ASUHAN KEPERAWATAN MIOMA UTERUS
Di susun oleh : WAHYUDINOR (12.21.2061) RAHMAT NORFAHMI (10.20.13!) ( 10.20.13!) RAMDHANI "A#UTRA (10.20.13$!) H%NDI&A #RANA #UT%RA (10.20.1'2) NIO DAM%**O (10.20. 130) M.HAIRI MA+MUN (10.20.1'22) A,DI #RA"%TYO (10.20.13$0) RAMANOOR (10.20. D%NY INDRAWAN (10.20 "U#RIADI "A*"ARI (10.20 STIKES (SEKOLAH TINGGI ILMU KESEHATAN) CAHAYA BANGSA BANJARMASIN 2013/2014
KATA PENGANTAR
Assalamu’alaikum .Wr.Wb #u-i su/u su/u /i n-/n n-/n /eh4i /eh4i Allh "WT n5 elh e7ei/n e7ei/n Rh 4n hi4h8NYA sehin55 /i 4 enelesi/n enelesi/n /lh ini e 9/u. T/ lu ul ul shl9 se sl /i hnu/n /e4 N7i 7es Muh4 Muh4 "AW 4n en5i/u 7eliu hin55 /hi n. Rs ei /sih /i si/n /e4 4osen /ee9n enis enis n5 elh e7i e7i7in 7in5 5 /i /i 4l 4l enuli enulisn sn.. Rs Rs ei ei /sih /sih -u5 -u5 /i /i si si/n /n /e4 /e4 en8en n5 elh ee7nu/i 4l en5uul/n 7hn /lh ini se /elu5 /i n5 -u5 i/u 7een 4l /eln;n e7un /lh. "eenuhn /i s4i /lh > les les 4i 4i se5l se5l /e/u /e/un5 n5n n n5 n5 4> 4> seo5 seo5 /lh /lh ini 7en?
DAFTAR ISI
,7 I Tin-un Teoiis Mio Uei.............................................................. Uei...................................................................................1 .....................1 #en5ein........................................ #en5ein............................................................... ............................................... ............................................... ..........................1 ...1 #o5enesis Dn #o?isiolo5i Mio Uei............................................... Uei............................................................1 .............1 %iolo5i.................................... %iolo5i........................................................... .............................................. .............................................. ...................................1 ............1 Tn4 4n @e-l................................................ @e-l....................................................................... .............................................. ...............................2 ........2 #olo5i Anoi/................................... Anoi/........................................................... ............................................... .........................................3 ..................3 #en5uh Mio #4 &ehiln 4n #eslinn..................... #eslinn............................................ ..............................3 .......3 #en5uh &ehiln 4n #eslinn 4 Mio Uei..........................................3 Uei..........................................3 &oli/si...................................... &oli/si............................................................. .............................................. ............................................... ............................' ....' Di5nos......................................... Di5nos................................................................ .............................................. .............................................. ............................' .....' #eei/sn Di5nosi/....................................... Di5nosi/.............................................................. .............................................. .............................' ......' #enn5nn.................................... #enn5nn........................................................... .............................................. .............................................. .............................$ ......$ &onse Ds &ee9n....................... &ee9n.............................................. .............................................. ........................................6 .................6 #en5/-in........................................ #en5/-in............................................................... .............................................. .............................................. ..........................6 ...6 #en5uuln D............................................ D................................................................... .............................................. ................................6 .........6 &eluhn U......................................... U................................................................ .............................................. ........................................6 .................6 Ri9 Reo4u/si....................................... Reo4u/si.............................................................. .............................................. ...................................6 ............6 D #si/olo5i................................. #si/olo5i........................................................ .............................................. ............................................... ............................ .... "us Resisi.......................... Resisi................................................. .............................................. .............................................. ................................. .......... Tin5/ &es4n........................ &es4n............................................... .............................................. .............................................. .............................. ....... "us Uini............................................ Uini................................................................... .............................................. ......................................... .................. "us @soinesinl...................... @soinesinl............................................. .............................................. ............................................... ............................! ....! Di5nos &ee9n..................... &ee9n............................................ .............................................. .............................................. ..........................! ...! Ren;n &ee9n.................... &ee9n........................................... .............................................. .............................................. .............................! ......! ,7 II Tin-un &sus........................................... &sus.................................................................. .............................................. .........................................1' ..................1' #en5/-in........................................ #en5/-in............................................................... .............................................. .............................................. ............................1$ .....1$ #en5uuln D............................................ D................................................................... .............................................. ..................................1$ ...........1$ #een;nn........................................... #een;nn.................... .............................................. .............................................. .............................................. .......................21 21 #el/snn ............................................ ................................................................... ............................................... .............................................2 .....................23 3 ,7 III #enuu..................................... #enuu............................................................ .............................................. .............................................. ...................................2' ............2' &esiuln....................................... &esiuln.............................................................. .............................................. .............................................. ............................2' .....2' D? #us/......................................... #us/................................................................ .............................................. ............................................2 .....................2$ $ BAB I
TINJUAN TEORITIS MIOMA UTERI IK!"#$% D&' P$"&*+ A P$", P$",$' $'+* +*&" &"
Mio uei 4lh neols -in/ n5 7esl 4i oo ueus 4n -in5n i/ n5 enun5n.Oleh /en iu> 4l /eus/n 4i/enl -u5 isilh ?i7oio> leioio> uun ?i7oi4 (Wi/n-osso> 200:33!). Mio Mio uei uei eu eu/n /n uo uo -in/ -in/ oo oo hi> hi> 4ise 4iseii -in5 -in5n n i/n i/n. . "ehin5 "ehin55 5 4 4 4l 4l 7enu/ 7enu/ 4 4 /en /en -in5 -in5n n i/n i/n> > 4oin 4oinn n 4n lun/ lun/ sehin55 oo hin 4oinn (Mnu7> 1!:'0). Mio uei 4lh eu7uhn uo -in/ 4i sel8sel olos iu n5 nn 4i7ei/n sesui 4en5n lo/sin 4i ueus (Hilon> 1$:106).
