ASUHAN ASU HAN KEPERAW KEP ERAWA ATAN PERSALINAN PREMATUR
Oleh :
Riris Purwita Widodo 220110120048
Fakutas K!"!rawata# U#i$!rsitas Pad%ad%ara# 201&
ASUHAN KEPERAWA KEPERAWATAN PERSALINAN PE RSALINAN PREMATUR
A. Kons Konsep ep Medi Medik k 1. Definisi P!"#s p!e$"#!#s% pd hid &n' "e!"#!% pe!slinn p!e"e!$ dp" didefinisikn se('i pe!slinn &n' "e!)di n"! #si keh$iln *+,- $in''# dihi"#n' d!i h!i pe!"$ hid "e!khi!. /A0O%1223. Men#!#" Wi(o4o /1223 &n' $en'#"ip pendp" d!i He!!on%dkk. Pe!slinn p!e$"#! dlh kon"!ksi #"e!#s &n' "e!"#! se"elh keh$iln *+ $in''# dn se(el#$ - $in''#% den'n in"e!5l kon"!ksi 6 hin'' 7 $eni" "# k#!n' dn dise!"i s"# "# le(ih "nd,"nd (e!ik#" : 1. Pe!#(hn se!5iks &n' p!o'!esif. *. Dil"si se!5iks * 8$ "# le(ih. -. Penipisn se!5iks 7+9 Men#!#" i!$ns&h /*++;3 $en'"kn p!"#s p!e$"#! dlh kelhi!n (&i pd s" $s keh$iln k#!n' d!i *62 h!i dihi"#n' d!i h!i "e!khi! hid i(#. Men#!#" Mo8h"! /12273 p!"#s p!e$"#! dlh pe!slinn pd keh$iln *7 s$pi - $in''#% (e!" (dn lhi! 1+++ s$pi *6++ '!$. P!"#s p!e$"#! dlh pe!slinn p #$#! keh$iln k#!n' d!i - $in'''# "# (e!" (dn lhi! n"! 6++ s$pi *<22 '!$. /Ss"!4in"% *++-3. *. E"iolo'i Pen&e(( Pen&e(( seki"! seki"! 6+9 kelhi!n kelhi!n p!e$"#!e p!e$"#!e "idk dike"h#i. dike"h#i. N$#n% sepe!"i' sepe!"i' pe!slinn p!e$"#!e "e!)di se"elh ke"#(n pe8h dini /PROM3. Ko$pliksi keh$iln lin% &n' (e!h#(#n'n den'n pe!slinn p!e$"#!e% $elip#"i keh$iln $#l"i )nin%hid!$nion% se!5iks "idk ko$pe"en% plsen" leps se8! p!e$"#!e dn infeksi "e!"en"# /sepe!"i% polinef!i"is dn ko!io$nioni"is3 /Ande!sen% Me!k"=% 122+3. Pd ke(n&kn ks#s% pen&e(( ps"i p!"#s p!e$"#!#s "idk dike"h#i% n$#n $en#!# $en#!#"" Ro$ps Ro$ps /*++<3 /*++<3 d (e(e! (e(e!p p !esiko !esiko &n' &n' dp" dp" $en&e(( $en&e((kn kn p!"#s p!"#s p!e$"#!% &i"# : . k" k"o! o! !esi !esiko ko $&o $&o! ! Keh$iln $#l"iple% hid!$nion% no$li #"e!#s% se!5iks "e!(#k le(ih d!i 1 8$ pd keh$iln -* $in''#% !i4&" (o!"#s pd "!i$es"e! II le(ih d!i s"# s"# kli% kli% !i4& !i4&"" pe!sl pe!slin inn n p!e$" p!e$"#! #! se(el# se(el#$n& $n&% % ope!si ope!si (do$i (do$inl nl pd pd keh$iln p!e"e!$% !i4&" ope!si konissi konissi dn i!i"(ili"s #"e!#s. (. k"o! !esiko $ino! : Pen&ki" &n' dise!"i de$$% pe!d!hn pe!5'in$ se"elh keh$iln 1* $in''#% !i4&" pielonefi"is% $e!okok le(ih d!i 1+ ("n' pe!h!i% !i4&" (o!"#s "!i$es"e! II% !i4&" (o!"#s pd "!i$es"e! I le(ih d!i s"# kli.
