KEPERAWATAN DEWASA 1 ASKEP ASKE P PADA PADA KLIEN KLIEN DENG DENGAN AN EPIDIDI EPIDIDIMIT MITIS IS
OLEH Nama
: A. Surya Abdi
Stam St ambu buk k : 1422 142201 0100 0035 355 5 Kelas
:B
PROGRAM PROGRAM STUDI ILMU KEPERAWATAN KEPERAWATAN FAKULTAS KESEHATAN MASYARAKAT MASYARAKAT UNIVERSITAS MUSLIM INDONESIA MAKASSAR 2012
Keperawatan Keperawatan Dewasa 1
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KONSEP DASAR PENYAKIT 1. Definisi Epididimitis adalah suatu kondisi medis yang dalam hal ini terdapat peradangan pada
epididimis (suatu struktur melengkung di bagian belakang testis yang fungsinya sebagai pengangkut, pengangkut, tempat penyimpanan, penyimpanan, dan pematangan pematangan sel sperma sperma yang berasal dari testis). testis). Kondisi ini mungkin dapat sangat menyakitkan, dan skrotum bisa menjadi merah, hangat, dan bengkak. Ini mungkin akut (tiba-tiba menyerang) namun jarang menjadi kronis.
2. Epidem demiolo iolog gi
Epididimitis Epididimitis diderita diderita 1 dari 144 klien laki-laki laki-laki (0,69 %) pada usia 18-50 tahun atau sekitar 600.000 kasus pada laki-laki usia 18-35 tahun di Amerika Serikat. Epididimitis diderita terutama oleh laki-laki usia 16-30 tahun dan usia 51-70 tahun. Dilaporkan baru-baru ini
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3. Etiologi
Bermacam penyebab timbulnya epididimitis tergantung dari usia klien, sehingga penyebab dari timbulnya epididimitis dibedakan menjadi : •
Infeksi bakteri non spesifik Bakteri Bakteri coliforms coliforms (misalnya (misalnya E coli, Pseudomonas, Pseudomonas, Proteus, Proteus, Klebsiella Klebsiella)) menjadi penyebab umum terjadinya terjadinya epididimitis pada anak-anak, dewasa dengan usia lebih dari dari 35 tahun tahun dan dan homos homosek eksua sual. l. Ureaplasma Ureaplasma urealyticum, urealyticum, Corynebacterium Corynebacterium,, Mycoplasma, Mycoplasma, dan Mima dan Mima polymor polymorpha pha juga juga dapat ditemukan ditemukan pada golongan golongan penderita penderita tersebut. Infeksi yang disebabkan oleh Haemop oleh Haemophilus hilus influenza dan N dan N meningitides meningitides sangat jarang terjadi.
•
Penyakit Menular Seksual (PMS) Chlamydia merupakan penyebab tersering pada laki-laki berusia kurang dari 35 tahun tahun denga dengan n akti aktivit vitas as seks seksual ual aktif aktif.. Infek Infeksi si yang yang diseba disebabka bkan n oleh oleh Neisseria Neisseria gonorrhoeae, gonorrhoeae, Treponema Treponema pallidum, pallidum, Trichomonas Trichomonas dan Gardnerella vaginalis juga sering terjadi pada populasi ini.
•
Virus Virus menjadi penyebab yang cukup dominan pada anak-anak. Pada epididimitis yang disebabkan oleh virus tidak didapatkan didapatkan adanya pyuria. Mumps merupakan virus virus yang yang seri sering ng menye menyebab babka kan n epidid epididim imit itis is sela selain in Coxsa Coxsacki ckiee viru viruss A dan Varicella.
•
TB (Tuberculosis) Epididi Epididimit mitis is yang disebab disebabkan kan oleh oleh basil basil tubercul tuberculosis osis sering sering terjadi terjadi di daerah daerah
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•
Penyebab infeksi lain (seperti (seperti Brucellosis, Brucellosis, Coccidioidomycosis, Coccidioidomycosis, Blastomycosis, Blastomycosis, Cytomegalovirus, Candidiasis, CMV pada HIV) dapat menjadi penyebab terjadinya epididimitis namun biasanya hanya terjadi pada individu dengan sistem imun tubuh yang rendah atau menurun.