B P&+!,$"$ P&+!,$"$#*# #*# -&" -&" P&+!.*! P&+!.*!!,* !,* M*!& M*!& U+$'* U+$'*
%iol iolo o5i n5 n5 si si ee-4 4in in io io uei ei s si i s s ini ini 7elu elu 4i/ehui."iulsi eso5en 4i4u5 sn5 7een unu/ e-4in io uei. Hioesis ini 4i4u/un5 oleh 4n io uei n5 7n/ 4ieu/n 4 usi eo4 eo4u/s u/sii 4n /e-4i /e-4inn nn en4h en4h 4 4 usi usi eno enouse use.. #ee #eeun un nuli nuli euni isi/o n5 in55i unu/ e-4in io uei> se4n5/n eeun uli euni isi/o elie enuun unu/ e-4in io uei. Bin Bin5 5n n io io uei uei le7i le7ih h 7n 7n/ / en5 en5n n4u 4un5 n5 ese eseo o eso eso5e 5en n -i/ -i/ 4i7n4in5/n 4en5n ioeiu nol. #eu7uhn io uei 7eisi 4 sei in4ii4u> 7h/n 4i n no4ul io 4 ueus n5 s. #e7e4n ini 7e/in 4en5n -ulh eseo eso5en 4n eseo o5eseone.
C E+*! +*!!, !,*
Wluun io uei e-4i 7n/ n ene77> nun hsil eneliin Mille 4n *is;hul n5 en5u/n 7h9 e-4in io uei e5nun5 4 sel8sel iu n5 e4 4 <ell Nes= n5 seln-un 4 4in5sn5 eus eneus oleh eso5en. Nun 4ei/in> 7e7e ?;o n5 4 en-4i ?;o en4u/un5 e-4in io 4lh : 9ni usi 3$8'$ hun> hil 4 usi u4> 5enei;>
8 /sino5eni/> se4n5/n n5 en-4i ?;o en;eus 4i e-4in o uei 4lh 4n sel n5 iu 4n e-4i 4 5n4euli. D T&"T&"-& & -&" -&" G$ G$& && &
A4n A4n o o i4 i4/ / sell sellu u e7 e7e ei/ i/n n 5e-l 5e-l /e /en n iu iu o o sein sein5 5 4ieu/n n 4isen5-> iu 4 s eei/sn 5ine/olo5i/. @e-l n5 4ieu/n 4ieu/nun un sn5 e5nun5 e5nun5 4 e sn5 o iu 7e4> 7e4> 7esn 7esn uo> eu7hn 4n /oli/si n5 e-4i ( "9ono> 1 ). A4un n48n4 n5 uun e-4i 4lh : •
Tuo ss> 4i79h eu "ein5 /li en4ei e5i /e 4o/e oleh /en 4n 5e-l ini.
•
#e4hn n5 7nol @n55un @n55un e4hn e4hn n5 e-4i uun uun 4lh hieenoe> hieenoe> eno5i> eno5i> 4n 4n 4 4 -u5 -u5 e- e-4i 4i e eo o5 5i. i. ,e7e ,e7e ?; ?;o o n5 n5 enen-4i 4i en ene7 e77 7 e4hn ini> n lin 4lh : 8
en en5u 5uh h oi iu u seh sehin5 in55 ee-4 4il ilh h hi hie elsi lsi en4 en4oe oei iu u s si i 4eno/sino en4oeiu.
8
#e #eu/ u/ n n en4 en4o oe ei iu u n5 n5 le7 le7ih ih lus lus 4i 4i 4 4 7i 7is s..
8
Ao?i en en4oeiu iu 4i s io su su7u/osu. u.
8
Mioeiu i4/ 4 7e/on/si oil /en 4n sn5 io 4in se7u ioeiu> sehin55 i4/ 4 en-ei e7uluh 4h n5 elluin 4en5n 7i/.
•
Rs Nei Rs nei nei 7u/nl 7u/nlh h 5e-l 5e-l n5 n5 /hs /hs ei ei 4 4 i7ul i7ul /en /en 5n55 5n55un un si/u si/ul lsi si 4h 4h 4 4 sn sn5 5 o o> > n5 n5 4ise 4ise ii ne/ ne/os osis is see see 4n 4n e4n5n
•
@e-l 4n Tn4 ene/nn
@n55u @n55un n ini e5n e5nun un5 5 4i 4i 7es 7es 4n e e o o uei. uei. #ene/ #ene/nn nn 4 4 /n4un /n4un5 5 /eih /eih /n /n ene7 ene77/ 7/n n oliu oliui> i> 4 4 ue ue 4 4 ene ene77 77/n /n eensio uine> 4 uee 4 ene77/n hi4ouee 4n hi4one?osis> 4 e;u e;u 4 4 ene7 ene77/ 7/n n o7si o7sisi si 4n enesi enesi>> 4 4 e7ul e7uluh uh 4h 4h 4n e7uluh li?e 4i n55ul 4 4 ene77/n e4e un5/i 4n nei nei n55ul. •
In?eilis 4n A7ous In?ei In?eili liss 4 4 e-4i e-4i 7il 7il sn5 sn5 io io enuu enuu u u ene/n ene/n u u enuu s inesiil u7> se4n5/n io su7u/osu -u5 eu4h/n e-4in 7ous oleh /en 4isosi on55 ueus.
E P&+! P&+!! !,* ,* A"&+ A"&+! !* *
Menuu le/n> io 4 4i75i: 1. Mio Mio su7 su7u/ u/os osu uCC 7e 7e4 4 4i 79 79h h en4o en4oe e iu iu 4n 4n eno enonn-ol ol /e 4l 4l on55 on55 ueus ueus.. Mio Mio ini 4 4 u7uh u7uh 7en 7en5/ 5/ii en-4i en-4i oli> oli> /eu4i /eu4in n 4ilhi/n ellui slun sei/s (o 5e7u). 2. Mio Mio in in u ulC lC io io e4 e4 4i 4in 4in4in 4in5 ue ueus us 4i n n se se7u 7u ioeiu. 3. Mio Mio su7seos su7seosu uCC 7il 7il u7uh u7uh /e lu 4in4in5 4in4in5 ueus ueus sehin5 sehin55 5 enon-o enon-oll 4 eu/n ueus> 4iliui oleh seos. Mio ini 4 u7uh 4i n /e4u lisn li5enu lu en-4i io uei inli5ene. "n5 io 4 en5li ne/osis 4n in?e/si n5 4ie/i/n /en 5n55un si/ulsi 4hn.Misln e-4i 4 io n5 4ilhi/n hin55 e4hn 7eu eo5i u eno5i 4isei leu/oe 4n 5n55un8 5n55un n5 4ise77/n oleh in?e/si 4i ueus sen4ii. F P$",&' P$",&' M*!& %&-& K$&*&" K$&*&" -&" -&" P$'#&*" P$'#&*"&" &"
Te4 io uei un5/in en5/i7/n hl8hl se75i 7ei/uC 1. Men5un5i Men5un5i /eun /eun5/inn 5/inn eeun eeun en-4i en-4i hil> hil> eu eu 4 io io uei uei su7u/osu. 2. &eun5 &eun5/in /inn n 7ou 7ouss 7e 7e7 7h. h. 3. &eli &elin nn n le/ le/ -nin -nin 4l 4l hi hi>> eu eu 4 4 io io n5 n5 7es 7es 4n le/ le/ su7seosu. '. Men5hln5 Men5hln5ii lhin lhin 7i> eu eu 4 4 io io n5 le/n le/n 4i sei/s. sei/s. $. Mee Meesuli suli lesn lesn lsen lsen> > eu eu 4 io io n5 n5 su78u/o su78u/osu su 4n inul.