Men#!#" Men#!#" Mn#( Mn#( /12273 /12273%% fk"o!, fk"o!,fk fk"o! "o! &n' &n' dp" dp" $en&e(( $en&e((kn kn "e!)d "e!)din& in& pe!slinn p!e"e!$ /p!e$"#!3 "# (e!" (dn lhi! !endh dlh : 1. k"o! i(# : ,
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-. Mnifes"si Klinis 1. Ski" Ski" k!$ k!$ sepe! sepe!"i "i $ens $ens"! "!#s #sii dp" dp" $e$(i $e$(in' n'#n' #n'k kn n den' den'n n ski ski"" lin' lin'k k! ! li'$en. *. Ski" p#n''#n'% p#n''#n'% (e!(ed (e!(ed den'n den'n &n' &n' dl$i dl$i oleh oleh 4ni" 4ni" h$il. h$il. -. Tekn Teknn n "# "# ski" ski" s#p!p#(i s#p!p#(ik% k% dp" dp" $e$(in'#n $e$(in'#n'kn 'kn den'n den'n infeks infeksii sl#! sl#!n n ken8in'. <. Senssi Senssi "ekn "eknn n "# "# (e!" (e!" pel5ik pel5iks. s. 6. Pe!#(hn Pe!#(hn k!k"e! k!k"e! )$lh $#"n $#"n 5'inl /le(ih /le(ih "e(l% "e(l% le(ih "ipis% "ipis% (e!i!% (e!i!% (e!d!h% (e!d!h% 8okl"% "# "k (e!4!n3. ;. Di!!he.
. Kon"!ksi Kon"!ksi #"e!#s #"e!#s &n' "idk "idk no!$l /ski" /ski" "# "# "idk3 "e!s "e!s le(ih le(ih se!in' se!in' d!i pd se"ip 1+ $eni" #n"#k 1 )$ "# le(ih dn "idk se$(#h den'n (e!(!in'. 7. Pe8h Pe8h $e$ $e$(! (!n n p!e p!e$ $"# "#!!. Tnd dn 'e)l kelinn p!e"e!$ h!#s "e!$s#k se('i !#"in pendidikn 4ni" seki"! *+,*< $in''# keh$iln.
<. P" P"ofi ofisiol siolo' o'ii En=i$ si"okinin dn p!os"'lndin% !#p"#! $e$(!n% ke"#(n pe8h% li!n d!h ke plsen plsen" " &n' &n' (e!k#! (e!k#!n' n' $en'ki $en'ki("k ("kn n n&e!i n&e!i dn in"ole in"ole!n !nsi si k"ifi k"ifi"s "s &n' &n' $eni$(#lkn kon"!ksi #"e!#s% sehin'' $en&e((kn pe!slinn p!e$"#!. Aki(" d!i pe!slinn pe!slinn p!e$"#! (e!d$pk (e!d$pk pd )nin dn pd i(#. Pd )nin% $en&e(( $en&e((kn kn kelhi kelhi! ! &n' &n' (el#$ (el#$ pd 4k"#n& 4k"#n& sehin' sehin'' ' "e!)i "e!)ilh lh i$"#! i$"#!i" i"ss )!in'n pd )nin. Slh s"# d$pkn& "e!)dilh $"#!i"s p!# &n' $en&e((kn !esiko 8ide! pd )nin. Sedn'kn pd i(#% !esiko "in''i pd keseh"n &n' $en&e((kn nsie"s dn k#!n'n& k#!n'n& info!$si info!$si "en"n' keh$iln keh$iln $en'ki("kn $en'ki("kn k#!n'n& pen'e"h#n #n"#k $e!4" dn $en)' keseh"n s" keh$iln. 6. As#h As#hn n Kep Kepe! e!4 4" "n n 6.1 Pen'k)in A. Si!k Si!k#l #ls sii Hipe!"ensi% Ede$ p"olo'is /"nd hipe!"ensi k!en keh$iln /HKK33% pen&ki" se(el#$n&. @. In"! In"!e' e'i" i"s s E'o E'o Adn& nsie"s sedn'. 0. Mknn ? 8i!n Ke"idkdek#"n "# pen$(hn (e!" (dn (e!le(ihn. D. N&e!i ? K"idkn&$nn Kon"!ksi in"e!$i"en s$pi !e'#l! &n' )!kn& k#!n' d!i 1+ $eni" sel$ plin' sediki" -+ de"ik dl$ -+,;+ $eni".