•
Obstruksi (seperti BPH, malformasi urogenital) memicu terjadinya refluks.
•
Vask Vaskul ulit itis is
(sep (seper erti ti
Heno Henoch ch-S -Sch chön önle lein in
purp purpur uraa
pada pada
anak anak-a -ana nak) k)
seri sering ng
menyebabkan epididimitis akibat adanya proses infeksi sistemik. •
Penggunaan Amiodarone dosis tinggi Amiodarone adalah obat yang digunakan pada kasus aritmia jantung dengan dosis awal 600 mg/har mg/hari-80 i-800 0 mg/har mg/harii selama selama 1-3 minggu minggu secara secara bertaha bertahap p dan dosis dosis pemeliharaan pemeliharaan 400 mg/hari. mg/hari. Penggunaan Penggunaan Amiodarone Amiodarone dosis tinggi tinggi ini (lebih (lebih dari 200 mg/ha mg/hari ri)) akan akan menim menimbul bulka kan n antib antibodi odi miod miodaro arone ne HCL HCL yang yang kemu kemudia dian n akan akan menyerang menyerang epididimis epididimis sehingga timbullah timbullah gejala epididimitis. epididimitis. Bagian yang sering terkena adalah bagian cranial dari epididmis dan kasus ini terjadi pada 3-11 % klien yang menggunakan obat Amiodarone. •
Prostatitis
Prostatitis merupakan reaksi inflamasi pada kelenjar prostat yang dapat disebabkan oleh oleh bakte bakteri ri maupu maupun n non bakte bakteri ri dapat dapat mnye mnyebar bar ke skro skrotu tum m menye menyebab babkan kan timbulnya epididimitis dengan rasa nyeri yang hebat, pembengkakan, kemerahan dan jika disentuh terasa sangat nyeri. Gejala yang juga sering menyertai adalah nyeri di selangkangan, selangkangan, daerah antara penis dan anus serta punggung bagian bawah, demam dan menggigil. Pada pemeriksaan colok dubur didapatkan prostat yang membengkak dan terasa nyeri jika disentuh •
Tindakan pembedahan seperti prostatektomi
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•
Kateterisasi dan instrumentasi
Terjadi epididimitis akibat tindakan kateterisasi maupun pemasangan instrumentasi dipicu oleh adanya infeksi pada urethra yang menyebar hingga ke epididimis. •
Blood borne infection
Epididimitis terjadi melalui infeksi yang penyebarannya melalui darah dari focus primer yang jauh, seperti seperti kulit, gigi, gigi, telinga, telinga, dan tenggoroka tenggorokan. n.
4. Pato Patofi fisi siol olog ogii
Epididimitis merupakan suatu infeksi epididimis yang biasanya turun dari prostat atau salura saluran n urine urine yang terinfe terinfeksi. ksi. Kondisi Kondisi ini dapat dapat juga terjadi terjadi sebagai sebagai komplik komplikasi asi dari Gonorrhoeae. Gonorrhoeae. Pada pria dibawah 35 tahun penyebab utama epididimitis adalahChlamydia adalah Chlamydia trachomatis. trachomatis. Infe Infeks ksii mula mulaii menj menjal alar ar dari dari bagi bagian an atas atas mela melalu luii uret urethr hraa dan dan dukt duktus us ejaku ejakulat lator orius ius kemu kemudi dian an berjal berjalan an sepan sepanjan jang g vas defe defere rens ns ke epidi epididi dimi mis. s. Rasa Rasa nyeri nyeri dirasakan pada unilateral dan rasa sakit pada kanalis inguinalis sepanjang jalur vas deferens kemudian mengalami nyeri dan pembengkakan pada skrotum dan daerah lipatan paha. Epididimis menjadi bengkak dan sangat sakit, suhu tubuh meningkat, menggigil, demam dan urine dapat mengandung nanah (pyuria) dan bakteri (bakteriuria).
