatal, rash
atau lesi, turgor jelek, petekie positif.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">II.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Diagnosa keperawatan<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">1.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Resiko tinggi infeksi berhubungan
dengan imunosupresi, malnutrisi dan pola hidup yang beresiko.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">2.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Resiko tinggi infeksi (kontak
pasien) berhubungan dengan infeksi HIV, adanya infeksi nonopportunisitik yang
dapat ditransmisikan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">3.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Intolerans aktivitas berhubungan
dengan kelemahan, pertukaran oksigen, malnutrisi, kelelahan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">4.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Perubahan nutrisi kurang dari
kebutuhan tubuh berhubungan dengan intake yang kurang, meningkatnya kebutuhan
metabolic, dan menurunnya absorbsi zat gizi.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">5.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Diare berhubungan dengan infeksi GI<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">6.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Tidak efektif koping keluarga
berhubungan dengan cemas tentang keadaan yang orang dicintai.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US"></span></div>
<div class="Section1">
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-US">I.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-US">Perencanaan keperawatan.<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid windowtext .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="page-break-inside: avoid;">
<td rowspan="2" style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 98.4pt;" valign="top" width="164">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 10.0pt;">Diagnosa Keperawatan<o:p></o:p></span></div>
</td>
<td colspan="3" 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: 548.6pt;" valign="top" width="914">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 10.0pt;">Perencanaan Keperawatan<o:p></o:p></span></div>
</td>
</tr>
<tr style="page-break-inside: avoid;">
<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: 133.75pt;" valign="top" width="223">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 10.0pt;">Tujuan dan criteria hasil<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 190.85pt;" valign="top" width="318">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 10.0pt;">Intervensi<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.0pt;" valign="top" width="373">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 10.0pt;">Rasional<o:p></o:p></span></div>
</td>
</tr>
<tr>
<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: 98.4pt;" valign="top" width="164">
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 10.0pt; mso-ansi-language: EN-US;">Resiko tinggi infeksi
berhubungan dengan imunosupresi, malnutrisi dan pola hidup yang beresiko.<o:p></o:p></span></div>
<div class="MsoNormal">
<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: 133.75pt;" valign="top" width="223">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 10.0pt;">Pasien
akan bebas infeksi oportunistik dan komplikasinya dengan kriteria tak ada
tanda-tanda infeksi baru, lab tidak ada infeksi oportunis, tanda vital dalam
batas normal, tidak ada luka atau eksudat.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 190.85pt;" valign="top" width="318">
<div class="MsoNormal" style="margin-left: 16.8pt; mso-list: l4 level1 lfo2; text-align: justify; text-indent: -16.8pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Monitor
tanda-tanda infeksi baru.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 16.8pt; mso-list: l4 level1 lfo2; text-align: justify; text-indent: -16.8pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">gunakan teknik
aseptik pada setiap tindakan invasif. Cuci tangan sebelum meberikan tindakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 16.8pt; mso-list: l4 level1 lfo2; text-align: justify; text-indent: -16.8pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">3.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Anjurkan pasien
metoda mencegah terpapar terhadap lingkungan yang patogen.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 16.8pt; mso-list: l4 level1 lfo2; text-align: justify; text-indent: -16.8pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">4.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Kumpulkan
spesimen untuk tes lab sesuai order.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 16.8pt; mso-list: l4 level1 lfo2; text-align: justify; text-indent: -16.8pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">5.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Atur pemberian
antiinfeksi sesuai order <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<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: 224.0pt;" valign="top" width="373">
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Untuk pengobatan dini<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Mencegah pasien terpapar oleh kuman
patogen yang diperoleh di rumah sakit.<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Mencegah bertambahnya infeksi<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Meyakinkan diagnosis akurat dan
pengobatan<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Mempertahankan kadar darah yang
terapeutik <o:p></o:p></span></i></div>
</td>
</tr>
<tr>
<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: 98.4pt;" valign="top" width="164">
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 10.0pt; mso-ansi-language: EN-US;">Resiko tinggi infeksi
(kontak pasien) berhubungan dengan infeksi HIV, adanya infeksi
nonopportunisitik yang dapat ditransmisikan.<o:p></o:p></span></div>
<div class="MsoNormal">
<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: 133.75pt;" valign="top" width="223">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 10.0pt;">Infeksi
HIV tidak ditransmisikan, tim kesehatan memperhatikan universal precautions
dengan kriteriaa kontak pasien dan tim kesehatan tidak terpapar HIV, tidak
terinfeksi patogen lain seperti TBC.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 190.85pt;" valign="top" width="318">
<div class="MsoNormal" style="margin-left: 16.8pt; mso-list: l1 level1 lfo3; text-align: justify; text-indent: -16.8pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Anjurkan pasien
atau orang penting lainnya metode mencegah transmisi HIV dan kuman patogen
lainnya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 16.8pt; mso-list: l1 level1 lfo3; text-align: justify; text-indent: -16.8pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Gunakan darah
dan cairan tubuh precaution bial merawat pasien. Gunakan masker bila perlu.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<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: 224.0pt;" valign="top" width="373">
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Pasien dan keluarga mau dan memerlukan
informasikan ini<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Mencegah transimisi infeksi HIV ke
orang lain<o:p></o:p></span></i></div>
</td>
</tr>
<tr>
<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: 98.4pt;" valign="top" width="164">
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 10.0pt; mso-ansi-language: EN-US;">Intolerans aktivitas
berhubungan dengan kelemahan, pertukaran oksigen, malnutrisi, kelelahan.<o:p></o:p></span></div>
<div class="MsoNormal">
<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: 133.75pt;" valign="top" width="223">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 10.0pt;">Pasien
berpartisipasi dalam kegiatan, dengan kriteria bebas dyspnea dan takikardi
selama aktivitas.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 190.85pt;" valign="top" width="318">
<div class="MsoNormal" style="margin-left: 21.6pt; mso-list: l6 level1 lfo4; text-align: justify; text-indent: -21.6pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Monitor respon
fisiologis terhadap aktivitas<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.6pt; mso-list: l6 level1 lfo4; text-align: justify; text-indent: -21.6pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Berikan bantuan
perawatan yang pasien sendiri tidak mampu<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.6pt; mso-list: l6 level1 lfo4; text-align: justify; text-indent: -21.6pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">3.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Jadwalkan
perawatan pasien sehingga tidak mengganggu isitirahat.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<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: 224.0pt;" valign="top" width="373">
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Respon bervariasi dari hari ke hari<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Mengurangi kebutuhan energi<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Ekstra istirahat perlu jika karena
meningkatkan kebutuhan metabolik<o:p></o:p></span></i></div>
</td>
</tr>
<tr>
<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: 98.4pt;" valign="top" width="164">
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 10.0pt; mso-ansi-language: EN-US;">Perubahan nutrisi kurang
dari kebutuhan tubuh berhubungan dengan intake yang kurang, meningkatnya
kebutuhan metabolic, dan menurunnya absorbsi zat gizi.<o:p></o:p></span></div>
<div class="MsoNormal">
<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: 133.75pt;" valign="top" width="223">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 10.0pt;">Pasien
mempunyai intake kalori dan protein yang adekuat untuk memenuhi kebutuhan
metaboliknya dengan kriteria mual dan muntah dikontrol, pasien makan TKTP,
serum albumin dan protein dalam batas n ormal, BB mendekati seperti sebelum
sakit.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 190.85pt;" valign="top" width="318">
<div class="MsoNormal" style="margin-left: 21.6pt; mso-list: l5 level1 lfo5; text-align: justify; text-indent: -21.6pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Monitor
kemampuan mengunyah dan menelan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.6pt; mso-list: l5 level1 lfo5; text-align: justify; text-indent: -21.6pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Monitor BB,
intake dan ouput<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.6pt; mso-list: l5 level1 lfo5; text-align: justify; text-indent: -21.6pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">3.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Atur antiemetik
sesuai order<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.6pt; mso-list: l5 level1 lfo5; text-align: justify; text-indent: -21.6pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">4.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Rencanakan diet
dengan pasien dan orang penting lainnya.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<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: 224.0pt;" valign="top" width="373">
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Intake menurun dihubungkan dengan
nyeri tenggorokan dan mulut<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Menentukan data dasar<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Mengurangi muntah<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Meyakinkan bahwa makanan sesuai dengan
keinginan pasien<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<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: 98.4pt;" valign="top" width="164">
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 10.0pt; mso-ansi-language: EN-US;">Diare berhubungan dengan
infeksi GI<o:p></o:p></span></div>
<div class="MsoNormal">
<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: 133.75pt;" valign="top" width="223">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 10.0pt;">Pasien
merasa nyaman dan mengnontrol diare, komplikasi minimal dengan kriteria perut
lunak, tidak tegang, feses lunak dan warna normal, kram perut hilang, <o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 190.85pt;" valign="top" width="318">
<div class="MsoNormal" style="margin-left: 21.6pt; mso-list: l2 level1 lfo6; text-align: justify; text-indent: -21.6pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Kaji
konsistensi dan frekuensi feses dan
adanya darah.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.6pt; mso-list: l2 level1 lfo6; text-align: justify; text-indent: -21.6pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Auskultasi
bunyi usus<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.6pt; mso-list: l2 level1 lfo6; text-align: justify; text-indent: -21.6pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">3.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Atur agen
antimotilitas dan psilium (Metamucil) sesuai order<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.6pt; mso-list: l2 level1 lfo6; text-align: justify; text-indent: -21.6pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">4.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Berikan
ointment A dan D, vaselin atau zinc oside<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 224.0pt;" valign="top" width="373">
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Mendeteksi adanya darah dalam feses<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Hipermotiliti mumnya dengan diare<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Mengurangi motilitas usus, yang pelan, emperburuk perforasi pada
intestinal<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Untuk menghilangkan distensi<o:p></o:p></span></i></div>
</td>
</tr>
<tr>
<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: 98.4pt;" valign="top" width="164">
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 10.0pt; mso-ansi-language: EN-US;">Tidak efektif koping
keluarga berhubungan dengan cemas tentang keadaan yang orang dicintai.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<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: 133.75pt;" valign="top" width="223">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 10.0pt;">Keluarga
atau orang penting lain mempertahankan suport sistem dan adaptasi terhadap
perubahan akan kebutuhannya dengan kriteria pasien dan keluarga berinteraksi
dengan cara yang konstruktif<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 190.85pt;" valign="top" width="318">
<div class="MsoNormal" style="margin-left: 14.45pt; mso-list: l0 level1 lfo7; text-align: justify; text-indent: -14.45pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 10.0pt;">Kaji koping keluarga terhadap sakit pasein dan
perawatannya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 14.45pt; mso-list: l0 level1 lfo7; text-align: justify; text-indent: -14.45pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 10.0pt;">Biarkan keluarga mengungkapkana perasaan secara
verbal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 14.45pt; mso-list: l0 level1 lfo7; text-align: justify; text-indent: -14.45pt;">
<!--[if !supportLists]--><span style="font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 10.0pt;">Ajarkan kepada keluaraga tentang penyakit dan
transmisinya.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<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: 224.0pt;" valign="top" width="373">
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Memulai suatu hubungan dalam bekerja
secara konstruktif dengan keluarga.<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Mereka tak menyadari bahwa mereka
berbicara secara bebas<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-size: 10.0pt;">Menghilangkan kecemasan tentang
transmisi melalui kontak sederhana.<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
</div>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<div align="center" class="MsoNormal" style="text-align: center;">
Daftar Pustaka</div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-indent: -36pt;">
Grimes, E.D, Grimes, R.M, and Hamelik, M, 1991, <i>Infectious Diseases,</i> Mosby Year Book, Toronto.</div>
<div class="MsoNormal" style="margin-left: 36pt; text-indent: -36pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-indent: -36pt;">
Christine L. Mudge-Grout, 1992, <i>Immunologic
Disorders,</i> Mosby Year Book, St. Louis.</div>
<div class="MsoNormal" style="margin-left: 36pt; text-indent: -36pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-indent: -36pt;">
Rampengan dan Laurentz, 1995, <i>Penyakit
Infeksi Tropik Pada Anak,</i> cetakan kedua, EGC, Jakarta.</div>
<div class="MsoNormal" style="margin-left: 36pt; text-indent: -36pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-indent: -36pt;">
Lab/UPF Ilmu Penyakit Dalam, 1994, <i>Pedoman
Diagnosis dan Terapi,</i> RSUD Dr. Soetomo Surabaya.</div>
<div class="MsoNormal" style="margin-left: 36pt; text-indent: -36pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-indent: -36pt;">
Lyke, Merchant Evelyn, 1992, <i>Assesing
for Nursing Diagnosis ; A Human Needs Approach,</i>J.B. Lippincott Company,
London.</div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="margin-left: 45pt; text-indent: -45pt;">
Phipps, Wilma. et al, 1991, <i>Medical
Surgical Nursing : Concepts and Clinical Practice,</i> 4<sup>th</sup> edition,
Mosby Year Book, Toronto</div>
<div class="MsoNormal" style="margin-left: 45pt; text-indent: -45pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 45pt; text-indent: -45pt;">
Doengoes, Marilynn, dkk, 2000, <i>Rencana
Asuhan Keperawatan ; Pedoman untuk Perencanaan dan Pendokumentasian Perawatan
Pasien,</i> edisi 3, alih bahasa : I Made Kariasa dan Ni Made S, EGC, Jakarta</div>
</span><br />
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt;">
<br /></div>
</li>
</ol>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-36818066933558663832012-11-11T03:51:00.003-08:002012-11-11T03:51:41.694-08:00tumor paru<br />
<div class="Section1">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">TUMOR PARU </span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">1. Definisi<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%;">
Karsinoma Bronkogenik
adalah tumor ganas paru primer yang berasal dari saluran nafas.</div>
<div class="MsoBodyTextIndent" style="line-height: 150%; text-align: justify;">
Di dalam
kepustakaan selalu di laporkan peningkatan insiden kanker paru secara
progresif, yang bukan hanya sebagai akibat peningkatan umur rata-rata manusia
serta kemampuan diagnostik yang lebih baik namun oleh karena memang karsinoma
bronkogenik lebih sering terjadi (Pengatar Ilmu Penyakit paru).<i><o:p></o:p></i></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2. Etiologi<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%;">
Seperti kanker pada
umumnya, etiologi yang pasti dari karsinoma bronkogenik masih belum diketahui,
namun diperkirakan bahwa inhalasi jangka panjang dari bahan karsinogenik
merupakan faktor utama, tanpa mengesampingkan kemungkinan peranan predisposisi
hubungan keluarga ataupun suku bangsa/ras serta status immunologis. Bahan
inhalasi karsinogenik yang banyak disorot adalah rokok. </div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<i>Pengaruh rokok:<o:p></o:p></i></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%;">
Bahan-bahan karsinogenik
dalam asap rokok adalah antara lain : polomium 210 dan 3,4 benzypyrene.
Penggunaan filter dikatakan dapat menurunkan resiko terkenanya karsinoma
bronkogenik, namun masih tetap lebih tinggi dibanding dengan bukan perokok.</div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
Didalam jangka panjang
yaitu, 10-20 tahun, merokok:</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">1-10 batang / hari meningkatkan resiko 15 kali<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">20-30 batang / hari meningkatkan resiko 40-50 kali<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">40-50 batang /hari meningkatkan resiko 70-80 kali.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<h1 style="line-height: 150%;">
<i><span lang="SV">Pengaruh Industri<o:p></o:p></span></i></h1>
<div class="MsoBodyTextIndent2" style="line-height: 150%;">
<span lang="SV">Yang paling banyak dihubungkan dengan karsinogenik
adalah asbestos, yang dinyatakan meningkatkan resiko kanker 6-10 kali. Menyusul
kemudian industri bahan-bahan radioaktif, penambang uramium mempunyai resiko 4
kali populasi pada umumnya. Paparan industri ini baru nampak pengaruhnya
setalah 15-20 tahun.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<h1 style="line-height: 150%;">
<i><span lang="SV">Pengaruh Penyakit Lain <o:p></o:p></span></i></h1>
<div class="MsoBodyTextIndent2" style="line-height: 150%;">
<span lang="SV">Tuberkulosi paru banyak dikaitkan sebagai faktor
predisposisi karsinoma brinkogenik, melalui mekanisme hyperplasi – metaplasi -
karsinoma insitu-karsinoma - bronkogenik sebagai akibat adanya jaringan parut
tuberkulosis.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<h1 style="line-height: 150%;">
<i><span lang="SV">Pengaruh Genetik dan Status imunologis<o:p></o:p></span></i></h1>
<div class="MsoBodyTextIndent2" style="line-height: 150%;">
<span lang="SV">Pada tahun 1954, Tokuhotu dapat membuktikan adanya
pengaruh keturunan yang terlepas daripada faktor paparan lingkungan, hal ini
membuka pendapat bahwa karsinoma bronkogenik dapat diturunkan. Penelitian
akhir-akhir ini condong bahwa faktor yang terlibat dengan enzim Aryl
Hidrokarbon Hidroksilase (AHH). Status immonologis penderita yang dipantau dari
cellular mediated menunjukan adanya korelasi antara derajat deferensiasi sel,
stadia penyakit, tanggapan terhadap pengobatan serta prognosis. Penderita yang
energi umumnya tidak memberikan tanggapan terhadap pengobatan dan lebih cepat
meninggal.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<h1 style="line-height: 150%; text-align: justify;">
<span lang="SV">Klasifikasi berdasarkan histopatologi dengan menggunakan mikroskop cahaya
biasa (WHO, 1977).<o:p></o:p></span></h1>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<span lang="SV">1. Karsinoma epidermois (Karsinoma Sel Skuamos).<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2. Adeno
Karsinoma<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">3. Small
cell undiferentiated carcinoma (oat cell)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">4. Large
cell undeferentiated carcinoma.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">4. Pemeriksaan
Penunjang :<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> a. Radiologi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: -21.25pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> 1). Massa Radiopaque di paru<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: -21.25pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> 2). Obstruksi jalan nafas dengan akibat
atelektasis<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: -21.25pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> 3). Pneumonia<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: -21.25pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> 4). Pembesaran Kelenjar Hilar<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="line-height: 150%; margin-left: 35.45pt; text-align: justify; text-indent: -21.25pt;">
5). Tumor Pancoast.Ca. Bronchogenik yang
terdapat disuperior pulmonary sulcus, pada apek lobus superior.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: -21.25pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> 6). Kelainan pada pleura<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: -21.25pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> 7). Kelainan tulang<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">
b. Bronkografi<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 1.0cm; text-align: justify;">
Adapun gambaran bronkografi yang dianggap patognomonik adalah
obstruksi stenosis irreguler, ste<span lang="SV">nosis
ekor tikus dan indentasi cap jempol.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">c. Sitologi<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 1.0cm; text-align: justify;">
<span lang="SV">Dahak yang
representatif dapat diperoleh melalui batuk spontan, dengan bantuan aerosol (
20% propylene glycol dalam larutan 10% NaCl. Dihangatkan sampai kurang lebih
45-50 C.)atau melalui bilasan/sikatan aspirasi bronkial.Tatalaksana pada Lung
Cancer Detection Program di New York adalah sbb. Saliva dan post nasal
discharge dikeluarkan dahulu, lalu penderita disuruh batuk dalam , dahak yang
dihasilkan segera difiksasi, kesemuanya ini dilakukan pada 3 hari
berturut-turut, sebaiknya pada pagi hari.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">d. Endoskopi<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 1.0cm; text-align: justify;">
<span lang="SV">Meliputi
pemeriksaan laringoskopi dan bronkoskopi serta bilasan bronkial,
kerokan/sikatan serta biopsi. Tujuan pemeriksaan bronkoskopi ( serat optik )
adalah :<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> 1.Mengetahui perubahan pada
bronkus akibat kanker paru.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> 2.Mengambil bahan untuk
pemeriksaan sitologis.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> 3.Memperhatikan perubahan pada
permukaan tumor/mukosa untuk <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> memperkirakan jenis keganasan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> 4.Menilai keberhasilan terapi.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> 5.Menentukan operbilitas kanker paru.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-indent: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">e. Biopsi<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 1.0cm; text-align: justify;">
<span lang="SV">Bahan biopsi dapat
diperoleh melalui cara biopsi perkutaneus transbronkial ataupun open biopsi.
Sedangkan bahannya dapat berupa jaringan kelenjar regional jaringan pleura
ataupun jaringan paru.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">5.
Klasifikasi Pentahapan Klinik ( clinical Staging )<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Berdasarkan TNM.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">T= Tumor : N. : Nodul, yaitu
kelenjar limfe M. : Metastase<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">T : T-0 : Tidak tampak tumor primer<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="DE" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-size: 10.0pt;">T-1 : Diameter tumor kurang dari 3 cm. Tanpa invasi ke Bronkus<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<span lang="DE" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-size: 10.0pt;">T-2 : Diameter tumor lebih dari 3 cm.
Dapat disertai atelektasis atau pneumonitis , <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<span lang="DE" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-size: 10.0pt;">
namun berjarak lebih dari 2 Cm. Dari Karina, serta belum adaefusi
pleura.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="DE" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-size: 10.0pt;">T-3 : Tumor ukuran besar dengan tanda invasi ke sekitar ( dinding toraks , <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<span lang="DE" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-size: 10.0pt;">
diafragma atau mediatinum )atau sudah berada dekat karina disertai efusi
<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<span lang="DE" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-size: 10.0pt;">
pleura.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<span lang="DE" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-size: 10.0pt;">
N : N-0 : Tidak didapatkan
penjalaran ke kelenjar limfe regional.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="DE" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-size: 10.0pt;"> </span><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> N-1
: Terdapat penjalaran ke kelenjar limfe hilus ipsilateral.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> N-2
: Terdapat penjalaran ke kelenjar
limfemediastinum atau kontralateral<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> N-3
: Terdapat penjalaran ke kelenjar
limfe ekstratorakal.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> M. M-0 :
Tidak terdapat metastase jauh.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;"> M-1 :
Sudah terdapat metastae jauh ke organ-organ lain.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Berdasarkan TNM. Disusun pentahapan
klinik sebagai berikut : <br />
a. Karsinoma insitu : T-0, N-0, M-0 , namun sitologi sputum positif untuk sel <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">ganas.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; mso-list: l4 level1 lfo1; tab-stops: list 18.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="DE" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="DE" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-size: 10.0pt;">Tahap I. T-1, N-0, M-0, atau T-2, N-0, M-0<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; mso-list: l4 level1 lfo1; tab-stops: list 18.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="DE" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="DE" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-size: 10.0pt;">Tahap II. T-2,
N-1,,M-0.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; mso-list: l4 level1 lfo1; tab-stops: list 18.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Tahap III:
bila sudah terdapat T-3, N-2, atau M-1.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-indent: -14.2pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">6.
Pengkajian :<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l0 level1 lfo3; tab-stops: list 0cm; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Aktivitas/istirahat.: Kelemahan, ketidakmampuan,
mempertahankan kebiasaan rutin, dispnoe karena aktivitas , kelesuan biasanya
tahap lanjut.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l0 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Sirkulasi Peningkaran Vena Jugulari, Bunyi jantung:
gesekan perikordial ( menujukan efusi ) tachicardia?disritmia, jari tabuh.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l0 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Integritas Ego. : Ansietas, takut akan kematian,
menolak kondisi yang berat, gelisah, insomnia, pertanyan yang diulang-ulang.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l0 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">d.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Eliminasi ; Diare yang hilang timbul (
ketidakseimbngan hormonal,)Peningkatan frekuesnsi/jumlah urine (
Ketidakseimbngan Hormonal ).<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l0 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">e.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Makanan/cairan
: Penurunan Berat badan, nafsu makan buruk, penurunan masukan makanan,
kesulitan menelan, haus/peningkatan masukan cairan <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-align: justify; text-indent: -21.25pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">
Kurus, kerempeng, atau
penampilan kurang bobot ( tahap lanjut 0, Edema
wajah, periorbital ( ketidakseimbangan hormonal ), Glukosa dalam urine .<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l0 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">f.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Ketidaknyamanan/nyeri:
nyeri dada, dimana tidak/dapat dipengaruhi oleh perubahan posisi.Nyeri
bahu/tangan, nyeri tulang/sendi, erosi kartilago sekunder terhadap peningkatan
hormon pertumbuhan.Nyeri abdomen hilang/timbul<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l0 level1 lfo3; tab-stops: list 0cm; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">g.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Pernafasan :
Batuk ringan atau perubahan pola batuk dari biasanya , peningkatan produksi
sputum, nafas pendek, pekerja terpapar bahan karsinogenik, serak, paralisis
pita suara, dan riwayat merokok.Dsipnoe, meni gfkat dengan kerja, peningkatan
fremitus taktil, krekels/mengi pada inspirasi atau ekspirasi ( ganguan aliran
udara ). Krekels/mengi yang menetap penyimpangan trakeal( area yang mengalami
lesi ) Hemoptisis.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l0 level1 lfo3; tab-stops: list 0cm; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">h.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Keamanan :
Demam, mungkin ada/tidak, kemerahan,
kulit pucat.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l0 level1 lfo3; tab-stops: list 0cm; text-indent: -21.25pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">i.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Seksualitas : Ginekomastia, amenorea, atau impoten.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l0 level1 lfo3; tab-stops: list 0cm; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">j.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Penyuluhan/pembelajaran : Faktor resiko keluarga, :
adanya riwayat kanker paru, TBC. Kegagalan untuk membaik.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">7. Diagnosa Keperawatan yang muncul
adalah :<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l3 level1 lfo4; tab-stops: list 0cm; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Bersihan jalan nafas tidak efektif, b/d peningkatan
jumlah/perubahan mukus /viskositas sekret, keterbatasan gerakan dada, /nyeri,
kelemahan,kelelahan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l3 level1 lfo4; tab-stops: list 0cm; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Nyeri akut b/d invasi kanker ke pleura, dinding dada.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l3 level1 lfo4; tab-stops: list 0cm; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pola pernafasan tidak efektif b/d obstruksi
trakeobronkialoleh sekret, perdarahan aktif, penurunan ekspansi paru, proses
inflamsi.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l3 level1 lfo4; tab-stops: list 0cm; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">d.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Kerusakan pertukaran gas b/d gangguan aliran udara ke
alveoli atau ke bagian utama paru,
perubahan membran alveoli ( atelektasis , edema paru , efusi, sekeresi
berlebihan,/perdarahan aktif.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l3 level1 lfo4; tab-stops: list 0cm; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">e.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Ansietas b/d
ketakutan /ancaman akan kematian , tindakan diagnostik, penyakit kronis.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l3 level1 lfo4; tab-stops: list 0cm; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">f.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Nutrisi kurang
dari kebutuhan tubuh b/d intake
inadekuat, peningkatan metabolisme, proses keganasan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-list: l3 level1 lfo4; tab-stops: list 0cm; text-align: justify; text-indent: -21.25pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">g.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Gangguan body image b/d perubahan struktur tubuh.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; tab-stops: list 0cm; text-align: justify; text-indent: -21.25pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: center 206.8pt left 365.3pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">8.
Perencanaan Keperawatan <o:p></o:p></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-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 76.3pt;" valign="top" width="102">
<h3 style="line-height: 150%;">
Diagnosa</h3>
</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: 92.15pt;" valign="top" width="123">
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Tujuan-Kriteria<o:p></o:p></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: 127.55pt;" valign="top" width="170">
<h3 style="line-height: 150%;">
Intervensi</h3>
</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: 127.6pt;" valign="top" width="170">
<h3 style="line-height: 150%;">
Rasional</h3>
</td>
</tr>
<tr>
<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: 76.3pt;" valign="top" width="102">
<div class="MsoNormal" style="margin-left: 7.1pt; text-indent: -7.1pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.Bersihan Jalan nafas
tidak efektif b/d peninjkatan jumlah/viskositas sekret, keterbatasan gerakan
dada/nyeri, kelemahan/kelelahan.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 92.15pt;" valign="top" width="123">
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Bersihan jalan nafas efektif.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kriteria ;<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo5; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menunjukan potensi jalan nafas.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo5; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cairan sekret mudah dikeluarkan/dibatukan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo5; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bunyi nafas jelas.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo5; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">d.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Whezing(-)/berkurang<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 127.55pt;" valign="top" width="170">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l5 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Auskultasi bunyi dada, untuk
karakter bunyi nafas dan adanya sekret.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l5 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Bantu untuk nafas dalam
efektif anjurkan batuk dengan posisi duduk. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l5 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi jumlah dan karakter sputum/aspirasi sekret.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l5 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Lakukan penghisapan dengan
menggunakan suction. Bila klien tidak dapat batuk.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l5 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Dorong masukan cairan/oral
sedikitnya 2500 CC/hari dalam toleransi jantung.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l5 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kolaborasi : Berikan/bantu
dengan IPBB , spirometri, meniup botol <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l5 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">7.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Gunakan oksigen
humidifikasi/nebulizer ultrasonik . Berikan cairan tambahan melalui IV sesuai
indikasi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l5 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">8.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Berikan bronkodilator,
ekspektoran, atau analgetik sesuai indikasi. <o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 127.6pt;" valign="top" width="170">
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Pernafasan bising, ronki, mengi menunjukan
tertahannya sekret/obstruksi jalan nafas<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Posisi duduk memungkinkan ekspansi paru
maksinal, upaya batuk untuk membuang sekret..<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Perubahan sekret menunjukan progresifitas
penyakit.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Penghisapan dapat merangsang batuk efektif.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Hidrasio adekuat untuk mempertahankan sekret
hilang/peningkatan pengeluaran.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Memudahkan pembuangan sekret.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Memberikan hidrasi maksimal/pengenceran sekret
untuk meningkatkan pengeluaran<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Menghilangkan spasme bronkus untuk memperbaiki
aliran udara. </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ekspektoiran
meningkatkan produksi mu.kus untuk mengencerkan sekret.<o:p></o:p></span></div>
</td>
</tr>
<tr>
<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: 76.3pt;" valign="top" width="102">
<div class="MsoNormal" style="margin-left: 7.1pt; text-indent: -7.1pt;">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">2.Kerusakan pertukaran gas b/d gg.
Aliran udata ke alveoli, perubahan membran alveolar kapiler ( atelektasis,
oedema paru, efusi, sekresi berlebihan, perdarahan aktif )<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 92.15pt;" valign="top" width="123">
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Pertukaran gas efektif.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kriteria :<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">GDA dalam batas normal,. Mebubjukan ventilasi
adekuat<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Menunjukan oksigenasi adekuat.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menunjukan
perbaikan distress pernafasan.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 127.55pt;" valign="top" width="170">
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catat
frekluensi dan kedalaman pernafasan , penggunaan otot bantu dan nafas bibir.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi
paru untuk penurunan bunyi nafas dan adanya bunyi tambahan krekels.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi
ferfusi daerah akral dan sianosis (
daun telinga, bibir, lidah dan membran lidah ) <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Lakukan tindakan untuk memperbaiki jalan nafas. <o:p></o:p></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">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Tinggikan kepala/tempat tidur sesuai dengan
kebutuhan.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Awasi tanda vital<o:p></o:p></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">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kaji tingkat kesadaran<o:p></o:p></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">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kaji toleransi aktivitas.<o:p></o:p></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">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kolaborasi:<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Awasi seri GDA.<o:p></o:p></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">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Berikan oksigen dengan metoda yang tepat.<o:p></o:p></span></div>
<div class="MsoNormal">
<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: 127.6pt;" valign="top" width="170">
<div class="MsoNormal">
<span lang="NL" style="font-size: 12.0pt; mso-ansi-language: NL; mso-bidi-font-size: 10.0pt;">Takhi[pnoe dan dispnoe menyertai obstruksi paru.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="NL" style="font-size: 12.0pt; mso-ansi-language: NL; mso-bidi-font-size: 10.0pt;">Area yang tak terventilasi dapat
diidentifikasikan dengan tak adanya
bunyi nafas.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NL" style="font-size: 12.0pt; mso-ansi-language: NL; mso-bidi-font-size: 10.0pt;">Menunjukan hipoksemia sistemik.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="NL" style="font-size: 12.0pt; mso-ansi-language: NL; mso-bidi-font-size: 10.0pt;">Jalan nafas lengket/kolaps menurunkan jumlah
alveoli yang berfungsi <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Secara negatif mempengaruhi pertukaran gas.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Meningkatkan ekspansi dada maksimal, membuat
mudah bernafas meningkatkan kenyamanan.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Tahkikardi/takhipnoe, dan perubahan pada TD.