G P$",&' P$",&' K$&*& K$&*&" " -&" P$'#&*"&" P$'#&*"&" %&-& %&-& M*!& U+$'* U+$'*
"e7li/n> /ehiln 4n eslinn 4 een5uhi io uei en-4iC 1. Tuo Tuo u7uh u7uh le7ih ;e ;e 4l 4l /ehiln /ehiln /i7 /i7 hieo? hieo?ii 4n e4e> e4e> eu eu 4l 4l 7uln 7uln87u 87ul ln n e e > > un5 un5/i /in n /en /en en5 en5 uh uh ho hoon onl l.. "ee "eelh lh /ehiln ' 7uln uo i4/ 7e7h 7es l5i. 2. Tuo Tuo en-4i en-4i le7ih lun/ lun/ 4l /ehi /ehiln ln>> 4 4 7eu7h 7eu7h 7enu/> 7enu/> 4n u4h u4h e-4i 5n55un si/ulsi 4i 4ln> sehin55 e-4i e4hn 4n ne/osis> eu 4i en5h8en5h uo. 3. Mio uei uei su7seosu su7seosu n5 7en5 7en5/i /i 4 4 en5li en5li un un n5/i n5/i /i7 /i7 4es/n ueus n5 /in l /in e7es.
HG$&& K*"*# K*"*# M*!& U+$'*
1. #e #e4 4 h hn n i4 i4/ / no no ll Hie Hi e en eno oe e
e4 e 4 h hn n
7n 7 n/ /
s s
ens e ns u usi si
/e / en n
elu e lus sn n
e e u/ u/ n n
en4o en 4oe ei iu u 4 4l l os oses es e ens ns u usi> si> 5 5n5 n55u 5un n /o /on n/ /si si o oo o hi hi> > e e4 4 h hn n 7e/en-n5n. A/i7 e4hn en4ei 4 en5eluh neis /en /e/un5n 4h> usin5> ;e lelh> 4n u4h e-4i in?e/si.
2. #en #ene/ e/nn nn h hi i n5 n5 e e7es 7es
D en5/i7/n es 7e 4i 74oen 75in 79h> su/ i/si4e?e/si> es nei /en ee/nn u s?.
IK!%**
1.#eu7uhn leiios/o. Mio 4i;ui5i se75i s;o 7il sel 7e7e hun i4/ e7es> se/onon5 E /onon5 en-4i 7es 7il hl iu e-4i sesu4h enouse
2.Tosi (un n5/i)
A4 /ln n5/i 4 io uei su7seosu en5li un. &lu oses ini e-4i en44/> uo /n en5li 5n55un si/ulsi /u 4en5n ne/osis -in5n 4n /n / 57n /lini/ 4i 74oen /u. 3.Ne/osis 4n In?e/si #4 o su7seosu n5 en-4i oli> u-un5 uo> /4n58/4n5 4 ellui /nlis sei/lis 4n 4ilhi/n 4i 5in> 4l hl ini /eun5/inn 5n55un siusi 4en5n /i7 ne/osis 4n in?e/si se/un4e. JD*&,"!#*#
Den5n 7e/e7n5n ulsono5?i> 7i/ 74oinl uun ns85inl> 4i5nosis io sn5 4ieu4h.MRI (5nei; esonn;e i5in5) -u5 4 4ie5un/ 4ie5un/n n 4l /ehiln /en MRI i4/ e/i 4isi ionissi.T ionissi.T8";n 8";n eu/n /onin4i/si oleh /en 4isi. Di5 Di5no nosis sis io io ue ueii 4l 4l /eh /ehi il ln n 7is 7isn n i4 i4/ / suli suli 9l 9lu uun un /4n58/4n5 4i7u /eslhn.Teu /ehiln /e7> neols oiu> 4n ueus 4i4el?is 4 enes/n 4i5nosis.A4n /ln io 7es e7 seei /el -nin> sehin55 /ehiln un55l 4isn5/ /ehiln /e7C u io /e;il 4isn5/ 75in /e;il -nin. Mio n5 lun/ 4n i4/ ene77/n /elinn 7enu/ ueus sn5 suli unu/ 4i7e4/n 4i7e4/n 4i ueus ueus 5i4us.,h 5i4us.,h/n> /n> 4 looi looi 9/u eu e7u/> e7u/> /4n58/4n5 i4/ un5/in unu/ 4i7u 4i5nosis n5 e. K P$$'*#&&" D*&,"!#+*
1.#e 1.#ee ei i/s /sn n D Dh h *en5 *en5/ / : H7: H7: uu uun> n> Al7u Al7ui in: n:
uu uun> n>
*e/o *e/osi si
:
uu uun n
enin5 enin5/> /> %i %iosi osi : uun uun 2.U"@ : elih ss 4 4eh ueus. 3.5inl Tou;he : 4i4/n e4hn e5in> e7 ss> /onsisensi 4n u/unn. '."iolo5i : enenu/n in5/ /e5nsn 4i sel8sel neols ese7u.> $.Ron5en : unu/ en5ehui /elinn n5 un5/in 4 n5 4 en5h7 in4/n oesi. 6.%@ 6.%@ : Men4e Men4ee/s e/sii /elin /elinn n n5 n5 un5/ un5/in in e-4i e-4i>> n5 n5 4 4 een een5 5uhi uhi
in4/n oesi. LP$"&",&"&"
R9 in 4u 4iin4i/i/n 7il e4hn en5n; -i9 u nei /u /u 74o 74oe en. n. #ee #een; n;n nn n l/s l/sn n hu huss 4ises 4isesu ui/ i/n n 4n 4n sesi sesi?i ?i/ / s s ei7n5n : /ehn 5e-l> /ein5inn euni n/ 4i /eu4in hi> 4n u/un uo. 1.