5. Klasi lasifi fik kasi
Epididimitis dapat diklasifikasikan menjadi akut dan kronis, tergantung pada lamanya gejala. •
Epididimitis Epididimitis akut akut
Epididi Epididimit mitis is akut
iliki iliki wakt
timbul timbul
i dan bengkak bengkak hany
dala
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•
Epididimitis Epididimitis kronis kronis
Epididi Epididimit mitis is yang telah terjadi terjadi selama selama lebih lebih dari enam minggu, minggu, ditandai ditandai oleh peradangan peradangan bahkan ketika tidak adanya suatu infeksi. Pengujian Pengujian diperlukan diperlukan untuk membedakan membedakan antara epididimitis epididimitis kronis dengan berbagai gangguan lain yang dapat menyebabkan nyeri skrotum konstan, termasuk di dalamnya kanker testis, urat skrotum membesar (varikokel), dan kista dalam epididimis. Selain itu, saraf-saraf di daerah skrotum yang terhubung ke perut kadang-kadang menyebabkan sakit mirip hernia. Kondisi ini dapat berkembang bahkan tanpa adanya penyebab yang telah dijelas dijelaskan kan sebelu sebelumnya mnya.. Dalam Dalam kondis kondisii sepert sepertii ini diperlu diperlukan kan perawat perawatan an yang mungkin agak lama. Hal ini dikarenakan terdapat hipersensitivitas struktur tertentu, term termas asuk uk saraf saraf dan dan otot otot,, yang yang dapat dapat menye menyebab babkan kan atau atau berk berkont ontri ribus busii pada pada epididimitis kronis.
6.
Manifestasi klinis
Gejala yang timbul tidak hanya berasal dari infeksi lokal namun juga berasal dari sumber infeksi yang asli. Gejala yang sering berasal dari sumber infeksi asli seperti duh urethra dan nyeri atau itching pada pada urethra (akibat urethritis), urethritis), nyeri panggul dan frekuensi frekuensi miksi yang meningkat, dan rasa terbakar saat miksi (akibat infeksi pada vesika urinaria yang disebut Cystitis), demam, nyeri pada daerah perineum, frekuensi miksi yang meningkat, urgensi, dan rasa perih dan terbakar saat miksi (akibat infeksi pada prostat yang disebut Prostatitis), demam dan nyeri pada region flank (akibat infeksi pada ginjal yang disebut Pielonefritis). Gejala lokal pada epididimitis berupa nyeri pada skrotum. Nyeri mulai timbul pada bagian belakang salah satu testis namun dengan cepat akan menyebar menyebar ke seluruh seluruh testis, testis, skrotum skrotum dan kadang ke daerah inguinal disertai peningkatan suhu badan yang tinggi. Biasanya hanya mengenai salah satu skrotum saja dan tidak disertai dengan mual dan muntah. Selain itu bisa juga disertai dengan pembengkakan dan kemerahan kemerahan testicular dan/atau scrotal dan
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berkemih, berkemih, nyeri ketika berhubungan berhubungan seksual seksual atau ejakulasi, ejakulasi, darah di dalam semen, dan nyeri selangkangan.
7. Pemeri Pemeriksa ksaan an diagno diagnosti stik/p k/penu enunja njang ng
A. Pemeri Pemeriksaa ksaan n labor laborato atorium rium •
Pemeriksaan darah lengkap dimana ditemukan leukosit meningkat dengan shift dengan shift to the left (10.000-30.000/ left (10.000-30.000/ µl).
•
Sperma analisa dimana terdapat leukosit > 1 juta/ml
•
Kultur semen sebagai konfirmasi untuk mendapatkan kuman penyebab dari epididimitis.
•
Kultur urine dan pewarnaan gram untuk kuman penyebab infeksi.
•
Analisa urine untuk melihat apakah disertai pyuria atau tidak.
•
Tes penyaringan untuk Chlamydia untuk Chlamydia dan Gonorrhoeae. Gonorrhoeae.
•
Kultur darah bila dicurigai telah terjadi infeksi sistemik pada penderita.