Terjadi seirng dengan perubahan asidosis.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Hipoksemia sistemik dapat ditunjukan pertamakali
oleh gelisah dan rangsang disertai penurunan kesadaran.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Hipoksemia menurunkan kemampuan untuk
berpartisipasi dalam aktivitas tanpa dispnoea berat, takikardia dan
disritmia.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Hipoksemia ada pada berbagai derajattergantung
pada jumlah obstruksi jalan nafas. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Memaksimalkan sediaan oksigen untuk pertukaran
gas . <o:p></o:p></span></div>
</td>
</tr>
<tr>
<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: 76.3pt;" valign="top" width="102">
<div class="MsoNormal" style="margin-left: 7.1pt; text-indent: -7.1pt;">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">3.Pola nafas tidak efektif b/d obstruksi trakeobronkial oleh bekuan darah, sekret banyak
,peradarahan aktif, penurunan ekspansi paru, proses inflamsi. <o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 92.15pt;" valign="top" width="123">
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Pola nafas efektif.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kriteria :<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Frekuensi nafas dalam rentang normal<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Suara paru jelas dan bersih.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berpartisipasi
dalam aktivitas.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 127.55pt;" valign="top" width="170">
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji
frekuensi , kedalaman pernafasan dan ekspansi dada., catat upaya pernafasan (
penggunaan otot bantu pernafasan )<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi
bunyi nafas, dan catat adanya bunyi nafas.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Observasi pola batuk dan karakter sekret<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Dorong dalam nafas dalam.dan latihan batuk.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kolaborasi:<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Berikan oksigen tambahan.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Berikan humidifikasi tambahan.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Bantu fisioterapi dada.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Siapkan/bantu bronkoskopi<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 127.6pt;" valign="top" width="170">
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kedalamam pernafasan bervariasi tergantung
derajat gagal nafas., ekspansi pada terbatas terjadi pada atelektasis.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Perubahan bunyi nafas menunjukan obstruksi
sekunder.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kongesti alveolar mengakibatkan batuk
kering/iritatif<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Meningktkan banyaknya sputum. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Memaksimalkan pernafasan dan menurunkan kerja
nafas.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Memberikan kelembaban pada membran mukosa dan
membantu pengenceran sekret.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Memudahkan upaya pernafasan dalam. Meningktkan
drainase sekret.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kadang=kadang berguna untuk membuang bekuan
darah, sekret serta membersihkan jalan nafas.<o:p></o:p></span></div>
</td>
</tr>
<tr>
<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: 76.3pt;" valign="top" width="102">
<div class="MsoNormal" style="margin-left: 7.1pt; text-indent: -7.1pt;">
<span lang="DA" style="font-size: 12.0pt; mso-ansi-language: DA; mso-bidi-font-size: 10.0pt;">4.Nyeri b/d. invasi kanker ke pleura, atau dinding dada.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 92.15pt;" valign="top" width="123">
<div class="MsoNormal">
<span lang="DA" style="font-size: 12.0pt; mso-ansi-language: DA; mso-bidi-font-size: 10.0pt;">Nyeri
hilang/ berkurang<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="DA" style="font-size: 12.0pt; mso-ansi-language: DA; mso-bidi-font-size: 10.0pt;">Kriteria <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="DA" style="font-size: 12.0pt; mso-ansi-language: DA; mso-bidi-font-size: 10.0pt;">:Klien nampak rileks.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kliuen dapat tidur.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Berpartisi dalam aktivitas.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 127.55pt;" valign="top" width="170">
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Tanyakan pasien tentang nyeri, Tentukan
karaktersitik nyeri<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kaji
pernyataan verbal dan non verbal nyeri pasien.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Evaluasi keefektifan pemberian obat<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Berikan tindakan kenyamanan, ubah posisi,
pijatan punggung dll.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Berikan lingkungan tenang.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kolaborasi: Berikan analgesik rutin s/d
indikasi..<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 127.6pt;" valign="top" width="170">
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Membantu dalam evaluasi gejala nyeri kanker yang
dapat melibatkan visera, saraf atau jaringan tulang<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Ketidaksesuaian antara verbal dan non verbal
menunjukan.derajat nyeri<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Memberikan obat berdasarkan aturan.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Meningkatkan relaksasi dan pengalihan
perhatian..<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Penurunan stress, menghemat energi<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Mempertahankan kadar obat, menghindari puncak
periode nyeri..<o:p></o:p></span></div>
</td>
</tr>
<tr>
<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: 76.3pt;" valign="top" width="102">
<div class="MsoNormal" style="margin-left: 7.1pt; text-indent: -7.1pt;">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">5.Ansietas b/d ancaman kematian, proses keganasan. <o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 92.15pt;" valign="top" width="123">
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Ansietas hilang/ berkurang<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kriteria <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Klien tampak rileks<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Klien dapat beristirahat. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Dapat bekerjasama dalam terapi.:<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 127.55pt;" valign="top" width="170">
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Evaluasi tingkat pemahaman pasien/orang terdekat
tentang diagnosa.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Akui rasa takut,
masalah pasien, dan dorong mengekspresikan perasaan.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kolaborasi :<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Libatkan pasien/orang terdekat dalam perencanaan
keperawatan <o:p></o:p></span></div>
<div class="MsoNormal">
<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: 127.6pt;" valign="top" width="170">
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Pemahaman persepsi melibatkan susunan
tekanan perawatan individu dan
memberikan informasi.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Memberi waktu untuk mengidentifikasi perasaan.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Dapat
memperbaiki perasaan kontrol.<o:p></o:p></span></div>
</td>
</tr>
<tr style="height: 3.5pt; mso-yfti-irow: 6; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; height: 3.5pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 76.3pt;" valign="top" width="102">
<div class="MsoNormal" style="margin-left: 7.1pt; text-indent: -7.1pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6.Nutrisi kurang dari
kebutuhan tubuh b/d intake kurang, peningkatan metabolisme, proses keganasan.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 3.5pt; 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: 92.15pt;" valign="top" width="123">
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Nutrisi terpenuhi.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kriteria :<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Menunjukan perubahan beratbadan.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Menunjukan perubahan pola makan.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Hb. Albumin dalam rentang normal.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 3.5pt; 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: 127.55pt;" valign="top" width="170">
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Catat ststus nutrisi pasien pada penerimaan,
catat turgor kulit, berat badan dan derajat kekurangan berat badan<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Pastikan pola diet pasien yang disukai/tidak
disukai<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Awasi pemasukan/pengeluaran dan berat badan
secara periodik<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Selidiki mual, muntah, anoreksia dan catat
kemungkinan hubungannya dengan obat<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Berikan periode istirahat sering.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Berikan perawatan mulut, sebelum dan sesudah
tindakan pernafasan.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Berikan Diet TKTP.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Kolaborasi :<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Rujuk ke ahli diet<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Awasi pemeriksaan lab. </span><span lang="DE" style="font-size: 12.0pt; mso-ansi-language: DE; mso-bidi-font-size: 10.0pt;">(
BUN, protein serum, albumin Hb.)<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Bila perlu berikan nutrisi parenteral. .<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 3.5pt; 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: 127.6pt;" valign="top" width="170">
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Berguna dalam mengidentifikasi derajat kurang
nutrisi dan menentukan pilihan intervensi.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Pertimbangan keinginan individu dapat
memperbaiki masukan diet.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Mengukur kefektifan nutrisi dan dukungan cairan.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Mencari pemecahan masalah, untuk meningkatkan
pemasukan nutrien.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Membantu menghemat energi., khususnya bila
kebutuhan metabolik meningkat<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Menurunkan perasaan tak enak, bekas sputum,
obatmerangsang pusat muntah..<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Memaksimalkan masukan nutrisi..<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Nilai rendah menunjukan malnutrisi<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatkan
masukan nutrisi adekuat.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
</div>
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-size: 10.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<div class="MsoTitle">
Daftar Pustaka</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 58.5pt; text-indent: -58.5pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Amin muhammad, Hood Alsagaff, 1989, <i>Pengantar
Ilmu Penyakit Paru,</i> </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Airlangga University Press, Surabaya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Blac,MJ Jacob., 1993, <i>l.uckman & Sorensen’s Medical surgical
Nursing A Phsycopsicologyc Approach,</i> W.B. Saunders Company, Philapidelpia.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Barbara Engram., 1999, <i>Rencana Asuhan Keperawatan Medikal Bedah.
Vol. 1,</i> Penerbit EGC, Jakarta.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<span lang="SV" style="font-size: 12pt;">Carpenito, L.J., 1999, <i>Rencana Asuhan & Dokumentasi
Keperawatan. Edisi. 2, </i>EGC Jakarta.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<span lang="SV" style="font-size: 12pt;">Corwin E., 2001, <i>Patofisiologi</i>, Cetakan I, EGC, Jakarta <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<span lang="SV" style="font-size: 12pt;">Mansjoer, Arif., et all., 1999,
<i>Kapita Selekta Kedokteran,</i> Fakultas
Kedokteran UI : Media Aescullapius Jakarta.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Marylin E doengoes., 2000, <i>Rencana
Asuhan keperawatan Pedoman untuk Perencnaan /pendokumentasian Perawatan Pasien,</i>
EGC,Jakarta.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 58.5pt; text-indent: -58.5pt;">
<span lang="SV" style="font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-size: 10.0pt;">Soeparman, Sarwono Waspadji, 1990, <i>Ilmu
Penyakit Dalam Jilid II,</i> Balai Penerbit FKUI, Jakarta.<o:p></o:p></span></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-19021648873236289182012-11-11T03:41:00.003-08:002012-11-11T03:41:21.273-08:00laporan pendahuluan epilepsi<br />
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Arial","sans-serif";">ASUHAN KEPERAWATAN KLIEN DENGAN
EPILEPSI<o:p></o:p></span></b></div>
<h2>
Oleh : Azharie, Skep, Ns</h2>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<h1>
PENDAHULUAN</h1>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Epilepsi
atau penyakit ayan dikenal sebagai satu penyakit tertua di dunia (2000 tahun
SM). Penyakit ini cukup sering dijumpai dan bersifat menahun. Penderita akan
menderita selama bertahun-tahun. Sekitar 0,5 – 1 % dari penduduk adalah
penderita epilepsy (Lumbantobing, 1998).<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<h1>
DEFINISI</h1>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Bangkitan
epilepsy adalah manifestasi gangguan otak dengan berbagai gejala klinis,
disebabkan oleh lepasnya muatan listrik dari neuron-neuron otak secara
berlebihan dan berkala tetapi reversible dengan bernagai etiologi (Tjahjadi,
dkk, 1996).<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Epilepsy
adalah kompleks gejala dari beberapa kelainan fungsi otak yang ditandai dengan
terjadinya kejang secara berulang. Dapat berkaitan dengan kehilangan kesadaran,
gerakan yang berlebihan, atau kehilangan tonus atau gerakan otot, dan gangguan
prilaku suasana hati, sensasi dan persepsi (Brunner dan suddarth, 2000).<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Kejang
adalah terbebasnya sekelompok neuron secara tiba-tiba yang mengakibatkan suatu
kerusakan kesadaran, gerak, sensasi atau memori yang besifat sementara. Istilah
epilepsy biasanya merupakan suatu kelaianan yang bersifat kronik yang timbul
sebagai suatu bentuk kejang berulang (Hudak dan Gallo, 1996). <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<h1>
ETIOLOGI</h1>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Tumor
otak Trauma
otak (5-50%)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Bekuan
darah pada otak Meningitis<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Gangguan
elektrolit Ensefalitis<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Gejala
putus alcohol/obat Gangguan
metabolic<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Toksik
substans Anoksia
cerebral<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Sebagian
kejang merupakan idiopatik <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<h1>
PRINSIP-PRINSIP PATOFISIOLOGI</h1>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Mekanisme
yang pasti dari aktivitas kejang pada otak tidak semuanya dapat dipahami.
Beberapa pemicu menyebabkan letupan abnormal mendadak stimulasi listrik,
menganggu konduksi syaraf normal otak. Pada otak yang tidak rentan terhadap
kejang, terdapat keseimbangan antar sinaptik eksitatori dan inhibitori yang
mempengaruhi neuron postsinaptik. Pada otak yang rentan terhadap kejang,
keseimbangan ini mengalami gangguan, menyebabkan pola ketidakseimbangan
konduksi listrik yang disebut perpindahan depolarisasi paroksismal. Perpindahan
ini dapat terlihat baik ketika terdapat pengaruh eksitatori yang berlebihan
atau pengaruh inhibitori yang tidak mencukupi (Hudak dan Gallo, 1996).<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Ketidakseimbangan
asetilkolin dan GABA. Asetilkolin dalam jumlah yang berlebihan menimbulkan
bangkitan kejang, sedangkan GABA menurunkan eksitabilitas dan menekan timbulnya
kejang.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<h1>
KLASIFIKASI INTERNASIONAL TENTANG KEJANG EPILEPSI</h1>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">(dikutip
dari Hudak dan Gallo, 1996)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l8 level1 lfo1; tab-stops: list 45.0pt; text-align: justify; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">I.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Kejang
Parsial <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l8 level2 lfo1; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">a.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Parsial
sederhana (kesadaran klien baik)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l8 level3 lfo1; tab-stops: list 117.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">1.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Motorik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l8 level3 lfo1; tab-stops: list 117.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">2.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Sensorik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l8 level3 lfo1; tab-stops: list 117.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">3.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Otonimi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l8 level3 lfo1; tab-stops: list 117.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">4.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Fisik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l8 level2 lfo1; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">b.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Parsial
kompleks (kerusakan kesadaran)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l8 level3 lfo1; tab-stops: list 117.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">1.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Parsial
sederhana diikuti penurunan kesadaran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l8 level3 lfo1; tab-stops: list 117.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">2.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Kerusakan
kesadaran saat awitan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l8 level2 lfo1; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">c.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Kejang
parsial generalisasi sekunder<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l8 level1 lfo1; tab-stops: list 45.0pt; text-align: justify; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">II.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Kejang
Umum<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l8 level2 lfo1; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">a.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Non
kejang<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l8 level2 lfo1; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">b.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Tonik-klonik
umum<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l8 level2 lfo1; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">c.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Tonik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l8 level2 lfo1; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">d.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Klonik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l8 level2 lfo1; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">e.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Mioklonik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l8 level2 lfo1; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">f.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Atonik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l8 level1 lfo1; tab-stops: list 45.0pt; text-align: justify; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">III.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif";">Kejang
Tidak terklasifikasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<h1>
MANIFESTASI KLINIK</h1>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<h1>
Kejang Parsial Sederhana</h1>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Hanya
jari atau tangan yang bergetar; atau mulut yang bergerenyut tak terkontrol;
bicara tidak dapat dimengerti; mungkin pening; dapat mengalami perubahan
penglihatan, suara, bau atau pengecapan yang tak lazim atau tak menyenangkan.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<h1>
Kejang Parsial Kompleks</h1>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Arial","sans-serif";">Masih
dalam keadaan sedikit bergerak atau gerakan secara otomatis tetapi tidak
bertujuan; dapat mengalami perubahan emosi, ketakutan, marah, kegirangan, atau
peka rangsang yang berlebihan; tidak mengingat periode tersebut ketika sudah
berlalu.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-family: "Arial","sans-serif";">Kejang
Umum (kejang grand Mal)<o:p></o:p></span></b></div>
<div class="MsoBodyText">
Mengenai kedua hemisfer
otak, kekuatan yang kuat dari seluruh tubuh diikuti dengan perubahan kedutan
dari relaksasi otot dan kontraksi (kontraksi tonik klonik umum)<o:p></o:p></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText">
FASE SERANGAN KEJANG</div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l6 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Fase Prodromal<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Beberapa
jam/hari sebelum seranga kejang. Berupa
perubahan alam rasa (mood), tingkah laku<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 18.0pt; text-indent: 18.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l6 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Fase Aura<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Merupakan
fase awal munculnya serangan. Berupa gangguan perasaan, pendengaran,
penglihatan, halusinasi, reaksi emosi afektif yang tidak menentu.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l6 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Fase Iktal<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Merupakan
fase serangan kejang, disertai gangguan muskuloskletal.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Tanda
lain : hipertensi, nadi meningkat, cyanosis, tekanan vu meningkat, tonus
spinkter ani meningkat, tubuh rigid-tegang-kaku, dilatasi pupil, stridor,
hipersalivasi, lidah resiko tergigit, kesadaran menurun.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l6 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Fase Post Iktal<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Merupakan
fase setelah serangan. Ditandai dengan : confuse lama, lemah, sakit kepala,
nyeri otot, tidur lama, amnesia retrograd, mual, isolasi diri.<o:p></o:p></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText">
STATUS EPILEPTIKUS</div>
<div class="MsoBodyText">
Serangan kejang yang
terjadi berulang, merupakan keadaan darurat. Berakibat kerusakan otak permanen,
dapat disebabkan karena : peningkatan suhu yang tinggi, penghentian obat
epileptik, kurang tidur, intoksikasi obat, trauma otak, infeksi otak.<o:p></o:p></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText">
PEMERIKSAAN DIAGNOSTIK</div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l10 level1 lfo3; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Elektroensefalografi
(EEG) membentu dalam mengklasifikasikan tipe kejang.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l10 level1 lfo3; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->CT Scan untuk
mendeteksi lesi, abnormalitas fokal, abnormalitas vaskuler cerebral, dan
perubahan degeneratif serebral.<o:p></o:p></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText">
PENATALAKSANAAN</div>
<div class="MsoBodyText">
Penatalaksaan epilepsy
direncanakan sesuai dengan program jangka panjang dan dibuat untuk memenuhi
kebutuhan khusus masing-masing klien.<o:p></o:p></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText">
Tujuan dari pengobatan
adalah untuk menghentikan kejang sesegera mungkin, untuk menjamin oksigenasi
serebral yang adekuat, dan untuk mempertahankan klien dalam status bebas
kejang.<o:p></o:p></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText">
Pengobatan Farmakologis</div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l0 level1 lfo4; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Pengobatan
biasanya dimulai dengan dosis tunggal.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l0 level1 lfo4; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Pengobatan anti
konvulsan utama termasuk karbamazepin, primidon, fenitoin, fenobarbital,
etosuksimidin, dan valproate.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l0 level1 lfo4; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Lakukan
pemeriksaan fisik secara periodic dan pemeriksaan laboratorium untuk klien yang
mendapatkan obat yang diketahui mempunyai efek samping toksik.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l0 level1 lfo4; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Cegah
terjadinya hiperplasi gingival dengan hygiene oral yang menyeluruh, perawatan
gigi teratur, dan masase gusi teratur untuk klien yang mendapatkan fenitoin
(Dilantin).<o:p></o:p></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText">
Pembedahan</div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l4 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Diindikasikan
bila epilepsy diakibatkan oleh tumuor intrakranial, abses, kista, atau anomaly
vaskuler.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l4 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Pengangkatan
secara pembedahan pada focus epileptogenik dilakukan untuk kejang yang berasal
dari area otak yang terkelilingi dengan baik yang dapat dieksisi tanpa
menghasilkan kelainan neurologis yang signifikan.<o:p></o:p></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText">
PROSES KEPERAWATAN</div>
<div class="MsoBodyText">
Pengkajian</div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l1 level1 lfo6; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Riwayat
kesehatan yang berhubungan dengan factor resiko bio-psiko-sosial-spiritual.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Data
subyektif : usia mulai mengalami sreanga, frekuensi serangan, factor presipitasi
(suhu tinggi, kurang tidur, keadaan emosional labil), pernah mengalami skit
berta yang disertai kejang. Pernah sakit cedera otak, operasi otak. Pernah
minum obat tertentu/alcohol. <st1:city w:st="on">Ada</st1:city>
riwayat penyakit yang sama dalam keluarga.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 18.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l1 level1 lfo6; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Aktifitas/Istirahat<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Data
subyektif : keadaan umum yang lemah, lelah, menyatakan keterbatasan aktifitas,
tidak dapat merawat diri sendiri.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Data
obyektif : menurunnya kekuatan otot/otot lemah.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 18.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l1 level1 lfo6; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Peredaran darah<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Data
obyektif : didapat data pada saat serangan : hipertensi, denyut nadi meningkat,
cyanosis. Setelah serangan tanda vital mungkin normal atau mungkin disertai
nadi dan pernafasan menurun.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l1 level1 lfo6; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Eliminasi<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Data
subyektif : tidak dapat menahan BAB dan BAK<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Data
obyektif : saat serangan tekanan VU dan otot spinkter meningkat. Setelah
serangan dalam keadaan inikontinensia otot-otot VU dan spinkter rileks.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l1 level1 lfo6; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;">
</span><!--[endif]-->Makanan/cairan<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Data
subyektif : selama serangan makanan sangat sensitive<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Data
obyektif : gigi/gusi mengalami kerusakan selama serangan, gusi
hiperplasi/bengkak akibat samping obat dilantin.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l1 level1 lfo6; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->6.<span style="font-size: 7pt;">
</span><!--[endif]-->Persyarafan<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Data
subyektif : <u>selama serangan</u> ada riwayat nyeri kepala,
kehilngankesadaran/pingsan, kehilangan kesadaran sesaat/lena, klien menangis,
jatuh ke lantai, disertai komponen motorik seperti kejang tonik-klonik,
mioklonik, tonik, klonik, atonik. Klien menggigit lidat, mulut berbuih, ada
inkontinensia urin dan feces, bibir-muka berubah warna/cyanosis<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 18.0pt;">
<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<u>Sesudah serangan</u> : klien
mengalami letargi, bingung, nyeri otot, gangguan bicara, nyeri kepala. <st1:city w:st="on">Ada</st1:city> perubahan gerakan
seperti hemiplegi sementara, klien ingat/tidak ingat kejadian yang menimpanya.
Terjadi/tidak terjadi perubahan tingkat kesadaran, pernafasan, dan denyut nadi.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 18.0pt;">
<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l1 level1 lfo6; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->7.<span style="font-size: 7pt;">
</span><!--[endif]-->Konsep diri <o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Data
subyektif : merasa rendah diri, ketidak berdayaan, tidak mempunyai harapan.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Data
obyektif : selalu waspada/berhati-hati dalam hubungan dengan orang lain.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l1 level1 lfo6; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->8.<span style="font-size: 7pt;">
</span><!--[endif]-->Interaksi
social<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Data
subyektif : mengalami gangguan interaksi dengan orang lain/keluarga karena
malu.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText">
Diagnosa dan Rencana Keperawatan</div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l5 level1 lfo7; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Resiko cedera
s.d perubahan kesadaran, kerusakan kognitif selama kejang atau kerusakan
mekanisme perlindungan diri.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 18.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Tujuan
keperawatan :<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Klien
terbebas dari resiko cedera fisik.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Intervensi
:<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 73.5pt; mso-list: l0 level2 lfo4; tab-stops: list 73.5pt; text-indent: -19.5pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Bersama klien
mengidentifikasi factor yang dapat menyebabkan serangan tiba-tiba.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 73.5pt; mso-list: l0 level2 lfo4; tab-stops: list 73.5pt; text-indent: -19.5pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Bila serangan
tidak terjadi di tempat tidur letakkan bantal di bawah kepala klien atau
letakkan kepala klien di pangkuan perawat untuk mencegah supaya kepala tidak
terbentur ke lantai.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 73.5pt; mso-list: l0 level2 lfo4; tab-stops: list 73.5pt; text-indent: -19.5pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Bila klien
mengalami aura, ajarkan klien untuk berbaring sebelum kejang terjadi untuk
mencegah jatuh.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 73.5pt; mso-list: l0 level2 lfo4; tab-stops: list 73.5pt; text-indent: -19.5pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Observasi tanda
vital, gunakan terkmometer aksila.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 73.5pt; mso-list: l0 level2 lfo4; tab-stops: list 73.5pt; text-indent: -19.5pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt;">
</span><!--[endif]-->Dampingi klien
saat serangan berlangsung untuk mencegah bahaya luka fisik, aspirasi, lidah
tergigit.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 73.5pt; mso-list: l0 level2 lfo4; tab-stops: list 73.5pt; text-indent: -19.5pt;">
<!--[if !supportLists]-->f.<span style="font-size: 7pt;">
</span><!--[endif]-->Miringkan
kepala untuk mencegah aspirasi.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 73.5pt; mso-list: l0 level2 lfo4; tab-stops: list 73.5pt; text-indent: -19.5pt;">
<!--[if !supportLists]-->g.<span style="font-size: 7pt;">
</span><!--[endif]-->Pertahankan patensi
jalan nafas atau pasang spatel lidah selama kejang jika dapat dipasang dengan
aman sebelum rahang mengatup.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 73.5pt; mso-list: l0 level2 lfo4; tab-stops: list 73.5pt; text-indent: -19.5pt;">
<!--[if !supportLists]-->h.<span style="font-size: 7pt;">
</span><!--[endif]-->Hindarkan
alat-alat yang mebahayakan.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 73.5pt; mso-list: l0 level2 lfo4; tab-stops: list 73.5pt; text-indent: -19.5pt;">
<!--[if !supportLists]-->i.<span style="font-size: 7pt;">
</span><!--[endif]-->Longgarkan
pakaian yang sempit dan taha ekstrimitas.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 73.5pt; mso-list: l0 level2 lfo4; tab-stops: list 73.5pt; text-indent: -19.5pt;">
<!--[if !supportLists]-->j.<span style="font-size: 7pt;">
</span><!--[endif]-->Berikan O2
tambahan selama dan setelah kejang.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 73.5pt; mso-list: l0 level2 lfo4; tab-stops: list 73.5pt; text-indent: -19.5pt;">
<!--[if !supportLists]-->k.<span style="font-size: 7pt;">
</span><!--[endif]-->Pertahankan
aliran dan selang-selang selama aktifitas kejang karena akses IV adalah kritis.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 73.5pt; mso-list: l0 level2 lfo4; tab-stops: list 73.5pt; text-indent: -19.5pt;">
<!--[if !supportLists]-->l.<span style="font-size: 7pt;">
</span><!--[endif]-->Catat aktifitas
motorik dan status keadaan umum klien selama kejang.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 54.0pt;">
Tindakan
kolaboratif :<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l7 level1 lfo8; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Berikan
obat-obatan sesuai program, missal anti epileptik, luminal, diazepam, glucose,
thiamine, dll<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l7 level1 lfo8; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Monitor dan
catat efek samping obat.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l7 level1 lfo8; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Monitor tingkat
keseimbangan elektrolit, glucose.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l5 level1 lfo7; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Resiko jalan
nafas tidak efektif/resiko pola nafas tidak efektif s.d sumbatan
trachebroncheal, menurunnya kesadaran.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Tujuan
Keperawatan :<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Jalan
nafas/pola nafas efektif, tidak terjadi aspirasi.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Intervensi
;<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l9 level1 lfo9; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Bila klien tak
sadar, jaga agar jalan nafas tetap lancar dan terbuka. Observasi tanda vital,
agar nutrisi/cairan dan elektrolit tetap seimbang, bila perlu beri infus.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l9 level1 lfo9; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Bila terdapat
lendir pada jalan nafas, lakukan suction.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l9 level1 lfo9; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Miringkan
kepala untuk mencegah aspirasi.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l9 level1 lfo9; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Berikan O2
tambahan sesuai program.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; tab-stops: list 72.0pt;">
<br /></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l5 level1 lfo7; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Gangguan konsep
diri : harga diri rendah s.d menderita epilepsy, tidak bisa mengontrol
diri saat serangan kejang terjadi.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 18.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Tujuan
Keperawatan :<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Klien
dapat mengidentifikasi perasaan, pola koping yang posistif/negatif. Secara
verbal mempunyai harga diri meningkat. Menerima keadaan dirinya dan perubahan
fungsi-peran-gaya hidup yang dihadapi.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Intervensi
;<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l2 level1 lfo10; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Diskusikan
tentang perasaan klien.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l2 level1 lfo10; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Dorong klien
untuk mengekspresikan pikiran dan perasaannya.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l2 level1 lfo10; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Kaji kemampuan
klien yang positif sesuai dengan keadaan sehingga dapat memanfaatkan kemampuan
tersebut untuk meningkatkan harga diri klien dan dapat hidup di masyarakat.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 54.0pt;">
Tindakan
kolaboratif :<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 90.0pt; mso-list: l2 level2 lfo10; tab-stops: list 90.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->bila perlu
anjurkan klien untuk mengikuti kelompok penderita epilepsy.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 90.0pt; mso-list: l2 level2 lfo10; tab-stops: list 90.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Diskusikan
dengan psychoterapist bila perlu tentang keadaan klien.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l5 level1 lfo7; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Kurang
pengetahuan s.d kebutuhan penatalaksanaan
penyakit secara mandiri.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Tujuan
Keperawatan :<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l5 level2 lfo7; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Klien
mengungkapkan pemahaman tentang diagnosa, pengobatan, rencana pengobatan, dan
tindakan pengamanan.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l5 level2 lfo7; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Klien/keluarga
akan mengungkapkan apa yang dilakukan jika klien mengalami kejang.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l5 level2 lfo7; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Klien akan
menyadari dari mana sumber-sumber informasi dan dukungan selanjutnya dapat
diperoleh.<o:p></o:p></div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText" style="margin-left: 36.0pt;">
Intervensi
;<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l3 level1 lfo11; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Kaji keadaan
patologis/kondisi klien dan pengobatan yang pernah didapat klien.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l3 level1 lfo11; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Berikan
informasi (verbal/tulisan) tentang keadaan klien dan regimen terapi.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l3 level1 lfo11; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Diskusikan
tentang pentingnya kontrol dan minum obat secara teratur.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l3 level1 lfo11; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Jelaskan pada klien
tentang keadaan yang sedang dihadapi klien dan factor-faktor yang da[pat
menimbulkan serangan.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l3 level1 lfo11; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt;">
</span><!--[endif]-->Jelaskan
keadaan yang aharus dihadapi terhadap keadaannya, seperti pekerjaan,
mengendarai mobil, olah raga dan rekreasi.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l3 level1 lfo11; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->f.<span style="font-size: 7pt;">
</span><!--[endif]-->Anjurkan klien
untuk selalu membawatanda pengenal bila bepergian.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l3 level1 lfo11; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->g.<span style="font-size: 7pt;">
</span><!--[endif]-->Perbaiki
kesalahan persepsi tentang penyakit.<o:p></o:p></div>
<div class="MsoBodyText" style="margin-left: 72.0pt; mso-list: l3 level1 lfo11; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->h.<span style="font-size: 7pt;">
</span><!--[endif]-->Validasi
pemahaman klien/keluarga tentang hal-hal yang ada.<o:p></o:p></div>
<div class="MsoBodyText">
<br /></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-12380582336618783472012-10-19T04:39:00.005-07:002012-10-19T04:39:35.549-07:00LEUKIMIA<br />
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 14.0pt; line-height: 150%;">LEUKEMIA<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">1.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Definisi<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Leukemia adalah poliferasi sel
lekosit yang abnormal, ganas, sering disertai bentuk leukosit yang lain dari
pada normal, jumlahnya berlebihan dan dapat menyebabkan anemia, trombisitopeni
dan diakhiri dengan kematian. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Leukemia adalah penyakit neoplasmik
yang ditandai oleh poliferasi abnormal dari sel-sel hematopoietik. (Virchow,
1847)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">2.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Etiologi<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Walaupun sebagian besar penderita
leukemia faktor-faktor penyebabnya tidak dapat diidentifikasi, tetapi ada
beberapa faktor yang terbukti dapat menyebabkan leukemia. Faktor-faktor
tersebut antara lain adalah:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level5 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Faktor
genetik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Insiden leukemia akut pada anak-anak
penderita sindrom Down adalah 20 kali lipat lebih banyak dari pada normal. Dari
data ini, ditambah kenyataan bahwa saudara kandung penderita leukemia mempuyai
resiko lebih tinggi untuk menderita sindrom Down, dapat diambil kesimpulan pula
bahwa kelainan pada kromosom 21 dapat menyebabkan leukemia akut. Dugaan ini
diperkuat lagi oleh data bahwa penderita leukemia garanulositik kronik dengan
kromosom <st1:city w:st="on"><st1:place w:st="on">Philadelphia</st1:place></st1:city>
translokasi kromosom 21, biasanya meninggal setelah memasuki fase leukemia
akut. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level5 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">b.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Faktor
lingkungan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Faktor-faktor lingkungan berupa
kontak dengan radiasi ionisasi desertai manifestasi leukemia yang timbul
bertahun-tahun kemudian. Zat-zat kimia (misalnya, benzen, arsen, klorampenikol,
fenilbutazon, dan agen antineoplastik) dikaitkan dengan frekuensi yang
meningkat, khususnya agen-agen akil. Leukemia juga meningkat pada penderita
yang diobati baik dengan radiasi atau kemoterapi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level5 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">c.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Virus<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<st1:city w:st="on"><st1:place w:st="on"><span style="font-family: "Book Antiqua","serif";">Ada</span></st1:place></st1:city><span style="font-family: "Book Antiqua","serif";"> beberapa hasil penelitian yang
menyebutkan bahwa virus sebagai penyebab leukemia antaralain: enzyme reverse
transcriptase ditenukan dalam darah penderita leukemia. Seperti diketahui,
ensim ini ditemukan didalam virus onkogenik seperti retrovirus tipe – C, yaitu
jenis virus RNA yang menyebabkan leukemia pada binatang.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">3.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Tanda dan Gejala<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Manifestasi klinik berkaitan dengan
berkurangnya atau tidak adanya sel hematopoietik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level5 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Peningkatan
produksi seri granulosit yang relatif matang.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level5 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">b.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Rasa
leleh, penurunan berat badan, anemia, rasa penuh dan sakit di perut dan mudah
berdarah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level5 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">c.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Pada
pemeriksaan fisis hampir 90% ditemukan splenomegali.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level5 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">d.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Nyeri
tekan pada tulang dada dan hematomegali.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level5 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">e.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Poliferasi
limfoblas abnormal alam susum tulang dan tempat-tempat ekstramedular.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level5 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">f.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Pembesaran
kelenjar getah bening, limpa, hati dan kelenjar mediastinum.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level5 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">g.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Infiltrasi
alat tubuh lain (paru, pleura, tulang, kulit)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">4.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Klasifikasi dan patofisiologi<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Klasifikasi leukemia terdiri dari
akut dan kronik, Klasifikasi kronik didasarkan pada ditemukannya sel darah putih
matang yang mencolok – granulosit (leukemia granulositik/mielositik) atau
limfosit (leukememia limfositik).<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Klasifikasi leukemia akut
menurut <b><i>the French-American-British (FAB)</i></b><i> Sbb:<o:p></o:p></i></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<b><span style="font-family: "Book Antiqua","serif";">Leukemia
limfoblastik akut :<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";"> <b>L-1 </b>Leukemia
limfositik akut pada masa kanak-kanak : pospulasi sel homogen<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<b><span style="font-family: "Book Antiqua","serif";"> L-1 </span></b><span style="font-family: "Book Antiqua","serif";">Leukemia limfositik akut tampak pada
orang dewasa : populasi sel heterogen<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<b><span style="font-family: "Book Antiqua","serif";"> L-3 </span></b><span style="font-family: "Book Antiqua","serif";">Limfoma Burkitt-tipe leukemia :
sel-sel besar, populasi sel homogen<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<b><span style="font-family: "Book Antiqua","serif";">Leukemia
mieloblastik akut :<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<b><span style="font-family: "Book Antiqua","serif";"> M-1 </span></b><span style="font-family: "Book Antiqua","serif";">Deferensiasi granulisitik tanpa pematangan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify; text-indent: 18.0pt;">
<b><span style="font-family: "Book Antiqua","serif";">M-2
</span></b><span style="font-family: "Book Antiqua","serif";">Deferensiasi granulositik disertai pematangan menjadi
stadium promielositik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify; text-indent: -36.0pt;">
<b><span style="font-family: "Book Antiqua","serif";">M-3 </span></b><span style="font-family: "Book Antiqua","serif";">Deferensiasi
granulositik disertai promielosit hipergranular yang dikaitkan dengan pembekuan
intravaskular tersebar <i>(Disseminated
intavascular coagulation)<o:p></o:p></i></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify; text-indent: -36.0pt;">
<b><span style="font-family: "Book Antiqua","serif";">M-4 </span></b><span style="font-family: "Book Antiqua","serif";">Leukemia
mielomonositik akut : kedua garis sel granulosit dan monosit<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify; text-indent: -36.0pt;">
<b><span style="font-family: "Book Antiqua","serif";">M-5a </span></b><span style="font-family: "Book Antiqua","serif";">Leukemia
monositik akut : kurang berdeferensiasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify; text-indent: -36.0pt;">
<b><span style="font-family: "Book Antiqua","serif";">M-5b </span></b><span style="font-family: "Book Antiqua","serif";">Leukemia
monositik akut : berdeferensiasi baik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify; text-indent: -36.0pt;">
<b><span style="font-family: "Book Antiqua","serif";">M-6 </span></b><span style="font-family: "Book Antiqua","serif";">Eritroblas
predominan disertai diseritropoesis berat<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify; text-indent: -36.0pt;">
<b><span style="font-family: "Book Antiqua","serif";">M-7 </span></b><span style="font-family: "Book Antiqua","serif";">Leukemia
megakariosit<b> <o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Leukemia dibagi menurut jenisnya
kedalam limfoid dan mieloid. Masing-masing ada yang akut dan kronik. Pada garis
besarnya pembagian leukemia adalah sebagai berikut:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level6 lfo1; mso-text-indent-alt: -9.0pt; text-align: justify; text-indent: -36.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span>I.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Leukemia
mieloid<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l3 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Leukemia
granulositik kronik/LGK(leukemia mieloid/mielositik/ mielogenus kronik)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Adalah suatu penyakit
mieloproliferatif karena sumsum tulang penderita ini menujukan gambaran hiperselular
disertai adanya proliferasi pada semua garis diferensiasi sel, yang ditandai
dengan produksi berlebihan seri granulosit yang relatif matang, jumlah
garanulosit umumnya lebih dari 30.000/mm3 dan paling sering terlihat pada orang
dewasa usia pertengahan tetapi juga dapat timbul pada setiap kelompok umur
lainnya. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Tamda dan gejala berkaitan dengan
keadaan hipermetabolik yaitu kelelahan, kehilangan berat badan, diaforesis
meningkat dan tidak tahan panas, limpa membesar pada 90 % kasus yang
mengakibatkan penuh pda abdomen dan mudah merasa kenyang. Angka harapan hidup
mediannya sekitar 3 tahun, baik dengan pengobatan maupun tanpa pengobatan. Pengobatan
dengan kemoterapi intermiten ditujukan pada penekanan hematopoesis yang
berlebihan dan mengurangi ukuran limpa, berbagai penderita berkembang menjadi
lebih progresif, fase resisten diseertai dengan pembentukan mieloblas yang
berlebihan (tansformasi blas). Kematian terjadi dalam beberapa minggu atau
beberapa bulan setelah transformasi blas, transplantasi sumsum tulang dari
individu lain (allogenik) yang dilakukan pada fase kronik stabil penderita LGK
memberikan suatu harapan kesembuhan , walaupun morbiditas dan mortalitas selama
transplantasi tetap tinggi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l3 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">b.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Leukemia
mielositik akut atau leukemia granulositik akut/ LGA (leukemia
mieloid/mielositik/granulositik/ mielogenus akut)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Merupakan neoplasma uniklonal yang
berasal dari trasformasi suatu atau beberapa sel hematopoietik. Sifat
sebenarnya dari lesi molekular yang bertanggung jawab atas sifat-sifat
neoplasmik dari sel yang berubah bentuknya tidak jelas, tapi defek kritis
adanya intrisik dan dapat diturunkan oleh keturunan sel tersebut (Clarkson,
1988). Tanda dan gekala leukemia akut berkaitan dengan netropenia dan
trombositopenia, ini adalah infeksi berat yang rekuren disertai dengan
timbulnya tukak pada membren mukosa, abses perirektal, pneumonia, septikemia
disertai menggigil, demam, takikardia, dan takipnea. Trombositopenia
mengakibatkan perdarahan yang dinyatakan dengan petekie dan ekimosis,
epistaksis, hematoma pada membran mukosa, serta perdarahan saluran cerna dan
sistem saluran kemih, tulang mungkin sakit dan lunak yang disebabkan oleh
infark tulang atau infiltrat periosteal. Anemia bukan merupakan manifestasi
awal disebabkan oleh karena umur eritrosit yang panjang (120 hari), jika terdapat anemia maka akan
terdapat gejala kelelahan, pusing dan dispnea waktu kerja fisik serta pucat
yang nyata.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Diagnosis LGA ditegakan dengan
melalui hitung jenis darah tepi dan pemeriksaan sumsum tulang serta pemeriksaan
kromosom. Hitung sel darah tepi dapat meninggi, normal atau menurun disertai
mieloblas dalam sirkulasi. Sumsum tulang hiperseluler disertai adanya kelebihan (50%) mieloblas yang mengandung badan Auer.