&ue55e en4oeiu D D en5 en5i4 i4en eni i?i ?i/s /sii /el /elin inn n 4 4 en4o en4oe ei iu u 4 en enin in5/ 5/i i/ /n n
/eun5/in /eun5/inn n /e5nsn /e5nsn en4oeiu en4oeiu.A7 .A7il il leioio leioio u/unn u/unn /e;il> i4/ en5u7h on55 en4oeiu 4n 7il en4oeiu enun-u//n e4hn nolu nolun ni i / / 4 4 4iei 4iei7 7n5/ n5/n n unu/ unu/ ene/ ene/no noi iu u 4en5n 4en5n 7le 7le /o7insi eso5en8o5esin.Hoon E hoon ese7u hus 4i5un/n 4en5n hi8hi> /en 4 e7n5/i/n leioio n5 su4h 4. 2.
#en5o7n oei? ( Mioe/oi 4n Hisee/oi ) Mio Mioe/ e/o oi i 4in 4in-u -u/ /n n 7i 7il l
sie sien n
hen4 hen4/ / e ee eh hn n/ /n n
u u
enin//n oensin unu/ hil. His Hise ee/ e/o oi i
eu eu / /n n
en5 en5o7 o7 n n
4e?i 4e?ini nii ie e
unu unu/ /
5e- 5e-l l
n5 n5
esisen.Nun> hiee/oi 4in-u/n 75i sien8sien sioi/ n5 i4/ l5i en5hen4/i n/ 4i /eu4in hi. 3.
R4ioei Tin4/n ini 7eu-un 5 oiu i4/ 7e?un5si l5i sehin55 en4ei
en5li en5li enouse. enouse.R4io R4ioei ei ini uun uun hn hn 4i/e-/n 4i/e-/n /lu e4 e4 /on in4i/si unu/ in4/n oei?.
IIK!"#$% D&' A#&" K$%$'&&+&" 1P$",&*&"
#en5/ #en5/-in -in 4lh 4lh ln5/ ln5/h h 9l 9l 4l 4l el/u el/u/n /n suhn suhn /ee9 /ee9 n n se; se; /esel /eselu uuh uhn n.. #en5 #en5/ /-i -in n e4 e4i iii 4i 4i i5 i5 h h n n iu iu C en5 en5u uu uln ln 4> 4> en5elo/n 4 u nlis nlis 4 4n euusn 4i5nose /ee9n (De/es RI> 11 ). &P$",%&" D&+&
#en5uuln 4 eu/n /e5in 4l en5hiun i?osi (484) 4i 4i /lien. /lien. D D n5 n5 4 4 4i/u 4i/uul/ ul/n n 4 4 /lien /lien sesu4h sesu4h e7e4 e7e4h hn n Tol Tol A74oinl Hsee/o n4 ,ilel "lhin5o Oohoe;o (TAH8,"O ) 4lh se75i 7ei/u . Mio Mio 7isn 7isn e-4i e-4i 4 4 usi usi eo4 eo4u/ u/i?> i?> lin5 lin5 sein5 sein5 4ieu/ 4ieu/n n 4 4 usi usi 3$ hun /es. 7. M/in u usi / olensi eh4 nei /n 7e/un5 ;. On5 On5 4e9s eun eun ii 4n en5e en5ehu huii ; e?e/i? e?e/i? 4l 4l ene enesui sui/n /n 4ii eu eu eh4 eu7hn eu7hn n5 n5 e-4i 4 4iin 4iin /i7 /i7 in4/n TAH8 TAH8 ,"O. 5 K$&" U+&&
&eluhn n5 i7ul 4 hi i -enis oesi 4lh s nei /en e-4i oe oeh hn n i i/ /n> n> ni niu ul lsi si -in -in5 5n n o5 o5n. n.R Rs s nei nei seel seelh h 7e4 7e4h h 7is 7isn n 7eln5sun5 2'8'! -. A4un A4un n5 elu 4i/-i 4 s nei ese7u 4lh : . *o/ *o/si si nei nei : 7. Inensis nei ;. W W/ /u u 4n 4n 4u 4usi si 4. &9l &9li is s nei nei.. 6 R*&&+ R$%'!-#*
.Hi4 Di/-i enn5 i9 en;he 4n hi4 e/hi> se77 io uei i4/ enh 4ieu/n se7elu en;he 4n en5li o?i 4 s enouse 7.Hil 4n #eslinn
1) &ehiln &ehiln een5uh een5uhii eu7uhn eu7uhn io> io> 4in io uei u7uh ;e 4 s hil ini
4ihu7un5/n 4en5n hoon eso5en> 4 s ii
4ihsil/n 4l -ulh n5 7es. 2) Bul Bulh h /eh /ehi il ln n 4n 4n n/ n/ n5 n5 hi4u hi4u e een en5 5u uhi hi si/ si/ol olo5 o5ii /lien /lien 4n 4n /elu5 eh4 hiln5n oi5n /e9nin.
- D&+& P#*!!,*
#en5n5/n o5n eo4u/si 4 sn5 7een5uh eh4 eosionl /lien 4n 4n 4ie 4iel lu/ u/n n 9/ 9/u u unu unu/ / eu euli li eu eu7 7h hn n n5 n5 e- e-4i 4i.. O5 O5n n e eo4 o4u/ u/si si eu/n /oonen /e9nin> 9ni elih ?un5si ensusi se75i l7n5 ?einis> ?einis> sehin55 sehin55 7ehenin 7ehenin ensusi ensusi 7is 4is/n se75i se75i hiln5n hiln5n esn esn /e9nin. #esn #esn se/su se/suli lis s 4l 4l i hu7un5 hu7un5n n se/sul se/sul elu elu 4in5 4in5ni ni .,e7e .,e7e 9ni 9ni es es ;e ;ess 7h9 7h9 hu7u hu7un5 n5n n se/su se/suli li ss eh ehl ln n5i 5i u u hil hiln5 n5n n /eu /eus sn. n. #en5ehun /lien enn5 4/ n5 /n e-4i sn5 elu esin si/olo5i /lien. $S+&+# R$#%*'&+!'*
Resisi 7is enin5/ u enuun . #en?sn n5 i7u 4 e4en5 n seos/o. ,uni en?sn /i7 li4h -uh /e7el/n5 u /i7 e4 se;e. "u "u u n5 /s eu/n eu/n 5e-l 5e-l e4 se;e 4 slun slun n?s . Ush 7u/ 7u/ 4n 7en?s 7en?s 4l 4il/sln/ 4il/sln/n n se5e 4 /lien n5 e/i e/i nesesi 5enel. . T*",&+ K$#&-&'&"
Tin5/ Tin5/ /es4n /es4n 4i7u/ 4i7u/i/n i/n ellui ellui en enn n se4ehn se4ehn n5 n5 hus hus 4i-97 4i-97 oleh /lien u 4i suuh unu/ el/u/n einh. isi in5/ /es4n 4iuli 4i 4i siun siun si si n5nu n5nu/ / > hus hus 4i o7se o7sesi si 4n enuu enuunn nn in5/ in5/ /es4 /es4n n eu/n 5e-l so/.