B. Peme Pemeri riks ksaan aan radiol radiolog ogis is
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•
Pemeriksaan Pemeriksaan menggunakan ultrasonografi ultrasonografi dilakukan dilakukan untuk melihat aliran darah
pada arteri arteri testikularis testikularis.. Pada epididimit epididimitis, is, aliran aliran darah pada arteri arteri testikularis testikularis cenderung cenderung meningkat. •
Ultrasonografi juga dapat dipakai untuk mngetahui adanya abses skrotum sebagai
komplikasi dari epididimitis. •
Epididimitis Epididimitis kronis daapt diketahui melalui pembesaran pembesaran testis testis dan epididimis yang
disertai penebalan tunika vaginalis dimana hal ini akan menimbulkan gambaran echo yang heterogen pada ultrasonografi.
2. Nucl Nuclea earr Scint Scintig igra raph phyy •
Peme Pemeri riks ksaan aan ini mengg mengguna unaka kan n techn technet etium ium-99 -99 trace tracerr dan dila dilakuk kukan an untuk untuk
mengko mengkonfir nfirmas masii hasil hasil pemeri pemeriksaa ksaan n aliran aliran darah darah yang meragu meragukan kan dengan dengan memakai memakai ultrasonografi. •
Pada epididimitis akut akan terlihat gambaran peningkatan penangkapan kontras.
•
Memiliki sensitivitas dan spesifitas 90-100 % dalam menentukan daerah iskemia
akibat infeksi. •
Pada keadaan skrotum yang hiperemis akan timbul diagnosis negatif palsu.
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8. Peme Pemeri riks ksaa aan n fisi fisik k •
Pada inspeksi ditemukan skrotum bisa menjadi merah dan bengkak. Ini mungkin
akut (tiba-t (tiba-tiba iba menyera menyerang) ng) namun namun jarang jarang menjadi menjadi kronis kronis,, dan terdapat terdapat pembes pembesara aran n skrotum dan isinya, dan terdapat nanah pada urine. •
Pada palpasi ditemukan testis pada posisi normal vertikal, ukuran kedua testis sama
besar, dan tidak terdapat terdapat peninggian peninggian pada salah satu testis. testis. Setelah Setelah beberapa hari, epididimis dan testis tidak dapat teraba terpisah karena bengkak yang juga meliputi testis. Akan teraba pembesaran atau penebalan dari epididimis secara keseluruhan, di kauda atau di kaput yang mengindikasikan kuman penyebab infeksi. Ditemukan juga rasa nyeri yang terlokalisir di epididimis dengan suhu yang sedikit meningkat karena aliran darah meningkat di daerah tersebut. Kulit skrotum teraba panas, kenyal, merah, dan bengkak bengkak karena karena adanya adanya edema edema dan infiltr infiltrate ate.. Funikulu Funikuluss spermat spermatikus ikus juga turut turut meradang menjadi bengkak dan nyeri. •
•
Hasil pemeriksaan refleks kremaster normal Phren sign bernila sign bernilaii positif positif dimana nyeri dapat berkurang bila skrotum diangkat ke
atas atas kare karena na penga pengangk ngkat atan an ini akan akan mengu mengura rangi ngi rega reganga ngan n pada pada test testis is.. Namun Namun pemeriksaan pemeriksaan ini kurang spesifik. spesifik. •
Pembesaran kelenjar getah bening di regio inguinalis.