Perubahan metabolik juga terlihat
disertai peningkatan asam urat yang disebabkan oleh tingginya pergantian sel
darah putih<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level6 lfo1; mso-text-indent-alt: -9.0pt; text-align: justify; text-indent: -36.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span>II.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Leukemia
limfoid<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Leukemia
limfositik kronik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Merupakan suatu gangguan limfoproliferatifyang
ditemukan pada kelompok umur tua (sekitar 60 tahun) yang dimanifestasikan oleh
poliferasi dan akmulasi limfosit matang kecil dalam sumsum tulang, darah
perifer,dan tempat-tempat ekstramedular dengan kadar yang mencapai 100.000/mm3
atau lebih, limposit abnormal umumnya adalah limposit B.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">b.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Book Antiqua","serif";">Leukemia
limfoblastik akut<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; text-align: justify;">
<span style="font-family: "Book Antiqua","serif";">Penyakit ini terdapat pada 20% orang
dewasa yang menderita leukemia, keadaan ini merupakan kanker yang paling sering
menyerang anak-anak dibawah umur 15 tahun denga puncak insidens antara umur 3
dan 4 tahun. Manifestasi berupa poliferasi limfoblas abnormal dalam sumsum
tulamg dan tempat-tempat ekstramedular.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">5.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Pengobatan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l2 level1 lfo4; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Protokol
pengobatan leukemia limfoblatik akut (LLA)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<b><span style="font-family: "Book Antiqua","serif";">INDUKSI<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span style="font-family: "Book Antiqua","serif";">Protokol
Nasional Prancis LALA’ 87<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<span style="font-family: "Book Antiqua","serif";">Syarat
: belum mendapatkan pengobatan sebelumnya, usia 60 tahun<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 114.0pt; tab-stops: 120.0pt; text-indent: -60.0pt;">
<span style="font-family: "Book Antiqua","serif";">Prednison :
</span><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: Arial;">60 mg/m²/oral (hari 1 s/d 22, tapp.of 22 s/d 28)</span><span style="font-family: "Book Antiqua","serif";"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 186.0pt; tab-stops: 180.0pt; text-indent: -126.0pt;">
<span style="font-family: "Book Antiqua","serif";">Vinkristin : </span><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: Arial;">1,5 mg/
m²/IV, ( hari 1,8,15,22), dosis total tidak boleh lebih dari 2,5 mg/1x.</span><span style="font-family: "Book Antiqua","serif";"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 120.0pt; tab-stops: 114.0pt; text-indent: -66.0pt;">
<span style="font-family: "Book Antiqua","serif";">Cyclophosphanamide : 600 mg/ m</span><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: Arial;">²/IV, (hr 1,8)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 120.0pt; tab-stops: 114.0pt; text-indent: -66.0pt;">
<span style="font-family: "Book Antiqua","serif";">Daunorubicin : 50 mg/ m</span><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: Arial;">²/IV, (hr
1,2,3)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 186.0pt; tab-stops: 180.0pt; text-indent: -132.0pt;">
<span style="font-family: "Book Antiqua","serif";">Profilaksis CNS : Methotrexante: 12
mg/total/intratekal, (hr 1 atau 3,8,15,22,125,150)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 186.0pt; tab-stops: 180.0pt; text-indent: -132.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l2 level1 lfo4; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">b.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Protokol
pengobatan leukemia mieloblastik akut (LMA)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l2 level2 lfo4; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">CHA (tidak termasuk Lam tipe
M-3,FAB/progranulostik akut)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt;">
<b><span style="font-family: "Book Antiqua","serif";">INDUKSI :<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt;">
<span style="font-family: "Book Antiqua","serif";">CCNU : 70 mg/ m</span><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: Arial;">²/oral,
(hr 1)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt;">
<span style="font-family: "Book Antiqua","serif";">Adriamycin : 35 mg/ m</span><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: Arial;">²/IV (hr
1,2,3 = 3 hari)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt;">
<span style="font-family: "Book Antiqua","serif";">ARA-C :
100 mg/ m</span><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: Arial;">²/IV-continous, (hr 1s/d 10 = 10 hari)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l2 level2 lfo4; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">LAM-VIII<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt;">
<b><span style="font-family: "Book Antiqua","serif";">INDUKSI : = LAM IV modified<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l2 level2 lfo4; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">LAM-IV modified<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt;">
<b><span style="font-family: "Book Antiqua","serif";">INDUKSI :<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; tab-stops: 180.0pt; text-indent: -18.0pt;">
<b><span style="font-family: "Book Antiqua","serif";"> </span></b><span style="font-family: "Book Antiqua","serif";">Daunorubicin : 45 mg/ m</span><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: Arial;">²/IV, (hr
1,2,3)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; tab-stops: 192.0pt; text-indent: -18.0pt;">
<span style="font-family: "Book Antiqua","serif";"> Cystosine arabinoside : 200 mg/ m</span><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: Arial;">²/IV-continous drip, (hr
1s/d 7)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; tab-stops: 192.0pt; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; tab-stops: 192.0pt; text-indent: -18.0pt;">
<b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: Arial;"> MAINTENANCE :<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; tab-stops: 192.0pt; text-indent: -18.0pt;">
<b><span style="font-family: "Book Antiqua","serif";"> </span>kapsul</b><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: Arial;"><o:p></o:p></span></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l2 level1 lfo4; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">c.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Protokol
pengobatan leukemia granulosit kronik (LGK)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 222.0pt; mso-list: l2 level2 lfo4; tab-stops: list 90.0pt left 216.0pt; text-indent: -150.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">INDUKSI : bila leukosit 50.000/ml → myleran 6 mg/hr
s/d leukosit 5 – 15.000 mg, kemudian istirahat 3 minggu, selanjutnya teruskan
dengan “maintenance”<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 222.0pt; mso-list: l2 level2 lfo4; tab-stops: list 90.0pt left 216.0pt; text-indent: -150.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Maintenance : Myleran<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 222.0pt; tab-stops: 216.0pt; text-indent: -132.0pt;">
<span style="font-family: "Book Antiqua","serif";">15.000 :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 222.0pt; tab-stops: 216.0pt; text-indent: -132.0pt;">
<span style="font-family: "Book Antiqua","serif";">15-25.000 : 2 mg/hari (7 hari)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 222.0pt; tab-stops: 216.0pt; text-indent: -132.0pt;">
<span style="font-family: "Book Antiqua","serif";">25-35.000 : 4 mg/hari (7 hari)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 222.0pt; tab-stops: 216.0pt; text-indent: -132.0pt;">
<span style="font-family: "Book Antiqua","serif";">35.000 : 6 mg/hari (7
hari)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 222.0pt; mso-list: l2 level2 lfo4; tab-stops: list 90.0pt left 216.0pt; text-indent: -150.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Pengobatan dengan Hydroxpurea
(HYDREA) 500 mg (menurut AZL) <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt;">
<span style="font-family: "Book Antiqua","serif";">Dosis : 15-25 mg/kg BB
dalam 2 jam dosis peroral<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l2 level2 lfo4; tab-stops: list 90.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">4)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Pengobatan
dengan Hydroxpurea (HYDREA) menurut “anjuran pembuat obat”<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 95.4pt; mso-border-alt: solid windowtext .5pt; 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: 42.0pt;" valign="top" width="56">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">BB (kg)<o:p></o:p></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: 172.45pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">Terapi INTERMITEN<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">(80 mg/kg BB, setiap 3 hari<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">sebagai dosis tunggal)<o:p></o:p></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: 154.95pt;" valign="top" width="207">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">Terapi CONTINUOUS<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">(20-30 mg/kg BB, setiap hari dosis tunggal)<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<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: 42.0pt;" valign="top" width="56">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">10<o:p></o:p></span></b></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: 172.45pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">1 ½ kapsul<o:p></o:p></span></b></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: 154.95pt;" valign="top" width="207">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">½ kapsul<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<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: 42.0pt;" valign="top" width="56">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">15<o:p></o:p></span></b></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: 172.45pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">2 kapsul<o:p></o:p></span></b></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: 154.95pt;" valign="top" width="207">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">1 kapsul<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<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: 42.0pt;" valign="top" width="56">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">10<o:p></o:p></span></b></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: 172.45pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">3 kapsul<o:p></o:p></span></b></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: 154.95pt;" valign="top" width="207">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">1 kapsul<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<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: 42.0pt;" valign="top" width="56">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">10<o:p></o:p></span></b></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: 172.45pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">5 kapsul<o:p></o:p></span></b></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: 154.95pt;" valign="top" width="207">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">2 kapsul<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<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: 42.0pt;" valign="top" width="56">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">10<o:p></o:p></span></b></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: 172.45pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">6 kapsul<o:p></o:p></span></b></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: 154.95pt;" valign="top" width="207">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">2 kapsul<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<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: 42.0pt;" valign="top" width="56">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">10<o:p></o:p></span></b></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: 172.45pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">8 kapsul<o:p></o:p></span></b></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: 154.95pt;" valign="top" width="207">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">3 kapsul<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<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: 42.0pt;" valign="top" width="56">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">10<o:p></o:p></span></b></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: 172.45pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">10 kapsul<o:p></o:p></span></b></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: 154.95pt;" valign="top" width="207">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">3 kapsul<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<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: 42.0pt;" valign="top" width="56">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">10<o:p></o:p></span></b></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: 172.45pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">11 kapsul<o:p></o:p></span></b></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: 154.95pt;" valign="top" width="207">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">4 kapsul<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<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: 42.0pt;" valign="top" width="56">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">10<o:p></o:p></span></b></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: 172.45pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">13 kapsul<o:p></o:p></span></b></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: 154.95pt;" valign="top" width="207">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">4 kapsul<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<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: 42.0pt;" valign="top" width="56">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">10<o:p></o:p></span></b></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: 172.45pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">14 kapsul<o:p></o:p></span></b></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: 154.95pt;" valign="top" width="207">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">5 kapsul<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<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: 42.0pt;" valign="top" width="56">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">100<o:p></o:p></span></b></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: 172.45pt;" valign="top" width="230">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">16 kapsul<o:p></o:p></span></b></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: 154.95pt;" valign="top" width="207">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "Book Antiqua","serif"; font-size: 10.0pt;">6 kapsul<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 90.0pt;">
<b><span style="font-family: "Book Antiqua","serif";">Efek samping : <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 135.0pt; mso-list: l2 level3 lfo4; tab-stops: list 135.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">supresi sumsum tulang : leukopenia,
terombositopenia, anemia.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 135.0pt; mso-list: l2 level3 lfo4; tab-stops: list 135.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Anoreksia, nausea, vomiting, nyeri
kepala, pusing, stomatitis,alopesia, skin rash, melena, nyeri perut,
diorientasi, edema paru.<o:p></o:p></span></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">6.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Diagnosa
keperawatan yang mungkin muncul :<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">PK : Depresi sumsum tulang<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">b.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">PK : Leukositosis<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">c.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">PK : Keterlibatan SP<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">d.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Risiko Infeksi b.d tidak adekuatnya
pertahanan sekunder<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">e.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Risiko terhadap cedera b.d bentuk
darah abnormal, kecenderungan perdarahan sekunder terhadap leukemia dan efek
samping kemoterapi <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Book Antiqua","serif"; mso-bidi-font-family: "Book Antiqua"; mso-fareast-font-family: "Book Antiqua";">f.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: "Book Antiqua","serif";">Ketidakberdayaan b.d ketidakmampuan
untuk mengontrol situasi, ketidakberdayaan <st1:city w:st="on"><st1:place w:st="on">gaya</st1:place></st1:city> hidup<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<br /></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-2231345365281990222012-10-13T15:30:00.004-07:002012-10-13T15:30:54.913-07:00COR<br />
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b>LAPORAN
PENDAHULUAN<o:p></o:p></b></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b>COR<o:p></o:p></b></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<h2>
Konsep Dasar</h2>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pengertian</div>
<div class="MsoBodyTextIndent" style="margin-left: 17.85pt; text-indent: 36.0pt;">
Cedera
kepala merupakan salah satu penyebab kematian dan kecacatan utama pada kelompok
usia produktif dan sebagian besar terjadi akibat kecelakaan lalu lintas (Arif
Mansjoer dkk, 2000 ; 3).</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Etiologi</div>
<div class="MsoBodyTextIndent" style="margin-left: 17.85pt; text-indent: 36.0pt;">
Trauma
langsung yang menyebabkan komser (gegar otak) pada titik terjadinya trauma itu
misalnya jatuh dari mobil dan kepala terbentur aspal.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
Klasifikasi</div>
<div class="MsoBodyTextIndent" style="margin-left: 17.85pt; text-indent: 36.0pt;">
Cedera
kepala dapat diklsifikasikan berdasarkan mekanisme, keparahan dan morfologi
cedera.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Mekanisme : berdasarkan adanya penetrasi duramater</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l1 level2 lfo2; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Trauma tumpul :
kecepatan tinggi (tabrakan mobil)</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; tab-stops: list 54.0pt;">
: kecepatan rendah
(terjatuh, terpukul)</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l1 level2 lfo2; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Trauma tembus (luka tembus perut dan cedera
tembus lainnya).</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Keparahan cedera</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l1 level2 lfo2; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Ringan :
skala koma (glasgow coma scale, gcs) 4-5-6</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l1 level2 lfo2; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Sedang :
Gcs 3-4-5</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l1 level2 lfo2; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Berat :
Gcs 1-2-3</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Morfologi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l1 level2 lfo2; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Fraktur tengkorak : kranium linier / stelatum :
depresi / non depresi ; terbuka / tertutup basis dengan / tanpa kelumpuhan
nervus VII.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l1 level2 lfo2; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Lesi intrakranial : fokal : epidural, subdural,
intraserebral</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 108.0pt;">
Difus : Konkusi ringan, konkusi
klasik, cedera </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 108.0pt; text-indent: 36.0pt;">
aksonal difus.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<o:p> </o:p><span style="line-height: 150%; text-align: justify; text-indent: -18pt;">1.</span><span style="font-size: 7pt; line-height: normal; text-align: justify; text-indent: -18pt;">
</span><span style="line-height: 150%; text-align: justify; text-indent: -18pt;">Manifestasi Klinis</span></div>
<div class="Section1">
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
Gejala pada
komosio cerebri biasanya adalah :</div>
</div>
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: auto;" />
</span>
<div class="Section2">
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Sakit kepala</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Bingung</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Muntah</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Takipneu/ dispneu</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Wajah tidak simetris</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Lemah</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Paralise</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Hemiparese</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Luka di kepala</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Akumulasi </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Spontan pada saluran nafas</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Adanya cairan dari hidung dan telinga</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Kejang</div>
</div>
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: auto;" />
</span>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Komplikasi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Oedema jaringan otak</div>
<div class="MsoBodyTextIndent">
Kontusio serebri merupakan pendarahan kecil
(plechia) pada jaringan pembuluh darah otak akibat pecahnya pembuluh darah
kapiler, hal ini bersama-sama rusaknya jaringan saraf/ otot.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Herniasi Cerebri : tekanan yang tinggi pada intra
kranial</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Meningitis</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->6.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pemeriksaan Fisik</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Makanan/ cairan</div>
<div class="MsoBodyTextIndent2">
Gejala : mual, muntah, biasanya dikarenakan adanya alergi
terhadap makanan tertentu dan perubahan selera.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; tab-stops: 81.0pt 90.0pt; text-align: justify; text-indent: -54.0pt;">
Tanda : muntah (proyektif)
gangguan menelan (batuk, air liur keluar, disfagia) </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pernafasan</div>
<div class="MsoBodyTextIndent2">
Tanda : perubahan pada pola nafas baik irama,
kedalaman, maupun frekuensi yaitu cepat dan dangkal bunyi nafas ronchi,
wheezing, stridor dan adanya pernafasan cuping hidung.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Eliminasi</div>
<div class="MsoBodyTextIndent2">
Gejala : akan didapatkan refensi urine dan
inkontinensia urin atau alvi</div>
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="page-break-before: always;" />
</span>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Nyeri/ kenyamanan</div>
<div class="MsoBodyTextIndent2">
Gejala : sakit kepala dengan intensitas dan lokasi yang
berbeda, biasanya lama.</div>
<div class="MsoBodyTextIndent2">
Tanda : wajah menyeringai, respon menarik pada
rangsangan nyeri dengan beban gelisah tidak bisa istirahat merintih</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Neuro sensori</div>
<div class="MsoBodyTextIndent2">
Gejala : kehilangan kesadaran sementara vertigo,
sinkope, tinitus</div>
<div class="MsoBodyTextIndent2">
Tanda : kadang didapatkan kaku kudula dan adanya
hemiparese, terjadi inuoiantes (tidak disadari) kejang dan ataksia</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->f.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Sirkulasi</div>
<div class="MsoBodyTextIndent2">
Gejala : perubahan tekanan darah, perubahan frekuensi
jantung, (Bradikardi, tachikardi) perubahan akral tergantung nadi dan suhu.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->g.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Aktifitas/ istirahat</div>
<div class="MsoBodyTextIndent2">
Gejala : merasa lemah, lelah, kaku, hilang keseimbangan</div>
<div class="MsoBodyTextIndent2">
Tanda : fraktur/ aisorasi, gangguan penglihatan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->h.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Keamanan</div>
<div class="MsoBodyTextIndent2">
Gejala : trauma baru/ trauma kecelakaan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->i.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Integritas ego</div>
<div class="MsoBodyTextIndent2">
Gejala : perubahan tingkah laku/ kepribadian</div>
<div class="MsoBodyTextIndent2">
Tanda : cemas, mudah tersinggung, bingung, dll.</div>
<div class="MsoBodyTextIndent2">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->7.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pemeriksaan Diagnostik</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level1 lfo10; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->CT Sean : tanpa/ dengan kontras mengidentifikasi adanya
heronagik, menentukan ukuran ventrikel,
pergeseran jaringan otak.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level1 lfo10; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Angiografi Serebial : menunjukkan kelainan sirkulasi
serebial, seperti pergeseran jaringan otak akibat edema, pendarahan, trauma.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level1 lfo10; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->X-Ray : mendeteksi perubahan struktur tulang (fraktur),
perubahan struktur garis (pendarahan/ edema), fragmen tulang.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level1 lfo10; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Analisa gas darah : mendeteksi ventilasi oleh atau
masalah pernafasan (oksigenasi) jika terjadi kenaikan tekanan intra kronial</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level1 lfo10; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Elektrolit : untuk mengoreksi keseimbangan elektrolit
sebagai akibat peningkatan tik. </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->8.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Penatalaksanaan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
Pedoman
resusitasi dan penilaian awal.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Menilai jalan nafas (airway)</div>
<div class="MsoBodyTextIndent">
Bersihkan jalan nafas dan debris dan muntahan,
lepaskan gigi palsu, pertahankan tulang servikal, pasang guedel bila dapat
ditolelir. Jika cedera orafasial mengganggu jalan nafas maka pasien harus di
inkubasi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Menilai pernafasan (breathing)</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify;">
Tentukan pasien apakah bernafas spontan selidiki dan atasi cedera dada
berat seperti pneumothoraks, tensif, hemopneumothoraks, pasang oksimotor jika
tersedia.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Menilai sirkulasi (circulation)</div>
<div class="MsoBodyTextIndent">
Otak yang rusak tidak mentolelir hypotensi. Hentikan
semua pendarahan dengan menekan atherinya. Perhatikan secara khusus adanya
cedera indra abdomen atau dan ekg. Bila tersedia pasang jalur intra vena yang
besar, ambil darah vena untuk pemeriksaan. Darah perifer lengkap, uteum,
elektrolit, glukosa, dan analisis darah arteri.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Obat kejang</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt;">
Kejang
kemorulsif dapat terjadi setelah cedera kepala dan harus diobati</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pemberian analgenetika</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->f.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pengobatan anti edema dengan larutan hypertonis yaitu
manilo 20% atau glukosa 40% atau gliserol</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->g.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Anti biotik yang mengandung garier darah otak
(penisilin) atau untuk infeksi anaerob diberikan aetrodozok</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l6 level3 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->h.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Makanan atau cairan pada trauma ringan bila mual muntah
tidak dapat diberikan apa-apa, hanya cairan infus dextrose 5%, aminofusin,
aminofel, 18 jam pertama dari terjadinya kecelakaan 1, 2-3 hari kemudian
diberikan makanan lunak.</div>
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="page-break-before: always;" />
</span>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b>BAB
II<o:p></o:p></b></div>
<h1>
ASUHAN KEPERAWATAN</h1>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
<h5>
<!--[if !supportLists]-->A.<span style="font-size: 7pt; font-weight: normal;"> </span><!--[endif]-->Pengkajian</h5>
<div class="MsoBodyTextIndent3" style="margin-left: 36.0pt; mso-list: l0 level1 lfo4; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Identifikasi px dan klg (penanggung jawab) nama, umur,
jenis kelamin, pendidikan, agama, suku bangsa, status perkawinan, alamat</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level1 lfo4; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Keluhan utama</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; tab-stops: list 36.0pt; text-align: justify;">
Px dengan COR ditandai dengan sakit kepala, pusing,
muntah, bingung, lemah, takipneu, dispneu kejang, adanya cairan dari hidung dan
telinga, pingsan (kurang dari 10 menit).</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l0 level1 lfo4; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Riwayat kesehatan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level2 lfo4; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Riwayat kesehatan sekarang </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.85pt; text-align: justify; text-indent: 36.0pt;">
Pada umumnya Px dengan komusio cerebri datang ke rumah
sakit dengan penurunan kesadaran tapi tidak begitu kurun, karena biasa tidak
ditemukan perubahan neurologist yang serius dan biasanya juga datang dengan
keadaan bingung, muntah, dispneu/takipneu, sakit kepala, akumulasi spontan pada
saluran nafas, adanya cairan dari hidung dan telinga serta adanya kejang.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level2 lfo4; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Riwayat kesehatan dahulu</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.85pt; text-align: justify; text-indent: 36.0pt;">
Riwayat kesehatan terdahulu haruslah diketahui dengan
baik yang berbidang penyakit persarafan maupun penyakit sistenik lain</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level2 lfo4; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Riwayat kesehatan keluarga</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.85pt; text-align: justify; text-indent: 36.0pt;">
Dalam riwayat kesehatan keluarga apakah ada salah satu
dari anggota keluarga menderita penyakit yang sama atau mempunyai penyakit
menular kronik dan herediter.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level2 lfo4; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Riwayat Psikososial</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.85pt; text-align: justify; text-indent: 36.0pt;">
Riwayat psikososial sangat berpengaruh dalam
psikologis kx dengan timbul gejala-gejala yang dialami dalam proses penerimaan
terhadap penyakitnya.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.85pt; text-align: justify; text-indent: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 53.85pt; text-align: justify; text-indent: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level2 lfo4; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pola-pola fungsi kesehatan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level1 lfo5; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pola persepsi dan tata laksana hidup sehat</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
Pada Px COR mengalami sedikit gangguan pada personal hygiene misalnya
mandi, gosok gigi, mencuci rambut dll.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level1 lfo5; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pola nutrisi dan metabolisme</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
Pada Px COR akan terjadi Pe dan fungsi pencernaan, bising<b> </b>usus
lemah, mual, muntah, kembung dan mengalami perubahan selera dan ganguan menelan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level1 lfo5; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pola eliminasi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
Pada cedera kepala sering terjadi gangguan serupa retensi urine,
inkonsinansia<b>, </b>ketidakmampuan menahan mikir dan terganggu proses
eliminasi Alvi.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level1 lfo5; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pola istirahat tidur</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
Kebiasaan pola tidur mengalami gangguan yang disebabkan oleh nyeri yang
dirasakan </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level1 lfo5; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pola aktifitas dan latihan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
Sebagian dari aktifitas dan latihan kx mengalami gangguan (lemah, lelah,
hilang keseimbangan)</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level1 lfo5; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->6.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pola persepsi dan konsep diri</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
Pada Px COR mengalami amnesia seputar kejadian, kehilangan kesadaran
sementara dan kita takut akan dikucilkan oleh keluarga dan teman-temannya.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level1 lfo5; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->7.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pola sensori dan kognitif</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
Adanya perubahan status mental, kehilangan kesadaran sementara vertigo.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level1 lfo5; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->8.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pola hubungan peran</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
Terjadinya hubungan peran yaitu kita merasa perhatian, tingkah laku, cara
berpikir mengalami perubahan.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level1 lfo5; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->9.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pola penaggulangan stress</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
Perlu ditanyakan hal-hal yang membuat px stress</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level1 lfo5; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->10.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Pola
reproduksi dan sexsual </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
Bila kita sudah mempunyai keluarga, anak, istri maka kita tidak akan
mengalami gangguan reproduksi sexsual begitu sebaliknya.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level1 lfo5; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->11.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Pola
tata nilai dan kepercayaan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
Ada ketahanan dan stress pertahanan, dan kita meminta pertolongan
mendekatkan diri pada tuhan.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
<br /></div>
<h5>
<!--[if !supportLists]-->B.<span style="font-size: 7pt; font-weight: normal;"> </span><!--[endif]-->Analisa
Data</h5>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.0pt;">
Data yang telah dikumpulkan kemudian di kelompokkan
dan dianalisa untuk menentukan masalah kesehatan kita. Untuk mengelompokkan
data di bagi menjadi 2 yaitu data subyektif dan data obyektif kemudian di
tentukan masalah keperawatan yang timbul berdasarkan prioritasnya.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.85pt; text-align: justify; text-indent: 36.0pt;">
<br /></div>
<h5>
<!--[if !supportLists]-->C.<span style="font-size: 7pt; font-weight: normal;"> </span><!--[endif]-->Diagnosa
Keperawatan</h5>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l9 level1 lfo6; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Nyeri pada kepala berhubungan dengan peningktan TIK</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l9 level1 lfo6; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Gangguan pemenuhan kebutuhan istirahat berhubungan
dengan nyeri yang dirasakan.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l9 level1 lfo6; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Potensial terjadinya pemenuhan nutrisi kurang dari
kebutuhan berhubungan dengan<b> </b> perubahan kemampuan untuk menerima makanan.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l9 level1 lfo6; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Potensial terjadinya peningkatan TIK<b> </b>adanya
proses desak akibat penumpukan cairan di dalam otak.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<br /></div>
<h5>
<!--[if !supportLists]-->D.<span style="font-size: 7pt; font-weight: normal;"> </span><!--[endif]-->Perencanaan</h5>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt;">
Diagnosa : nyeri pada kepala berhubungan
dengan peningkatan TIK<b><o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify;">
Tujuan <b> </b>: nyeri
dapat berkurang / hilang dalam waktu 1 x 24 jam</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify;">
KH<b> </b>:
nyeri kepala berkurang / hilang, px tenang, tidak gelisah, </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 99.0pt; text-align: justify; text-indent: 9.0pt;">
<b> </b>dapat
istirahat dengan tenang.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: 36.0pt;">
Intervensi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l7 level1 lfo7; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Kaji mengenai lokasi, intensitas, penyebaran, tingkat
kegawatan dan keluhan-keluhan Kx </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; text-align: justify;">
R/ <b> </b>Untuk memudahkan membuat
intervensi.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l7 level1 lfo7; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Ajarkan latihan tehnik relaksasi seperti latihan nafas
dalam dan relaksasi otot-otot </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify; text-indent: -18.0pt;">
R/ Dapat mengurangi ketegangan saraf sehingga px
merasa lebih rileks dan dapat mengurangi nyeri kepala.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l7 level1 lfo7; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Kurangi stimulus yang tidak menyenangkan dari luar dan
berikan tindakan yang menyenangkan px seperti pijat di daerah punggung, kaki
dan lain-lain</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify; text-indent: -18.0pt;">
R/ Responden<b> </b>yang tidak menyenangkan menambah
ketegangan saraf dan dapat mengalihkan rangsangan nyeri dan dapat mengurangi /
menghilangkan rasa nyeri.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 99.0pt; text-indent: -63.0pt;">
Diagnosa
: Potensial terjadinya TIK berhubungan
dengan adanya proses desak akibat cairan dalam otak</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Tujuan : Tekanan intrakranial kembali normal</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
KH : - Kesadaran baik, GCS 4,5,6</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
- Pupil tidak membesar, isokor</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
- TTV normal</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b> </b>Intervensi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l4 level1 lfo8; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Kaji status neurologist yang berhubungan dengan<b> </b>tanda-tanda
peningkatan TIK terutama GCS </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify; text-indent: -18.0pt;">
R/ Dapat di ketemukan secara dini adanya tanda-tanda
peningkatan TIK<b> </b>sehingga dapat menentukan arah tindakan selanjutnya.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l4 level1 lfo8; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Monitor TTV</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; text-align: justify;">
R/<b> </b>Dapat mendeteksi dini adanya tanda-tanda peningkatan TIk</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l4 level1 lfo8; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Monitor asupan dan pengeluaran setiap 8 jam sekali</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify; text-indent: -18.0pt;">
R/ Untuk mencegah kelebihan cairan yang dapat
menambah oedema<b> </b>sehingga terjadinya peningkatan TIK</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l4 level1 lfo8; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Kolaborasi dengan tim medis dalam pemberian obat-obatan
anti oedema seperti manitol, glisenol dan lasix.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify; text-indent: -18.0pt;">
R/ Obat-obatan tersebut berguna untuk menarik cairan
dari intro seluler ke ekstra seluler.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<h3 style="mso-list: l3 level3 lfo3; tab-stops: list 27.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->E.<span style="font-size: 7pt; font-weight: normal;">
</span><!--[endif]-->Implementasi</h3>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify;">
Implementasi merupakan perwujudan dari rencana keperawatan yang telah di
tentukan meliputi tindakan iindependent dan kolaborasi usaha tersebut dilakukan
untuk membantu kita dan menentukan kebutuhannya.</div>
<h4 style="mso-list: l3 level3 lfo3; tab-stops: list 27.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->F.<span style="font-size: 7pt; font-weight: normal;">
</span><!--[endif]-->Evaluasi</h4>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify;">
Evaluasi merupakan keberhasilan dari rencana keperawatan yang telah di
susun dalam memenuhi kebutuhan kita. Tahap evaluasi merupakan kunci<b> </b>keberhasilan
dalam menggunakan dan menentukan proses keperawatan (synopsis dasar-dasar Ke
Des Kes RI, 1969).</div>
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="page-break-before: always;" />
</span>
<div align="center" class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: center;">
<b>DAFTAR PUSTAKA<o:p></o:p></b></div>
<div align="center" class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: center;">
<br /></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo9; tab-stops: list 36.0pt; text-align: justify;">Diane (Boughman dan Joam C. Hockely, <i>Keperawatan
Medikal Bedah</i>. EGC, Jakarta. 1996).</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo9; tab-stops: list 36.0pt;">Doenges Marilyn E. <i>Rencana Asuhan Keperawatan</i>.
EGC. Jakarta. 2000.</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo9; tab-stops: list 36.0pt; text-align: justify;"><i>Pedoman Diagnosis dan Terapi</i>. Lab/UPF Ilmu
Bedah RSUD Dr. Soetomo. Surabaya. 1994.</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo9; tab-stops: list 36.0pt; text-align: justify;"><i>Pedoman Standar Asuhan Keperawatan</i>. Depkes
RI tahun 1994.</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo9; tab-stops: list 36.0pt; text-align: justify;">Mansjoer Arif dkk. <i>Kapita Selekta Kedokteran</i>.