,S+&+# U'*"&'*
Reensi Reensi uine lin5 uu uu e-4i seelh e7e4hn e7e4hn 5ine/olo 5ine/olo5i> 5i> /lien n5 n5 hi4si hi4sin n 7i/ 7i/ 7isn 7isn 7i/ 7isn 7isn
/en;in /en;in5 5 seelh seelh 6 si si ! - seelh seelh
e7e4hn. Bulh uu uine n5 se4i/i /i7 /ehiln5n ;in u7uh s oesi> unh /i7 nesesi.
S+&+# G+'!*"+$#+*"& G+'!*"+$#+*"&
Fun5si
5soinesinl
7isn
ulih
4
2'8'
-
seelh
e7e4hn>e5nun5 4 /e/un e?e/ n/ose 4 ene/nn inesinl. A7uloi A7uloi 4n /oes /oes hn5 hn5 elu 4i7ei/n unu/ en5hiln5/n en5hiln5/n 5s 4l usus. 2
D*&,"!#& K$%$'&&+&"
1. Resi/o Resi/o 5n5un #e?usi -in5n -in5n 7ehu7un5n 7ehu7un5n 4en5n enuunn enuunn lin 4h se/un4e se/un4e /i7 uo 2. @n55un @n55un s nn nn (nei ) 7. 4 ne/osis ne/osis u -in5n -in5n 4n e?le/s sse oo se/un4e /i7 uo 3. 5n55un ol ol eliinsi ui 7.4 7.4 ene/n uo uo 4 /n4un5 /n4un5 /en;in5 . '. @n55un @n55un ol eliinsi eliinsi Ali 7. 4 ene/nn ene/nn uo uo 4 e;u $. es 7. 4 /un5n /un5n ene5hun ene5hun enn5 en/i en/i se enl/snn 6. Resi/o Resi/o e-4i in?e/si 7. 4 enuunn enuunn iun u7uh u7uh se/un4e /i7 /i7 5n55un heolo5 heolo5is is (e4hn)
R%NANA &%#%RAWATAN Di5nos :Gangguan :Gangguan perfusi jaringan b.d penurunan aliran darah sekunder akibat tumor Tu-un
: Ti4/ e-4i 5n55un e?usi -in5n sel 4l e9n
&iei &iei
: H7 : 11 11 E 13 5 G. Tn4 Tn4 il il 4l 4l 7s 7s no nol> l> ;ill ;ill e?il e?illl Nol Nol>> &on-un5i Ti4/ neis
Ren;n ineensi : 1. &-i i ill si5n> si5n> en5is en5isin in /i /ile le.> .> /4 /4 H7 R Menu /on4is /lien 4n unu/ eneu/n in4/n seln-un 2. O7se O7sesi si e4 e4h hn n n5 n5 4
R Mene Meneu u/ /n n -ul -ulh h 4h 4h n5 n5 hiln hiln5 5 sehin sehin55 55 4 4 4il 4il/u /u/ /n n in4 in4/ /n n seln-un 3. ,ei O/si5en O/si5en sesui sesui /e7uuh /e7uuhn n 7il un;ul un;ul n48 n48n4 n4 so/ so/ hioole hioolei/ i/ R Men;e5h hio/si /i7 /ehiln5n 7n/ 4h '. &ol7osi &ol7osi e7e e7ein in ;in ;in inen inen u u ns?usi ns?usi sesui sesui /e7uuhn /e7uuhn R en55ni en55ni ;in 4h n5 hiln5 hiln5 $. e ln-u/ ln-u/n n o7sesi o7sesi il il si5n si5n i 2 - si si /e4n /e4n e7i/ e7i/ R e5elusi in4/n /ee9n n5 4il/u/n Di5nos 2 : Nyeri Nyeri b. d nekrosis/trauma jaringan dan dan spasme otot sekunder akibat tumor Tu-un : "eelh 4il/u/n in4/n /ee9n 4ih/n nei nei 7e/un5 &iei : 8 sien i4/ en/n en/n nei u nei 7e/un5 8 ine inens nsi is s ne nei i 7e/ 7e/u un n5 5 8 %/s %/ses esii u/ u/ >u >u7u 7uh h ele ele/s /s
Ren;n Ineensi : 1. &-i lo/si> lo/si> inensi inensis> s> /uli /uliss 4n 4n /9ni /9nis s nei nei R Meeu/n lo/si 4n su7e nei unu/ eneu/n in4/n seln-un 2. ,i;/n ,i;/n lsn lsn en5 en5 in4ii4u in4ii4u en5li en5li nei nei R e7ei en5ehun /lien enn5 ?isiolo5is nei 3. A-/n A-/n ehni/ ehni/ el/s el/ssi si 4n 4n 4is 4is/si /si R Rel/ssi 4n 4is/si en5un5i nei 4en5n en5lih/n ehin /lien eh4 nei. '. &ol7o &ol7osi si e7e e7ein in nl5e nl5ei/ i/ R Anl5ei/ e7lo/s iuls nei /e o/ sehin55 nei 7e/un5. Di5 Di5no nos s 3 :Cemas Cemas b. d kurang kurangnya nya pengetah pengetahuan uan tentang tentang kanker kanker servik servik dan pengobatannya Tu-un Tu-un
: "eelh 4i7ei in4/n in4/n /ee9n /ee9n sel 2' - ;es sien 7e/un5 hiln5
&iei
: 8 #sien en5un5//n s ;esn 7e/un5 8 #sien en5i4en en5i4eni?i/ i?i/si si n4 4n 5e-l n5 n5 hus 4ilo/n 4ilo/n 8 #sien en5i4en en5i4eni?i/ i?i/si/n si/n su7e su7e /oin5 n5 n5 4i5un/n 4i5un/n 8 Men5u/ Men5u/n n 4n en5ei en5ei ; en5un en5un5i 5i /e;esn /e;esn
Ineensi : 1.