•
Pada pemeriksaan colok dubur mungkin didapatkan tanda prostatitis kronis yaitu
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Epididi Epididimit mitis is akan sulit sulit untuk untuk membeda membedakan kan dari torsio torsio testis testis (kondis (kondisii ketika ketika salura saluran n spermatika ke kedua testis memotong suplai darah). Keduanya dapat terjadi pada waktu yang sama. Epididimitis Epididimitis biasanya memiliki bentuk serangan serangan bertahap. bertahap. Pada pemeriksaan fisik, testis biasanya ditemukan berada dalam posisi normal vertikal, ukuran yang sama dengan pasangannya, dan tidak naik tinggi. Temuan khas adalah kemerahan, hangat, dan pembengkakan pembengkakan skrotum, skrotum, dengan kelembutan kelembutan belakang belakang testis, testis, jauh dari tengah (ini adalah posisi normal dari epididimis epididimis relatif relatif terhadap testis). testis). Refleks Refleks kremaster, kremaster, apabila sebelum sebelumnya nya normal normal,, akan tetap terliha terlihatt normal normal.. Ini adalah tanda tanda yang berguna berguna untuk untuk mebedakannya dari torsio testis. Analisis urine kemungkinan normal atau tidak normal. Sebelum munculnya teknik-teknik canggih canggih pencitr pencitraan aan medis, medis, eksplor eksplorasi asi bedah bedah adalah adalah standar standar perawat perawatan. an. Saat ini USG Doppler adalah tes yang lebih disukai. Hal ini dapat menunjukkan peningkatan aliran darah (juga (juga dibandi dibandingka ngkan n dengan dengan sisi sisi normal normal), ), sebagai sebagai lawan lawan dari dari torsio torsio testis testis.. Penguji Pengujian an tambahan mungkin diperlukan untuk mengidentifikasi penyebab yang mendasari. Pada anak-anak, sebuah kelainan saluran kemih sering ditemukan. Pada pria aktif secara seksual, tes untuk penyakit menular seksual dapat dilakukan. Ini mungkin termasuk mikroskop dan pembiakan pembiakan dari sampel urine, Gram strain strain dan pembiakan pembiakan dari cairan atau swab dari saluran kemih, tes amplifikasi asam nuklir (untuk memperkuat dan mendeteksi DNA atau asam nukleat mikroba lainnya) atau tes untuk sifilis dan HIV.
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11. Penatala Penatalaksan ksanaan aan
Penatalaksanaan epididimitis meliputi dua hal yaitu penatalaksanaan medis dan bedah, yaitu : a. Pena Penata tala laks ksan anaa aan n medis medis Antibiotik digunakan bila diduga adanya suatu proses infeksi. Antibiotik yang sering digunakan adalah : •
Fluoroquinolones, namun penggunaannya telah dibatasi karena terbukti resisten terhadap kuman Gonorrhoeae.
•
Cefalosporin (Ceftriaxon).
•
Levofloxacin atau Ofloxacin untuk mengatasi infeksi Chlamydia, pada kasus yang disebabkan oleh organisme enterik (seperti E. coli) coli) dan digunakan pada klien yang alergi penisilin.
•
Doxycycline, Azithromycin, dan Tetrasiklin digunakan untuk mengatasi infeksi bakteri non gonokokal gonokokal lainnya. lainnya.
•
Pada anak-ana anak-anak, k, Fluoroq Fluoroquino uinolone loness dan Doxycyc Doxycycline line sebaikn sebaiknya ya dihinda dihindari. ri. Bakter Bakterii yang menyeba menyebabkan bkan infeksi infeksi salura saluran n kemih kemih sering sering menjadi menjadi penyeba penyebab b
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•
Skrotum Skrotum lebih lebih ditinggi ditinggikan kan dengan dengan melakuk melakukan an tirah tirah baring baring total total selama selama dua sampai tiga hari untuk mencegah regangan berlebihan pada skrotum.
•
Kompres es/kompres dingin pada skrotum untuk mengurangi rasa sakit.
•
Pemberian analgesik dan NSAID.
•
Mencegah penggunaan instumentasi pada urethra.