Media Aesculapius. FKUI. 2000.</li>
</ol>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-19737364561038075942012-10-12T23:50:00.003-07:002012-10-12T23:50:30.551-07:00LAPORAN PENDAHULUAN CAMPAK<br />
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<span style="font-family: "Vineta BT"; font-size: 18.0pt; line-height: 150%;">LAPORAN
PENDAHULUAN<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<span style="font-family: "Vineta BT"; font-size: 18.0pt; line-height: 150%;">CAMPAK<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 9.35pt 18.7pt;">
<b>1. Pengertian <o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 65.45pt; text-indent: -47.45pt;">
<b><i>Campak</i></b><i> </i>adalah
penyakit akut yang ditandai dengan adanya ruam kulit yang khas.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 65.45pt; text-indent: -47.45pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 18.7pt;">
<b>2. Etiologi<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
Virus RNA,
paramikroviridae serus morbilivirus. </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
Dikenal hanya 1
tipe antigan saja yang strukturnya mirip dengan virus penyebab parotitis
epidemis dan parainfluenza. Virus tersebut ditemukan di dalam sekesi
nasofaring, darah dan air kemih, paling tidak selama periode prodormal dan
untuk waktu singkat setelah munculnya ruam kulit. Pada suhu ruangan , virus
tersebut dapat tetap aktiv selama 34 jam.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level1 lfo8; tab-stops: 18.7pt list 36.0pt; text-indent: -36.0pt;">
<!--[if !supportLists]--><b>3.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>Tanda
dan gejala<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<b><u>Dibagi
dalam 4 stadium</u></b> :</div>
<ol start="1" style="margin-top: 0cm;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt;"><b><i>Stadium Inkubasi<o:p></o:p></i></b></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt;">
Berlangsung
selama 10 – 12 hari yang disertai dengan gejala atau keluhan.</div>
<ol start="2" style="margin-top: 0cm;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt;"><b><i>Stadium Prodormal<o:p></o:p></i></b></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt;">
Disertai dengan
suatu eritema ( bercak koplik ) pada mukosa pipi dan faring. Demam ringan
hingga konjungtivitis ringan, batuk yang bertambah berat.</div>
<ol start="3" style="margin-top: 0cm;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt;"><b><i>Stadium Mukopurulen<o:p></o:p></i></b></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt;">
Ditandai dengan
ruam – ruam kulit berbentuk mukopurulen, muncul berurutan yang dimulai dari
leher, muka, badan , lengan hingga tungkai yang di iringi demam tinggi.</div>
<ol start="4" style="margin-top: 0cm;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt;"><b><i>Stadium Pemulihan <o:p></o:p></i></b></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt;">
Erupsi hilang
meninggalkan bekas yang lebih tua dan terjadi disquamasi.</div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 18.7pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level1 lfo8; tab-stops: 18.7pt list 36.0pt; text-indent: -36.0pt;">
<!--[if !supportLists]--><b>4.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>Epidemiologi<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
Biasanya
penyakit ini terjadi pada masa anak – anak yang kemudian menimbulkan kekebalan
seumur hidup.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level1 lfo8; tab-stops: list 18.7pt; text-indent: -36.0pt;">
<!--[if !supportLists]--><b>5.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>Diagnosa
Banding<o:p></o:p></b></div>
<ol start="1" style="margin-top: 0cm;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo2; tab-stops: list 36.0pt;"><b><i>German Measles<o:p></o:p></i></b></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt;">
Tidak ada bercak
koplik, ada pembesaran keenjar sub occipital, servikal bagian posterior,
belakang telinga.</div>
<ol start="2" style="margin-top: 0cm;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo2; tab-stops: list 36.0pt;"><b><i>Eksantema Subituma<o:p></o:p></i></b></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt;">
Ruam akan timbul
bila suhu tubuh meningkat.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level1 lfo8; tab-stops: list 18.7pt; text-indent: -36.0pt;">
<!--[if !supportLists]--><b>6.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>Komplikasi<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.0pt; mso-list: l8 level2 lfo8; tab-stops: list 37.4pt; text-indent: -52.3pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Otitis Media Akut</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.0pt; mso-list: l8 level2 lfo8; tab-stops: list 37.4pt; text-indent: -52.3pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Enchepalitis</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.0pt; mso-list: l8 level2 lfo8; tab-stops: list 37.4pt; text-indent: -52.3pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Bronkopnemonia</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.0pt; mso-list: l8 level2 lfo8; tab-stops: list 37.4pt; text-indent: -52.3pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Hemiplegia, afasia </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.0pt; mso-list: l8 level2 lfo8; tab-stops: list 37.4pt; text-indent: -52.3pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Paraplegi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.0pt; mso-list: l8 level2 lfo8; tab-stops: list 37.4pt; text-indent: -52.3pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Acuritis optica</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.7pt;">
Imuno supresive
measles enchelopati, didapatkan pada anak dengan morbili yang sedang menderita
defisiensi immunologik karena keganasan
atau pemakaian obat – obatan immunosupresi.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.7pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level1 lfo8; tab-stops: list 18.7pt; text-indent: -36.0pt;">
<!--[if !supportLists]--><b>7.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>Penatalaksanaan<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 19.85pt; mso-list: l1 level3 lfo10; tab-stops: 37.4pt list 150.25pt; text-indent: -1.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ä<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Pemberian vitamin A</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 19.85pt; mso-list: l1 level3 lfo10; tab-stops: 37.4pt list 150.25pt; text-indent: -1.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ä<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Istirahat tirah baring selama suhu tubuh
meningkat, pemberian antipiretik</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 19.85pt; mso-list: l1 level3 lfo10; text-indent: -1.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ä<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]-->Pemberian
antibiotik pada anak – anak yang berisiko tinggi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 19.85pt; mso-list: l1 level3 lfo10; text-indent: -1.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ä<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]-->Pemberian
obat batuk dan sedativum</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 19.85pt; mso-list: l1 level3 lfo10; text-indent: -1.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ä<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]-->Pencegahan
dan pengobatan untuk komplikasi yang timbul.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level1 lfo8; tab-stops: list 18.7pt; text-indent: -36.0pt;">
<!--[if !supportLists]--><b>8.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>Prognosa<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
Baik pada anak
dengan keadaan umum baik dan sebaliknya.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level1 lfo8; tab-stops: list 18.7pt; text-indent: -36.0pt;">
<!--[if !supportLists]--><b>9.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>Pencegahan
<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.0pt; mso-list: l8 level2 lfo8; tab-stops: list 37.4pt; text-indent: -52.3pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Imunisasi aktif</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt;">
Dengan pemberian
live attencated measles vaccine atau strain edmoster B. sekarang strain schwarf atau moraten.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.0pt; mso-list: l8 level2 lfo8; tab-stops: list 37.4pt; text-indent: -52.3pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Imunisasi pasif</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt;">
Dengan pemberian
gamma globin, tapi jarang digunakan di <st1:country -region="-region" w:st="on">Indonesia</st1:country>.</div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<st1:personname w:st="on"><st2:givenname w:st="on"><span style="font-family: "Vineta BT";">ASUHAN</span></st2:givenname><span style="font-family: "Vineta BT";"> <st2:sn w:st="on">KEPERAWATAN</st2:sn></span></st1:personname><span style="font-family: "Vineta BT";"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 0cm; mso-list: l4 level1 lfo3; tab-stops: list 18.7pt; text-indent: 0cm;">
<!--[if !supportLists]--><b>A.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>PENGKAJIAN
<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 19.4pt;">
<b><u>Data Fokus<o:p></o:p></u></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Usia 0 – 10 tahun.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Status Sosial Ekonomi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Keluarga : tingkat ekonomi rendah mempengaruhi
tingkat pengetahuan dan status kesehatan ( penularan campak dan higiene
makanan).</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Tempat tinggal klien : campak adalah endemis di
sebagian besar dunia.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Keluhan utama : sesuai stadium campak.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Riwayat kehamilan atau persalinan ibu : apakh
selama kehamilan, ibu pernah menderita penyakit yang sama.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Riwayat penyakit lalu : riwayat imunisasi ( 9 –
12 bln ).</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Riwayat penyakit keluarga : adakah anggota
keluarga lain yang menderita penyakit yang sama ?</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Sosial : hubungan klien dengan teman sebaya.
Adakah teman yang menderita campak ?</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->ADL</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Kebutuhan cairan / nutrisi.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Kebutuhan istirahat / tidur </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Personal higiene budaya tidak boleh dimandikan.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level2 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->☺<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Aktifitas / bermain.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 0cm; mso-list: l4 level1 lfo3; tab-stops: list 18.7pt; text-indent: 0cm;">
<!--[if !supportLists]--><b>B.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><st1:personname w:st="on"><st2:givenname w:st="on"><b>PEMERIKSAAN</b></st2:givenname><b> <st2:sn w:st="on">FISIK</st2:sn></b></st1:personname><b><o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level3 lfo3; tab-stops: list 37.4pt; text-indent: -18.7pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ä<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->K/u lemah</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level3 lfo3; tab-stops: list 37.4pt; text-indent: -18.7pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ä<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><st1:stockticker w:st="on">TTV</st1:stockticker>
: suhu meningkat.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level3 lfo3; tab-stops: list 37.4pt; text-indent: -18.7pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ä<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Ditemukan conjungtivitis, bercak koplik pada
curuncula lakrimalis, mukopurulen / perdarahan hidung/ mulut pada tipe
hemoragik.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l4 level3 lfo3; tab-stops: list 37.4pt; text-indent: -18.7pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ä<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Splenomegali ringan, limfadenopati mesentrika
sehingga nyeri abdomen.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 0cm; mso-list: l4 level1 lfo3; tab-stops: list 18.7pt; text-indent: 0cm;">
<!--[if !supportLists]--><b>C.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>PEMERIKSAAN
PENUNJANG<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.7pt;">
Selama stadium
prodormal dapat terlihat sel raksasa berinti banyak pada hapusan mukosa hidung.
pada biakan jaringan dapat diisolasi virus penyebab.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.7pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.7pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.7pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 0cm; mso-list: l4 level1 lfo3; tab-stops: list 18.7pt; text-indent: 0cm;">
<!--[if !supportLists]--><b>D.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><st1:personname w:st="on"><st2:givenname w:st="on"><b>DIAGNOSA</b></st2:givenname><b> <st2:sn w:st="on">KEPERAWATAN</st2:sn></b></st1:personname><b> YANG <st1:personname w:st="on"><st2:givenname w:st="on">MUNGKIN</st2:givenname> <st2:sn w:st="on">MUNCUL</st2:sn></st1:personname><o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.7pt;">
<b>1. Resiko defisit vulome cairan berhubungan
dengan peningkatan suhu tubuh</b> </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 71.0pt; mso-list: l8 level2 lfo8; tab-stops: 18.7pt list 56.1pt; text-indent: -33.6pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><i>K<b>riteria
standart <o:p></o:p></b></i></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 56.1pt; tab-stops: 18.7pt;">
Intake
out put cairan seimbang </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 56.1pt; tab-stops: 18.7pt;">
Keadaan
umum baik <b><i><o:p></o:p></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 56.1pt; mso-list: l8 level2 lfo8; tab-stops: 18.7pt list 46.75pt; text-indent: -18.7pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><b><i>Intervensi
:<o:p></o:p></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 74.8pt; mso-list: l6 level1 lfo4; tab-stops: list 27.35pt; text-indent: -18.7pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Catat
berkenih pertama dan selanjutnya.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 74.8pt; mso-list: l6 level1 lfo4; tab-stops: list 27.35pt; text-indent: -18.7pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Lakukan
pemberian makanan peroral, perhatikan jumlah yang ditelan, dimakan dan yang
dimuntahkan.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 74.8pt; mso-list: l6 level1 lfo4; tab-stops: list 27.35pt; text-indent: -18.7pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Pantau
masukan dan keluaran urine</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 74.8pt; mso-list: l6 level1 lfo4; tab-stops: list 27.35pt; text-indent: -18.7pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Kolaborasi
cairan parenteral.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.7pt;">
<b>2. Perubahan
nutrisi kurang dari kebutuhan<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 62.35pt; mso-list: l6 level2 lfo4; tab-stops: list 56.1pt; text-indent: -24.95pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><b><i>Kriteria
Standart :<o:p></o:p></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 56.1pt;">
Peningkatan asupan
cairan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 56.1pt;">
Keadaan umum
baik</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 62.35pt; mso-list: l6 level2 lfo4; tab-stops: list 56.1pt; text-indent: -24.95pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><b><i>Intervensi
:<o:p></o:p></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 0cm; mso-list: l11 level1 lfo5; tab-stops: list 39.0pt; text-indent: 56.1pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Timbangan
BB bayi, bandingkan BB saat ini dengan BB sebelum sakit.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 0cm; mso-list: l11 level1 lfo5; tab-stops: list 39.0pt; text-indent: 56.1pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Kaji
tingkat dehidrasi ( turgor kulit, membran mukosa, haluaran urin ).</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 0cm; mso-list: l11 level1 lfo5; tab-stops: list 39.0pt; text-indent: 56.1pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Perhatikan
frekwensi dan jumlah makan </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 0cm; mso-list: l11 level1 lfo5; tab-stops: list 39.0pt; text-indent: 56.1pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Auskultasi
bising usus</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 0cm; mso-list: l11 level1 lfo5; tab-stops: list 39.0pt; text-indent: 56.1pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Berikan
oral higiene</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 0cm; mso-list: l11 level1 lfo5; tab-stops: list 39.0pt; text-indent: 56.1pt;">
<!--[if !supportLists]-->f.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Kolaborasi
dengan tim gizi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.7pt;">
<b>3. Kerusakan
pertukaran gas berhubungan dengan perubahan membran alveoli<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 74.0pt; mso-list: l11 level2 lfo5; tab-stops: list 56.1pt; text-indent: -36.6pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><b><i>Kriteria
standart :<o:p></o:p></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 56.1pt;">
Ventilasi baik, O2
jaringan baik</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 56.1pt;">
GDA dalam batas
normal, tidak ada gejala distres pernafasan </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 74.0pt; mso-list: l11 level2 lfo5; tab-stops: list 56.1pt; text-indent: -36.6pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><b><i>Intervensi
:<o:p></o:p></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 65.45pt; mso-list: l3 level1 lfo6; tab-stops: list 39.0pt; text-indent: -9.35pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Kaji
kedalaman, frekwensi dan kemudian pernafasan </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 65.45pt; mso-list: l3 level1 lfo6; tab-stops: list 39.0pt; text-indent: -9.35pt;">
<!--[if !supportLists]-->b.<!--[endif]-->Observasi
warna kulit, membran mukosa, catat adanya cianosis perifer/sentral</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 65.45pt; mso-list: l3 level1 lfo6; tab-stops: list 39.0pt; text-indent: -9.35pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Kaji
status mental</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 65.45pt; mso-list: l3 level1 lfo6; tab-stops: list 39.0pt; text-indent: -9.35pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Awasi
suhu tubuh. Bantu tindajan kenyamanan untk menurunkan demam dan menggigil.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 65.45pt; mso-list: l3 level1 lfo6; tab-stops: list 39.0pt; text-indent: -9.35pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Kolaborasi
pemberian O2</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 0cm; mso-list: l3 level1 lfo6; tab-stops: list 39.0pt left 65.45pt; text-indent: 56.1pt;">
<!--[if !supportLists]-->f.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->GDA, Nadi
eksometri</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.7pt; tab-stops: 37.4pt;">
<b>4.
Hipertermia berhubungan dengan proses
infeksi<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 74.0pt; mso-list: l3 level2 lfo6; tab-stops: list 56.1pt; text-indent: -36.6pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><i>Kriteria standart</i> :</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 56.1pt;">
Suhu tubuh dalam
batas normal 36,5 – 37,4 C</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 56.1pt;">
Klien tidak
kedinginan </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 74.0pt; mso-list: l3 level2 lfo6; tab-stops: list 56.1pt; text-indent: -36.6pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-bidi-font-style: italic; mso-fareast-font-family: Wingdings;">Æ<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><i>Intervensi
:<o:p></o:p></i></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l7 level1 lfo7; tab-stops: list 39.0pt; text-indent: 18.7pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Pantau
suhu klien, apakah ada diaphoresis</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l7 level1 lfo7; tab-stops: list 39.0pt; text-indent: 18.7pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Pantau
suhu lingkungan dan batasi jumlah pengunjung</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l7 level1 lfo7; tab-stops: list 39.0pt; text-indent: 18.7pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Berikan
kompres hangat</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; mso-list: l7 level1 lfo7; tab-stops: list 39.0pt; text-indent: 18.7pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Perhatikan
jumlah intake dan output</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; text-indent: -18.7pt;">
<b>5. Jalan nafas tidai efektif
berhubungan dengan akumulasi sekret dan spasme jalan nafas<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 19.85pt; mso-list: l2 level3 lfo11; tab-stops: list 56.1pt; text-indent: 17.55pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ä<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><st1:personname w:st="on"><st2:givenname w:st="on"><b><i>Kriteria</i></b></st2:givenname><b><i>
<st2:sn w:st="on">Standart</st2:sn></i></b></st1:personname><b><i><o:p></o:p></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 108.0pt; mso-list: l10 level3 lfo12; tab-stops: list 74.8pt; text-indent: -51.9pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Jalan
nafas baik, suara nafas bersih</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 108.0pt; mso-list: l10 level3 lfo12; tab-stops: list 74.8pt; text-indent: -51.9pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Tidak
ada disnoe, tidak ada cyanosis</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 19.85pt; mso-list: l2 level3 lfo11; tab-stops: 56.1pt; text-indent: 17.55pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ä<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><b><i>Intervensi
:<o:p></o:p></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 74.8pt; mso-list: l2 level4 lfo11; tab-stops: 56.1pt list 74.8pt; text-indent: -18.7pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Kaji
frekwensi, kedalaman pernafasan dan gerakan dada</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 74.8pt; mso-list: l2 level4 lfo11; tab-stops: 56.1pt list 74.8pt; text-indent: -18.7pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Auskultasi
area paru, catat area penurunan / tidak ada aliran udara dan bunyi nafas,
adventisius, misalnya mengi, krakels</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 74.8pt; mso-list: l2 level4 lfo11; tab-stops: 56.1pt list 74.8pt; text-indent: -18.7pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Bimbing
dalam melakukan nafas dalam dan batuk efektif</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 74.8pt; mso-list: l2 level4 lfo11; tab-stops: 56.1pt list 74.8pt; text-indent: -18.7pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Penghisapan
lendir sesuai indikasi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 74.8pt; mso-list: l2 level4 lfo11; tab-stops: 56.1pt list 74.8pt; text-indent: -18.7pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Kolaborasi
dengan tim medis dalam pemberian analgesik, mukolitik, ekspektoran,
bronkodilator.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.7pt; tab-stops: 37.4pt;">
<b>6.
Resiko penyebaran infeksi berhubungan dengan
organisme virulen</b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; tab-stops: 37.4pt 56.1pt;">
<b><i>Kriteria
Standart<o:p></o:p></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; tab-stops: 37.4pt 56.1pt;">
Infeksi
silang tidak terjadi dibuktikan keluarga dan pasien lainnya tidak ada yang
tertular</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 37.4pt; tab-stops: 37.4pt 56.1pt;">
<b><i>Intervensi<o:p></o:p></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l5 level1 lfo9; tab-stops: list 36.0pt left 56.1pt; text-indent: 1.4pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Tempatkan
anak pada ruang khusus </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l5 level1 lfo9; tab-stops: list 36.0pt left 56.1pt; text-indent: 1.4pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Pertahankan
isolasi yang ketat di rumah sakit</div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l5 level1 lfo9; tab-stops: list 36.0pt left 56.1pt; text-indent: 1.4pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Gunakan
prosedur perlindungan infeksi jika melakukan kontak dengan anak</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l5 level1 lfo9; tab-stops: list 36.0pt left 56.1pt; text-indent: 1.4pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Mempertahankan
istirahat sselama periode prodormal </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l5 level1 lfo9; tab-stops: list 36.0pt left 56.1pt; text-indent: 1.4pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Berikan
antibiotik sesuai order</div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 56.1pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h1 align="center" style="line-height: 150%; text-align: center;">
DAFTAR PUSTAKA</h1>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 28.05pt; text-indent: -28.05pt;">
Greenburg, Cindy Smith, 1992. <i>Nursing Planning Guides for Children,</i>
William and Wiliam; Baltimor <st1:country -region="-region" w:st="on">USA</st1:country></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 28.05pt; text-indent: -28.05pt;">
Laboratorium Ilmu Kesehatan Anak, 1994. <i>Pedoman Diagnosis dan Terapi</i>
<i>RSUD dr. Soetomo</i>; <st1:city w:st="on">Surabaya</st1:city></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 28.05pt; text-indent: -28.05pt;">
Mansjoer A. dkk. 2000. <i>Kapita Selekta Kedokteran.</i> Media
Aesculapius: <st1:city w:st="on">Jakarta</st1:city></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 28.05pt; text-indent: -28.05pt;">
Whaley, Wong. 1995. <i>Nursing Care Of Infant and Children Ed. 5</i>
Mosby Year Book ; <st1:state w:st="on">Missouri</st1:state>
<st1:country -region="-region" w:st="on">USA</st1:country>
</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 28.05pt; text-indent: -28.05pt;">
Yuliani R & Suriadi. 2001. <i>Buku Pegangan Praktek Klinik Asuhan
Keperawatan Edisi I. </i>Sagung seto: <st1:city w:st="on">Jakarta</st1:city>.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21.0pt;">
</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21.0pt;">
<br /></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-24831352047275082902012-10-12T23:47:00.001-07:002012-10-12T23:47:21.894-07:00LAPORAN PENDAHULUAN ABLASIO RETINA <br />
<div class="Section1">
<div class="MsoTitle">
<span lang="IN">LAPORAN
PENDAHULUAN<o:p></o:p></span></div>
<div class="MsoTitle">
<span lang="IN">ABLASIO RETINA<o:p></o:p></span></div>
<div class="MsoTitle">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l9 level1 lfo1; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pengertian<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 31.5pt; text-indent: 31.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Ablasio
berasal dari bahasa Latin ablatio yang berarti pembuangan atau terlepasnya
salah satu bagian badan. Menurut Vera H. Darling dan Margaret R. Thorpe (1996)
menjelaskan bahwa ablasio retina lebih tepat disebut dengan separasi retina.
Disebutkan demikian karena terdapat robekan retina sehingga terjadi pengumpulan
cairan retina antara lapisan basilus (sel batang) dan komus (sel kerucut)
dengan sel-sel epitelium pigmen retina. Keadaan ini dapat terjadi karena
lapisan luar retina (sel epitel pigmen) dan lapisan dalam (pars optika)
terletak dalam aposisi tanpa membentuk perlekatan kecuali di sekitar diskus
optikus dan pada tepinya yang bergelombang yang dhsebut ora serata.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 31.5pt; text-indent: 31.5pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l9 level1 lfo1; tab-stops: list 21.85pt left 31.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Faktor-Faktor yang Mempengaruhi Timbulnya
Masalah <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 31.5pt; text-indent: 31.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Ada
beberapa faktor yang mempengaruhi timbulnya masalah, bila ditinjau dari
beberapa sudut pandang, antara lain :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l11 level1 lfo2; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Anatomi dan Fisiologi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 45.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Mata
adalah suatu organ komplek yang berkembang sangat fotosensitif yang
memungkinkan analisa dengan tepat bentuk, intensitas cahaya, dan warna yang
dipantulkan dari obyek (Loise Junquend, MD dan Jose Larneiro, 1997 :195).<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Indera
penglihatan terdiri atas 3 bagian, yaitu :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l3 level1 lfo3; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bola mata (bulbus okuli) dengan saraf
optik (nervus optikus)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l3 level1 lfo3; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Alat penunjang (adnexa)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l3 level1 lfo3; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Rongga orbita (cavum orbitae)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l1 level1 lfo4; tab-stops: list 43.65pt left 49.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">a)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bola mata, terdiri dari 3 lapisan :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l10 level1 lfo5; tab-stops: list 65.5pt left 90.0pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Sklera.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 31.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Merupakan
lapisan fibrous yang elastis yang merupakan bagian dinding luar bola mata dan
membentuk bagian putih mata. Bagian depan sklera tertutup oleh kantong
konjungtiva (Syaifuddin, 1997 :147).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l12 level1 lfo11; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Khoroid.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 31.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Suatu
membran berpigmen yang berada dibawah sklera yang membantu perpendaran cahaya.
Tepat dibawah kornea, khoroid berubah menjadi iris (Elizabeth J. Corwin, 2000
:201).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l12 level1 lfo11; tab-stops: 54.0pt list 65.5pt left 90.0pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Retina.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 31.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Retina
mencakup duapertiga bagian dalam dinding belakang bola mata. Retina merupakan
lembaran jaringan neural berlapis banyak yang melekat erat pada satu lapis sel
epitel berpigmen yang kemudian menempel pada membran Brunch. Bagian anterior
retina melekat erat pada epitel pigmen. Di bagian belakang, saraf optik melekatkan
retina ke dinding bola mata. Di lain tempat retina mudah dipisahkan dari epitel
pigmen. Pada orang dewasa, ora serata di bagian temporal bola mata letaknya
kurang lebih 6,5 mm dibelakang garis Schwalbe, sedangkan di bagian nasalnya
kurang lebih 5,7 mm di belakang garis yang sama. Di ora serata tebal retina 0,1
mm, sedangkan di polus posterior 0,23 mm. Yang paling tipis adalah fovea
sentral yaitu bagian tengah makula. Retina normal bersifat bening dan sebagian
cahaya di pantulkan di batas vitreoretina. Pada pemeriksaan oftalmoskopis
direk, permukaan fovea yang cekung menghasilkan bayangan lampu terbalik dan
nyata. Fovea sentral yang terletak kira-kira 3,5 mm di sebelah lateral papil
optik khusus untuk membedakan penglihatan yang halus. Di fovea, semua reseptor
adalah sel kerucut, lapisan nuklear luar tipis, lapisan parenkim lainnya
bergeser sentrifulgar, dan membran limitans dalam tipis. Hampir di seluruh
retina akson sel-sel reseptor melintas langsung ke bagian dalam lapisan
pleksiform luar berhubungan dengan dendrit sel-sel lapisan horisontal dan
sel-sel bipolar yang menuju keluar dari lapisan nuklear dalam, tetapi di makula
akson sel-sel reseptor miring arahnya dan dinamakan lapisan serabut Henle.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 31.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Akson
sel-sel bipolar berhubungan dengan sel amakrin dan sel ganglion di lapisan
pleksiform dalam yang teranyam dengan rapat. Akson panjang sel-sel ganglion
berjalan melalui lapisan serabut saraf menuju saraf optik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 31.5pt;">
<span lang="IN">Retina di pasok darah dari 2 sumber. Lapisan
koriokapiler adalah lapisan tunggal yang terdiri atas kapiler-kapiler dengan
rongga-rongga yang tersusun rapat dan melekat erat pada permukaan luar membran
Brunch. Koriokapiler memasok darah pada sepertiga bagian luar retina, termasuk
lapisan-lapisan pleksiform luar dan nuklear luar, fotoreseptor dan epitel
pigmen. Duapertiga bagian dalam retina menerima cabang-cabang arteri retina
sentral. Karena koriokapiler adalah satu-satunya pemasok darah ke fovea
sentral, sedangkan fovea sentral adalah bagian terpenting dari retina, maka
apabila retina di daerah ini terlepas dari dasarnya, maka akan terjadi
kerusakan fovea untuk selama-lamanya
(Daniel Vaughan dan Tailor Asbury, 1995 : 191).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l1 level1 lfo4; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">b)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Alat Penunjang (Adnexa)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l2 level1 lfo6; tab-stops: list 65.5pt left 90.0pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Kelopak mata (palpebra)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Merupakan
lipatan jaringan yang mudah digerakkan dan berfungsi melindungi mata. Merupakan
kulit tubuh tertipis, longgar dan lentur, sehingga mudah mengalami pembengkakan
hebat dan kemudian bisa normal kembali ke ukuran semula (Daniel Vaughan dan
Taylor Asbury, 1995 : 69).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l7 level1 lfo12; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Kelenjar air mata (Aparatus lakrimalis)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Aparatus
lakrimalis menghasilkan airmata yang terdiri atas : kelenjar lakrimalis, duktus
lakrimalis atas dan bawah, kantung lakrimalis, dan duktus nasolakrimalis (John
Gibson, MD, 1995 : 250). <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l7 level1 lfo12; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Otot-otot penggerak rongga mata
(Muskulus okuli)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 85.5pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Merupakan
otot ekstrinsik mata yang terdiri dari 7 buah otot, 6 buah otot diantaranya
melekat dengan os kavum orbitalis, 1 buah mengangkat kelopak mata ke atas.
Muskulus rektus okuli berorigo pada anulus tendineus komunis, yang merupakan
sarung fibrosus yang menyelubungi nervus optikus (Syaifuddin, 1997 : 146).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l5 level1 lfo13; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">c)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Rongga Orbita<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Secara skematik rongga orbita digambarkan sebagai piramid dengan 4 dinding
yang puncaknya di belakang. Dinding lateral dan dinding medial orbita membentuk
sudut 45 derajat, sehingga terbentuk sudut tegak lurus antara kedua dinding
lateral tersebut. Bentuk orbita seperti buah pear, dengan saraf optik sebagai
batangnya (Daniel Vaughan dan Taylor Asbury, 1995 : 265).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l11 level1 lfo2; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Patofisiologi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 31.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Longgarnya
perlekatan antara epitel pigmen dan retina menyebabkan keduanya bisa terlepas
satu terhadap yang lain, sehingga cairan bisa terkumpul diantaranya. Cairan
tersebut biasanya berasal dari bagian badan kaca yang cair yang dengan bebas
melewati lubang di retina menuju kedalam rongga yang terbentuk karena
terlepasnya epitel pigmen dari retina tersebut (Daniel Vaughan dan Taylor
Asbury, 1995 : 205).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 31.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Penyebab
ablasio retina pada orang muda yang matanya tampak sehat dan refraksi lensanya
normal adalah karena adanya kelemahan perlekatan bagi retina untuk melekat
dengan lapisan dibawahnya. Kelemahan yang biasanya tidak terdiagnosis letaknya di pinggiran bawah retina.
Kadang-kadang di tempat yang sama terdapat kista retina kecil. Jika pinggiran
retina terlepas dari perlekatannya maka akan terbentuk suatu lubang seperti
yang disebutkan diatas (Robert Youngson, 1985 : 120).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 31.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pada
ablasio retina, bagian luar retina yang sebelumnya mendapat nutrisi dari
pembuluh darah koriokapiler tidak lagi mendapat nutrisi yang baik dari koroid.
Akibatnya akan terjadi degenerasi dan atropi sel reseptor retina. Pada saat degenerasi
retina terjadi kompensasi sel epitel pigmen yang melakukan serbukan sel ke
daerah degenerasi. Akibat reaksi kompensasi akan terlihat sel epitel pigmen di
depan retina. Selain itu juga akan terjadi penghancuran sel kerucut dan sel
batang retina. Bila degenerasi berlangsung lama, maka sel pigmen akan
bermigrasi ke dalam cairan sub retina dan ke dalam sel reseptor kerucut dan
batang.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bila
pada retina terdapat ruptur besar maka badan kaca akan masuk ke dalam cairan
sub retina. Apabila terjadi kontak langsung antara badan kaca dan koroid maka
akan terjadi degenerasi koroid. Apabila terjadi degenerasi sel reseptor maka
keadaan ini akan berlanjut ke dalam jaringan yang lebih dalam, yang kemudian
jaringan ini diganti dengan jaringan glia.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Apabila
proses diatas belum terjadi dan ablasio retina ditemukan dini dan kemudian
kedudukan retina dikembalikan ke tempat asalnya, maka akan terjadi pengembalian
penglihatan yang sempurna (Dr Sidarta Illyas, 1984 : 108).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l11 level1 lfo2; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Penatalaksanaan (Terapi)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pengobatan
pada ablasio retina adalah dengan tindakan pembedahan atau operasi. Tujuan
operasi adalah untuk mengeluarkan cairan sub retina, menutup lubang atau
robekan dan untuk melekatkan kembali retina. Hal ini dikarenakan jarang terjadi
pertautan kembali secara spontan. Apabila diagnosis ablasio retina telah
ditegakkan maka pasien harus MRS dan dipersiapkan untuk menjalani operasi.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Opersi ablasio retina tersebut antara lain :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l6 level1 lfo7; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Elektrodiatermi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 36.55pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Dengan menggunakan jarum elektroda, melalaui sclera untuk memasukkan cairan
subretina dan mengeluarkan suatu bentuk eksudat dari pigmen epithelium yang
menempel pada retina.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l6 level1 lfo7; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Sclera Buckling<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 36.55pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Suatu bentuk tehnik dengan jalan sclera dipendekkan, lengkungan terjadi
dimana kekuatan pigmen epithelium lebih menutup retina, mengatasi pelepasan
retina dan menempatkan posisi semula, maka sebuah silikon kecil diletakkan pada
sclera dan diperkuat dengan membalut melingkar. Peralatan tersebut dapat
mempertahankan agar retina tetap berhubungan dengan koroid dan sclera eksudat
dari pigmen epithelium lebih menutup sclera.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l6 level1 lfo7; tab-stops: list 21.85pt 35.45pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Photocoagulasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 36.55pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Suatu sorotan cahaya dengan laser menyebabkan dilatasi pupil. Dilakukan
dengan mengarahkan sinar laser pada epithelium yang mengalami pigmentasi.