E. Pe!nfsn M#n'kin
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. Ke$nn Infeksi $#n'kin d /$isln& infeksi sl#!n ke$ih /ISK3 dn "# infeksi 5'in3 . Seks#li"s T#ln' se!5ikl dil"si. Pe!d!hn $#n'kin "e!lih". Me$(!n $#n'kin !#p"#! /KPD3. Pe!d!hn "!i$es"e! ke"i'. Ri4&" (o!si% pe!slinn p!e$"#!% !i4&" (iopsi kon#s. U"e!#s U"e!#s $#n'ki $#n'kin n dis"en dis"ensi si (e!le( (e!le(ih ihn% n% k!en k!en hid!$ hid!$nio nion% n% $k!os $k!oso$i o$i "# "# 'e"si 'e"si $#l"iple. H. In"e!ksi sosil M#n'kin "e!'olon' pd kels sosil &n' !endh.
I. Pe$e!iksn di'nos"ik Ul"!sono'!fi : Pen'k)in 'e"si /den'n (e!" (dn )nin 6++ s$pi *6++ '!$3 Tes Tes ni"!=in : $enen"#kn KPD >#$lh sel d!h p#"ih : >ik $en'l$i penin'k"n% $k i"# $enndkn dn& infeks infeksii $nios $niosen" en"esi esiss &i"# &i"# !dio !dio lesi"i lesi"in n "e!hd "e!hdp p sfin' sfin'o$i o$ieli elin n /L?S3 /L?S3 $ende" $ende"eks eksii fof" of"iidi'l di'liise! se!ol /P3 P3 #n" #n"#k $"#! "#!i" i"s s p! p!# )ni )nin% n% "# "# infek nfekssi $ni $nio" o"iik. Pe$n"#n elek"!onik : $e$flidsi k"ifi"s #"e!#s ? s""#s )nin. 6.*. Di'nos 1. Ak"ifi"s Ak"ifi"s inole! inole!n n (e!h#(#n'n (e!h#(#n'n den'n den'n hipe!sensi"i hipe!sensi"i5i"s 5i"s o"o" o"o" ? sel#le! sel#le!.. *. Ke!8#nn% Ke!8#nn% !esiko !esiko "in''i. "in''i. k"o! k"o! !esiko !esiko dp" $elip#"i $elip#"i "oksik "oksik &n' &n' (e!h#(#n'n (e!h#(#n'n den'n dosis ? efek s$pin' "okoli"ik. -. 0ede! !esiko !esiko "in''i "in''i "e!hdp "e!hdp )nin% (e!h#(#n (e!h#(#n'n 'n den'n den'n !esiko !esiko $elhi!kn $elhi!kn (&i (&i p!e"e!$.
<. Ansi Ansie" e"s s%% ke" ke"k# k#" "n n (e!h (e!h#( #(#n #n' 'n n den' den'n n k!is k!isis is si"# si"#s sio ion nl% l% n8 n8$ $n n &n' &n' di!skn "# k"#l pd di!i dn )nin. 6. K#!n K#!n' ' pen'e pen'e" "h# h#n n $en'e $en'en nii pe!s pe!sl lin inn n p!e" p!e"e!$ e!$%% ke(# ke(#"# "#h hn n "ind "indkn kn dn p!o'nosis (e!h#(#n'n den'n keslhn in"e!p!e"si "# k#!n' info!$si. ;. N&e!i N&e!i k#" "# ke"idkn& ke"idkn&$ $nn nn (e!h#(#n (e!h#(#n'n 'n den'n den'n kon"!k kon"!ksi si o"o" dn efek o(",o("n. 6.-. In"e!5ensi 1. Di'nos : Ak"ifi"s inole!n (e!h#(#n'n den'n hipe!sensi"i5i"s o"o" ? sel#le!. T#)#n : Men#!#nkn "in'k" k"ifi"s. In"e!5ensi Rsionl : ,