b. Penatalaksanaan Penatalaksanaan bedah bedah Penatalaksanaan di bidang bedah meliputi : •
Scrotal exploration Tindaka Tindakan n ini digunak digunakan an bila bila telah telah terjadi terjadi kompli komplikasi kasi dari epididim epididimitis itis dan orchitis orchitis seperti seperti abses, pyocele, maupun terjadinya terjadinya infark pada testis. testis. Diagnosis Diagnosis in
al ba
da
di
kk
laku lakuka ka
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2) Infa Infark rk pada pada tes testi tiss 3) Epididi Epididimit mitis is kroni kroniss dan dan orchal orchalgia gia 4) Infert Infertilit ilitas as sekunder sekunder sebagai sebagai akibat akibat dari inflam inflamasi asi maupun maupun obstru obstruksi ksi dari duktus epididimis 5) Atrofi Atrofi testis testis yang diikuti hipogonadotropik hipogonadotropik hipogonadism hipogonadism 6) Fist Fistul ulaa kut kutan aneu euss 7) Penyeba Penyebaran ran infeks infeksii ke organ organ lain atau atau sistem sistem tubuh tubuh
13. Pencegah Pencegahan an
Pada saat menjalani menjalani pembedahan, pembedahan, seringkali seringkali diberikan diberikan antibiotik antibiotik profilaktik profilaktik (sebagai tindakan pencegahan) kepada orang-orang yang memiliki risiko menderita epididimitis. Epididimitis akibat penyakit menular seksual bisa dicegah dengan cara tidak melakukan
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KONSEP DASAR ASUHAN KEPERAWATAN
1. PENGKAJIA JIAN
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vaskul vaskulit itis is
(sep (seper erti ti
Henoc Henoch-S h-Sch chönl önlei ein n
purpur purpuraa
pada pada
anak anak-a -anak nak), ),
pengg pengguna unaan an
Amioda Amiodarone rone dosis dosis tinggi tinggi,, prosta prostatit titis, is, tindaka tindakan n pembeda pembedahan han sepert sepertii prostat prostatekt ektomi, omi, kateterisasi dan instrumentasi, dan blood borne infection. 4. Data ata fokus : Data subjektif : -
Klien Klien meng mengatak atakan an mera merasaka sakan n nyeri nyeri pada pada skrot skrotum um dan dan lipata lipatan n paha
-
Klie Klien n meng mengel eluh uh dem demam am dan dan men mengg ggig igil il
-
Klie Klien n mengel mengeluh uh nyeri nyeri pada pada selan selangk gkang angan an dan dan pangg panggul ul
-
Klien mengatakan setiap berkemih dirasakan seperti ada rasa terbakar dan perih
-
Klie Klien n menga mengatak takan an frek frekue uensi nsi ber berkem kemihn ihnya ya menin meningk gkat at
-
Klie Klien n men mengel geluh uh nyeri nyeri keti ketika ka berke berkemih mih
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-
Deny Denyut ut nadi nadi klie klien n > 100 100 x/m x/men enit it
-
Klie Klien n tam tampa pak k meng menggi gigi gill
-
Kuli Kulitt kli klien en tera teraba ba hang hangat at
-
Kuli Kulitt sekit sekitar ar skr skrot otum um kli klien en tam tampak pak keme kemerah rahan an
-
Klien Klien tampa tampak k bingu bingung ng keti ketika ka dita ditanya nya tentang tentang penyakit penyakitnya nya
5. Pemeriksaan diagnostik dan fisik
A. Pemeriksaan Pemeriksaan laboratorium laboratorium •
Pemeriksaan darah lengkap dimana ditemukan leukosit meningkat dengan shift dengan shift to the left (10.000-30.000/ left (10.000-30.000/ µl).
•
Sperma analisa dimana terdapat leukosit > 1 juta/ml
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•
Pemeriksaan ini memiliki rentang tentang kegunaan yang luas dimana pemeriksaan
ini lebih banyak digunakan untuk membedakan epididimitis dengan penyebab akut skrotum lainnya. •
Keefektifan pemeriksaan ini dibatasi oleh nyeri dan ukuran anatomi klien (seperti
ukuran bayi berbeda dengan dewasa). •
Pemeriksaan Pemeriksaan menggunakan ultrasonografi ultrasonografi dilakukan dilakukan untuk melihat aliran darah
pada arteri arteri testikularis. testikularis. Pada epididimitis, epididimitis, aliran aliran darah pada arteri arteri testikularis testikularis cenderung meningkat.
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3) Vesicourethtro Vesicourethtrogram gram (VCUG), (VCUG), Cystourethroscopy, Cystourethroscopy, dan USG abdomen •
Pemeriksaan ini digunakan untuk mengetahui suatu anomali congenital pada klien
anak-anak dengan bakteriuria dan epididimitis.