,ei ,ei /ese /esen n 4 /lien /lien 4n 4n /elu5 /elu5 unu/ unu/ en5un en5un5/ 5// /n n esn esn 4n> l/u/n /on/ n5 sein5 R &on/ sein5 /n eni7ul/n s e; 4 e9
2.
Doon5 Doon5 4is/ 4is/usi usi e7u e7u/ / enn enn5 5 io> io> en5l en5ln n on5 on5 lin> lin> en5o7 en5o7n n 4n ene7uhnn. ene7uhnn. R 4en5n 7e7i; se; e7u/ 4 /lien enn5 /n hi4u /n e7ei 4oon5n 4n hn /lien
3.
TunTun-u/ u// /n n 4n 4n h h n n R &lien hus e un hn 4n oisi unu/ e el/u/n en5o7n.
'.
/-i /-i su7 su7e e ;oi ;oin5 n5 n5 n5 ese ese4i 4i R Men5i4eni?i/si ;oin5 osii? /lien
$.
A-/n A-/n /lien /lien unu/ unu/ en55u en55un/ n/n n ;oin ;oin5 5 n5 n5 osi osii? i? R oin5 osii? eu/n slh su ; en5un5i /e;esn
BAB II TINJAUAN KASUS A
P$",&*&"
Tn55l #en5/-in
: 1! Buli 2011> u/ul 0.00 WI,
Te #en5/-in
: #oli &n4un5n R"U# 4."oe4ono M4iun
1
P$",%&" -& -&+& A
,io4
D&+& #5$+*.
Isi
"ui
N
: N. <#=
Tn <"=
Uu
: $0 h
$$ h
A5
: Isl
Isl
"u/u7n5s
: B9In4onesi
B9In4onesi
#en4i4i/n
: "D
"D
#e/e-n
: ,uuh
,uuh
#en5hsiln
: R. 600.000>87ln
R. 600.000>87ln
"us il
: Meni/h
Meni/h
*7 ni/h : 2 h1
2 h1
Al
: @o7o5n RT.1!0 Bi9n> M4iun
No. e5ise
: 68'28$86
2).&eluhn u I7u 4n5 4i oli /n4un5n R"U# D."oe4ono M4iun /en in5in /onol os /ue5e io uei. I7u en5eluh usin5.
3).Ri9 /esehn ) Ri Ri9 9 /eseh /eseh n n n5 n5 llu llu
I7u en5/n i4/ enh en4ei en/i 4en5n 5e-l -nun5 7e4e784e7 (en/i -nun5)> e/nn 4h in55i (hieensi)> 7u/ l le7ih 4i 2 in55u (T,)> s/i s ,A& (5in-l)> 7n/ /n> 7n/ inu 4n sein5 /en;in5 (DM)> 5n55un -i9 uun e7e/un 4h. I7u i4/ enh oesi 4i 4eh eu> 4ise/i n55ul> l 5eneli uun 75in u7uh n5 lin. "e7elun euni /eluhn 4 9/u 7e/i?is> /eu4in ei/s /e oli /n4un5n 4 n55l n55l $ Buli 2011 4n MR" n55l n55l 6 Buli 2011 4en5n 4i5nos io uei (5e7on). Men-lni ;ue5e 4n n?usi 4 n55l Buli 2011. 7) Ri9 /esehn se/n5 I7u en5/n s ini 4l /e4n seh> su4h i4/ en5li e4hn 4n nei eu hn se4i/i usin5. ;) Ri Ri9 9 /eseh /eseh n n /elu /elu5 5 Di4l /elu5 i4/ 4 n5 en4ei en/i seei n5 se4n5 4i4ei i7u se/n5 4) Ri Ri9 9 /e7i4 /e7i4n nn n
Ri9 hi4 Men;he usi 1' hun> hi4 eu si/lus 30 hi> l hi4 hi> 5ni e7lu 3 sehi /onsisensi en;e. I7u i4/ es/n nei s hi4. "e-/ 2 7uln e/hi ini i7u en5eluh e4hn> 4n 4ise/i 7en-oln es nei 7il unu/ /iis 7e.
Ri9 /ehiln> eslinn 4n ni?s #'000' n/ e si 4en5n /ee 7is 4iolon5 7i4n. "el /ehiln 4n eslinn si 4en5n ni?s 4i n/ e si /ee i7u sellu seh / enh en5li /e4n n5 7nol. "eu n/ lhi ;u/u 7uln. An/ e/e;il 7eusi 10 hun.
e) Ri9 &, &, "e-/ /elhin n/ e i7u en55un/n &, suni/. "eelh /elhin n/ e/hi i7u en5i/ui o5 &, seil hun 2000. ?) #o #ol l /e /e7i 7is sn n seh sehi i8h 8hi i
Nuisi
"e7elu MR" : M/n 3 sehi 4en5n /oosisi nsi> su (s9i> 7> /n5/un5)> lu/ (hu> ee> elu). Minu J 6 5els ehi (i uih J eh hn5> /4n58/4n5 /oi). "el 4i R" : /n 3 /li sehi 4en5n /oosisi nsi> su (9oel> /;n5 n-n5> 7) 4n lu/ (45in5> hu> hu> ee). Minu i uih 3 7ool Ku Ku L lien J2 5els eh hn5 sehi.
%liinsi
"e7elu MR" : ,A, 1 sehi> /onsisensi le7e/> 9n /unin5 en55uli> 7u /hs. ,A& '8$ /li sehi 9n /unin5 -enih. I7u es/n nei 4i 4eh 7en-oln s ,A&. "el 4i R": ,A, 1 sehi> /onsisensi /onsisensi le7e/> 9n /unin5 en55uli> 7u /hs. /hs. ,A& $86 /li sehi 9n /unin5 -enih
Isih Diuh> I7u 7is i4u l ! - (21.00 E 0$.00 WI,).i4u sin5 J 1 - (- 13.00 E 1'.00 WI,) i4/ 4 5n55un "el 4i R" : Ti4u l - 21.00 WI,> l sein5 e7n5un /en eu5s n5 en55ni in?us> 7n5un 5i - 0'.00 WI,. "in5 i4u sel 2 - (- 11.00 E 13.00 WI,).