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>elsk >elskn n lsn lsn pe!l#n& pe!l#n& "i!h (!in' (!in'%% pen''#nn pen''#nn posisi posisi !ek#$ !ek#$(en (en ki!i?$ ki!i?$i!i i!in' n' dn pen#!#nn k"ifi"s. Tindkn ini di"#)#kn #n"#k $e$pe!"hnkn )nin )#h d!i se!5ik se!5ikss dn $enin' $enin'k" k"kn kn pe!f#s pe!f#sii #"e!#s% #"e!#s% "i!h "i!h (!in' (!in' dp" dp" $en#!# $en#!#nkn nkn pek pek !n'sn' #"e!#s. @e!i @e!ik kn n "ind "indk kn n ken& ken&$ $n nn n sepe sepe!" !"ii 'oso 'osok kn n p#n'' p#n''#n #n'% '% pe!# pe!#( (hn hn posi posisi si%% "# "# pen#!#nn s"i$#l#s dl$ !#n'n /$isln& l$p# !ed#p3 Men#!#nkn "e'n'n o"o" dn kelelhn se!" $enin'k"kn !s n&$n. Kelo Kelo$p $pokk okkn n k"i k"i5i 5i" "ss se( se(n& n&k k $#n'k $#n'kin in%% sepe sepe!" !"ii pe$(e! pe$(e!i in n o(" o(" "nd "nd 5i"l 5i"l dn dn pen'k)in. Menin'k"kn kese$p"n klien #n"#k (e!is"i!h" le(ih l$ din"! in"e!#psi #n"#k "indkn (e!ik#"n&. @e!i @e!ik kn n pe!i pe!iod odee "np "np in"e in"e!# !#ps psii #n"# #n"#k k is"i is"i! !h h"? "?"i "id# d#!!. Meni Menin' n'k k"k "kn n is"i is"i! !h h"% "% $en8e'h kelelhn% dn dp" $enin'k"kn !elkssi. @e!ik @e!ikn n k"i5i" k"i5i"ss pen'lih pen'lihn% n% sepe!" sepe!"ii $e$(8% $e$(8% $enden $enden'! '!kn kn !sio !sio dn $enon"o $enon"on n "ele5isi "# k#n)#n'n den'n "e$n &n' dipilih "# kel#!'. Me$(n"# klien dl$ kopin' den'n pen#!#nn k"ifi"s .
*. Di'nos Di'nos : Ke!8#n Ke!8#nn% n% !esiko !esiko "in''i "in''i.. k"o! k"o! !esiko !esiko dp" dp" $elip# $elip#"i "i "oksik "oksik &n' &n' (e!h#(#n'n den'n dosis ? efek s$pin' "okoli"ik T#)#n : Men8e'h "# $e$ini$lkn 8ede! $"e!l Mndi!i. In"e!5ensi Rsionl : ,
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Te$p"k Te$p"kn n klien klien pd pd posisi posisi l"e!l l"e!l%% "in''ikn "in''ikn kepl kepl sel$ sel$ pe$(e!in pe$(e!in inf#s o(" I Men#!#nkn i!i(ili"s #"e!in% $enin'k"kn pe!f#si plsen" dn $en8e'h hipo"ensi s#pine. Pn" Pn"# # "nd "nd 5i" 5i"l% l% #sk #sk#l #l" "si si p!# p!#%% pe!h pe!h" "ik ikn n i!e' i!e'#l #l! !i" i"s s )n" )n"#n #n' ' dn dn lpo! lpo!k kn n dispne dispne ? sesk sesk dd. dd. Ko$pli Ko$pliks ksi% i% sepe!" sepe!"ii ede$ ede$ p#l$on p#l$one! e!%% dis!i" dis!i"$i $i )n"#n )n"#n' ' ?