Epithelium menyerap sinar tersebut dan merubahnya dalam bentuk panas. Metode
ini digunakan untuk menutup lubang dan sobekan pada bagian posterior bola mata.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l6 level1 lfo7; tab-stops: list 21.85pt left 31.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">4)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Cyro Surgery<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 35.4pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Suatu
pemeriksaan super cooled yang dilakukan pada sclera, menyebabkan kerusakan
minimal seperti suatu jaringan parut, pigmen epithelium melekat pada retina.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l6 level1 lfo7; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">5)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Cerclage<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 36.55pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Operasi yang dikerjakan untuk mengurangi tarikan badan kaca. Pada keadaan
cairan retina yang cukup banyak dapat dilaksanakan phungsi lewat sclera.<o:p></o:p></span></div>
</div>
<span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<div class="Section2">
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l4 level1 lfo10; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Dampak Masalah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Gangguan
penglihatan merupakan masalah utama yang muncul pada pasien dengan ablasio
retina. Adanya gangguan ini secara langsung dapat menimbulkan berbagai masalah
pada pola hidup pasien sebagai makhluk ciptaan Tuhan yang holistik. Berbagai
masalah yang muncul, antara lain :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l0 level1 lfo8; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bagi Individu<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l13 level1 lfo9; tab-stops: 49.5pt list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola aktifitas dan pergerakan tubuh<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pasien
ablasio retina post operasi harus banyak beristirahat dan mengurangi aktifitas
yang dapat memperburuk kondisi kesehatannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l13 level1 lfo9; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola kognitif dan sensori<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 70.9pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Adanya
gangguan sensori persepsi visual dapat menimbulkan keluhan kesukaran untuk
membaca, melihat, dan lain sebagainya pada diri pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l13 level1 lfo9; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola penanggulangan stress <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 70.9pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Emosi
dan kondisi psikis pasien ablasio retina akan menjadi labil. Pada pasien akan
muncul rasa cemas dan kekhawatiran akan kehilangan penglihatannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 37.15pt; mso-list: l8 level1 lfo14; tab-stops: 49.5pt list 61.65pt; text-indent: 6.5pt;">
<!--[hf !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">4)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola persepsi diri<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 70.9pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Kecemasan
dapat timbul pada pasien ablasio retina, juga dapat muncul rasa khawatir dan
takut akibat penurunan tajam penglihatannya. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 37.15pt; mso-list: l8 level1 lfo14; tab-stops: list 61.65pt; text-indent: 6.5pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">5)<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola persepsi dan tata laksana hidup sehat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 70.9pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Dengan
keadaannya, maka pada pasien ablasio retina dapat timbul perubahan tentang
penatalaksanaan kesehatannya sehingga dapat menimbulkan masalah dalam merawat
diri sendiri.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 37.15pt; mso-list: l8 level1 lfo14; tab-stops: list 61.65pt; text-indent: 6.5pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">6)<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola hubungan inter personal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 70.9pt; text-indent: 41.05pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Dengan kondisi kesehatannya, maka dapat timbul isolasi sosial pada diri
pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 37.15pt; mso-list: l8 level1 lfo14; tab-stops: list 61.65pt; text-indent: 6.5pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">7)<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola tidur dan istirahat <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Dengan
kondisi psikis yang labil maka pasien dapat mengalami gangguan pola tidur dan
istirahat.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l0 level1 lfo8; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bagi keluarga<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 49.65pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Dengan sakitnya salah satu anggota keluarga, maka akan mempengaruhi kondisi
psikologis seluruh anggota keluarga.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 49.65pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Biaya pengobatan yang mahal, perilaku pasien yang sulit untuk bekerjasama,
kurangnya pengetahuan anggota keluarga yang lain dalam merawat pasien juga
merupakan masalah tersendiri bagi keluarga.<o:p></o:p></span></div>
</div>
<span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l5 level3 lfo13; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">B.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Asuhan Keperawatan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Suatu
sistem dalam merencanakan pelayanan asuhan keperawatan yang mempunyai empat
tahapan yang terdiri dari pengkajian, perencanaan, implementasi, dan evaluasi
(Lismidar,1990).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.85pt; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pengkajian<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.85pt; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;"></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Merupakan
tahap awal dari landasan proses keperawatan. Tahap pengkajian terdiri dari tiga
kegiatan yaitu, pengumpulan data, pengelompokan data, dan perumusan diagnosis
keperawatan (Lismidar, 1990).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l19 level1 lfo4; tab-stops: list 21.85pt left 49.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt; mso-bidi-font-weight: bold;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pengumpulan data<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l2 level1 lfo7; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Identitas pasien <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-indent: 31.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Meliputi nama, umur untuk mengetahui angka kejadian pada usia keberapa,
jenis kelamin untuk membandingkan angka kejadian antara laki-laki dan
perempuan, pekerjaan untuk mengetahui apakah penderita sering menggunakan
tenaga secara berlebihan atau tidak.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l2 level1 lfo7; tab-stops: list 43.65pt left 63.0pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Riwayat penyakit sekarang <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-indent: 31.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pada pengkajian ini yang perlu dikaji adanya keluhan pada penglihatan
seperti penglihatan kabur, melihat kilatan–kilatan kecil, adanya tirai hitam
yang menutupi area penglihatan, adanya penurunan tajam penglihatan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l2 level1 lfo7; tab-stops: list 43.65pt left 63.0pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Riwayat penyakit dahulu<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Adakah riwayat penyakit dahulu yang diderita pasien yang berhubungan dengan
timbulnya ablasio retina yaitu adanya miopi tinggi, retinopati, trauma pada
mata.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l2 level1 lfo7; tab-stops: list 43.65pt left 63.0pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">4)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Riwayat penyakit keluarga<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Adakah anggota keluarga lain yang mengalami penyakit seperti yang dialami
pasien dan miopi tinggi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l2 level1 lfo7; tab-stops: list 43.65pt left 63.0pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">5)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Riwayat psikososial dan spiritual<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bagaimana hubungan pasien dengan anggota keluarga yang lain dan lingkungan
sekitar sebelum maupun sesudah sakit. Apakah pasien mengalami kecemasan, rasa
takut, kegelisahan karena penyakit yang dideritanya dan bagaimana pasien
menggunakan koping mekanisme untuk menyelesaikan masalah yang dihadapinya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l2 level1 lfo7; tab-stops: list 43.65pt left 49.5pt 63.0pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">6)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola-pola fungsi kesehatan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 67.5pt; text-indent: 40.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Masalah
yang sering muncul pada pasien dengan post ablasio retina apabila tidak
terdapat komplikasi, adalah sebagai berikut :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l13 level1 lfo1; tab-stops: list 65.5pt left 81.0pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(a)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola persepsi dan tata laksana hidup<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 70.9pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bagaimana
persepsi pasien tentang hidup sehat, dan apakah dalam melaksanakan talaksana
hidup sehat penderita membutuhkan bantuan orang lain atau tidak.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l13 level1 lfo1; tab-stops: list 65.5pt left 81.0pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(b)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola tidur dan istirahat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Dikaji
berapa lama tidur, kebiasaan disaat tidur dan gangguan selama tidur sebelum
pelaksanaan operasi dan setelah palaksanaan operasi. Juga dikaji bagaimana pola
tidur dan istirahat selama masuk rumah sakit.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l13 level1 lfo1; tab-stops: list 65.5pt left 81.0pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(c)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola aktifitas dan latihan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Apa
saja kegiatan sehari-hari pasien sebelum masuk rumah sakit. Juga ditanyakan
aktifitas pasien selama di rumah sakit, sebelum dan setelah pelaksanaan
operasi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l13 level1 lfo1; tab-stops: list 65.5pt left 81.0pt 85.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(d)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola hubungan dan peran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bagaimana
hubungan pasien dengan lingkungan sekitarnya. Apakah peranan pasien dalam
keluarga dan masyarakat. Juga ditanyakan bagaimana hubungan pasien dengan
pasien lain dirumah sakit,sebelum dan setelah pelaksanaan operasi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l13 level1 lfo1; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(e)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola persepsi dan konsep diri<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bagaimana
body image, harga diri, ideal diri, dan identitas diri pasien. Apakah ada
perasaan negatif terhadap dirinya. Juga bagaimana pasien menyikapi kondisinya
setelah palaksanaan operasi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l13 level1 lfo1; tab-stops: list 65.5pt left 81.0pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(f)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola sensori dan kognitif<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bagaimana
daya penginderaan pasien. Bagaimana cara berpikir dan jalan pikiran pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l13 level1 lfo1; tab-stops: list 65.5pt left 81.0pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(g)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pola penanggulangan stress<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bagaimana
pasien memecahkan masalah yang dihadapi dan stressor yang paling sering muncul
pada pasien.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l2 level1 lfo7; tab-stops: list 43.65pt left 63.0pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">7)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pemeriksaan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l10 level1 lfo17; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">a)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Status kesehatan umum<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 67.5pt; text-indent: -3.7pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bagaimana
keadaan penyakit dan tanda-tanda vitalnya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l10 level1 lfo17; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">b)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pemeriksaan mata<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pemeriksaan pada mata dibagi
berdasarkan segmen-segmen, yaitu :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pemeriksaan segmen anterior :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l0 level2 lfo8; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Adanya pembengkakan pada palpebrae atau
tidak, biasanya pada klien post operasi ablasio retina, palpebraenya akan
bengkak.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l0 level2 lfo8; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Keadaan lensa, bila tidak ada konplikasi
lain, maka keadaan lensanya adalah jernih.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l0 level2 lfo8; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(4)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bagaimana keadaan pupilnya, pupil pada
klien ablasio retina yang telah masuk rumah sakit akan melebar sebagai akibat
dari pemberian atropin.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l0 level2 lfo8; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(5)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Kamera Okuli Anteriornya biasanya dalam.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l0 level2 lfo8; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(6)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Bagaimana keadaan konjungtivanya,
biasanya pasien post operasi akan mengalami hiperemi pada konjungtivanya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pemeriksaan segmen posterior<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l4 level2 lfo5; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Corpus vitreum ada kelainan atau tidak.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l4 level2 lfo5; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Ada atau tidak pupil syaraf optiknya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.8pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pemeriksaan diagnostik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l4 level3 lfo5; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Visus, untuk mengetahui tajam
penglihatan, adakah penurunan atau tidak dan untuk mengetahui sisa penglihatan
yang masih ada. Pengujian ini dengan menggunakan kartu snelen yang dibuat
sedemikian rupa sehingga huruf tertentu yang dibaca dengan pusat optik mata
membentuk sudut 50<sup>0</sup> untuk jarak tertentu. Pada ablasio retina
didapatkan penurunan tajam penglihatan. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 65.5pt; mso-list: l4 level3 lfo5; tab-stops: list 65.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Fundus kopi, untuk mengetahui bola mata
seperti warna retina, keadaan retina, reflek dan gambaran koroid.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l4 level4 lfo5; tab-stops: 18.0pt list 21.85pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Analisis data<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 36.15pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Setelah pengumpulan data dilakukan, kemudian data tersebut dikelompokkan
dan dianalisis. Data tersebut dikelompokkan menjadi dua jenis. Yang pertama
adalah data subyektif, yaitu data yang diungkapkan oleh pasien dan data
obyektif, yaitu data yang didasarkan pada pengamatan penulis. Data tersebut
dikelompokkan berdasarkan peranannya dalam menunjang suatu masalah, dimana
masalah tersebut berfokus kepada pasien dan respon yang tampak pada pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 36.15pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l4 level4 lfo5; tab-stops: list 21.85pt left 40.5pt; text-indent: -21.85pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Diagnosis keperawatan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Dari
hasil analisis data diatas, dapat dirumuskan menjadi diagnosis keperawatan
sebagai berikut :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l12 level1 lfo2; tab-stops: list 43.65pt 58.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Gangguan rasa nyaman (nyeri) sehubungan
dengan luka post operasi ablasio retina.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l12 level1 lfo2; tab-stops: list 43.65pt 58.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Potensial terjadi infeksi sehubungan
adanya luka operasi ablasio retina.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l12 level1 lfo2; tab-stops: list 43.65pt 58.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Gangguan aktifitas pemenuhan kebutuhan
diri sehubungan dengan bed rest total.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l12 level1 lfo2; tab-stops: 13.5pt list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">4)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Adanya kecemasan sehubungan dengan
ancaman kehilangan penglihatan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l12 level1 lfo2; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">5)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Gangguan konsep diri (harga diri rendah)
sehubungan dengan kerusakan penglihatan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l12 level1 lfo2; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">6)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Potensial terjadi kecelakaan sehubungan
dengan penurunan tajam penglihatan.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; tab-stops: list 13.5pt 21.85pt; text-indent: -21.85pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Perencanaan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-indent: 45.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Tahap
perencanaan meliputi prioritas diagnosis keperawatan, tujuan dilakukan asuhan
keperawatan, dan kriteria hasil yang diharapkan dari pasien serta merumuskan
rencana tindakan keperawatan yang akan terjadi.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Diagnosis Keperawatan Pertama<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 31.5pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Gangguan rasa nyaman (nyeri)
sehubungan dengan luka post operasi ablasio retina.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Tujuan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; text-indent: .65pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Rasa
nyeri pasien hilang atau berkurang sehingga dapat meningkatkan rasa kenyamanan
pasien.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Kriteria Hasil<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l11 level2 lfo9; tab-stops: list 43.65pt left 67.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Secara verbal pasien mengatakan rasa
nyaman terpenuhi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l11 level2 lfo9; tab-stops: list 43.65pt 58.5pt left 67.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Secara verbal pasien mengatakan rasa
nyeri hilang atau berkurang.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Rencana Tindakan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l11 level3 lfo9; tab-stops: list 43.65pt left 67.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Kolaborasi dengan individu untuk
menjelaskan metode apa yang digunakan untuk menurunkan intensitas nyeri
(relaksasi,distraksi)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l11 level3 lfo9; tab-stops: list 43.65pt left 67.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Kolaborasi dengan tim dokter untuk
memberikan analgesik pada penurunan rasa nyeri yang optimal.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l11 level3 lfo9; tab-stops: list 43.65pt left 67.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">(3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pantau tekanan darah setiap 4 jam.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Rasional<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l2 level2 lfo7; tab-stops: 35.45pt list 43.65pt 67.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)</span><!--[endif]--><span lang="IN" style="line-height: 150%;">Untuk mengetahui keinginan pasien akan jenis tehnik
penurun nyeri yang diinginkan pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l2 level2 lfo7; tab-stops: 35.45pt list 43.65pt 67.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)</span><!--[endif]--><span lang="IN" style="line-height: 150%;">Tim dokter dapat menentukan menentukan jenis analgesik
yang diperlukan pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l2 level2 lfo7; tab-stops: 35.45pt list 43.65pt 67.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(3)</span><!--[endif]--><span lang="IN" style="line-height: 150%;">Rasa nyeri dapat menaikkan tekanan darah pasien.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Diagnosis Keperawatan Kedua<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt;">
<span lang="IN" style="line-height: 150%;">Potensial terjadi
infeksi sehubungan dengan adanya luka operasi<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Tujuan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt;">
<span lang="IN" style="line-height: 150%;">Tidak terjadi infeksi
pada luka post operasi ablasio retina.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Kriteria Hasil<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l3 level2 lfo20; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Pasien mampu melaporkan
adanya tanda-tanda infeksi, seperti rasa nyeri, bengkak, panas.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l3 level2 lfo20; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;"> Tidak didapatkan adanya tanda-tanda infeksi.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Rencana Tindakan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l15 level2 lfo19; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Pantau adanya tanda-tanda
infeksi seperti, kemerahan, bengkak, nyeri, panas.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l15 level2 lfo19; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Kaji status nutrisi pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l15 level2 lfo19; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Instruksikan pada pasien
pada pasien dan keluarga pasien untuk
melakukan tindakan aseptik yang sesuai.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l15 level2 lfo19; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(4)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;"> Gunakan tehnik aseptik selama mengganti
balutan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l15 level2 lfo19; tab-stops: list 43.65pt left 58.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(5)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Kolaborasi dengan tim dokter
dalam pemberian antibiotik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l15 level2 lfo19; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(6)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Rawat luka setiap hari.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l15 level2 lfo19; tab-stops: list 43.65pt left 63.8pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(7)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Kaji lingkungan pasien yang
dapat menimbulkan infeksi.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Rasional<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l18 level2 lfo3; tab-stops: list 43.65pt 63.8pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Infeksi yang lebih dini
diketahui akan lebih mudah penanganannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l18 level2 lfo3; tab-stops: list 43.65pt 63.8pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Pemberian asupan kalori dan
protein yang sesuai dengan kebutuhan dapat menunjang proses penyembuhan pasien
.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l18 level2 lfo3; tab-stops: list 43.65pt 63.8pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Untuk mencegah kontaminasi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l18 level2 lfo3; tab-stops: list 43.65pt 63.8pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(4)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Tehnik aseptik dapat
mencegah terjadinya infeksi nosokomial.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l18 level2 lfo3; tab-stops: list 43.65pt 63.8pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(5)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Tim dokter dapat menentukan
jenis antibiotik yang sesuai dengan kondisi pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l18 level2 lfo3; tab-stops: list 43.65pt 63.8pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(6)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Rawat luka setiap hari dapat
mencegah masuknya kuman.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l18 level2 lfo3; tab-stops: list 43.65pt 63.8pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(7)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Kondisi lingkungan pasien
yang jelek dapat menimbulkan infeksi nosokomial.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Diagnosis Keperawatan Ketiga<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 31.5pt;">
<span lang="IN" style="line-height: 150%;">Gangguan aktifitas
pemenuhan kebutuhan diri sehubungan dengan bed rest total.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Tujuan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; tab-stops: 18.0pt; text-indent: 13.5pt;">
<span lang="IN" style="line-height: 150%;">Pasien dapat memenuhi kebutuhan dirinya sesuai dengan
kondisinya.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Kriteria Hasil<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 49.5pt;">
<span lang="IN" style="line-height: 150%;">Secara verbal, pasien
mengatakan dapat memenuhi kebutuhan diri yang sesuai dengan kondisinya.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Rencana Tindakan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l9 level2 lfo6; tab-stops: list 43.65pt 67.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Latih pasien untuk dapat
melakukan latihan yang sesuai dengan kondisinya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l9 level2 lfo6; tab-stops: list 43.65pt 67.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Orientasikan lingkungan
sekitar kepada pasien.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Rasional<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l5 level1 lfo15; tab-stops: list 43.65pt left 58.5pt list 70.9pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Dengan latihan yang baik,
pasien akan mampu memaksimalkan kemampuannya untuk memenuhi kebutuhannya yang
sesuai dengan kondisinya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l5 level1 lfo15; tab-stops: list 43.65pt left 58.5pt list 70.9pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Pengenalan pada lingkungan
akan membantu pasien dalam memenuhi kebutuhan dirinya.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Diagnosis Keperawatan
Keempat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 22.5pt;">
<span lang="IN" style="line-height: 150%;">Adanya kecemasan
sehubungan dengan ancaman kehilangan penglihatan.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Tujuan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="IN" style="line-height: 150%;">Cemas berkurang atau
hilang.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Kriteria Hasil<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l14 level1 lfo18; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Pasien mampu menggunakan
koping yang efektif.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l14 level1 lfo18; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Pasien tidak tampak murung.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l14 level1 lfo18; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Pasien dapat tidur dengan
tenang.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Rencana Tindakan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l7 level1 lfo16; tab-stops: list 43.65pt left 54.0pt list 2.0cm; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Monitor tingkat kecemasan
pasien melalui observasi respon fisiologis.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l7 level1 lfo16; tab-stops: list 43.65pt left 54.0pt list 2.0cm; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Beri informasi yang jelas
sesuai dengan tingkat pengetahuan pasien tentang penyakit yang dideritanya.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Rasional<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l8 level2 lfo14; tab-stops: list 43.65pt left 54.0pt list 67.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Dengan monitor tingkat
kecemasan dapat diketahui berapa besar stressor yang dihadapi pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l8 level2 lfo14; tab-stops: list 43.65pt left 54.0pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Pemberian informasi dapat
mengurangi kecemasan pasien.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Diagnosis Keperawatan Kelima<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt;">
<span lang="IN" style="line-height: 150%;">Gangguan citra diri
sehubungan dengan kerusakan penglihatan.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Tujuan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="IN" style="line-height: 150%;">Pasien dapat mencapai
kembali citra diri yang optimal.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Kriteria Hasil<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l16 level1 lfo21; tab-stops: list 43.65pt left 58.5pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Pasien mampu mengekspresikan
tentang perubahan dan perkembangan kearah penerimaan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l16 level1 lfo21; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Pasien mampu menunjukkan
rerspon yang adaptif terhadap perubahan citra diri. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Rencana Tindakan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l17 level3 lfo10; tab-stops: list 43.65pt 54.0pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Sediakan waktu bagi pasien
untuk mengungkapkan perasaannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l17 level3 lfo10; tab-stops: list 43.65pt 54.0pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Tingkatkan hubungan dan
dorongan dari orang terdekat.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l17 level3 lfo10; tab-stops: list 43.65pt 54.0pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Bantu pasien dalam diskusi
dan penerimaan perubahan ketajaman penglihatan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l17 level3 lfo10; tab-stops: list 43.65pt 54.0pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(4)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Dorong kemandirian yang
ditoleransi.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Rasional<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l17 level1 lfo10; tab-stops: list 43.65pt left 54.0pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Hal ini dapat menumbuhkan
perasaan pada pasien bahwa masih ada orang yang menaruh perhatian pada pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l17 level1 lfo10; tab-stops: list 43.65pt left 54.0pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Orang terdekat mampu
mengangkat kepercaayaan diri pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l17 level1 lfo10; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">4)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Dari diskusi yang dilakukan
diharapkan pasien dapat mengungkapkan perasaannya dan dapat mencari jalan
keluar dari masalah yang dihadapi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l17 level1 lfo10; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">5)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Untuk menumbuhkan
kepercayaan diri pasien.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Diagnosis Keperawatan
Keenam<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt;">
<span lang="IN" style="line-height: 150%;">Potensial terjadi
kecelakaan sehubungan dengan penurunan tajam penglihatan.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Tujuan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<span lang="IN" style="line-height: 150%;">Tidak terjadi
kecelakaan atau cedera pada pasien. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Kriteria Hasil<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l6 level1 lfo11; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Tidak terjadi perlukaan pada
pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l6 level1 lfo11; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Pasien dapat mengetahui
faktor yang dapat menyebabkan perlukaan.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Rencana Tindakan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l1 level1 lfo12; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Periksa adanya perlukaan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l1 level1 lfo12; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Orientasikan pada pasien
lingkungan sekitarnya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l1 level1 lfo12; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Hindari ketegangan pada
pasien.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN" style="line-height: 150%;">Rasional<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l20 level1 lfo13; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(1)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Dengan mengkaji perlukaan
dapat mencegah terjadinya perlukaan yang lebih parah.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l20 level1 lfo13; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(2)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Diharapakan pasien dapat
dapat mengenal lingkungannya sehingga akan mengurangi resiko terjadinya
kecelakaan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 43.65pt; mso-list: l20 level1 lfo13; tab-stops: list 43.65pt; text-indent: -21.8pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%;">(3)<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%;">Ketegangan dapat menyebabkan
kecelakaan.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; tab-stops: list 21.85pt; text-indent: -21.85pt;">
<span lang="IN" style="line-height: 150%;">Pelaksanaan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%;">Tahap perencaan ini merupakan tindakan keperawatan yang nyata kepada pasien
yang merupakan perwujudan dari segala tindakan yang telah direncanakan pada
tahap perencanaan.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; tab-stops: 21.3pt; text-indent: -21.85pt;">
<span lang="IN" style="line-height: 150%;">Evaluasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; tab-stops: 54.0pt; text-indent: 36.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Evaluasi merupakan tahap akhir dari suatu proses keperawatan yang merupakan
tindakan yang kontinu dan melibatkan seluruh tenaga kesehatan yang terlibat
dalam penanganan pasien, termasuk pasien itu sendiri. Pada tahap ini akan kita
ketahui sejauh mana keberhasilan asuhan keperawatan yang kita laksanakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-indent: -18.0pt;">
<span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Sedangkan hasil yang kita harapkan adalah :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 40.5pt; mso-list: l20 level3 lfo13; tab-stops: list 40.5pt left 54.0pt; text-indent: -22.5pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Rasa nyeri pasien berkurang atau hilang
sehingga meningkatkan rasa nyaman.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 40.5pt; mso-list: l20 level3 lfo13; tab-stops: list 40.5pt left 54.0pt; text-indent: -22.5pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Tidak terjadi infeksi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 40.5pt; mso-list: l20 level3 lfo13; tab-stops: list 40.5pt left 54.0pt; text-indent: -22.5pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pasien dapat memenuhi kebutuhan dirinya
sesuai dengan kondisinya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 40.5pt; mso-list: l20 level3 lfo13; tab-stops: list 40.5pt left 54.0pt; text-indent: -22.5pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">d.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Rasa cemas pasien hilang atau berkurang.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 40.5pt; mso-list: l20 level3 lfo13; tab-stops: list 40.5pt left 54.0pt; text-indent: -22.5pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">e.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Pasien dapat mencapai harga diri yang
optimal.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 40.5pt; mso-list: l20 level3 lfo13; tab-stops: list 40.5pt left 54.0pt; text-indent: -22.5pt;">
<!--[if !supportLists]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">f.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="IN" style="line-height: 150%; mso-ansi-language: IN; mso-bidi-font-size: 10.0pt;">Tidak terjadi pencederaan diri.<o:p></o:p></span></div>
<br />
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-33275476548626865902012-10-10T19:26:00.002-07:002012-10-10T19:26:09.314-07:00DIARE<br />
<div class="MsoTitle" style="line-height: 150%;">
DIARE</div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b><span style="font-family: "Benguiat Bk BT","serif"; font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Pengertian<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%;">
Yaitu buang air besar dengan bentuk
lembek/cair bahkan dapat berupa air saja, frekuensi lebih sering dari biasanya
(biasanya lebih dari 3 kali dalam sehari)</div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h2>
Penyebab</h2>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Infeksi oleh karena penyebaran kuman yang
menyebabkan diare.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Kuman ini biasanya menyebar melalui makanan atau
minuman yang tercemar tinja dan atau kontak langsung dengan tinja penderita</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Gangguan penyerapan makanan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Alergi makanan dan keracunan makanan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Daya tahan tubuh menurun</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Keadaan ini biasanya berlangsung sementara
setelah infeksi virus misal : campak dan mungkin berlangsung lama seperti
penderita AIDS</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Faktor lingkungan dan perilaku</div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h3>
Macam-Macam Diare</h3>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b>Diare Akut</b>, jika kurang dari 1 minggu</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b>Diare Persisten</b>, jika diare 14 hari atau
lebih</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b>Diare</b> dengan tinja bercampur darah (Disentri)</div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h3>
Akibat bila diare berlanjut</h3>
<div class="MsoNormal" style="line-height: 150%;">
Apabila diare terus berlanjut maka
akibatnya adalah <b><u>kekurangan cairan atau dehidrasi<o:p></o:p></u></b></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h3>
Tanda-Tanda Dehidrasi</h3>
<div class="MsoNormal" style="line-height: 150%; margin-left: 13.5pt; mso-list: l4 level1 lfo1; text-indent: -13.5pt;">
<!--[if !supportLists]--><b>1.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>Dehidrasi
Berat<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 31.5pt; mso-list: l4 level2 lfo1; tab-stops: list 36.0pt; text-indent: -13.5pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->tidak sadar (letargis)</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 31.5pt; mso-list: l4 level2 lfo1; tab-stops: list 36.0pt; text-indent: -13.5pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->mata cekung</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 31.5pt; mso-list: l4 level2 lfo1; tab-stops: list 36.0pt; text-indent: -13.5pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->malas minum atau tidak bisa minum</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 31.5pt; mso-list: l4 level2 lfo1; tab-stops: list 36.0pt; text-indent: -13.5pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->cubitan kulit perut kembalinya sangat lama</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level1 lfo1; tab-stops: list 13.5pt; text-indent: -13.5pt;">
<!--[if !supportLists]--><b>2.</b><!--[endif]--><b> Dehidrasi Ringan/ Sedang<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level2 lfo1; text-indent: -54.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Gelisah, rewel atau mudah marah</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level2 lfo1; text-indent: -54.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Mata cekung</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level2 lfo1; text-indent: -54.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Haus, minum dengan lahap</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level2 lfo1; text-indent: -54.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Cubitan kulit perut kembalinya lambat</div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h3>
Penanganan Dehidrasi</h3>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l1 level1 lfo2; tab-stops: list 18.0pt; text-indent: -36.0pt;">
<!--[if !supportLists]--><b>1.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></b><!--[endif]--><b>Dehidrasi Ringan<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l1 level2 lfo2; tab-stops: list 45.0pt; text-indent: -49.5pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Beri cairan tambahan sebanyak anak mau</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level2 lfo1; tab-stops: list 58.5pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->ASI tetap diberikan pada anak yang masih menyusu</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level2 lfo1; tab-stops: list 58.5pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->ORALIT/ Larutan gula garam</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level2 lfo1; tab-stops: list 58.5pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Cairan makanan, air tajin, kuah sayur atau air
matang</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 40.5pt; mso-list: l1 level2 lfo2; tab-stops: list 45.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Lanjutkan pemberian makan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 40.5pt; mso-list: l1 level2 lfo2; tab-stops: list 45.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pergi ke Pusat Pelayanan Kesehatan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l1 level1 lfo2; tab-stops: list 22.5pt; text-indent: -36.0pt;">
<!--[if !supportLists]--><b>2.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></b><!--[endif]--><b>Dehidrasi Sedang/Ringan<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l1 level2 lfo2; tab-stops: list 45.0pt; text-indent: -49.5pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Memberikan cairan tambahan seperti penangan dehidrasi
ringan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l1 level2 lfo2; tab-stops: list 45.0pt; text-indent: -49.5pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Pemberian ORALIT secara intensif selama periode 3 jam</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l1 level2 lfo2; tab-stops: list 45.0pt; text-indent: -49.5pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Ulangi penilaian dan klasifikasikan derjat dehidrasinya</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l1 level1 lfo2; tab-stops: list 22.5pt; text-indent: -36.0pt;">
<!--[if !supportLists]--><b>3.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></b><!--[endif]--><b>Dehidrasi Berat<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
Rujuk segera ke
Pusat Pelayanan Kesehatan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l1 level1 lfo2; tab-stops: list 22.5pt; text-indent: -36.0pt;">
<!--[if !supportLists]--><b>4.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></b><!--[endif]--><b>Diare Persisten dan Disentri<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level2 lfo1; text-indent: -49.5pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Lakukan penggantian cairan bila terjadi
dehidrasi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level2 lfo1; text-indent: -49.5pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Pemakaian antibiotik sesuai anjuran dokter</div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h3>
Cara Mencegah Diare</h3>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Meningkatkan pemberian ASI</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Memperbaiki pemberian makanan pendamping ASI</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Menggunakan air bersih yang cukup</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Mencuci tangan dengan sabun</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Menggunakan jamban yang benar</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Membuang tinja bayi dan anak-anak yang tepat</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Imunisasi Campak</div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b>Hal-Hal </b><b><span style="font-family: "BernhardFashion BT"; font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">PENTING
</span>yang harus dilakukan bila Terjadi
Diare<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level3 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Mencegah
terjadinya dehidrasi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level2 lfo1; tab-stops: list 40.5pt; text-indent: -49.5pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Berikan cairan lewat minum sebanyak-banyaknya</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level4 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Mengobati
dehidrasi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level4 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Tetap
memberikan makanan</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l4 level4 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt; line-height: normal;"> </span><!--[endif]-->Mengobati
masalah lain yang menyertai dehidrasi</div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h4>
Cara Membuat Larutan Gula Garam</h4>
<div class="MsoNormal" style="line-height: 150%; margin-left: 13.5pt; mso-list: l4 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Sediakan air matang 200 cc ( 1 gelas)</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 13.5pt; mso-list: l4 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Tambahkan gula pasir 1 sendok makan dan garam 1
sendok teh</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 13.5pt; mso-list: l4 level2 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Aduk sampai larut</div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<h5>
<b>Cara Pembuatan dan Pemberian ORALIT<o:p></o:p></b></h5>
<div class="MsoNormal" style="line-height: 150%; margin-left: 13.5pt; mso-list: l0 level1 lfo5; tab-stops: list 13.5pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Sediakan air matang 1 gelas (200 cc) dsan
campurkan 1 bungkus ORALIT untuk ukuran air 200 cc kemudian aduk sampai larut</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 13.5pt; mso-list: l0 level1 lfo5; tab-stops: list 13.5pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Berikan 1 sendok the tiap 1-2 menit untuk anak
di bawah umur 2 tahun</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 13.5pt; mso-list: l0 level1 lfo5; tab-stops: list 13.5pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Berikan beberapa teguk dari gelas untuk anak
yang lebih tua</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 13.5pt; mso-list: l0 level1 lfo5; tab-stops: list 13.5pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Bila anak muntah tuunggulah 10 menit kemudian
berikan cairan lebih lama</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: -4.5pt; text-indent: 18.0pt;">
( misalnya 1 sendok selama 2-3
menit)</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 13.5pt; mso-list: l0 level1 lfo5; tab-stops: list 13.5pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Bila diare berlanjut setelat ORALIT habis
berikan cairan lain seperti dijelaskan atau ker petugas kesehatan untuk
mendapatkan ORALIT</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 13.5pt; mso-list: l0 level1 lfo5; tab-stops: list 13.5pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]-->Berikan ORALIT tiap habis BAB dengan jumlah
sebagai berikut:</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 13.5pt; tab-stops: list 13.5pt; text-indent: -18.0pt;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 18.9pt; 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;">
<tbody>
<tr style="height: 69.6pt;">
<td style="background: #D9D9D9; border: solid windowtext 1.0pt; height: 69.6pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 81.0pt;" width="108">
<h1 style="line-height: 150%;">
UMUR</h1>
</td>
<td style="background: #D9D9D9; border-left: none; border: solid windowtext 1.0pt; height: 69.6pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 206.3pt;" width="275">
<h1 style="line-height: 150%;">
<o:p> </o:p></h1>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b>Jumlah
ORALIT yang diberikan tiap BAB<o:p></o:p></b></div>
</td>
</tr>
<tr>
<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: 81.0pt;" valign="top" width="108">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<
1 tahun</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: 206.3pt;" valign="top" width="275">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
50-100
ml</div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
</td>
</tr>
<tr>
<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: 81.0pt;" valign="top" width="108">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
1-4
tahun</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: 206.3pt;" valign="top" width="275">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
100-200
ml</div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
</td>
</tr>
<tr>
<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: 81.0pt;" valign="top" width="108">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
>
5 tahun</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: 206.3pt;" valign="top" width="275">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
200-300
ml</div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
</td>
</tr>
<tr>
<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: 81.0pt;" valign="top" width="108">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
Dewasa</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: 206.3pt;" valign="top" width="275">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
300-400
ml</div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-89624279165749064452012-10-09T19:18:00.001-07:002012-10-09T19:18:52.322-07:00Askep Teori Tentang Kejang Demam<br />
<h3>
KEJANG DEMAM</h3>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]--><b>A.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>PENGERTIAN<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 19.6pt; text-align: justify; text-indent: 16.4pt;">
Kejang merupakan perubahan fungsi otak mendadak dan
sementara sebagai akibat dari aktivitas neuronal yang abnormal dan pelepasan
listrik serebral yang berlebihan.(betz & Sowden,2002)</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 19.6pt; text-align: justify; text-indent: 16.4pt;">
Kejang demam ialah bangkitan kejang yang terjadi pada
kenaikan suhu tubuh ( suhu rektal diatas 38<sup>0</sup> C) yang disebabkan oleh
proses ekstrakranium.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 19.6pt; text-align: justify; text-indent: 16.4pt;">