#esonl h5iene Diuh> i7u n4i 2 sehi 5i 4n soe. @oso/ 5i5i 7esn 4en5n n4i. @ni /in 4n ;eln 4l 2 sehi. &es 2 sein55u 4en5n sho. "eh7is ,A, uun ,A& sellu ;e7o/ 4en5n s7un 4n i 7esih 4i 4en /e 7el/n5. Al5i sel en5elu/n 4h i7u sellu ;e7o/. "el 4i R" : I7u hn 4isi7in /en 4isn5 in?us> 5ni /in 1 sehi> 5ni so?e 2 sehi 5i 4n soe.
A/iis I7u 7e/e- se75i e45n5 4n 7is en5e-/n e/e-n uh isln es/> en;u;i 4n enu.
Re/esi
Diuh i7u en-ln/n /iisn se75i i7u uh n55 4n se75i 7uuh 4i7nu n/n n5 in55l seuh. Tei sel s/i i7u le7ih 7n/ isih 4iuh.
"el 4i R" i7u hn isih 4i e i4u /en 4i7ei 7hn in?us sehin55 /un5 lelus 7e5e/. Hn /lu ,A,,A& i7u -ln /e / n4i 4i7nu /elu5. 5) &o &on4 n4isi isi #s #si/ i/os osoi oil l I7u es /u 4n /h9i se-/ en4ei en/i ese7u. Wluun 4ei/in> i7u su4h enei /e4nn. I7u sein5 enn/n enn5 /eln-un 4i oses en5o7n. h) "iiul I7u el/sn/n shol $ 9/u 4n 7eus 4i 7uln 4hn. W/u 4i R" / 7is el/u/n shol 4en5n seesin /en 4isn5 in?us. Hn s- i7u sellu 7e4o 4n sh 4 /e4nn. i) &e &e4 4 n n so sosi sil l 7u4 7u4 "e7elu uun sel 4i9 4i uh s/i i7u i4/ enh inu -u8-un. 1.
D o7 o7e/i? 1) &e &e4 4 n n u uu u &es4n
: An Ane eis is : oosenis
2) T Tn4 n48 8n n4 4 i i ll T
: 10110 H5
"
: 36>$ o
N
: !' n
R
: 2' n
T,
: 1$$ ;
,,
: $6 /5
3) #e #ee ei i/s /s n n ?isi/ ?isi/ &el : R7 R7u u 7esih> 7esih> 9n hi 4 se4i/i se4i/i u7n u7n>> ese7n ese7n e e>> 7n/ n5 ono/ Mu/ : ,esih> i4/ se77 M: "ieis> ;on-un5i le7 le7 neis> s/le uih> uih> 5/ u; @i5i 4n 4n ulu ulu : Mulu 7esih> i4/ i4/ 4 ;ies> u/os u/os 7i7i 5/ /ein5. Telin5
: ,enu/ sieis> se4i/i se;e .
Hi4un5
: Ti4/ 4 oli> i4/ e4 en?sn ;uin5 hi4un5.
*ehe
: Ti Ti4/ 4 4 e e7esn /e /elen- oi4 uun /e /elen- li li?e> i4/ 4 7en4un5n en -u5ulis.
D4
: "ieis> i i4/ 4 eni/n 4in4in5 44 s 7en?s> i4/ 4 7uni on;hi 4n 9eehin5.
Me
: ,enu/ sieis> i4/ 4 7en-oln 7nol 4 u4
A74oen
: Ti4/ Ti4/ e4 7en-oln 7nol> i4/ e4 nei e/n
@ene @e ne li li
: Ti Ti4 4/ / e e4 4 e en5 n5el elu u n n 4 4 h h e e 5 5in in >> i i4 4/ / 4 4 ;on4ilo /uinl> i4/ 4 i;es>i4/ 4 e7en5//n /elen- s/ene 4n /elen- 7olini> i4/ e4 /euihn.
Anus
: Ti4/ 4 heooi4.
%/seis
:
•
As
: "ieis> /e4u n5n 4 4i5e//n 4en5n 7is
•
,9h
: ,enu/ sieis> i4/ 4 oe4e> i4/ 4 i;es.
') #e #ee ei/ i/s sn n enu enunn-n n5 5 Hsil #A (olo5i noi) n55l $ Buli 2011. •
*eioo uei
•
%n4oeiu /elen- ?se se/esi ie5ul she4in5 H, e/hi n55l 11 Buli 2011 >3 5G. Tei : E #lsine
•
1.
i , ole
31 7le
31 7le
Anlis 4 Di5nosslh
#'000'> usi i7u $0 hun 4en5n os ;ue5e 4n eesi io uei hi /e8.
D 4s
D" : E I7u I7u en5/n en5/n elh euni ' on5 n/> e/e;il 7eusi 10 hun> lhi ;u/u 7uln. 8 I7u en5/n usin se/n5 $0 hun. 8 I7u en5/n elh en-lni ;ue5e 4n n?usi ' /ol? s in4i/si io uei 4 n55l Buli 2011 4n se/n5 su4h i4/ es nei s 7e/i?is. 8 I7u en5/n es/n ;es /h en/in 7is se7uh ol u i4/. 8 I7u en5/n sih es/n usin5 4n les. DO : 8 &e4n uu : Aneis 8 &es4n : ;oosenis 8 Tn48n4 il T : 10110 H5 " : 36>$ o N : !' n R : 2' n T, 1$$ ;
Di5nosslh
D 4s
,, $6 /5 8 M : ;on-un5i le7 neis> s/le uih> uih> 5/ u;> 7enu/ sieis. 8 A74oen : Ti4/ e4 uo> i4/ 4 lu/ 7e/s oesi> i4/ e4 nei e/n. Telh 4il/u/n ;ue5e n55l Buli 2011. 8 H7 n55l n55l 11 -uli 2011 >3 5G. D": I7u en5/n usin5. DO: Tn48n4 il:
#usin5 sehu7un5n 4en5n enin5/n e/nn 4h.