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"kik "kik!di !di% % 'i"s 'i"sii % dispne dispne% % n&e!i n&e!i dd dd dn penin' penin'k" k"n n pd 5ol#$e 5ol#$e pls$ pls$ $#n'ki $#n'kin n "e!)d "e!)dii pd pe$(e!i pe$(e!in n 'nosi 'nosiss !esep" !esep"o! o! (e" (e" /!i"!o /!i"!odin din%% isoB#p! isoB#p!in3 in3 dn "e!(#" "e!(#"li lin n s#lf" s#lf"%% &n' &n' $e!n' $e!n'sn sn' ' !esep" !esep"o! o! (e"* (e"* /kh#s# /kh#s#sn& sn& pd pen''#n pen''#nn n s"e!oid (e!s$3. Ti$(n' Ti$(n' klien klien se"ip se"ip h!i Me$e!iks Me$e!iks po"ensil po"ensil pe!#(h pe!#(hn n f#n'si f#n'si pe!ke$i pe!ke$ihn hn ? !e"ensi !e"ensi 8i!n. Pn"# Pn"# dn& dn& $en'n $en'n"#k "#k%% ke$e!h ke$e!hn n k!en k!en pns% pns% dep!esi dep!esi pe!nf pe!nfs sn n dn dep!esi dep!esi !eflek !eflekss "endon "endon dl$ dl$ den'n den'n "ep". "ep". Tnd nd dep!esi dep!esi ne#!o$# ne#!o$#sk# sk#l! l!%% $ennd $enndkn kn $enin'k"kn kd! M'SO< se!#$. Sedi Sedik kn n n"i n"ido" do" /Kls /Klsi# i#$ $ 'l#ko 'l#kon n"" #n"# #n"#k k M'SO M'SO< < p!op p!opno noll #n"# #n"#k k !i"! !i"!odi odin n "# "# "e!(#l"in s#lf"3. Pe$(e!in n"ido" $#n'kin pe!l# #n"#k $e$(lik "# $en'"si efek 'en "okoi"ik. Kol(o!si
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In"e!5ensi Rsionl : @n" @n"# # ses# ses#i i ke(#" ke(#"#h #hn n den' den'n n pe$e pe$e!i !iks ks n n 5'in 5'in s"e! s"e!il il Un"#k Un"#k $en'k $en'k) )ii s"" s""#s #s se!5ik se!5ikl. l. Pe$e!i Pe$e!iks ksn n 5'inl 5'inl dipe!" dipe!"hn hnkn kn $ini$# $ini$#$% $% k!en k!en hl ini dp" dp" $en$(h $en$(h kepekn kepekn #"e!#s. #"e!#s. Ke$nn Ke$nn "okoli"ik "okoli"ik (il se!5iks se!5iks (e!dil"si (e!dil"si le(ih d!i < 8$ "# "# $enon non)ol 7+9 "idk di dok#$ ok#$en en""sikn dn se8! #$#$ #$#$ di kon"!indiksikn. @e!i @e!ik kn n l!# l!#" "n n I "# lo(#s lo(#s 8i! 8i!n n ses# ses#i i indi indik ksi si.. Hid! Hid!s sii dp dp"$ "$en en#! #!#n #nkn kn k"ifi"s #"e!#s. Se(el#$ $#li "e!pi o("% hid!si $enin'k"kn kli!ens 'in)l dn $e$in$lkn hipo"ensi. @e!i @e!ik kn n nife nifedi dipi pine ne /p!o8 /p!o8!d !di i33 di "eln "eln dn dik#n dik#n& &h h den' den'n n $k $kn n dn dn $in#$ $in#$.. Nifedipine dp" di'n"i den'n "e!(#"lin s#lf". Nifedipin% pen&ek" sl#!n klsi#$% di'#nkn se8! pe!8o(n (il o(" lin ''l #n"#k $enekn k"ifi"s #"e!#s. Psn' kos kki n"ie$ n"ie$(olik (olik dn (e!ikn (e!ikn l"ihn l"ihn !en"n' !en"n' 'e!k 'e!k psif psif pd pd kki kki se"ip se"ip 1,*)$. Men8e'h pen'#$p#ln d!h pd eks"!e$i"s (4h% &n' dp" "e!)di k!en !elkssi o"o" hl#s. Ps Psn' n' k"e k"e""e! ind4e nd4ellln' ses# es#ii indik ndiks sii. Hl# Hl#! !n n #!i #!in h!# h!#ss dip dipn" n"# #d dn n dipe!"hnkn (il $e$(e!ikn M'SO<. Hl#!n h!#s pd sediki"kn& -+ $l?)$ "# 1++ $l pd pe!iode < )$. A"#! A"#! #n"#k $e$ind $e$indhk hkn n klien ke fsili fsili"s "s !esiko !esiko "in''i "in''i "# "# p#s" p#s" pe!4" pe!4"n n "!sie! "!sie!%% (il k"ifi"s #"e!#s $ene"p (e!s$n den'n pe$(e!in "okoli"ik. Me$(n"# $en)$in ke"e!sedin pe!4"n in"ensif &n' "ep"% &n' $#n'kin dipe!l#kn oleh (&i (!# lhi! (e!s$n den'n kelhi!n p!e"e!$.
-. Di'nos : 0ede! !esiko "in''i "e!hdp )nin% (e!h#(#n'n den'n !esiko $elhi!kn (&i p!e"e!$.