Jadi kejang demam adalah kenaikan suhu tubuh yang
menyebabkan perubahan fungsi otak akibat perubahan potensial listrik serebral
yang berlebihan sehingga mengakibatkan renjatan berupa kejang.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 19.6pt; text-align: justify; text-indent: 16.4pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]--><b>B.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>ETIOLOGI<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: 17.0pt;">
Infeksi ekstrakranial , misalnya OMA dan infeksi respiratorius bagian
atas</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: 17.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]--><b>C.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>PATOFISIOLOGI<o:p></o:p></b></div>
<div class="MsoBodyTextIndent" style="text-indent: 18.5pt;">
Peningkatan suhu tubuh
dapat mengubah keseimbangan dari membran sel neuron dan dalam waktu singkat
terjadi difusi ion kalium dan natrium melalui membran tersebut dengan akibat
teerjadinya lepas muatan listrik. Lepas muatan listrik ini demikian besarnya
sehingga dapat meluas keseluruh sel maupun membran sel sekitarnya dengan
bantuan bahan yang disebut neurotransmiter dan terjadi kejang. Kejang demam
yang terjadi singkat pada umumnya tidak berbahaya dan tidak meninggalkan gejala
sisa. Tetapi kejang yang berlangsung lama ( lebih dari 15 menit ) biasanya
disertai apnea, meningkatnya kebutuhan oksigen dan energi untuk kontraksi otot
skelet yang akhirnya terjadi hipoksemia, hiperkapnia, asidosis laktat yang
disebabkan oleh metabolisme anaerobik, hipotensi arterial disertai denyut
jantung yang tidak teratur dan suhu tubuh makin meningkat yang disebabkan oleh
makin meningkatnya aktivitas otot, dan selanjutnya menyebabkan metabolisme otak
meningkat. Faktor terpenting adalah gangguan peredaran darah yang mengakibatkan
hipoksia sehingga meningkatkan permeabilitas kapiler dan timbul edema otak yang
mngakibatkan kerusakan sel neuron otak. Kerusakan pada daerah medial lobus
temporalis setelah mendapat serangan kejang yang berlangsung lama dapat menjadi
matang dikemudian hari sehingga terjadi serangan epilepsi spontan, karena itu
kejang demam yang berlangsung lama dapat menyebabkan kelainan anatomis diotak
hingga terjadi epilepsi.</div>
<div class="MsoNormal">
</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.0pt; mso-list: l3 level1 lfo1; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]--><b>A.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>MANIFESTASI KLINIK<o:p></o:p></b></div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Kejang parsial ( fokal, lokal )</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l3 level3 lfo1; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Kejang parsial sederhana :</div>
<div class="MsoBodyTextIndent" style="margin-left: 53.9pt; text-indent: -2.1pt;">
Kesadaran
tidak terganggu, dapat mencakup satu atau lebih hal berikut ini :</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Tanda – tanda motoris, kedutan pada wajah, atau
salah satu sisi tubuh; umumnya gerakan setipa kejang sama.</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Tanda atau gejala otonomik: muntah, berkeringat,
muka merah, dilatasi pupil.</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Gejala somatosensoris atau sensoris khusus :
mendengar musik, merasa seakan ajtuh dari udara, parestesia.</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Gejala psikis : dejavu, rasa takut, visi
panoramik.</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l3 level3 lfo1; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Kejang parsial kompleks</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Terdapat gangguankesadaran, walaupun pada
awalnya sebagai kejang parsial simpleks</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Dapat mencakup otomatisme atau gerakan otomatik
: mengecap – ngecapkan bibir,mengunyah, gerakan menongkel yang berulang – ulang
pada tangan dan gerakan tangan lainnya.</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Dapat tanpa otomatisme : tatapan terpaku</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Kejang umum ( konvulsi atau non konvulsi )</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l3 level3 lfo1; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Kejang absens</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Gangguan kewaspadaan dan responsivitas</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Ditandai dengan tatapan terpaku yang umumnya
berlangsung kurang dari 15 detik</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Awitan dan akhiran cepat, setelah itu kempali
waspada dan konsentrasi penuh</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l3 level3 lfo1; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Kejang mioklonik</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kedutan – kedutan involunter pada otot atau sekelompok
otot yang terjadi secara mendadak.</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Sering terlihat pada orang sehat selaam tidur
tetapi bila patologik berupa kedutan keduatn sinkron dari bahu, leher, lengan
atas dan kaki.</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Umumnya berlangsung kurang dari 5 detik dan
terjadi dalam kelompok</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kehilangan kesadaran hanya sesaat.</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l3 level3 lfo1; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Kejang tonik klonik</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Diawali dengan kehilangan kesadaran dan saat
tonik, kaku umum pada otot ekstremitas, batang tubuh dan wajah yang berlangsung
kurang dari 1 menit</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Dapat disertai hilangnya kontrol usus dan
kandung kemih</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Saat tonik diikuti klonik pada ekstrenitas atas
dan bawah.</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Letargi, konvulsi, dan tidur dalam fase
postictal</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l3 level3 lfo1; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Kejang atonik</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Hilngnya tonus secara mendadak sehingga dapat
menyebabkan kelopak mata turun, kepala menunduk,atau jatuh ke tanah.</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l3 level4 lfo1; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Singkat dan terjadi tanpa peringatan.</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.0pt; mso-list: l3 level1 lfo1; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]--><b>B.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>KOMPLIKASI<o:p></o:p></b></div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Aspirasi</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Asfiksia</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Retardasi mental</div>
<div class="MsoBodyTextIndent" style="margin-left: 17.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.0pt; mso-list: l3 level1 lfo1; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]--><b>C.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>UJI LABORATORIUM DAN DIAGNOSTIK<o:p></o:p></b></div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Elektroensefalogram ( EEG ) : dipakai unutk membantu
menetapkan jenis dan fokus dari kejang.</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]--><st1:street w:st="on">Pemindaian
CT</st1:street> : menggunakan kajian sinar X yang lebih
sensitif dri biasanya untuk mendeteksi perbedaan kerapatan jaringan.</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Magneti resonance imaging ( MRI ) : menghasilkan
bayangan dengan menggunakan lapanganmagnetik dan gelombang radio, berguna untuk
memperlihatkan daerah – daerah otak yang itdak jelas terliht bila menggunakan
pemindaian CT</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Pemindaian positron emission tomography ( PET ) : untuk
mengevaluasi kejang yang membandel dan membantu menetapkan lokasi lesi,
perubahan metabolik atau alirann darah dalam otak</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;">
</span><!--[endif]-->Uji laboratorium</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l6 level4 lfo2; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Pungsi lumbal : menganalisis cairan serebrovaskuler</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l6 level4 lfo2; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Hitung darah lengkap : mengevaluasi trombosit
dan hematokrit</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l6 level4 lfo2; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Panel elektrolit</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l6 level4 lfo2; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Skrining toksik dari serum dan urin</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l6 level4 lfo2; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->GDA</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l6 level4 lfo2; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kadar kalsium darah</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l6 level4 lfo2; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kadar natrium darah</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l6 level4 lfo2; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kadar magnesium darah</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.0pt; mso-list: l3 level1 lfo1; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]--><b>D.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>PENATALAKSANAAN MEDIS<o:p></o:p></b></div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Memberantas kejang Secepat mungkin</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.3pt; text-indent: -.7pt;">
Diberikan
antikonvulsan secara intravena jika klien masih dalam keadaan kejang, ditunggu
selama 15 menit, bila masih terdapat kejang diulangi suntikan kedua dengan
dosis yang sama juga secara intravena. Setelah 15 menit suntikan ke 2 masih
kejang diberikan suntikan ke 3 dengan dosis yang sama tetapi melalui
intramuskuler, diharapkan kejang akan berhenti. Bila belum juga berhenti dapat
diberikan fenobarbital atau paraldehid 4 % secara intravena.</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Pengobatan penunjang</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt;">
Sebelum memberantas
kejang tidak boleh Dilupakan perlunya pengobatan penunjang</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l2 level1 lfo3; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Semua pakaian ketat dibuka</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l2 level1 lfo3; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Posisi kepala sebaiknya miring untuk mencegah
aspirasi isi lambung</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l2 level1 lfo3; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Usahakan agar jalan nafas bebas untuk menjamin
kebutuhan oksigen, bila perlu dilakukan intubasi atau trakeostomi.</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l2 level1 lfo3; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Penhisapan lendir harus dilakukan secara tertur
dan diberikan oksigen.</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Pengobatan rumat </div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l5 level1 lfo4; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Profilaksis intermiten</div>
<div class="MsoBodyTextIndent" style="margin-left: 53.9pt;">
Untuk mencegah kejang
berulang, diberikan obat campuran anti konvulsan dan antipietika. Profilaksis
ini diberikan sampai kemungkinan sangat
kecil anak mendapat kejang demam sederhana yaitu kira - kira sampai anak umur 4
tahun.</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l5 level1 lfo4; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Profilaksis jangka panjang</div>
<div class="MsoBodyTextIndent" style="margin-left: 15.05pt; text-indent: 36.0pt;">
Diberikan
pada keadaan </div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l5 level2 lfo4; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Y<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Epilepsi yang diprovokasi oleh demam</div>
<div class="MsoBodyTextIndent" style="margin-left: 73.7pt; mso-list: l5 level2 lfo4; tab-stops: list 73.7pt; text-indent: -22.65pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Y<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kejang demam yang mempunyai ciri :</div>
<div class="MsoBodyTextIndent" style="margin-left: 90.7pt; mso-list: l5 level3 lfo4; tab-stops: list 91.7pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Terdapat gangguan perkembangan saraf seperti serebral
palsi, retardasi perkembangan dan mikrosefali</div>
<div class="MsoBodyTextIndent" style="margin-left: 90.7pt; mso-list: l5 level3 lfo4; tab-stops: list 91.7pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Bila kejang berlangsung lebih dari 15 menit, berdifat
fokal atau diikiuti kelainan saraf yang sementara atau menetap</div>
<div class="MsoBodyTextIndent" style="margin-left: 90.7pt; mso-list: l5 level3 lfo4; tab-stops: list 91.7pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Riwayat kejang tanpa demam yang bersifat genetik</div>
<div class="MsoBodyTextIndent" style="margin-left: 90.7pt; mso-list: l5 level3 lfo4; tab-stops: list 91.7pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Kejang demam pada bayi berumur dibawah usia 1 bulan</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l3 level2 lfo1; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Mencari dan mengobati penyebab</div>
<div class="MsoBodyTextIndent" style="margin-left: 17.0pt;">
<br /></div>
<div align="center" class="MsoBodyTextIndent" style="margin-left: 0cm; text-align: center;">
<b>ASUHAN KEPERAWATAN PADA ANAK DENGAN KEJANG
DEMAM<o:p></o:p></b></div>
<div class="MsoBodyTextIndent" style="margin-left: 17.0pt; mso-list: l7 level1 lfo5; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->A.<span style="font-size: 7pt;">
</span><!--[endif]-->Pengkajian</div>
<div class="MsoBodyTextIndent" style="margin-left: 0cm; text-indent: 17.0pt;">
Pengkajian
neurologik :</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l4 level1 lfo6; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Tanda – tanda vital</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Suhu</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Pernapasan</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Denyut jantung</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Tekanan darah</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Tekanan nadi</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l4 level1 lfo6; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Hasil pemeriksaan kepala</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Fontanel : menonjol, rata, cekung</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Lingkar kepala : dibawah 2 tahun</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Bentuk Umum</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l4 level1 lfo6; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Reaksi pupil</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Ukuran</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Reaksi terhadap cahaya</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kesamaan respon</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l4 level1 lfo6; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Tingkat kesadaran</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kewaspadaan : respon terhadap panggilan</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Iritabilitas</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Letargi dan rasa mengantuk</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Orientasi terhadap diri sendiri dan orang lain</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l4 level1 lfo6; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;">
</span><!--[endif]-->Afek</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Alam perasaan</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Labilitas</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l4 level1 lfo6; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->6.<span style="font-size: 7pt;">
</span><!--[endif]-->Aktivitas kejang</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Jenis</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Lamanya</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l4 level1 lfo6; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->7.<span style="font-size: 7pt;">
</span><!--[endif]-->Fungsi sensoris</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Reaksi terhadap nyeri</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Reaksi terhadap suhu</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l4 level1 lfo6; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->8.<span style="font-size: 7pt;">
</span><!--[endif]-->Refleks</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Refleks tendo superfisial</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Reflek patologi</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l4 level1 lfo6; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->9.<span style="font-size: 7pt;">
</span><!--[endif]-->Kemampuan intelektual</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kemampuan menulis dan menggambar</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l4 level2 lfo6; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kemampuan membaca</div>
<div class="MsoBodyTextIndent">
<br /></div>
<div class="MsoBodyTextIndent">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 17.0pt; mso-list: l7 level1 lfo5; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]--><b>B.<span style="font-size: 7pt; font-weight: normal;"> </span></b><!--[endif]--><b>Diagnosa keperawatan<o:p></o:p></b></div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l4 level3 lfo6; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Resiko tinggi cidera</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l4 level3 lfo6; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Gangguan citra tubuh</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l4 level3 lfo6; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Resiko tinggi koping keluarga dan koping individu tidak
efektif</div>
<div class="MsoBodyTextIndent" style="margin-left: 17.0pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 17.0pt; mso-list: l7 level1 lfo5; tab-stops: list 18.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]--><b>C.<span style="font-size: 7pt; font-weight: normal;"> </span></b><!--[endif]--><b>Intervensi keperawatan<o:p></o:p></b></div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l8 level1 lfo7; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Kejang</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l0 level2 lfo8; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Lindungi anak dari cidera</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l0 level2 lfo8; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Jangan mencoba untuk merestrain anak</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l0 level2 lfo8; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Jika anak berdiri atau duduk sehingga terdapat
kemungkinan jatuh, turunkan anak tersebut agar tidak jatuh</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l0 level2 lfo8; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Jangan memasukan benda apapun kedalam mulut anak</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l0 level2 lfo8; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Longgarkan pakaiannya jika ketat</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l0 level2 lfo8; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Cegah anak agar tidak trpukul benda tajam,
lapisi setiap benda yang mungkin terbentur dengan anak dan singkirkan semua
benda tajam dari daerah tersebut</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l0 level2 lfo8; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Miringkan badan anak untuk mem fasilitasi
bersihan jalan nafas dari sekret</div>
<div class="MsoBodyTextIndent" style="margin-left: 34.0pt; mso-list: l8 level1 lfo7; tab-stops: list 35.0pt; text-indent: -17.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Lakukan observasi secara teliti dan catat aktiitas
kejang untuk membantu diagnosis atau pengkajian respon pengobatan</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l1 level1 lfo9; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Waktu awitan dan kejadian pemicu</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l1 level1 lfo9; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Aura</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l1 level1 lfo9; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Jenis kejang</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l1 level1 lfo9; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Lamanya kejang</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l1 level1 lfo9; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Intervensi selama kejang</div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt; mso-list: l1 level1 lfo9; tab-stops: list 52.0pt; text-indent: -17.05pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Tanda tanda vital</div>
<div class="MsoBodyTextIndent">
<br /></div>
<div class="MsoBodyTextIndent">
<br /></div>
<div class="MsoBodyTextIndent">
<br /></div>
<div class="MsoBodyTextIndent">
<br /></div>
<div class="MsoBodyTextIndent">
<br /></div>
<div align="center" class="MsoBodyTextIndent" style="text-align: center;">
<b>DAFTAR
PUSTAKA<o:p></o:p></b></div>
<div align="center" class="MsoBodyTextIndent" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.0pt; mso-list: l1 level2 lfo9; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Betz Cecily L, Sowden Linda A. (2002). <i>Buku Saku Keperawatan Pediatri</i>. <st1:city w:st="on">Jakarta</st1:city> : EGC.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.0pt; mso-list: l1 level2 lfo9; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Sacharin Rosa M. (1996). <i>Prinsip Keperawatan Pediatrik</i>. Alih bahasa : Maulanny R.F. Jakarta
: EGC.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.0pt; mso-list: l1 level2 lfo9; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->Arjatmo T.(2001). <i>Keadaan Gawat Yang Mengancam Jiwa</i>.
<st1:city w:st="on">Jakarta</st1:city> : <st1:city w:st="on">gaya</st1:city> baru</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 17.0pt; mso-list: l1 level2 lfo9; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.0pt;">
<!--[if !supportLists]--><i>4.<span style="font-size: 7pt; font-style: normal; line-height: normal;"> </span></i><!--[endif]--><b>Kejang Pada Anak</b>. www.
Pediatrik.com/knal.php<i><o:p></o:p></i></div>
<div class="MsoBodyTextIndent">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 0cm;">
<br /></div>
<div class="MsoBodyTextIndent">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div align="center" class="MsoBodyTextIndent" style="margin-left: 0cm; text-align: center;">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<br />
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-40140906063976100152012-10-08T20:39:00.002-07:002012-10-08T20:39:41.075-07:00Askep Teori Pada Fraktur Femur<br />
<div class="MsoTitle">
ASUHAN KEPERAWATAN FRAKTUR FEMUR</div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<h1>
<!--[if !supportLists]-->I.<span style="font-size: 7pt; font-weight: normal;">
</span><!--[endif]-->DEFENISI </h1>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 1.0cm;">
Rusaknya kontinuitas tulang
pangkal paha yang dapat disebabkan oleh trauma langsung, kelelahan otot,
kondisi-kondisi tertentu seperti degenerasi tulang / osteoporosis.</div>
<div class="MsoNormal">
<br /></div>
<h1 style="margin-left: 21.3pt; tab-stops: 21.85pt;">
<!--[if !supportLists]-->II.<span style="font-size: 7pt; font-weight: normal;">
</span><!--[endif]-->FISIOLOGI / ANATOMI</h1>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 1.0cm;">
Persendian panggul merupakan bola
dan mangkok sendi dengan acetabulum bagian dari femur, terdiri dari : kepala,
leher, bagian terbesar dan kecil, trokhanter dan batang, bagian terjauh dari
femur berakhir pada kedua kondilas. Kepala femur masuk acetabulum. Sendi
panggul dikelilingi oleh kapsula fibrosa, ligamen dan otot. Suplai darah ke
kepala femoral merupakan hal yang penting pada faktur hip. Suplai darah ke
femur bervariasi menurut usia. Sumber utamanya arteri retikuler posterior,
nutrisi dari pembuluh darah dari batang femur meluas menuju daerah tronkhanter
dan bagian bawah dari leher femur.</div>
<div class="MsoNormal">
<br /></div>
<h1>
<!--[if !supportLists]-->III.<span style="font-size: 7pt; font-weight: normal;"> </span><!--[endif]-->KLASIFIKASI</h1>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 1.0cm;">
Ada 2 type dari fraktur femur,
yaitu :</div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l1 level1 lfo1; text-indent: 0cm;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Fraktur Intrakapsuler femur yang terjadi di dalam
tulang sendi, panggul</div>
<div class="MsoNormal" style="margin-left: 1.0cm;">
dan Melalui kepala femur (capital fraktur)</div>
<div class="MsoNormal" style="margin-left: 49.65pt; mso-list: l0 level1 lfo2; text-indent: 0cm;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Hanya di bawah kepala femur</div>
<div class="MsoNormal" style="margin-left: 49.65pt; mso-list: l0 level1 lfo2; text-indent: 0cm;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Melalui leher dari femur</div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l1 level1 lfo1; text-indent: 0cm;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Fraktur Ekstrakapsuler; </div>
<div class="MsoNormal" style="margin-left: 42.9pt; mso-list: l0 level1 lfo2; text-indent: 0cm;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Terjadi di luar sendi dan kapsul, melalui
trokhanter femur yang lebih</div>
<div class="MsoNormal" style="margin-left: 42.9pt;">
besar/yang lebih kecil /pada daerah
intertrokhanter.</div>
<div class="MsoNormal" style="margin-left: 42.9pt; mso-list: l0 level1 lfo2; text-indent: 0cm;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Terjadi di bagian distal menuju leher femur
tetapi tidak lebih dari 2</div>
<div class="MsoNormal" style="margin-left: 42.9pt;">
inci di
bawah trokhanter kecil. </div>
<div class="MsoNormal" style="margin-left: 42.9pt;">
<br /></div>
<h1>
<!--[if !supportLists]-->IV.<span style="font-size: 7pt; font-weight: normal;"> </span><!--[endif]-->PATOFISIOLOGI</h1>
<div class="MsoNormal">
<br /></div>
<h2 style="margin-left: 1.0cm;">
<!--[if !supportLists]--><i><span style="font-weight: normal; mso-bidi-font-weight: bold;">A.<span style="font-size: 7pt; font-style: normal;">
</span></span></i><!--[endif]--><i><span style="font-weight: normal; mso-bidi-font-weight: bold;">Penyebab fraktur adalah
trauma<o:p></o:p></span></i></h2>
<div class="MsoNormal" style="margin-left: 1.0cm;">
Fraktur patologis; fraktur yang
diakibatkan oleh trauma minimal atau tanpa trauma berupa </div>
<div class="MsoNormal" style="margin-left: 1.0cm;">
yang disebabkan oleh suatu
proses., yaitu :</div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l0 level1 lfo2; text-indent: 0cm;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Osteoporosis Imperfekta</div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l0 level1 lfo2; text-indent: 0cm;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Osteoporosis</div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l0 level1 lfo2; text-indent: 0cm;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Penyakit metabolik</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoTitle">
TRAUMA</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Dibagi menjadi dua, yaitu :</div>
<ul style="margin-top: 0cm;" type="disc">
<li class="MsoNormal">Trauma
langsung, yaitu benturan pada tulang. Biasanya penderita terjatuh dengan
posisi miring dimana daerah trokhanter mayor langsung terbentur dengan
benda keras (jalanan).</li>
<li class="MsoNormal">Trauma
tak langsung, yaitu titik tumpuan benturan dan fraktur berjauhan, misalnya
jatuh terpeleset di kamar mandi pada orangtua.</li>
</ul>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>TANDA DAN GEJALA<o:p></o:p></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Nyeri hebat di tempat fraktur </div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Tak mampu menggerakkan ekstremitas bawah </div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Rotasi luar dari kaki lebih pendek</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Diikuti tanda gejala fraktur secara umum,
seperti : fungsi berubah, bengkak, kripitasi, sepsis pada fraktur terbuka,
deformitas.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>PENATALAKSANAAN MEDIK<o:p></o:p></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->X.Ray</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Bone scans, Tomogram, atau MRI Scans</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Arteriogram : dilakukan bila ada kerusakan
vaskuler.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->CCT kalau banyak kerusakan otot.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoTitle">
TRAKSI</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Penyembuhan fraktur bertujuan mengembalikan fungsi tulang
yang patah dalam jangka waktu sesingkat mungkin </div>
<div class="MsoNormal">
Metode Pemasangan traksi:</div>
<div class="MsoNormal">
<i>Traksi Manual<o:p></o:p></i></div>
<div class="MsoNormal">
Tujuan : Perbaikan dislokasi, Mengurangi fraktur, Pada
keadaan Emergency.</div>
<div class="MsoNormal">
Dilakukan dengan menarik bagian tubuh.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>Traksi Mekanik <o:p></o:p></b></div>
<div class="MsoNormal">
Ada dua macam, yaitu : </div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal"><b><i>Traksi
Kulit<o:p></o:p></i></b></li>
</ol>
<div class="MsoNormal" style="margin-left: 35.75pt;">
Dipasang pada dasar sistem
skeletal untuk struktur yang lain, misalnya: otot. Traksi kulit terbatas </div>
<div class="MsoNormal" style="margin-left: 35.75pt;">
untuk 4 minggu dan beban < 5
kg.</div>
<div class="MsoNormal" style="margin-left: 35.75pt;">
Untuk anak-anak waktu beban
tersebut mencukupi untuk dipakai sebagai fraksi definitif, bila tidak
diteruskan dengan pemasangan gips.</div>
<div class="MsoNormal" style="margin-left: 35.75pt;">
<br /></div>
<ol start="2" style="margin-top: 0cm;" type="1">
<li class="MsoNormal"><b><i>Traksi
Skeletal<o:p></o:p></i></b></li>
</ol>
<div class="MsoNormal" style="margin-left: 35.45pt;">
Merupakan traksi definitif pada
orang dewasa yang merupakan balanced traction. Dilakukan untuk menyempurnakan
luka operasi dengan kawat metal atau penjepit melalui tulang/jaringan metal.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>KEGUNAAN PEMASANGAN
TRAKSI<o:p></o:p></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 1.65pt;">
Traksi yang dipasang pada leher,
di tungkai, lengan atau panggul, kegunaannya :</div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l0 level1 lfo2; text-indent: 7.1pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Mengurangi nyeri akibat spasme otot</div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l0 level1 lfo2; text-indent: 7.1pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Memperbaiki dan mencegah deformitas</div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l0 level1 lfo2; text-indent: 7.1pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Immobilisasi</div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l0 level1 lfo2; text-indent: 7.1pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Difraksi penyakit (dengan penekanan untuk nyeri tulang sendi).</div>
<div class="MsoNormal" style="margin-left: 1.0cm; mso-list: l0 level1 lfo2; text-indent: 7.1pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Mengencangkan pada perlekatannya.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>MACAM - MACAM TRAKSI<o:p></o:p></b></div>
<div class="MsoNormal">
<br /></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal"><b><i>Traksi
Panggul<o:p></o:p></i></b></li>
</ol>
<div class="MsoNormal" style="margin-left: 35.45pt;">
Disempurnakan dengan pemasangan
sebuah ikat pinggang di atas untuk mengikat puncak iliaka.</div>
<div class="MsoNormal" style="margin-left: 35.45pt;">
<br /></div>
<ol start="2" style="margin-top: 0cm;" type="1">
<li class="MsoNormal"><b><i>Traksi
Ekstension (Buck’s Extention)<o:p></o:p></i></b></li>
</ol>
<div class="MsoNormal" style="margin-left: 35.45pt;">
Lebih sederhana dari traksi
kulit dengan menekan lurus satu kaki ke dua kaki. Digunakan untuk immibilisasi
tungkai lengan untuk waktu yang singkat atau untuk mengurangi spasme otot.</div>
<div class="MsoNormal" style="margin-left: 35.45pt;">
<br /></div>
<ol start="3" style="margin-top: 0cm;" type="1">
<li class="MsoNormal"><b><i>Traksi
Cervikal <o:p></o:p></i></b></li>
</ol>
<div class="MsoNormal" style="margin-left: 35.45pt;">
Digunakan untuk menahan kepala
extensi pada keseleo, kejang dan spasme. Traksi ini biasa dipasang dengan
halter kepala.</div>
<div class="MsoNormal" style="margin-left: 35.45pt;">
<br /></div>
<ol start="4" style="margin-top: 0cm;" type="1">
<li class="MsoNormal"><b><i>Traksi
Russell’s<o:p></o:p></i></b></li>
</ol>
<div class="MsoNormal" style="margin-left: 35.45pt;">
Traksi ini digunakan untuk
frakstur batang femur. Kadang-kadang juga digunakan untuk terapi nyeri punggung
bagian bawah. Traksi kulit untuk skeletal yang biasa digunakan.</div>
<div class="MsoNormal" style="margin-left: 35.45pt;">
Traksi ini dibuat sebuah bagian
depan dan atas untuk menekan kaki dengan pemasangan vertikal pada lutut secara
horisontal pada tibia atau fibula.</div>
<div class="MsoNormal" style="margin-left: 35.45pt;">
<br /></div>
<ol start="5" style="margin-top: 0cm;" type="1">
<li class="MsoNormal"><b><i>Traksi
khusus untuk anak-anak<o:p></o:p></i></b></li>
</ol>
<div class="MsoNormal" style="margin-left: 35.45pt;">
Penderita tidur terlentang 1-2
jam, di bawah tuberositas tibia dibor
dengan steinman pen, dipasang staples pada steiman pen. Paha ditopang dengan
thomas splint, sedang tungkai bawah ditopang
atau Pearson attachment. Tarikan dipertahankan sampai 2 minggu atau
lebih, sampai tulangnya membentuk callus yang cukup. Sementara itu otot-otot
paha dapat dilatih secara aktif. </div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>PENGKAJIAN<o:p></o:p></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo3; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;"> </span><!--[endif]-->Riwayat
keperawatan</div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l11 level1 lfo4; tab-stops: list 18.0pt left 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Riwayat Perjalanan penyakit</div>
<div class="MsoNormal" style="margin-left: 54.85pt; mso-list: l7 level1 lfo10; tab-stops: list 54.85pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Keluhan utama klien datang ke RS atau pelayanan
kesehatan</div>
<div class="MsoNormal" style="margin-left: 54.85pt; mso-list: l7 level1 lfo10; tab-stops: list 54.85pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Apa penyebabnya, kapan terjadinya kecelakaan
atau trauma</div>
<div class="MsoNormal" style="margin-left: 54.85pt; mso-list: l7 level1 lfo10; tab-stops: list 54.85pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Bagaimana dirasakan, adanya nyeri, panas, bengkak
dll</div>
<div class="MsoNormal" style="margin-left: 54.85pt; mso-list: l7 level1 lfo10; tab-stops: list 54.85pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Perubahan bentuk, terbatasnya gerakan</div>
<div class="MsoNormal" style="margin-left: 54.85pt; mso-list: l7 level1 lfo10; tab-stops: list 54.85pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kehilangan fungsi</div>
<div class="MsoNormal" style="margin-left: 54.85pt; mso-list: l7 level1 lfo10; tab-stops: list 54.85pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Apakah klien mempunyai riwayat penyakit
osteoporosis</div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l11 level1 lfo4; tab-stops: list 18.0pt left 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Riwayat pengobatan sebelumnya</div>
<div class="MsoNormal" style="margin-left: 54.85pt; mso-list: l3 level1 lfo11; tab-stops: list 54.85pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Apakan klien pernah mendapatkan pengobatan jenis
kortikosteroid dalam jangka waktu lama</div>
<div class="MsoNormal" style="margin-left: 54.85pt; mso-list: l3 level1 lfo11; tab-stops: list 54.85pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Apakah klien pernah menggunakan obat-obat
hormonal, terutama pada wanita</div>
<div class="MsoNormal" style="margin-left: 54.85pt; mso-list: l3 level1 lfo11; tab-stops: list 54.85pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Berapa lama klien mendapatkan pengobatan
tersebut</div>
<div class="MsoNormal" style="margin-left: 54.85pt; mso-list: l3 level1 lfo11; tab-stops: list 54.85pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kapan klien mendapatkan pengobatan terakhir</div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l11 level1 lfo4; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;"> </span><!--[endif]-->Proses
pertolongan pertama yang dilakukan</div>
<div class="MsoNormal" style="margin-left: 54.85pt; mso-list: l10 level1 lfo12; tab-stops: list 54.85pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Pemasangan bidai sebelum memindahkan dan
pertahankan gerakan diatas/di bawah tulang yang fraktur sebelum dipindahkan</div>
<div class="MsoNormal" style="margin-left: 54.85pt; mso-list: l10 level1 lfo12; tab-stops: list 54.85pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Tinggikan ekstremitas untuk mengurangi edema</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo3; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;"> </span><!--[endif]-->Pemeriksaan
fisik</div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l9 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;"> </span><!--[endif]-->Mengidentifikasi
tipe fraktur </div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l9 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;"> </span><!--[endif]-->Inspeksi
daerah mana yang terkena</div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l5 level1 lfo5; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "CE","serif"; mso-fareast-font-family: CE; mso-hansi-font-family: "OzHandicraft BT";">-<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Deformitas yang nampak jelas</div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l5 level1 lfo5; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "CE","serif"; mso-fareast-font-family: CE; mso-hansi-font-family: "OzHandicraft BT";">-<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Edema, ekimosis sekitar lokasi cedera</div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l5 level1 lfo5; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "CE","serif"; mso-fareast-font-family: CE; mso-hansi-font-family: "OzHandicraft BT";">-<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Laserasi</div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l5 level1 lfo5; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "CE","serif"; mso-fareast-font-family: CE; mso-hansi-font-family: "OzHandicraft BT";">-<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Perubahan warna kulit</div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l5 level1 lfo5; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "CE","serif"; mso-fareast-font-family: CE; mso-hansi-font-family: "OzHandicraft BT";">-<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kehilangan fungsi daerah yang cidera</div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l9 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;"> </span><!--[endif]-->Palpasi</div>
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Bengkak, adanya nyeri dan penyebaran</div>
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Krepitasi</div>
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Nadi, dingin</div>
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Observasi spasme otot sekitar daerah fraktur<b><o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
</div>
<div class="Section1">
<div class="MsoNormal">
<b>NURSING PLANING<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 8.95pt; mso-list: skip;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .75pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed; width: 1021px;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 27.9pt;" width="37">
<div align="center" class="MsoNormal" style="text-align: center;">
<b>NO<o:p></o:p></b></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 139.5pt;" width="186">
<div align="center" class="MsoNormal" style="text-align: center;">
<b>DIAGNOSA KEPERAWATAN<o:p></o:p></b></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 162.0pt;" width="216">
<div align="center" class="MsoNormal" style="text-align: center;">
<b>INTERVENSI<o:p></o:p></b></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 171.0pt;" width="228">
<div align="center" class="MsoNormal" style="text-align: center;">
<b>RASIONALISASI<o:p></o:p></b></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 27.9pt;" valign="top" width="37">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
1.</div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 139.5pt;" valign="top" width="186">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal">
Potensial terjadinya syok s/d
perdarahan yg banyak</div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 162.0pt;" valign="top" width="216">
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
INDENPENDEN:</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l1 level1 lfo1; text-indent: -7.2pt;">
<!--[if !supportLists]-->a)<!--[endif]-->Observasi tanda-tanda vital.</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l1 level1 lfo1; text-indent: -7.2pt;">
<!--[if !supportLists]-->b)<!--[endif]-->Mengkaji sumber, lokasi, dan
banyak- nya per darahan</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l1 level1 lfo1; text-indent: -7.2pt;">
<!--[if !supportLists]-->c)<!--[endif]-->Memberikan posisi supinasi</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip;">
<br /></div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l1 level1 lfo1; text-indent: -7.2pt;">
<!--[if !supportLists]-->d)<!--[endif]-->Memberikan banyak cairan (minum)</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
KOLABORASI:</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l5 level1 lfo11; text-indent: -7.2pt;">
<!--[if !supportLists]-->a)<!--[endif]-->Pemberian cairan per infus</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l5 level1 lfo11; text-indent: -7.2pt;">
<!--[if !supportLists]-->b)<!--[endif]-->Pemberian obat koa-gulan sia
(vit.K, Adona) dan peng- hentian perdarahan dgn fiksasi.</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l5 level1 lfo11; text-indent: -7.2pt;">
<!--[if !supportLists]-->c)<!--[endif]-->Pemeriksaan laborato- rium (Hb,
Ht)</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 171.0pt;" valign="top" width="228">
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l0 level1 lfo2; text-indent: -7.2pt;">
<!--[if !supportLists]-->a)<!--[endif]-->Untuk mengetahui tanda-tanda syok
se- dini mungkin</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l0 level1 lfo2; text-indent: -7.2pt;">
<!--[if !supportLists]-->b)<!--[endif]-->Untuk menentukan tindak an</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l0 level1 lfo2; text-indent: -7.2pt;">
<!--[if !supportLists]-->c)<!--[endif]-->Untuk mengurangi per darahan dan
men- cegah kekurangan darah ke otak.</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l0 level1 lfo2; text-indent: -7.2pt;">
<!--[if !supportLists]-->d)<!--[endif]-->Untuk mencegah ke- kurangan cairan
</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
(mengganti
cairan yang hilang)</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l0 level1 lfo2; text-indent: -7.2pt;">
<!--[if !supportLists]-->e)<!--[endif]-->Pemberian cairan per-infus.</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l0 level1 lfo2; text-indent: -7.2pt;">
<!--[if !supportLists]-->f)<!--[endif]-->Membantu proses pem-bekuan darah
dan untuk menghentikan perda-rahan.</div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: skip; text-indent: -7.2pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 7.2pt; mso-list: l0 level1 lfo2; text-indent: -7.2pt;">
<!--[if !supportLists]-->g)<!--[endif]-->Untuk mengetahui ka-dar Hb, Ht
apakah perlu transfusi atau tidak.</div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 27.9pt;" valign="top" width="37">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
2.</div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 139.5pt;" valign="top" width="186">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Gangguan rasa nyaman:</div>
<div class="MsoNormal">
Nyeri s/d perubahan
fragmen tulang, luka pada jaringan lunak, pemasangan back slab, stress, dan
cemas</div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 162.0pt;" valign="top" width="216">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
INDEPENDEN:</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level1 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;"> </span><!--[endif]-->Mengkaji
karakteris- tik nyeri : lokasi, durasi, intensitas nyeri dengan meng- gunakan
skala nyeri (0-10)</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level1 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->b)<span style="font-size: 7pt;"> </span><!--[endif]-->Mempertahankan
im- mobilisasi (back slab)</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level1 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;"> </span><!--[endif]-->Berikan
sokongan (support) pada ektremitas yang luka.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level1 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->d)<span style="font-size: 7pt;"> </span><!--[endif]-->Menjelaskan
seluruh prosedur di atas</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
KOLABORASI:</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level1 lfo3; text-indent: -18.0pt;">
<!--[if !supportLists]-->e)<span style="font-size: 7pt;"> </span><!--[endif]-->Pemberian
obat-obatan analgesik </div>
<div class="MsoNormal">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 171.0pt;" valign="top" width="228">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo4; text-indent: -18.0pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;"> </span><!--[endif]-->Untuk
mengetahui tingkat rasa nyeri sehingga dapat me- nentukan jenis tindak annya.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo4; text-indent: -18.0pt;">
<!--[if !supportLists]-->b)<span style="font-size: 7pt;"> </span><!--[endif]-->Mencegah
pergeser- an tulang dan pe- nekanan pada jaring- an yang luka.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo4; text-indent: -18.0pt;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;"> </span><!--[endif]-->Peningkatan
vena return, menurunkan edem, dan me- ngurangi nyeri.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo4; text-indent: -18.0pt;">
<!--[if !supportLists]-->d)<span style="font-size: 7pt;"> </span><!--[endif]-->Untuk
mempersiap- kan mental serta agar pasien berpartisipasi pada setiap tindakan
yang akan dilakukan.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo4; text-indent: -18.0pt;">
<!--[if !supportLists]-->e)<span style="font-size: 7pt;"> </span><!--[endif]-->Mengurangi
rasa nyeri</div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 27.9pt;" valign="top" width="37">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
3. </div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 139.5pt;" valign="top" width="186">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Potensial infeksi se- hubungan dengan luka terbuka.</div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 162.0pt;" valign="top" width="216">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
INDEPENDEN:</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l12 level1 lfo5; text-indent: -18.0pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;"> </span><!--[endif]-->Kaji
keadaan luka (kontinuitas dari kulit) terhadap ada- nya: edema, rubor, kalor,
dolor, fungsi laesa.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l12 level1 lfo5; text-indent: -18.0pt;">
<!--[if !supportLists]-->b)<span style="font-size: 7pt;"> </span><!--[endif]-->Anjurkan
pasien untuk tidak memegang bagian yang luka.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l12 level1 lfo5; text-indent: -18.0pt;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;"> </span><!--[endif]-->Merawat
luka dengan menggunakan tehnik aseptik</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l12 level1 lfo5; text-indent: -18.0pt;">
<!--[if !supportLists]-->d)<span style="font-size: 7pt;"> </span><!--[endif]-->Mewaspadai
adanya keluhan nyeri men- dadak, keterbatasan gerak, edema lokal, eritema
pada daerah luka.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
KOLABORASI:</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l4 level1 lfo12; text-indent: -18.0pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;"> </span><!--[endif]-->Pemeriksaan
darah : leokosit</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l4 level1 lfo12; text-indent: -18.0pt;">
<!--[if !supportLists]-->b)<span style="font-size: 7pt;"> </span><!--[endif]-->Pemberian
obat-obatan :</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
antibiotika dan TT (Toksoid Tetanus)</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l4 level1 lfo12; text-indent: -18.0pt;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;"> </span><!--[endif]-->Persiapan
untuk operasi sesuai indikasi </div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 171.0pt;" valign="top" width="228">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l8 level1 lfo6; text-indent: -18.0pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;"> </span><!--[endif]-->Untuk
mengetahui tanda-tanda infeksi.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l8 level1 lfo6; text-indent: -18.0pt;">
<!--[if !supportLists]-->b)<span style="font-size: 7pt;"> </span><!--[endif]-->Meminimalkan
terjadinya kontaminasi.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l8 level1 lfo6; text-indent: -18.0pt;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;"> </span><!--[endif]-->Mencegah
kontami- nasi dan kemungkin- an infeksi silang.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l8 level1 lfo6; text-indent: -18.0pt;">
<!--[if !supportLists]-->d)<span style="font-size: 7pt;"> </span><!--[endif]-->Merupakan
indikasi adanya osteomilitis.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo13; text-indent: -18.0pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;"> </span><!--[endif]-->Lekosit
yang me- ningkat artinya sudah terjadi proses infeksi </div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo13; text-indent: -18.0pt;">
<!--[if !supportLists]-->b)<span style="font-size: 7pt;"> </span><!--[endif]-->Untuk
mencegah ke- lanjutan terjadinya infeksi. dan pencegah an tetanus.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo13; text-indent: -18.0pt;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;"> </span><!--[endif]-->Mempercepat
proses penyembuhan luka dan dan penyegahan peningkatan infeksi.</div>
<div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 27.9pt;" valign="top" width="37">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
4.</div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 139.5pt;" valign="top" width="186">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Gangguan aktivitas sehubungan dengan kerusakan
neuromuskuler skeletal, nyeri, immobilisasi.</div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 162.0pt;" valign="top" width="216">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
INDEPENDEN:</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo7; text-indent: -18.0pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;"> </span><!--[endif]-->Kaji
tingkat im- mobilisasi yang disebabkan oleh edema dan persepsi pasien tentang
immobilisasi ter- sebut.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo7; text-indent: -18.0pt;">
<!--[if !supportLists]-->b)<span style="font-size: 7pt;"> </span><!--[endif]-->Mendorong
parti- sipasi dalam aktivitas rekreasi (menonton TV, membaca kora, dll ).</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo7; text-indent: -18.0pt;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;"> </span><!--[endif]-->Menganjurkan
pasien untuk melakukan latihan pasif dan aktif pada yang cedera maupun yang
tidak.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo7; text-indent: -18.0pt;">
<!--[if !supportLists]-->d)<span style="font-size: 7pt;"> </span><!--[endif]-->Membantu
pasien dalam perawatan diri</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo7; text-indent: -18.0pt;">
<!--[if !supportLists]-->e)<span style="font-size: 7pt;"> </span><!--[endif]-->Auskultasi
bising usus, monitor kebiasa an eliminasi dan menganjurkan agar b.a.b.