8
T : 10110 H5
8
" : 36>$ 0
8
N : !' eni
8
R : 2' e
CP$'$"6&"&&"
Tn55l 1! Buli 2011 Di5nos Tu-un
: #'000'> usi i7u $0 hun os ;ue5e 4n eesi io uei hi /e8 4en5n slh nei 4n hieensi. : E Anei esi
•
Rs nn eenuhi
•
es 7e/un5 &iei
•
: E &U i7u 7i/
TT : T 1100 1100 E 1'00 H5 N 0 E 6 eni eni " 36>$ E 3>$ 0 R 16 E 20 eni
•
&on-un5i le7 eh u4
•
H7 nol (12816 5G)
•
&lien 4 en5un5//n /e;esnn
•
&lien enn5
•
&lien en5ei enn5 en/in.
Ineensi : Bels/n /e4 /lien enn5 /e4nn R /lien en5ei 4n /ooei? 4en5n in4/n n5 /n 4il/u/n. O7sesi n48n4 il R es en5sn5 enin5/n hoon 4enlin sehin55 e/nn 4h 4n n4i enin5/ &ol7osi 4en5n i 5ii unu/ e7ein 4ii T&T# R oein e7nu enin5/n H7 &ol7osi 4en5n i 5ii unu/ e7ein 4ii en4h 5 R @ 4 e7u e/nn 4h se/in enin5/ An-u/n 4 i7u unu/ en-5 /e7esihn 4eh 5eneli R Men-5 /e7esihn 4 en5hin4/n 4i in?e/si Y/in/n sien 7h9 en/in Insllh 4 4ise7uh/n
R Me7ei/n hn 5 sien es /in 4n oiis A-/n 4 i7u ; inu o7 n5 7en R #e7ein ei n5 e /n ee;e oses ene7uhn An-u/n 4 sien unu/ sellu 7e4o sesui 4en5n /e/innn R Do 4 enen/n hi sehin55 ;es 7e/un5. D
P$&#&"&&"
Tn55l 1! Buli 2011 u/ul 10.00 WI, Di5nos : #'000'> usi i7u $0 hun os ;ue5e 4n eesi io uei hi /e8 4en5n slh nei 4n hieensi. #o5nos 7i/. Ileensi 1. Men-els/n Men-els/n 4 4 /lien /lien enn5 enn5 /e4nn /e4nn 7h9 s ini ini uo uo 4l u7uh u7uh i7u i7u su4h 4i7il 4n i7u i4/ elu /h9i. 2. Men5o7se Men5o7sesi si TT. TT. Di4/ Di4/n: n: T 101 10110 10 H5> H5> " 36>$ 0> N !' eni> R 2' eni. 3. Mel/u Mel/u/n /n /ol7o /ol7osi si 4en5n 4en5n i 5ii unu/ unu/ e7ei e7ein n 4ii T&T# T&T#.. '.
Mel/u/n Mel/u /n /ol7os /ol7osii 4en5n 4en5n i e4is e4is unu/ unu/ e7ein e7ein o7 o7 ni nei. nei.
$. Mel/u Mel/u/n /n /ol7o /ol7osi si 4en5n 4en5n i e4is e4is unu/ unu/ e7ein e7ein o7 o7 ni hiee hieensi. nsi. 6. Men5n-u/n Men5n-u/n 4 4 i7u unu/ unu/ sellu en-5 en-5 /e7esih /e7esih5n 5n 5in 5in seei 5ni 5ni ;eln ;eln 4l inil 2 sehi7sh> ;e7o/ 4i h 4en /e 7el/n5.
BABI III PENUTUP A KE KESI SIMP MPUL ULAN AN
Mio uei 4lh neols -in/ n5 7esl 4i oo ueus 4n -in5n i/ n5 enun5n. Oleh /en iu> 4l /eus/n 4i/enl -u5 isilh ?i7oio> leioio> uun ?i7oi4. %iolo5i n5 si e-4in io uei si s ini 7elu 4i/ehui. "iulsi eso5en 4i4u5 sn5 7een unu/ e-4in io uei. Hioesis ini 4i4u/un5 oleh 4n io uei n5 7n/ 4ieu 4ieu/n /n 4 4 usi usi eo4 eo4u/s u/sii 4n /e-4i /e-4inn nn en4h en4h 4 4 usi usi eno enouse. use. #eeun #eeun nuli euni euni isi/o n5 in55i unu/ e-4in e-4in io io uei> se4n5/n eeun uli euni isi/o elie enuun unu/ e-4in io uei. Bin5n io uei le7ih 7n/ en5n4un5 eseo eso5en -i/ 4i7n4in5/n 4en5n ioeiu nol. #eu7uhn io uei 7eisi 4 sei in4ii4u> 7h/n 4i n no4ul io 4 ueus n5 s. #e7e4n ini 7e/in 4en5n -ulh eseo eso5en 4n eseo o5eseone. Menuu le/n> io 4 4i75i: 1.Mio su7u/osu 2. Mio inul 3.Mio su7seosu #4 #4 uun uun i4/ i4/ 4il/u 4il/u/n /n oesi oesi unu/ unu/ en5n en5n5/ 5/ io io 4l 4l /ehi /ehiln ln.. Dei/i Dei/in n ul ul i4/ i4/ 4il/u 4il/u/n /n 7ou 7ouss oo/ oo/u us. s. A7il A7il e-4 e-4ii 4e5enesi eh 4 io 4en5n 5e-l85e-l seei 4ise7u 4i s> 7isn si/ /onsei? 4en5n isih87in5 4n en59sn n5 /e e7ei hsil n5 ;u/u eus/n.
DAFTAR PUSTAKA
,5in O7sei P @ine/olo5i F&. Un4. 13. Ginekologi 13. Ginekologi.. %ls. ,n4un5
enio> *n4 Bull> 2000. Buku 2000. Buku aku !iagnosa "epera#atan. "epera#atan . %4isi !.%@. B/ @lle> Dnielle. hee> Bne.2000. $en%ana Bne.2000. $en%ana Asuhan "epera#atan "epera#atan &nkologi.%@. &nkologi. %@. B/ Hono> Hono> #oe4-o. #oe4-o. 2000. 2000. "anker "anker erviks/ erviks/'eh 'eher er $ahim $ahim ( )asala )asalah h krini krining ng di *ndone *ndonesia sia.. &usus # /on5es &O@I I Dens. Mi7 ol.$ No.2 Mei 2001 2001. !iktat 2001. !iktat "uliah *lmu "epera#atan )aternitas TA : 200001 #"I&.F&. Uni> "u7 "i?i4in> A74ul ,i>4//. 2001. Buku A%uan Nasional +elayanan "esehatan )aternal dan Neonatal. Ysn ,in #us/ "9ono #9ioh4-o P BN&&R8#O@I. B/