T#)#n T#)#n : Me$pe!"hn Me$pe!"hnkn kn keh$iln keh$iln sediki"n& sediki"n& s$pi s$pi kondisi kondisi &n' $en#n)#kkn $"#"i"s (&i. In"e!5ensi Rsionl : ,
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K)i kondisi kondisi i(# i(# &n' &n' di kon"!indik kon"!indiksikn sikn "e!hdp "e!hdp "e!pi "e!pi s"e!oid s"e!oid #n"#k #n"#k $e$#dhkn $e$#dhkn $"# $"#!i !i" "ss p!# p!# )ni )nin. n. Pd Pd HKK HKK dn dn ko!i ko!io o$n $nio ioni ni"i "is% s% "e! "e!pi pi s"e! s"e!oi oid d dp dp"" $e$pe!(e!" $e$pe!(e!" hipe!"ensi hipe!"ensi dn $en#"#pi $en#"#pi "nd infeksi. S"e!oid dp" $enin'k"kn $enin'k"kn 'l#kos d!h pd psien den'n di(e"es. O(" "idk kn efek"if (il "idk $$p# $en#nd kelhi!n sediki"n& <7 )$. K)i K)i D>> D>> C pe!h pe!h" "ik ikn n dn dn& & k"i k"ifi fi" "ss #"e! #"e!#s #s "# "# pe!# pe!#( (h hn n se5i se5ik kl. l. Sip Sipk kn n "e!hd "e!hdp p ke$#n' ke$#n'kin kinn n kelhi kelhi!n !n p!e"e! p!e"e!$. $. Tokoli okoli"ik "ik dp" dp" $enin' $enin'k" k"kn kn D>>. D>>. Kelhi!n dp" sn'" 8ep" pd (&i ke8il (il kon"!ksi #"e!#s $ene"p "idk !esponsif pd "okoli"ik% "# (il pe!#(hn se!5ikl (e !ln)#". Tekn Teknkn kn pen"in' pen"in'n& n& pe!4 pe!4"n "n "ind "indk k ln)#" ln)#" >ik )nin )nin "idk "idk dilhi dilhi!k !kn n dl$ h!i d!i pe$(e!in "e!oid% dosis h!#s di#ln' se"ip $in''#. @e!ik @e!ikn n "e!pi "okol "okoli"i i"ik k ses#i ses#i pesn pesnn n Me$(n"# Me$(n"# $en#!#n $en#!#nkn kn k"ifi" k"ifi"s s s$io$e s$io$e"!i "!il l #n"#k $en8e'h ? $en#nd kelhi!n dini.
<. Di'nos : Ansie"s% ke"k#"n (e!h#(#n'n den'n k!isis si"#sionl% n8$n &n' di!skn "# k"#l pd di!i dn )nin. T#)#n : Men'#n'kpkn pe$h$n si"#si indi5id# dn k$#n'kinn hsil khi!. In"e!5ensi Rsionl : , ,
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O!ien" O!ien"si sikn kn klien klien dn psn psn'n 'n pd pd lin'k#n' lin'k#n'n n pe!sli pe!slinn nn.. Me$(n"# Me$(n"# klien klien dn o!n' "e!dek" $e!s $#dh dn le(ih n&$n pd seki"! $e!ek An)#!k An)#!kn n pen''#n pen''#nn n "eknik "eknik !elks !elkssi si Me$#n Me$#n'ki 'kink nkn n klien $endp $endp"k "k ke#n" ke#n"#n' #n'n n $ksi$#$ $ksi$#$ d!i pe!iode is"i!!h is"i!!h"% "% $en8e'h $en8e'h kelelhn kelelhn o"o" dn $e$pe!(iki $e$pe!(iki li!n d!h #"e!#s. An)#!k An)#!kn n pen'#n' pen'#n'kp kpn n !s !s !s "k#k "k#k dn $sl $slh. h. Dp" Dp" $e$(n" $e$(n"# # $en#!#nk $en#!#nkn n nsie"s dn $e!n'sn' iden"ifiksi pe!ilk# kopin'. @e!ik @e!ikn n sed"if sed"if (il (il "indk "indkn n lin "idk "idk (e!hs (e!hsil il Me$(e!i Me$(e!ikn kn efek efek $enenn' $enenn'kn kn dn "!#ilise!.