teratur.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo7; text-indent: -18.0pt;">
<!--[if !supportLists]-->f)<span style="font-size: 7pt;"> </span><!--[endif]-->Memberikan
diit tinggi protein , vitamin , dan
mi- neral.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
KOLABORASI :</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo14; text-indent: -18.0pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;"> </span><!--[endif]-->Konsul
dengan bagi- an fisioterapi</div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 171.0pt;" valign="top" width="228">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo8; text-indent: -18.0pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;"> </span><!--[endif]-->Pasien
akan mem- batasi gerak karena salah persepsi (persepsi tidak pro- posional)</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo8; text-indent: -18.0pt;">
<!--[if !supportLists]-->b)<span style="font-size: 7pt;"> </span><!--[endif]-->Memberikan
ke- sempatan untuk me- ngeluarkan energi, memusatkan per- hatian,
meningkatkan perasaan mengontrol diri pasien dan membantu dalam mengurangi
isolasi sosial.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo8; text-indent: -18.0pt;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;"> </span><!--[endif]-->Meningkatkan
aliran darah ke otot dan tulang untuk me- ningkatkan tonus otot,
mempertahankan mobilitas sendi, men- cegah kontraktur / atropi dan reapsorbsi
Ca yang tidak digunakan.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo8; text-indent: -18.0pt;">
<!--[if !supportLists]-->d)<span style="font-size: 7pt;"> </span><!--[endif]-->Meningkatkan
ke- kuatan dan sirkulasi otot, meningkatkan pasien dalam me- ngontrol
situasi, me- ningkatkan kemauan pasien untuk sembuh.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo8; text-indent: -18.0pt;">
<!--[if !supportLists]-->e)<span style="font-size: 7pt;"> </span><!--[endif]-->Bedrest,
penggunaan analgetika dan pe- rubahan diit dapat menyebabkan penurunan
peristaltik usus dan konstipasi.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo8; text-indent: -18.0pt;">
<!--[if !supportLists]-->f)<span style="font-size: 7pt;"> </span><!--[endif]-->Mempercepat
proses penyembuhan, mencegah penurunan BB, karena pada immobilisasi biasanya
terjadi penurunan BB (20 - 30 lb).</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
Catatan : Untuk sudah dilakukan traksi.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l9 level1 lfo15; text-indent: -18.0pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;"> </span><!--[endif]-->Untuk
menentukan program latihan.</div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 27.9pt;" valign="top" width="37">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
5.</div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 139.5pt;" valign="top" width="186">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Kurangnya pengetahuan tentang kondisi, prognosa, dan
pengo- batan sehubungan dengan kesalahan dalam pe- nafsiran, tidak familier
dengan sumber in- formasi.</div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 162.0pt;" valign="top" width="216">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
INDEPENDEN:</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo9; text-indent: -18.0pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;"> </span><!--[endif]-->Menjelaskan
tentang kelainan yang muncul prognosa,
dan harap- an yang akan datang.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo9; text-indent: -18.0pt;">
<!--[if !supportLists]-->b)<span style="font-size: 7pt;"> </span><!--[endif]-->Memberikan
dukung an cara-cara mobili- sasi dan ambulasi sebagaimana yang dianjurkan
oleh bagi- an fisioterapi.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo9; text-indent: -18.0pt;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;"> </span><!--[endif]-->Memilah-milah
aktif- itas yang bisa mandiri dan yang harus dibantu.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo9; text-indent: -18.0pt;">
<!--[if !supportLists]-->d)<span style="font-size: 7pt;"> </span><!--[endif]-->Mengidentifikasi
pe- layanan umum yang tersedia seperti team rehabilitasi, perawat keluarga
(home care)</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo9; text-indent: -18.0pt;">
<!--[if !supportLists]-->e)<span style="font-size: 7pt;"> </span><!--[endif]-->Mendiskusikan
tentang perawatan lanjutan.</div>
<div class="MsoNormal">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 171.0pt;" valign="top" width="228">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l14 level1 lfo10; text-indent: -18.0pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;"> </span><!--[endif]-->Pasien
mengetahui kondisi saat ini dan hari depan sehingga pasien dapat menentu kan
pilihan.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l14 level1 lfo10; text-indent: -18.0pt;">
<!--[if !supportLists]-->b)<span style="font-size: 7pt;"> </span><!--[endif]-->Sebagian
besar fraktur memerlukan penopang dan fiksasi selama proses pe- nyembuhan
sehingga keterlambatan pe- nyembuhan disebab- kan oleh penggunaan alat bantu
yang kurang tepat.</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l14 level1 lfo10; text-indent: -18.0pt;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;"> </span><!--[endif]-->Mengorganisasikan
kegiatan yang diperlu kan dan siapa yang perlu menolongnya. (apakah
fisioterapi, perawat atau ke- luarga).</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l14 level1 lfo10; text-indent: -18.0pt;">
<!--[if !supportLists]-->d)<span style="font-size: 7pt;"> </span><!--[endif]-->Membantu
meng- fasilitaskan perawa- tan mandiri memberi support untuk man- diri.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l14 level1 lfo10; text-indent: -18.0pt;">
<!--[if !supportLists]-->e)<span style="font-size: 7pt;"> </span><!--[endif]-->Penyembuhan
fraktur tulang kemungkinan lama (kurang lebih 1 tahun) sehingga perlu
disiapkan untuk perencanaan perawatan lanjutan dan pasien koopratif. </div>
</td>
</tr>
</tbody></table>
</div>
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" /></span></b><br />
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span></b></div>
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span></b></div>
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span></b></div>
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span></b></div>
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span></b></div>
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span></b></div>
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
</div>
<div class="MsoNormal">
<b>DAFTAR
KEPUSTAKAAN<i><o:p></o:p></i></b></div>
<div class="MsoNormal">
Doenges M.E. (1989) <u>Nursing Care
Plan</u>, Guidlines for Planning Patient Care (2 nd ed ). Philadelpia, F.A.
Davis Company.<b><i><o:p></o:p></i></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Long; BC and Phipps WJ (1985) <u>Essential
of Medical Surgical Nursing : A Nursing Process Approach</u> St. Louis. Cv.
Mosby Company.<b><i><o:p></o:p></i></b></div>
<br />
<div class="MsoNormal" style="margin-left: 44.95pt; mso-list: l13 level1 lfo13; tab-stops: list 36.0pt 38.2pt; text-indent: -18.0pt;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br /></span></b></div>
<div class="MsoNormal" style="margin-left: 26.95pt;">
<br /></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com2tag:blogger.com,1999:blog-4511732320299108871.post-30075571990724929332012-10-08T20:33:00.000-07:002012-10-08T20:33:08.542-07:00Askep Teori DM<br />
<div align="center" class="MsoBodyTextIndent" style="line-height: 150%; tab-stops: 36.0pt; text-align: center;">
<span style="font-family: "Times New Roman","serif";">LANDASAN
TEORI DM</span></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 18.7pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">1.
Pengertian Diabetes mellitus<u><o:p></o:p></u></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; tab-stops: 45.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"> </span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Diabetes Mellitus
adalah keadaan hiperglikemi kronik yang disertai berbagai kelainan metabolik
akibat gangguan hormonal yang menimbulkan berbagai komplikasi kronik pada mata,
ginjal, saraf dan pembuluh darah . Diabetes Mellitus klinis adalah suatu
sindroma gangguan metabolisme dengan hiperglikemia yang tidak semestinya
sebagai akibat suatu defisiensi sekresi insulin atau berkurangnya efektifitas
biologis dari insulin atau keduanya. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; tab-stops: 45.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -36.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">2.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal; line-height: normal;"> </span></span></b><!--[endif]--><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Klasifikasi<o:p></o:p></span></b></div>
<h4 style="line-height: 150%;">
<span style="color: windowtext; font-weight: normal;">Klasifikasi
Diabetes Mellitus dari National Diabetus Data Group: Classification and
Diagnosis of Diabetes Mellitus and Other Categories of Glucosa Intolerance:<o:p></o:p></span></h4>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level2 lfo1; tab-stops: 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Klasifikasi
Klinis<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level3 lfo1; tab-stops: 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Diabetes
Mellitus<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level4 lfo1; tab-stops: 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">a)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Tipe
tergantung insulin (DMTI), Tipe I <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level4 lfo1; tab-stops: 72.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">b)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Tipe
tak tergantung insulin (DMTTI), Tipe II<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level5 lfo1; tab-stops: 90.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">(1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">DMTTI
yang tidak mengalami obesitas<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level5 lfo1; tab-stops: 90.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">(2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">DMTTI
dengan obesitas<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level3 lfo1; tab-stops: 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Gangguan
Toleransi Glukosa (GTG)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level3 lfo1; tab-stops: 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Diabetes
Kehamilan (GDM)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 36.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">b). Klasifikasi risiko statistik<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level3 lfo1; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">4)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Sebelumnya
pernah menderita kelainan toleransi glukosa<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level3 lfo1; tab-stops: 36.0pt list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">5)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Berpotensi
menderita kelainan toleransi glukosa<o:p></o:p></span></div>
<div class="MsoFooter" style="line-height: 150%; margin-left: 18.0pt; tab-stops: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoFooter" style="line-height: 150%; margin-left: 18.0pt; tab-stops: 36.0pt; text-align: justify;">
Pada Diabetes Mellitus tipe 1 sel-sel β pancreas yang
secara normal menghasilkan hormon insulin dihancurkan oleh proses autoimun,
sebagai akibatnya penyuntikan insulin diperlukan untuk mengendalikan kadar
glukosa darah. Diabetes mellitus tipe I ditandai oleh awitan mendadak yang
biasanya terjadi pada usia 30 tahun.</div>
<div class="MsoFooter" style="line-height: 150%; margin-left: 18.0pt; tab-stops: 36.0pt; text-align: justify;">
Diabetes mellitus tipe II terjadi akibat penurunan
sensitivitas terhadap insulin (resistensi insulin) atau akibat penurunan jumlah produksi insulin.</div>
<div class="MsoFooter" style="line-height: 150%; margin-left: 18.0pt; tab-stops: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -36.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">3.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal; line-height: normal;"> </span></span></b><!--[endif]--><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Etiologi<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; mso-list: l1 level2 lfo1; tab-stops: 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Diabetes Mellitus tergantung insulin (DMTI)<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l1 level3 lfo1; tab-stops: 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Faktor genetic<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Penderita diabetes tidak mewarisi diabetes tipe I itu sendiri
tetapi mewarisi suatu presdisposisi atau kecenderungan genetic kearah
terjadinya diabetes tipe I. Kecenderungan genetic ini ditentukan pada individu
yang memililiki tipe antigen HLA <i>(Human Leucocyte Antigen) </i>tertentu. HLA
merupakan kumpulan gen yang bertanggung jawab atas antigen tranplantasi dan
proses imun lainnya.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l1 level3 lfo1; tab-stops: 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Faktor imunologi<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Pada diabetes tipe I terdapat bukti adanya suatu respon
autoimun. Ini merupakan respon abnormal dimana antibody terarah pada jaringan
normal tubuh dengan cara bereaksi terhadap jaringan tersebut yang dianggapnya
seolah-olah sebagai jaringan asing.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; tab-stops: 54.0pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; tab-stops: 54.0pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l1 level3 lfo1; tab-stops: 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Faktor lingkungan<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Faktor eksternal yang dapat memicu destruksi sel β pancreas,
sebagai contoh hasil penyelidikan menyatakan bahwa virus atau toksin tertentu
dapat memicu proses autuimun yang dapat menimbulkan destuksi sel β pancreas.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level2 lfo1; tab-stops: 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">b.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal; line-height: normal;"> </span></span></b><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Diabetes
Mellitus tak tergantung insulin (DMTTI)<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 36.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Secara pasti penyebab dari DM tipe II
ini belum diketahui, factor genetic diperkirakan memegang peranan dalam proses
terjadinya resistensi insulin. Diabetes Mellitus tak tergantung insulin (DMTTI)
penyakitnya mempunyai pola familiar yang kuat. DMTTI ditandai dengan kelainan
dalam sekresi insulin maupun dalam kerja insulin. Pada awalnya tampak terdapat
resistensi dari sel-sel sasaran terhadap kerja insulin. Insulin mula-mula
mengikat dirinya kepada reseptor-reseptor permukaan sel tertentu, kemudian
terjadi reaksi intraselluler yang meningkatkan transport glukosa menembus
membran sel. Pada pasien dengan DMTTI terdapat kelainan dalam pengikatan
insulin dengan reseptor. Hal ini dapat disebabkan oleh berkurangnya jumlah
tempat reseptor yang responsif insulin pada membran sel. Akibatnya terjadi
penggabungan abnormal antara komplek reseptor insulin dengan system transport
glukosa. Kadar glukosa normal dapat dipertahankan dalam waktu yang cukup lama
dan meningkatkan sekresi insulin, tetapi pada akhirnya sekresi insulin yang
beredar tidak lagi memadai untuk mempertahankan euglikemia . Diabetes Mellitus
tipe II disebut juga Diabetes Mellitus tidak tergantung insulin (DMTTI) atau <i>Non
Insulin Dependent Diabetes Mellitus</i> (NIDDM) yang merupakan suatu kelompok
heterogen bentuk-bentuk Diabetes yang lebih ringan, terutama dijumpai pada
orang dewasa, tetapi terkadang dapat timbul pada masa kanak-kanak.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 36.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Faktor risiko yang berhubungan dengan
proses terjadinya DM tipe II, diantaranya adalah:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: 36.0pt list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Usia
( resistensi insulin cenderung meningkat pada usia di atas 65 tahun)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: 36.0pt list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Obesitas<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: 36.0pt list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Riwayat
keluarga<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: 36.0pt list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">4)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Kelompok
etnik</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: 36.0pt list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<b style="line-height: 150%; text-indent: -18pt;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">3. Patofisiologi</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: 36.0pt list 54.0pt; text-align: justify; text-indent: -18.0pt;">
</div>
<div class="MsoBodyTextIndent" style="line-height: 150%; tab-stops: 54.0pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Ibarat suatu
mesin, tubuh memerlukan bahan untuk membentuk sel baru dan mengganti sel yang
rusak. Disamping itu tubuh juga memerlukan energi supaya sel tubuh dapat
berfungsi dengan baik. Energi yang dibutuhkan oleh tubuh berasal dari bahan
makanan yang kita makan setiap hari. Bahan makanan tersebut terdiri dari unsur
karbohidrat, lemak dan protein . <o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";"> Pada
keadaan normal kurang lebih 50% glukosa yang dimakan mengalami metabolisme
sempurna menjadi CO2 dan air, 10% menjadi glikogen dan 20% sampai 40% diubah
menjadi lemak. Pada Diabetes Mellitus semua proses tersebut terganggu karena
terdapat defisiensi insulin. Penyerapan glukosa kedalam sel macet dan
metabolismenya terganggu. Keadaan ini menyebabkan sebagian besar glukosa tetap
berada dalam sirkulasi darah sehingga terjadi hiperglikemia.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";"> Penyakit
Diabetes Mellitus disebabkan oleh karena gagalnya hormon insulin. Akibat
kekurangan insulin maka glukosa tidak dapat diubah menjadi glikogen sehingga
kadar gula darah meningkat dan terjadi hiperglikemi. Ginjal tidak dapat menahan
hiperglikemi ini, karena ambang batas untuk gula darah adalah 180 mg% sehingga
apabila terjadi hiperglikemi maka ginjal tidak bisa menyaring dan mengabsorbsi
sejumlah glukosa dalam darah. Sehubungan dengan sifat gula yang menyerap air
maka semua kelebihan dikeluarkan bersama urine yang disebut glukosuria.
Bersamaan keadaan glukosuria maka sejumlah air hilang dalam urine yang disebut
poliuria. Poliuria mengakibatkan dehidrasi intra selluler, hal ini akan
merangsang pusat haus sehingga pasien akan merasakan haus terus menerus
sehingga pasien akan minum terus yang disebut polidipsi.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";"> Produksi
insulin yang kurang akan menyebabkan menurunnya transport glukosa ke sel-sel
sehingga sel-sel kekurangan makanan dan simpanan karbohidrat, lemak dan protein
menjadi menipis. Karena digunakan untuk melakukan pembakaran dalam tubuh, maka
klien akan merasa lapar sehingga menyebabkan banyak makan yang disebut
poliphagia. Terlalu banyak lemak yang dibakar maka akan terjadi penumpukan
asetat dalam darah yang menyebabkan keasaman darah meningkat atau asidosis. Zat
ini akan meracuni tubuh bila terlalu banyak hingga tubuh berusaha mengeluarkan
melalui urine dan pernapasan, akibatnya bau urine dan napas penderita berbau
aseton atau bau buah-buahan. Keadaan asidosis ini apabila tidak segera diobati
akan terjadi koma yang disebut koma diabetik .<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; tab-stops: 54.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">4.
Gejala Klinis<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";"> Seseorang dapat dikatakan menderita Diabetes
Mellitus apabila menderita dua dari tiga gejala yaitu<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin: 0cm 0cm 0.0001pt 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Keluhan
TRIAS: Banyak minum, Banyak kencing dan Penurunan berat badan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin: 0cm 0cm 0.0001pt 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">b.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Kadar
glukosa darah pada waktu puasa lebih dari 120 mg/dl<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin: 0cm 0cm 0.0001pt 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">c.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Kadar
glukosa darah dua jam sesudah makan lebih dari 200 mg/dl<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; tab-stops: 36.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";"> Keluhan yang sering terjadi pada penderita
Diabetes Mellitus adalah: Poliuria, Polidipsia, Polifagia, Berat badan menurun,
Lemah, Kesemutan, Gatal, Visus menurun, Bisul/luka, Keputihan. <o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; tab-stops: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -36pt;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">5. Komplikasi<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";"> Beberapa komplikasi dari Diabetes
Mellitus adalah<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin: 0cm 0cm 0.0001pt 70.65pt; text-indent: -52.65pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">a)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Akut<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin: 0cm 0cm 0.0001pt 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Hipoglikemia
dan hiperglikemia<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin: 0cm 0cm 0.0001pt 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Penyakit
makrovaskuler : mengenai pembuluh darah besar, penyakit jantung koroner
(cerebrovaskuler, penyakit pembuluh darah kapiler).<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin: 0cm 0cm 0.0001pt 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Penyakit
mikrovaskuler, mengenai pembuluh darah
kecil, retinopati, nefropati.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin: 0cm 0cm 0.0001pt 54pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">4)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Neuropati
saraf sensorik (berpengaruh pada ekstrimitas), saraf otonom berpengaruh pada
gastro intestinal, kardiovaskuler .<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin: 0cm 0cm 0.0001pt 70.65pt; text-indent: -52.65pt;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">b)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Komplikasi
menahun Diabetes Mellitus<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 54.0pt; mso-list: l6 level2 lfo1; tab-stops: 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Neuropati diabetik<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 54.0pt; mso-list: l6 level2 lfo1; tab-stops: 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Retinopati diabetik<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 54.0pt; mso-list: l6 level2 lfo1; tab-stops: 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Nefropati diabetik<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 54.0pt; mso-list: l6 level2 lfo1; tab-stops: 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">4)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Proteinuria<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 54.0pt; mso-list: l6 level2 lfo1; tab-stops: 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">5)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Kelainan koroner<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 54.0pt; mso-list: l6 level2 lfo1; tab-stops: 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">6)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Ulkus/gangren <o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 88.65pt; text-indent: -34.65pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Terdapat lima grade ulkus diabetikum antara lain:<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 153.0pt; mso-list: l6 level6 lfo1; tab-stops: 72.0pt list 135.0pt left 153.0pt; text-indent: -99.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(a)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Grade 0 : tidak ada luka<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 153.0pt; mso-list: l6 level6 lfo1; tab-stops: 72.0pt list 135.0pt left 153.0pt; text-indent: -99.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(b)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Grade I : kerusakan hanya sampai pada permukaan kulit<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 153.0pt; mso-list: l6 level6 lfo1; tab-stops: 72.0pt list 135.0pt left 153.0pt; text-indent: -99.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(c)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Grade II : kerusakan kulit mencapai otot dan tulang<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 153.0pt; mso-list: l6 level6 lfo1; tab-stops: 72.0pt list 135.0pt left 153.0pt; text-indent: -99.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(d)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Grade III : terjadi abses<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 153.0pt; mso-list: l6 level6 lfo1; tab-stops: 72.0pt list 135.0pt left 153.0pt; text-indent: -99.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(e)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Grade IV : Gangren pada kaki bagian distal<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 153.0pt; mso-list: l6 level6 lfo1; tab-stops: 72.0pt list 135.0pt left 153.0pt; text-indent: -99.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(f)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Grade V : Gangren pada seluruh kaki dan tungkai bawah
distal<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin: 0cm 0cm 0.0001pt 36pt; text-indent: -36pt;">
<!--[if !supportLists]--><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">6.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal; line-height: normal;"> </span></span></b><!--[endif]--><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Penatalaksanaan
Diabetes mellitus<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; tab-stops: 36.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Tujuan utama
terapi DM adalah mencoba menormalkan aktivitas insulin dan kadar glukosa darah
dalam upaya mengurangi terjadinya komplikasi vaskuler serta neuropatik. Tujuan
terapeutik pada setiap tipe DM adalah mencapai kadar glukosa darah normal (<i>euglikemia)
</i>tanpa terjadi hipoglikemia dan gangguan series pada pola aktivitas pasien.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; tab-stops: 36.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Ada lima
konponen dalam penatalaksanaan DM, yaitu:<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo6; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Diet<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 36.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Syarat diet DM hendaknya dapat:<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 180.0pt; mso-list: l2 level5 lfo6; tab-stops: 54.0pt list 180.0pt; text-indent: -144.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Memperbaiki kesehatan umum penderita<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 180.0pt; mso-list: l2 level5 lfo6; tab-stops: 54.0pt list 180.0pt; text-indent: -144.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Mengarahkan pada berat badan normal<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 180.0pt; mso-list: l2 level5 lfo6; tab-stops: 54.0pt list 180.0pt; text-indent: -144.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Menormalkan pertumbuhan DM anak dan DM dewasa muda<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 180.0pt; mso-list: l2 level5 lfo6; tab-stops: 54.0pt list 180.0pt; text-indent: -144.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">4)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Mempertahankan kadar KGD normal<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 180.0pt; mso-list: l2 level5 lfo6; tab-stops: 54.0pt list 180.0pt; text-indent: -144.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">5)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Menekan dan menunda timbulnya penyakit angiopati diabetik<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 180.0pt; mso-list: l2 level5 lfo6; tab-stops: 54.0pt list 180.0pt; text-indent: -144.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">6)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Memberikan modifikasi diit sesuai dengan keadaan penderita.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 180.0pt; mso-list: l2 level5 lfo6; tab-stops: 54.0pt list 180.0pt; text-indent: -144.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">7)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Menarik dan mudah diberikan<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Prinsip diet DM, adalah:<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l1 level1 lfo4; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Jumlah sesuai kebutuhan <o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l1 level1 lfo4; tab-stops: 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Jadwal diet ketat<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l1 level1 lfo4; tab-stops: 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Jenis: boleh dimakan/tidak<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Diit DM sesuai dengan paket-paket yang telah disesuaikan
dengan kandungan kalorinya.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l5 level1 lfo5; tab-stops: list 54.0pt left 126.0pt 144.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Diit DM I : 1100 kalori<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l5 level1 lfo5; tab-stops: list 54.0pt left 126.0pt 144.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Diit DM II : 1300 kalori<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l5 level1 lfo5; tab-stops: list 54.0pt left 126.0pt 144.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Diit DM III : 1500 kalori<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l5 level1 lfo5; tab-stops: list 54.0pt left 126.0pt 144.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">4)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Diit DM IV : 1700 kalori<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l5 level1 lfo5; tab-stops: list 54.0pt left 126.0pt 144.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">5)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Diit DM V : 1900 kalori<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l5 level1 lfo5; tab-stops: list 54.0pt left 126.0pt 144.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">6)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Diit DM VI : 2100 kalori<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l5 level1 lfo5; tab-stops: list 54.0pt left 126.0pt 144.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">7)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Diit DM VII : 2300 kalori<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l5 level1 lfo5; tab-stops: list 54.0pt left 126.0pt 144.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">8)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Diit DM VIII : 2500 kalori<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Diit I s/d III : diberikan kepada penderita yang terlalu
gemuk<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Diit IV s/d V : diberikan kepada penderita dengan berat badan
normal<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Diit VI s/d VIII : diberikan kepada penderita kurus. Diabetes
remaja, atau diabetes komplikasi,<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Dalam melaksanakan diit diabetes sehari-hari hendaklah
diikuti pedoman 3 J yaitu:<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 81.0pt; tab-stops: 72.0pt; text-indent: -45.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">J I : jumlah
kalori yang diberikan harus habis, jangan dikurangi atau ditambah<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 72.0pt; tab-stops: 72.0pt; text-indent: -36.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">J II : jadwal diit
harus sesuai dengan intervalnya.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 72.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">J III : jenis
makanan yang manis harus dihindari<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 72.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Penentuan jumlah kalori Diit Diabetes Mellitus harus
disesuaikan oleh status gizi penderita, penentuan gizi dilaksanakan dengan
menghitung Percentage of relative body weight (BBR= berat badan normal) dengan
rumus:<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 72.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";"> BB (Kg)<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 72.0pt;">
<!--[if gte vml 1]><v:line id="_x0000_s1026" style='position:absolute;
left:0;text-align:left;z-index:251660800' from="1in,11.4pt" to="2in,11.4pt"/><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 95px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 98px; z-index: 251660800;"><img height="2" src="file:///C:/Users/intel/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1026" width="98" /></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">BBR = X 100 %<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 72.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";"> TB (cm) – 100<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 126.0pt; tab-stops: 72.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Kurus (underweight)<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 126.0pt; tab-stops: 72.0pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l3 level1 lfo7; tab-stops: 162.0pt 180.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Kurus (underweight) : BBR < 90 % <o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l3 level1 lfo7; tab-stops: 162.0pt 180.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Normal (ideal) : BBR 90 – 110 %<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l3 level1 lfo7; tab-stops: 162.0pt 180.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Gemuk (overweight) : BBR > 110 %<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l3 level1 lfo7; tab-stops: 162.0pt 180.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">4)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Obesitas, apabila :
BBR > 120 %<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; tab-stops: 54.0pt 162.0pt 180.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">- Obesitas ringan :
BBR 120 – 130 %<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; tab-stops: 54.0pt 162.0pt 180.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">- Obesitas sedang :
BBR 130 – 140 %<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; tab-stops: 54.0pt 162.0pt 180.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">- Obesitas berat : BBR 140 – 200 %<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; tab-stops: 54.0pt 162.0pt 180.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">- Morbid : BBR > 200 %<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 162.0pt 180.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Sebagai pedoman jumlah kalori yang diperlukan sehari-hari
untuk penderita DM yang bekerja biasa adalah:<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level1 lfo8; tab-stops: list 54.0pt left 99.0pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">kurus : BB X 40 – 60 kalori sehari<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level1 lfo8; tab-stops: list 54.0pt left 99.0pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Normal : BB X 30 kalori sehari<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level1 lfo8; tab-stops: list 54.0pt left 99.0pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Gemuk : BB X 20 kalori sehari<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level1 lfo8; tab-stops: list 54.0pt left 99.0pt 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">4)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Obesitas : BB X 10-15 kalori sehari<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo6; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">b.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Latihan<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 36.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Beberapa kegunaan latihan teratur setiap hari bagi penderita
DM, adalah:<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level5 lfo6; tab-stops: 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Meningkatkan kepekaan insulin (glukosa uptake), apabila
dikerjakan setiap 1 ½ jam sesudah makan, berarti pula mengurangi insulin
resisten pada penderita dengan kegemukan atau menambah jumlah reseptor insulin
dan meningkatkan sensitivitas insulin dengan reseptornya.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level5 lfo6; tab-stops: 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Mencegah kegemukan apabila ditambah latihan pagi dan sore<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level5 lfo6; tab-stops: 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Memperbaiki aliran perifer dan menambah supply oksigen<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level5 lfo6; tab-stops: 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">4)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Meningkatkan kadar kolesterol-high density lipoprotein<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level5 lfo6; tab-stops: 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">5)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Kadar glukosa otot dan hati menjadi berkurang, maka latihan
akan dirangsang pembentukan glikogen baru<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level5 lfo6; tab-stops: 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">6)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Menurunkan kolesterol (total) dan trigliserida dalam darah
karena pembakaran asam lemak menjadi lebih baik.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo6; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">c.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Penyuluhan<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 36.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Penyuluhan Kesehatan Masyarakat Rumah Sakit (PKMRS) merupakan
salah satu bentuk penyuluhan kesehatan kepada penderita DM, melalui
bermacam-macam cara atau media misalnya: leaflet, poster, TV, kaset video,
diskusi kelompok, dan sebagainya.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo6; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">d.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Obat<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; mso-list: l2 level5 lfo6; tab-stops: 54.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Tablet OAD (Oral Antidiabetes)<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 54.0pt; tab-stops: 54.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">a) Mekanisme kerja
sulfanilurea<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 225.0pt; mso-list: l2 level6 lfo6; tab-stops: 90.0pt list 225.0pt; text-indent: -153.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">kerja OAD tingkat prereseptor : pankreatik, ekstra pancreas<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 225.0pt; mso-list: l2 level6 lfo6; tab-stops: 90.0pt list 225.0pt; text-indent: -153.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">kerja OAD tingkat reseptor<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 72.0pt; mso-list: l2 level2 lfo6; tab-stops: 54.0pt list 72.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">b)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Mekanisme kerja Biguanida<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 72.0pt; tab-stops: 90.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Biguanida tidak mempunyai efek pankreatik, tetapi mempunyai
efek lain yang dapat meningkatkan efektivitas insulin, yaitu:<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level6 lfo6; tab-stops: 90.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Biguanida pada tingkat prereseptor </span><span style="color: windowtext; font-family: Wingdings; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Wingdings;">à</span><span style="color: windowtext; font-family: "Times New Roman","serif";"> ekstra