C. Pemeriksaan Pemeriksaan fisik •
Pada inspeksi ditemukan skrotum menjadi merah dan bengkak. Ini mungkin akut
(tiba-tiba menyerang) namun jarang menjadi kronis, dan terdapat pembesaran skrotum
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•
Pada anak-anak, epididimitis dapat disertai dengan anomaly congenital pada traktus
urogenitalis seperti ureter ektopik, vas deferens ektopik, dan lain-lain.
2. DIAGNOSA KEPERAWATAN 1) Hiper Hiperter termi mia a berh berhub ubung ungan an den denga gan n ker kerusa usaka kan n kontr kontrol ol suhu suhu sekun sekunder der akiba akibatt
epididimitis ditandai dengan suhu tubuh klien > 37,5 oC, klien tampak menggigil, kulit klien teraba hangat, tampak ada pembengkakan pada skrotum klien, kulit sekitar skrotum klien tampak kemerahan, nadi klien > 100 x/menit.
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kulit klien teraba hangat, tampak ada pembengkakan pada skrotum klien, kulit sekitar skrotum klien tampak kemerahan, nadi > 100 100 x/menit. 2)
Nyeri akut berhubungan dengan adanya pus saat berkemih berkemih ditandai dengan
klien tampak meringis kesakitan, klien tampak gelisah, skala nyeri klien 4, denyut nadi klien > 100 x/menit. 3)
PK Infeksi
4)
Disfu isfung ngsi si seks seksua uall berh berhub ubun unga gan n deng dengan an peru peruba baha han n fung fungssi tubuh ubuh akiba akibatt
proses penyakit akibat epididimitis epididimitis ditandai dengan klien mengeluh mengeluh nyeri saat
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•
Klien melaporkan panas badannya turun
•
Tidak tampak pembengkakan pada skrotum klien
•
Tidak terdapat kemerahan di kulit sekitar skrotum klien
•
Nadi klien klien dalam batas normal normal (60-100 (60-100 x/menit) x/menit)
Mandiri :
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Kolaborasi Kolaborasi :
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Untuk Untuk menge mengeta tahui hui tingk tingkat at rasa rasa nyeri nyeri sehi sehingg nggaa dapat dapat menen menentu tukan kan jenis jenis tindakannya. 2. Kaji Kaji faktorfaktor-fakt faktor or yang dapat dapat mempe memperbur rburuk uk nyeri nyeri klien klien
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Setela Setelah h diberi diberikan kan asuhan asuhan keperaw keperawatan atan selama selama …x24 …x24 jam diharapk diharapkan an tidak tidak ada tanda-tanda infeksi dengan kriteria hasil : •
Tidak terjadi komplikasi infeksi
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4)
Disf Disfun ungs gsii seks seksua uall berh berhub ubun unga gan n deng dengan an per perub ubah ahan an fun fungs gsii tubu tubuh h akib akibat at
proses penyakit akibat epididimitis ditandai dengan klien mengeluh mengeluh nyeri saat mela melakuk kukan an hu hubu bunga ngan n seksua seksual, l, klien klien meng mengung ungkap kapkan kan ren renda dahn hnya ya batas batas
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Menjaga privasi klien sangat penting karena masalah seksual merupakan masalah yang sensitive 3.
Mulai ulaila lah h dari dari topi topicc yan yang g kur kuran ang g sen sensi siti tive ve ke pali paling ng sens sensit itiv ivee
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Titles you can't find anywhere else
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Titles you can't find anywhere else
Try Scribd FREE for 30 days to access over 125 million titles without ads or interruptions! Start Free Trial Cancel Anytime.
Titles you can't find anywhere else
Try Scribd FREE for 30 days to access over 125 million titles without ads or interruptions! Start Free Trial Cancel Anytime.
Titles you can't find anywhere else
Try Scribd FREE for 30 days to access over 125 million titles without ads or interruptions! Start Free Trial Cancel Anytime.