6. Di'nos : K#!n' pen'e"h#n $en'eni pe!slinn p!e"e!$% ke(#"#hn "indkn dn p!o'nosis (e!h#(#n'n den'n keslhn in"e!p!e"si "# k#!n' info!$si. T#)#n : Men'#n'kpkn kesd!n "en"n' i$pliksi dn ke$#n'kinn hsil pe!slinn p!e"e!$. Mndi!i
In"e!5ensi Rsionl : , , , ,
Ps" Ps"ik ikn n pen' pen'e" e"h h# #n n klie klien n "en" "en"n n' ' pe!s pe!sl lin inn n p!e" p!e"e! e!$ $ dn dn ke$ ke$#n'k #n'kin inn n hsi hsill Me$(#" d" ds! dn $en'iden"ifiksi ke(#"#hn @e!ik @e!ikn n info!$s info!$sii "en"n' "en"n' pe!4 pe!4"n "n "indk "indk ln)# ln)#"" (il klien klien p#ln' p#ln' Klien Klien $#n'kin $#n'kin pe!l# ke$(li #n"#k ke"e!"#!n pe$n"#n dn "# "indkn An)#!k An)#!kn n klien klien $en'os $en'oson'k on'kn n knd#n' knd#n' ke$ih ke$ih se"ip se"ip * )$ s" s" "e!) "e!)' '.. Men8e'h Men8e'h "eknn knd#n' ke$ih pen#h pd #"e!#s &n' pek. Tin) Tin)# # #ln' #ln' ke(#"# ke(#"#h hn n 8i! 8i!n n se"i se"ip p h!i% h!i% $isl $isln& n& * s$pi s$pi - #!" #!" /1%2 /1%2 *%71 *%7133 8i!n dn $en'hind!i kfein. Dehid!si dpF" $eni$(#lkn penin'k"n kepekn o"o" #"e!#s.
Kol(o!si
In"e!5ensi Rsionl : ,
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Teknk knkn n #n"# #n"#k k $en' $en'hi hind nd! !ii o(" o(" &n' &n' di)# di)#l l (e( (e(ss se$e se$en" n"! ! 'en 'en "oko "okoli li"i "ik k di(e!ikn ke8#li den'n i=in dok"e!. Pen''#nn (e!s$n den'n o(" &n' di)#l (e(s dp" $en&e((kn efek $en''n''#% kh#s#sn& (il o(" &n' di)#l (e(s $e$p#n&i efek s$pin' se!#p den'n 'en "okoli"ik /$isln&% n"ihis"$in "# inhle! den'n efek (!onkodil"si sepe!"i spinef!in3. @e!i @e!ik kn n info info!$ !$s sii "en" "en"n n' ' $en' $en''#n '#nkn kn "okoli "okoli"i "ik k o!l o!l (e!s (e!s$ $ $k $knn nn.. Mkn Mknn n $e$pe!(iki "ole!nsi "e!hdp o(" dn pen#!#nn efek s$pin'
;. Di'nos Di'nos : N&e!i k#" "# ke"idkn&$n ke"idkn&$nn n (e!h#(#n'n (e!h#(#n'n den'n kon"!ksi kon"!ksi o"o" dn efek o(",o("n. T#)#n : Melpo!kn ke"idkn&$nn $en)di $ini$l dn "e!kon"!ol. In"e!5ensi Rsionl : ,
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Pe!8ep Pe!8ep"" p!oses p!oses pene!i pene!i$ $n n dn lk#kn lk#kn "i!h "i!h (!in' (!in' pd pd klien% klien% dn'n dn'n $en''#n $en''#nkn kn posisi $i!in' keki!i. Posisi $i!in' keki!i $e$pe!(iki li!n d!h #"e!#s dn dp" $en#!#nkn kepekn #"e!#s. Tin)# n)# #ln #ln' ' "ekn "eknik ik !el !elks kss sii Me$( Me$(n n"# "# $en# $en#!# !#nk nkn n pe!s pe!sep epsi si klie klien n "en" "en"n n' ' ke"idkn&$nn dn $enin'k"kn !s kon"!ol. @e!i @e!ik kn n nl nl'e 'esi sik k ses# ses#i i indi indik ksi si Anl' nl'es esik ik !in' !in'n n $en# $en#!# !#nk nkn n "e' "e'n' n'n n dn dn ke"idkn&$nn o"o".
DATAR PUSTAKA 1. Mo8h"! Mo8h"! R#s"$% R#s"$% P!of. P!of. D!. MPH% 1227. 1227. Sinopsis Sinopsis O(s"e"! O(s"e"!i. i. >k!": >k!": E0. E0. 2. Doen'oes% E. M!l&n% *++1. Ren8n Pe!4"n M"e!nl?@&i. >k!": E0.