pankreatik<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 108.0pt; mso-list: l2 level7 lfo6; tab-stops: 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Menghambat absorpsi karbohidrat<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 108.0pt; mso-list: l2 level7 lfo6; tab-stops: 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Menghambat glukoneogenesis di hati<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 108.0pt; mso-list: l2 level7 lfo6; tab-stops: 108.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">-<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Meningkatkan afinitas pada reseptor insulin<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level6 lfo6; tab-stops: 90.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Biguanida pada tingkat reseptor : meningkatkan jumlah
reseptor insulin<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level6 lfo6; tab-stops: 90.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Biguanida pada tingkat pascareseptor : mempunyai efek
intraseluler <o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 214.65pt; mso-list: l6 level5 lfo1; tab-stops: 36.0pt 54.0pt list 214.65pt; text-indent: -178.65pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Insulin<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: -106.65pt; mso-list: l0 level2 lfo8; tab-stops: list -106.65pt left 54.0pt; text-indent: 160.65pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">a)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Indikasi penggunaan insulin<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; mso-list: l0 level3 lfo8; tab-stops: 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">DM tipe I<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; mso-list: l0 level3 lfo8; tab-stops: 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">DM tipe II yang pada saat tertentu tidak dapat dirawat dengan
OAD<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; mso-list: l0 level3 lfo8; tab-stops: 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(3)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">DM kehamilan<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; mso-list: l0 level3 lfo8; tab-stops: 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(4)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">DM dan gangguan faal hati yang berat<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; mso-list: l0 level3 lfo8; tab-stops: 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(5)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">DM dan infeksi akut (selulitis, gangren)<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; mso-list: l0 level3 lfo8; tab-stops: 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(6)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">DM dan TBC paru akut<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; mso-list: l0 level3 lfo8; tab-stops: 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(7)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">DM dan koma lain pada DM<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; mso-list: l0 level3 lfo8; tab-stops: 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(8)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">DM operasi<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; mso-list: l0 level3 lfo8; tab-stops: 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(9)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">DM patah tulang<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; mso-list: l0 level3 lfo8; tab-stops: 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(10)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">DM dan underweight<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; mso-list: l0 level3 lfo8; tab-stops: 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(11)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">DM dan penyakit Graves<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 72.0pt; tab-stops: 99.0pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: -106.65pt; mso-list: l0 level2 lfo8; tab-stops: list -106.65pt left 54.0pt; text-indent: 160.65pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">b)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Beberapa cara pemberian insulin<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; mso-list: l0 level3 lfo8; tab-stops: 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Suntikan insulin subkutan<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; tab-stops: 99.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Insulin reguler mencapai puncak kerjanya pada 1-4 jam,
sesudah suntikan subcutan, kecepatan absorpsi di tempat suntikan tergantung
pada beberapa factor antara lain:<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 117.0pt; mso-list: l6 level6 lfo1; tab-stops: 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(a)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">lokasi suntikan<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 117.0pt; tab-stops: 117.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">ada 3 tempat suntikan yang sering dipakai yitu dinding perut,
lengan, dan paha. Dalam memindahkan suntikan (lokasi) janganlah dilakukan
setiap hari tetapi lakukan rotasi tempat suntikan setiap 14 hari, agar tidak
memberi perubahan kecepatan absorpsi setiap hari.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 117.0pt; mso-list: l6 level6 lfo1; tab-stops: 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(b)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Pengaruh latihan pada absorpsi insulin<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 117.0pt; tab-stops: 36.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Latihan akan mempercepat absorbsi apabila dilaksanakan dalam
waktu 30 menit setelah suntikan insulin karena itu pergerakan otot yang
berarti, hendaklah dilaksanakan 30 menit setelah suntikan.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 117.0pt; mso-list: l6 level6 lfo1; tab-stops: 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(c)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Pemijatan (Masage)<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 117.0pt; tab-stops: 117.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Pemijatan juga akan mempercepat absorpsi insulin.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 117.0pt; mso-list: l6 level6 lfo1; tab-stops: 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(d)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Suhu<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 117.0pt; tab-stops: 36.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Suhu kulit tempat suntikan (termasuk mandi uap) akan
mempercepat absorpsi insulin.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 117.0pt; mso-list: l6 level6 lfo1; tab-stops: 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(e)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Dalamnya suntikan<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 117.0pt; tab-stops: 36.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Makin dalam suntikan makin cepat puncak kerja insulin
dicapai. Ini berarti suntikan intramuskuler akan lebih cepat efeknya daripada
subcutan.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 117.0pt; mso-list: l6 level6 lfo1; tab-stops: 117.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(f)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Konsentrasi insulin<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 117.0pt; tab-stops: 36.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Apabila konsentrasi insulin berkisar 40 – 100 U/ml, tidak terdapat
perbedaan absorpsi. Tetapi apabila terdapat penurunan dari u –100 ke u – 10
maka efek insulin dipercepat.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; mso-list: l0 level3 lfo8; tab-stops: 99.0pt; text-indent: -27.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">(2)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Suntikan intramuskular dan intravena<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 99.0pt; tab-stops: 36.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Suntikan intramuskular dapat digunakan pada koma diabetik
atau pada kasus-kasus dengan degradasi tempat suntikan subkutan. Sedangkan
suntikan intravena dosis rendah digunakan untuk terapi koma diabetik.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; mso-list: l2 level1 lfo6; tab-stops: 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: "Times New Roman","serif";">e.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: "Times New Roman","serif";">Cangkok pankreas<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 36.0pt;">
<span style="color: windowtext; font-family: "Times New Roman","serif";">Pendekatan terbaru untuk cangkok pancreas adalah segmental
dari donor hidup saudara kembar identik .<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 36.0pt; tab-stops: 36.0pt;">
<br /></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: 36.0pt list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<b style="line-height: 150%; text-indent: -18pt;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><br /></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; tab-stops: 36.0pt; text-align: justify; text-indent: -18.0pt;">
<br /></div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0tag:blogger.com,1999:blog-4511732320299108871.post-72844369311999473782012-10-05T17:30:00.001-07:002012-10-05T17:30:16.067-07:00<br />
<div class="MsoTitle" style="text-align: center;">
<b> LAPORAN PENDAHULUAN<o:p></o:p></b></div>
<div class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;"> ASUHAN
KEPERAWATAN ACUTE LYMPHOBLASTIC<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">LEUKEMIA PADA
ANAK USIA PRA SEKOLAH<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
<b><span style="font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">PENGERTIAN<o:p></o:p></span></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Acute lympobastic leukemia adalah bentuk akut dari leukemia
yang diklasifikasikan menurut cell yang lebih banyak dalam sumsum tulang yaitu
berupa lymphoblasts.</div>
<div class="MsoNormal">
Pada keadaan leukemia terjadi proliferasi sel leukosit yang
abnormal, ganas, sering disertai bentuk leukosit yang lain daripada normal,
jumlahnya berlebihan dan dapat menyebabkan anemia, trombositopenia, dan
diakhiri dengan kematian.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Faktor penyebab ALL tidak diketahui, tapi dimungkinkan
karena interaksi sejumlah faktor :</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;"> </span><!--[endif]-->Neoplasia</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;"> </span><!--[endif]-->Infeksi</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;"> </span><!--[endif]-->Radiasi</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;"> </span><!--[endif]-->Keturunan</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;"> </span><!--[endif]-->Zat
kimia</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->6.<span style="font-size: 7pt;"> </span><!--[endif]-->Murasi
gen</div>
<div class="MsoNormal">
<br /></div>
<h1>
EPIDEMIOLOGI</h1>
<div class="MsoNormal">
Leukemia akut cepat terjadi dan lambat penyembuhannya, dapat
diakhiri dengan kematian bila tidak segera diobati. ALL sering ditemukan pada
anak-anak (82 %) daripada umur dewasa (!*%) dan lebih sering ditemukan pada
anak laki-laki daripada anak perempuan.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<h1>
PATOFISIOLOGI</h1>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Komponen sel darah terdiri atas eritrosit atau sel darah
merah (RBC) dan leukosit atau sel darah putih (WBC) serta trombosit atau
platelet. Seluruh sel darah normal diperoleh dari sel batang tunggal yang
terdapat pada seluruh sumsum tulang. Sel batang dapat dibagi ke dalam lymphpoid
dan sel batang darah (myeloid), dimana pada kebalikannya menjadi cikal bakal
sel yang terbagis epanjang jalur tunggal khusus. Proses ini dikenal sebagai
hematopoiesis dan terjadi di dalam sumsum tulang tengkorak, tulang belakang.,
panggul, tulang dada, dan pada proximal epifisis pada tulang-tulang yang
panjang.</div>
<div class="MsoNormal">
ALL meningkat dari sel batang lymphoid tungal dengan
kematangan lemah dan pengumpulan sel-sel penyebab kerusakan di dalam sumsum
tulang. Biasanya dijumpai tinmgkat pengembangan lymphoid yang berbeda dalam
sumsum tulang mulai dari yang sangat mentah hingga hampir menjadi sel normal. Derajat
kementahannya merupakan petunjuk untk menentukan/meramalkan kelanjutannya. Pada
pemeriksaan darah tepi ditemukan sel muda limfoblas dan biasanya ada
leukositosis (^)%), kadang-kadang leukopenia (25%). Jumlah leukosit neutrofil
seringkali rendah, demikian pula kadar hemoglobin dan trombosit. Hasil
pemeriksaan sumsum tulang biasanya menunjukkan sel-sel blas yang dominan.
Pematangan limfosit B dimulai dari sel stem pluripoten, kemudian sel stem
limfoid, pre pre-B, early B, sel B intermedia, sel B matang, sel plasmasitoid
dan sel plasma. Limfosit T juga berasal dari sel stem pluripoten, berkembang
menjadi sel stem limfoid, sel timosit imatur, cimmom thymosit, timosit matur,
dan menjadi sel limfosit T helper dan limfosit T supresor.</div>
<div class="MsoNormal">
Peningkatan prosuksi leukosit juga melibatkan tempat-tempat
ekstramedular sehingga anak-anak menderita pembesaran kelenjar limfe dan
hepatosplenomegali. Sakit tulang juga sering dijumpai. Jugaa timbul serangan
pada susunan saraf pusat, yaitu sakit kepala, muntah-muntah, “seizures” dan
gangguan penglihatan.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><span style="font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">PERTUMBUHAN DAN PERKEMBANGAN
ANAK PRA SEKOLAH (1-6 TAHUN)<o:p></o:p></span></b></div>
<div class="MsoNormal">
<br /></div>
<h2>
Menurut Soetjiningsih</h2>
<div class="MsoNormal">
Anak usia pra sekolah digolongkan pada usia 1 – 6 tahun</div>
<div class="MsoNormal">
<br /></div>
<h2>
Menurut Donna L Wong</h2>
<div class="MsoNormal">
Masa Anak Pra Sekolah
atau disebut juga masa anak-anak awal berada pada usia 3 – 6 tahun</div>
<div class="MsoNormal">
<br /></div>
<h2>
Perkembangan Psokoseksual menurut Sigmund Freud</h2>
<div class="MsoNormal">
Disebut fase laten ( usia 5 – 12 tahun )</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Anak masuk permulaan fase pubertas</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Periode integrasi, dimana anak harus berhadapan dengan
berbagai tuntutan sosial</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Fase tenang</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Dorongan libido mereda</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Erotik zone berkurang</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Anak tertarik dengan peer group</div>
<div class="MsoNormal">
<br /></div>
<h2>
Perkembangan Psikososial menurut Erik Erikson</h2>
<div class="MsoNormal">
Kepercayaan yang diperoleh anak pra sekolah diartikan bahwa
ia diperbolehkan memiliki inisiatif dalam belajar mencari pengalaman-pengalaman
baru secara aktif seperti bagaimana dan mengapa tentanang sesuatu sehinggga
anak dapat memperluas aktifitasnya. Jika anak dilarang atau diomeli maka anak
akan merasa bersalah dan menjadi anak peragu untuk melakukan sesuatu percobaan
yang menantang keterampilan motorik dan bahasanya.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<h1>
PENGKAJIAN DATA KEPERAWATAN</h1>
<div class="MsoNormal">
<br /></div>
<h2>
Identitas</h2>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Acute lymphoblastic leukemia sering terdapat pada anak-anak
usia di bawah 15 tahun (85%) , puncaknya
berada pada usia 2 – 4 tahun. Rasio lebih sering terjadi pada anak laki-laki
daripada anak perempuan.</div>
<div class="MsoNormal">
<br /></div>
<h2>
Riwayat Kesehatan</h2>
<h3>
Keluhan Utama</h3>
<div class="MsoNormal">
Pada anak pra sekolah keluhan yang sering muncul tiba-tiba
adalah demam, lesudan malas makan atau nafsu makan berkurang, pucat (anemia)
dan kecenderungan terjadi perdarahan.</div>
<div class="MsoNormal">
<br /></div>
<h3>
Riwayat kesehatan masa lalu</h3>
<div class="MsoNormal">
Pada penderita ALL sering ditemukan riwayat keluarga yang
erpapar oleh chemical toxins (benzene dan arsen), infeksi virus (epstein barr,
HTLV-1), kelainan kromosom dan penggunaan obat-obatann seperti phenylbutazone
dan khloramphenicol, terapi radiasi maupun kemoterapi.</div>
<div class="MsoNormal">
<br /></div>
<h2>
Pola Persepsi – mempertahankan kesehatan</h2>
<div class="MsoNormal">
Tidak spesifik dan berhubungan dengan kebiasaan buruk dalam
mempertahankan kondisi kesehatan dan kebersihan diri. Kadang ditemukan laporan
tentang riwayat terpapar bahan-bahan kimia dari orangtua.</div>
<div class="MsoNormal">
<br /></div>
<h2>
Pola Latihan dan Aktivitas</h2>
<div class="MsoNormal">
Anak penderita ALL sering ditemukan mengalami penurunan
kordinasi dalam pergerakan, keluhan nyeri pada sendi atau tulang.</div>
<div class="MsoNormal">
Anak sering dalam keadaan umum lemah, rewel, dan
ketidakmampuan melaksnakan aktivitas rutin seperti berpakaian, mandi, makan,
toileting secara mandiri. </div>
<div class="MsoNormal">
Dari pemeriksaan fisik dedapatkan penurunan tonus otot, kesadaran somnolence, keluhan jantung
berdebar-debar (palpitasi), adanya murmur, kulit pucat, membran mukosa pucat,
penurunan fungsi saraf kranial dengan atau disertai tanda-tanda perdarahan
serebral.</div>
<div class="MsoNormal">
Anak mudah mengalami kelelahan serta sesak saat beraktifitas
ringan, dapat ditemukan adanya dyspnea, tachipnea, batuk, crackles, ronchi dan
penurunan suara nafas. </div>
<div class="MsoNormal">
Penderita ALL mudah mengalami perdarahan spontan yang tak
terkontrol dengan trauma minimal, gangguan visual akibat perdarahan retina, ,
demam, lebam, purpura, perdarahan gusi, epistaksis.</div>
<div class="MsoNormal">
<br /></div>
<h2>
Pola Nurisi</h2>
<div class="MsoNormal">
Anak sering mengalami penurunan nafsu makan, anorexia,
muntah, perubahan sensasi rasa, penurunan berat badan dan gangguan menelan,
serta pharingitis.</div>
<div class="MsoNormal">
Dari pemerksaan fisik ditemukan adanya distensi abdomen,
penurunan bowel sounds, pembesaran limfa, pembesaran hepar akibat invasi
sel-sel darah putih yang berproliferasi secara abnormal, ikterus, stomatitis,
ulserasi oal, dan adanya pmbesaran gusi
(bisa menjadi indikasi terhadap acute monolytic leukemia)</div>
<div class="MsoNormal">
<br /></div>
<h2>
Pola Eliminasi</h2>
<div class="MsoNormal">
Anak kadang mengalami diare, penegangan pada perianal, nyeri
abdomen, dan ditemukan darah segar dan faeces berwarna ter, darah dalam urin,
serta penurunan urin output.</div>
<div class="MsoNormal">
Pada inspeksi didapatkan adanya abses perianal, serta adanya
hematuria.</div>
<div class="MsoNormal">
<br /></div>
<h2>
Pola Tidur dan Istrahat</h2>
<div class="MsoNormal">
Anak memperlihatkan penurunan aktifitas dan lebih banyak
waktu yang dihabiskan untuk tidur /istrahat karena mudah mengalami kelelahan.</div>
<div class="MsoNormal">
<br /></div>
<h2>
Pola Kognitif dan Persepsi</h2>
<div class="MsoNormal">
Anak penderita ALL sering ditemukan mengalami penurunan
kesadaran (somnolence) , iritabilits otot dan “seizure activity”, adanya
keluhan sakit kepala, disorientasi, karena sel darah putih yang abnormal berinfiltrasi
ke susunan saraf pusat.</div>
<div class="MsoNormal">
<br /></div>
<h2>
Pola Mekanisme Koping dan Stress</h2>
<div class="MsoNormal">
Anak berada dalam kondisi yang lemah dengan pertahan tubuh
yang sangat jelek. Dalam pengkajian dapt ditemukan adanya depresi, withdrawal,
cemas, takut, marah, dan iritabilitas. Juga ditemukan peerubahan suasana hati,
dan bingung.</div>
<div class="MsoNormal">
<br /></div>
<h2>
Pola Seksual</h2>
<div class="MsoNormal">
Pada pasien anak-anak pola seksual belum dapat dikaji</div>
<div class="MsoNormal">
<br /></div>
<h2>
Pola Hubungan Peran</h2>
<div class="MsoNormal">
Pasien anak-anak usia pra sekolah merasa kehilangan
kesempatan bermain dan berkumpul bersama teman-teman serta belajar.</div>
<div class="MsoNormal">
<br /></div>
<h2>
Pola Keyakinan dan Nilai</h2>
<div class="MsoNormal">
Anak pra sekolah mengalami kelemahan umum dan
ketidakberdayaan melakukan ibadah.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<h3>
Pemeriksaan Diagnostik</h3>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo3; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;"> </span><!--[endif]-->Count
Blood Cells : indikasi normocytic, normochromic anemia</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo3; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;"> </span><!--[endif]-->Hemoglobin
: bisa kurang dari 10 gr%</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo3; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;"> </span><!--[endif]-->Retikulosit
: menurun/rendah</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo3; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;"> </span><!--[endif]-->Platelet
count : sangat rendah (<50.000/mm)</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo3; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;"> </span><!--[endif]-->White
Blood cells : > 50.000/cm dengan peningkatan immatur WBC (“kiri ke kanan”)</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo3; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->6.<span style="font-size: 7pt;"> </span><!--[endif]-->Serum/urin
uric acid : meningkat</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo3; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->7.<span style="font-size: 7pt;"> </span><!--[endif]-->Serum
zinc : menurun</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo3; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->8.<span style="font-size: 7pt;"> </span><!--[endif]-->Bone
marrow biopsy : indikasi 60 – 90 % adalah blast sel dengan erythroid prekursor,
sel matur dan penurunan megakaryosit</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l11 level1 lfo3; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->9.<span style="font-size: 7pt;"> </span><!--[endif]-->Rongent
dada dan biopsi kelenjar limfa : menunjukkan tingkat kesulitan tertentu</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<h1>
DIAGNOSA KEPERAWATAN</h1>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l14 level1 lfo4; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;"> </span><!--[endif]-->Resiko
tinggi terhadap infeksi berhubungan dengan perubahan maturitas sel darah merah,
peningkatan jumlah limfosit imatur, imunosupresi</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l14 level1 lfo4; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;"> </span><!--[endif]-->Resiko
terhadap penurunan volume cairan berhubungan dengan pengeluaran berlebihan
seperti muntah, perdarahan, diare, penurunan intake cairan</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l14 level1 lfo4; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;"> </span><!--[endif]-->Perubahan
kenyamanan : Nyeri akut berhubungan dengan
pembesaran kelenjar limfe, efek sekunder pemberian anti leukemic agents</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l14 level1 lfo4; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;"> </span><!--[endif]-->Intoleransi
aktifitas berhubungan dengan kelemahan, penurunan sumber energi, peningkatan
laju metabolik akibat produksi lekosit yang berlebihan, ketidakseimbangan
suplai oksigen dengan kebutuhan</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<h1>
RENCANA KEPERAWATAN</h1>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l4 level1 lfo5; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;"> </span><!--[endif]-->Resiko
tinggi terhadap infeksi berhubungan dengan perubahan maturitas sel darah merah,
peningkatan jumlah limfosit imatur, imunosupresi</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Batasan karakteristik :</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Peningkatan jumlah lekosit</div>
<div class="MsoNormal">
- Count Blood
Cells : indikasi normocytic, normochromic anemia</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Kriteria Hasil :</div>
<div class="MsoNormal">
Klien akan : </div>
<div class="MsoNormal">
1. Mengidentifikasi
faktor resiko yang dapat dikurangi</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l4 level1 lfo5; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;"> </span><!--[endif]-->Menyebutkan
tanda dan gejala dini infeksi</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-table-layout-alt: fixed;">
<tbody>
<tr>
<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 align="center" class="MsoNormal" style="text-align: center;">
Intervensi</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: 212.15pt;" valign="top" width="283">
<div align="center" class="MsoNormal" style="text-align: center;">
Rasional</div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
</tr>
<tr>
<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-left: 18.0pt; mso-list: l3 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Lakukan tindakan untuk mencegah pemajanan pada sumber
yang diketahui atau potensial terhadap infeksi :</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo7; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Pertahankan isolasi protektif sesuai kebijakan
institusional</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo7; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Pertahankan teknik mencuci tangan dengan cermat</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo7; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Beri hygiene yang baik</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo7; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Batasi pengunjung yang sedang demam, flu atau infeksi</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo7; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt;">
</span><!--[endif]-->Berikan hygiene perianal 2 x sehari dan setiap BAB</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo7; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->f.<span style="font-size: 7pt;">
</span><!--[endif]-->Batasi bunga segar dan sayur segar</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo7; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->g.<span style="font-size: 7pt;">
</span><!--[endif]-->Gunakan protokol rawat mulut</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo7; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->h.<span style="font-size: 7pt;">
</span><!--[endif]-->Rawat klien dengan neutropenik terlebih dahulu</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Laporkan bila ada perubahan tanda vital</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: 18.0pt; mso-list: l3 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Dapatkan kultur sputum, urine, diare, darah dan
sekresi tubuh abnormal sesuai anjuran</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Jelaskan alasan kewaspadaan dan pantangan</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;">
</span><!--[endif]-->Yakinkan klien dan keluarganya bahwa peningkatan
kerentanan pada infeksi hanya sementara</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo6; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->6.<span style="font-size: 7pt;">
</span><!--[endif]-->Minimalkan prosedur invasif</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<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: 212.15pt;" valign="top" width="283">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo8; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Kewaspadaan meminimalkan pemajanan klien terhadap
bakteri, virus, dan patogen jamur baik endogen maupun eksogen</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<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: 18.0pt; mso-list: l1 level1 lfo8; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Perubahan tanda-tanda vital merupakan tanda din
terjadinya sepsis, utamanya bila terjadi peningkatan suhu tubuh</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo8; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Kultur dapat mengkonfirmasikan infeksi dan
mengidentifikasi organisme penyebab</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo8; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Pengertian klien dapat memperbaiki kepatuhan dan
mengurangi faktor resiko</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo8; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;">
</span><!--[endif]-->Granulositopeniaa dapat menetap 6-12 minggu.
Pengetian tentang sifat sementara granulositopenia dapat membantu mencegah
kecemasan klien dan keluarganya </div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
6. Prosedur tertentu dapat menyebabkan trauma jaringan,
menngkatkan kerentanan infeksi</div>
<div class="MsoNormal">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l8 level1 lfo12; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;"> </span><!--[endif]-->Resiko
terhadap penurunan volume cairan berhubungan dengan pengeluaran berlebihan
seperti muntah, perdarahan, diare, penurunan intake cairan</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Batasan karakteristik :</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Muntah +</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Perdarahan masif +</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Diare +</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Intake < output</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Kriteria Hasil :</div>
<div class="MsoNormal">
Klien akan :</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level1 lfo9; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;"> </span><!--[endif]-->Memperlihatkan
keadaaan volume cairan yang adekuat</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level1 lfo9; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;"> </span><!--[endif]-->Memperlihatkan
tanda-tanda vital dalam bataas normal</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level1 lfo9; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;"> </span><!--[endif]-->Memperlihatkan
urine output, PH dalam batas normal</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-table-layout-alt: fixed;">
<tbody>
<tr>
<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 align="center" class="MsoNormal" style="text-align: center;">
Intervensi</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: 212.15pt;" valign="top" width="283">
<div align="center" class="MsoNormal" style="text-align: center;">
Rasional</div>
</td>
</tr>
<tr>
<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-left: 18.0pt; mso-list: l5 level1 lfo10; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Monitor intake dan output . Catat penurunan urin, dan
besarnya PH</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
2. Hitung berat badan setiap hari</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
3. Motivasi klien untuk minum 3 – 4 l/hari jika tanpa
kontra indikasi</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level1 lfo9; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Kaji adanya petechie pada kulit dan membran mukosa,
perdarahan gusi</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level1 lfo9; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;">
</span><!--[endif]-->Gunakan alat-alat yang tidak menyebakan resiko
perdarahan</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level1 lfo9; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->6.<span style="font-size: 7pt;">
</span><!--[endif]-->Berikan diet makanan lunak</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Kolaborasi :</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l15 level1 lfo11; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Pemberian cairan sesuai indikasi</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
2. Monitor pemeriksaan diagnostik : Platelet, Hb/Hct,
bekuan darah</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: 212.15pt;" valign="top" width="283">
<div class="MsoNormal">
Penurunan sirkulasi sekunder dapat menyebabkan
berkurangnya sirkulasi ke ginjal atau berkembang menjadi batu ginjal sehingga
menyebabkan retensi cairan atau gagal ginjal</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Sebagai ukuran keadekuatan volume cairan. Intake yang
lebih besar dari output dapat diindikasikan menjadi renal obstruksi.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Meningkatkan aliran urin, mencegah asam urat, dan
membersihkan sisa-sisa obat neoplastik</div>
<div class="MsoNormal">
Supresi bone marrow dan prosuduksi platelet menyebabkan
klien beresiko mengalami perdarahan</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Jaringan yang mudah robek dan mekanisme pembekuan dapat
menyebabkan perdarahan meskipun karena trauma ringan</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Mencegah iritasi gusi</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Mempertahankan cairan dan elektrolit yang tidak bisa
dilakukan per oral, menurunkan komplikasi renal</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Bila platelet <20.000/mm( akibat pengaruh sekunder obat
neoplastik ) , klien cenderung mengalami perdarahan. Penurunan Hb/Hct
berindikasi terhadap perdarahan.</div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
3. Perubahan
kenyamanan : Nyeri akut berhubungan dengan
pembesaran kelenjar limfe, efek sekunder pemberian anti leukemic agents</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Batasan karakteristik :</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Keluhan nyeri (tulang,sarf, sakit kepala, dll)</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Distraksi menahan, ekspresi meringis, menangis,
perubahan tonus otot</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Respon-respons autonomik</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Kriteria hasil :</div>
<div class="MsoNormal">
Klien akan :</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l9 level1 lfo13; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;"> </span><!--[endif]-->Melaporkan
nyeri berkurang atau hilang</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l9 level1 lfo13; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;"> </span><!--[endif]-->Memperlihatkan
perilaku positif dalam mengatasi nyeri</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-table-layout-alt: fixed;">
<tbody>
<tr>
<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 align="center" class="MsoNormal" style="text-align: center;">
Intervensi</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: 212.15pt;" valign="top" width="283">
<div align="center" class="MsoNormal" style="text-align: center;">
Rasional</div>
</td>
</tr>
<tr>
<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-left: 18.0pt; mso-list: l7 level1 lfo14; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Kaji tingkat nyeri, gunakan skala 1 – 10</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo14; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Monitor vital signs, catat reaksi non verbal</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo14; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Ciptakan lingkungan yang tenang dan kurangi stimulus</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo14; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Berikan posisi yang nyaman</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo14; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;">
</span><!--[endif]-->Latih ROM exercise</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo14; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->6.<span style="font-size: 7pt;">
</span><!--[endif]-->Evaluasi mekanisme koping klien</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Kolaborasi :</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l12 level1 lfo15; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Analgetik</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l12 level1 lfo15; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Narkotik</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
3. Tranguilizer</div>
<div class="MsoNormal">
<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: 212.15pt;" valign="top" width="283">
<div class="MsoNormal">
Berguna mengkaji kebutuhan intervensi , bisa berindikasi
perkembangan komplikasi</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Berguna dalam validasi verbal dan mengevaluasi keefektifan
intervensi</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Meningkatkan kemampuan istrahat dan memperkuat kemampuan
koping</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Menurunkan gangguan pada tulang dan sendi</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Meningkatkan sirkulasi jaringan dan mobilitas sendi</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Penggunaan persepsi pribadi untuk mengatasi nyeri dapat
membantu klien memiliki koping yang lebih efektif</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Diberikan untuk nyeri ringan</div>
<div class="MsoNormal">
Cat : jangan menggunakan aspirin karena bisa menyebabkan
perdarahan</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Diberikan untuk nyeri sedang-berat</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Memperkkuat kerja analgetik/narkotik</div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l9 level1 lfo13; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;"> </span><!--[endif]-->Intoleransi
aktifitas berhubungan dengan kelemahan, penurunan sumber energi, peningkatan
laju metabolik akibat produksi lekosit yang berlebihan, ketidakseimbangan
suplai oksigen dengan kebutuhan</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Batasan karakteristik :</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Keluhan lemah, anak memperlihatkan penurunan kemampuan
beraktifitas</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Anak rewel, dyspnea</div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Abnormal HR atau respon perubahan TD</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Kriteria hasil :</div>
<div class="MsoNormal">
Klien akan menunjukkan partisipasi dalam ADL sesuai
kemampuan</div>
<div align="center" class="MsoNormal" style="text-align: center;">
<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-table-layout-alt: fixed;">
<tbody>
<tr>
<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 align="center" class="MsoNormal" style="text-align: center;">
Intervensi</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: 212.15pt;" valign="top" width="283">
<div align="center" class="MsoNormal" style="text-align: center;">
Rasional</div>
</td>
</tr>
<tr>
<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-left: 18.0pt; mso-list: l10 level1 lfo16; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Evaluasi keluhan lemah, rewel, ketidakberdayaan dalam
ADL</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
2.. Ciptakan lingkungan yang tenang dan istrahat yang
tidak terganggu</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l9 level1 lfo13; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Bantu dalam setiap pemenuhan rawat diri/ADL</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l9 level1 lfo13; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;">
</span><!--[endif]-->Jadwalkan pemberian makan sebelum kemoterapi. Beri
oral hidrasi sebelum makan dan anti emetik sesuai indikasi</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Kolaborasi :</div>
<div class="MsoNormal">
Pemberian suplemen O2 sesuai anjuran</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: 212.15pt;" valign="top" width="283">
<div class="MsoNormal">
Efek leukemia, anemia dan kemoterapi dapat menjadi satu
sehingga memerlukan bantuan dalam pemenuhan aktifitas ADL</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Mengumpulkan energi untuk beraktifitas dan untuk
regenerasi sel</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Memaksimalkan kemampuan untuk rawat diri</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Meningkatkan intake sebelum terjadi mual akibat efek
samping kemoterapi</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Memaksimalkan kemampuan oksigenasi untuk uptake seluler</div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<h4>
DAFTAR PUSTAKA</h4>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Boediwarsono, Dr (1998), <i>Bahan
Kuliah Hematologi</i>, FK Universitas Airlangga, Surabaya</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Carpenito, Lynda Juall (2001), <i>Buku Saku Diagnosa Keperawatan</i> edisi 8, EGC, Jakarta</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Carpenito, Lynda Juall (1995<i>), Rencana Asuhan dan Dokumentasi Keperawatan</i>, edisi 2, EGC,
Jakarta</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Gale,Danielle(2000), <i>Rencana
Asuhan Keperawatan Onkologi</i>, EGC, Jakarta</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Hoffbrand, AV (1989<i>), Kapita Selecta Haematology</i>, edisi 2, EGC,
Jakarta</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Luckmann’s Sorensen (1996<i>),
Medical Surgical Nursing, Core Principles</i>, WB Saunders, Philadelphia</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-indent: -42.55pt;">
Probowati,
Ririn SKp (2000<i>), Bahan Kuliah Ilmu
Keperawatan Anak</i>, PSIK, Universitas Airlangga, Surabaya </div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Soeparman (1990), <i>Ilmu
Penyakit Dalam II,</i> Balai Penerbit FKUI, Jakarta</div>
singgih bayuhttp://www.blogger.com/profile/00336623289104205489noreply@blogger.com0