TUGAS KEPERAWATAN GERONTIK MAKALAH ASUHAN GERONTIK DENGAN DIABETES MELLITUS
DISUSUN OLEH : KARTIK KARTIKA A NURMALIA NURMALIA A. ( P1742071 P17420713010 3010)) VIKA RAHMAWA RAHMAWATI (P17420713022) (P17420713 022)
POLTEKKES KEMENKES SEMARANG PRODI DIV KEPERAWATAN MAGELANG 2016
BAB I PENDAHULUAN
A. Latar !"a#a$% Pr&'!' !$a a*a"a+ #!a*aa$ ,a$% t-*a# *aat *-+-$*ar#a$. Ma$'-a '!!rt- +a"$,a '!a a#+"# +-* *-*$-a -$- !$,a- /ata' #!/!ra*aa$$,a *a$ a#a$ /!ra#+-r *!$%a$ #!at-a$. P!r/a+a$!r/a+a$ a*a '-a "a$t *a$ #!$*ra$ #!'!+ata$$,a #a*a$%#a*a$% '#ar *-/!*a#a$ *ar- #!"a-$a$ at&"&%- ,a$% t!ra*- a#-/at !$,a#-t. Da"a /-*a$% !$*&#r-$&"&%- +a-r '!a r&*#'- *a$ !$%!"ara$ +&r&$ *-!$%ar+&"!+ !$-!$- ,a$% 'a$%at *-!$%ar+- &"!+ r&'!' !$a*- ta. D-a/!t!' !""-t' ,a$% t!r*aat a*a '-a "a$t %a/ara$ #"-$-'$,a /!rar-a'- "a' *ar- ta$a %!a"a 'aa- *!$%a$ #&"-#a'- $,ata ,a$% #a*a$%#a*a$% !$,!ra- !$,a#-t ata !r/a+a$ ,a$% /-a'a *-t!- a*a '-a "a$t.
. R'a$ Ma'a"a+ 1. Aa ,a$% *-a#'* *!$%a$ *-a/!t!' !""-t' 2. a%a-a$a %a/ara$ #"-$-' *-a/!t!' !""-t' 3. a%a-a$a a'+a$ #!!ra5ata$ %!r&$t-# ,a$% !$*!r-ta *-a/!t!' !""-t' 6. Ta$ P!$"-'a$ 1. M!$%!ta+- *!-$-'- *-a/!t!' !""-t' 2. M!$%!ta+- %a/ara$ #"-$-' *-a/!t!' !""-t' 3. M!$%!ta+- a'+a$ #!!ra5ata$ %!r&$t-# ,a$% !$*!r-ta *-a/!t!' !""-t'
BAB II
TINJAUAN PUSTAKA
A. K&$'! La$'-a P!$%!rt-a$ "a$'-a (La$t U'-a) a*a"a+ a'! !$r$$,a #!aa$ a#a" *a$ -'-#8 ,a$% *- "a- *!$%a$ a*a$,a /!/!raa !r/a+a$ *a"a +-*. S!/a%a- a$a *- #!ta+-8 #!t-#a a$'-a !$9aa- '-a *!5a'a8 -a !$,a- #!aa$ r!r&*#'- *a$ !"a+-r#a$ a$a#. K!t-#a #&$*-'+-* /!r/a+8 '!'!&ra$% a#a$ #!+-"a$%a$ t%a' *a$ $%'- -$-8 *a$ !a'#'!"a$t$,a8 ,a-t '-a "a$t8 #!*-a$ at-. a%- a$'-a ,a$% $&ra"8 '-aa &ra$%$,a8 t!$t t!"a+ '-a !$!r-a #!a*aa$ /ar *a"a '!t-a a'! +-*$,a *a$ !$9&/a !$,!'a-#a$ *-r- *!$%a$ #&$*-'- "-$%#$%a$,a (Dar&&8 2004). P!$%!rt-a$ "a$'-a ("a$t 'a) !$rt UU $& 4 ta+$ 1;< a*a"a+ '!'!&ra$% ,a$% !$9aa- r << ta+$8 t-*a# /!r*a,a !$9ar- $a#a+ '!$*-r- $t# #!!r"a$ +-*$,a '!+ar-+ar- *a$ !$!r-a $a#a+ *ar- &ra$% "a-$ (Wa+,*-8 2000) '!*a$%#a$ !$r UU $&.12 ta+$ 1= t!$ta$% #!'!a+t!raa$ "a$'-a ("a$t '-a) a*a"a+ '!'!&ra$% ,a$% t!"a+ !$9aa- '-a *-ata' ;0 ta+$ (D!'&'8 1). U'-a "a$t a*a"a+ '!'at ,a$% +ar' *-t!r-a '!/a%a- 'at #!$,ataa$ *a$ !$&!$a /-&"&%-'. K!+-*a$ -t a#a$ *-a#+-r*!$%a$ r&'!' !$aa$ ,a$% /!ra#+-r *!$%a$ #!at-a$ (Hta!a8 200<). S!*a$%#a$ !$rt Or%a$-'a'- K!'!+ata$ D$-a (WHO) !$%!rt-a$ "a$'-a *-%&"&$%#a$ !$a*- 48 ,a-t: a. U'-a !rt!$%a+a$ (-**"! a%!) 4< < ta+$ /. La$t '-a (!"*!r",) ;0 74 ta+$ 9. La$t '-a ta (&"*) 7< > 0 ta+$ *. La$'-a 'a$%at ta (!r, &"*) *-ata' 0 ta+$. La$'-a ("a$t '-a) a*a"a+ #!"&&# !$**# ,a$% /!r'-a ;0 ta+$ #! ata' (Har*,5-$&t& *a$ S!t-a/*+-8 1). Pa*a "a$t '-a a#a$ t!ra*- r&'!' !$%+-"a$%$,a #!aa$ ar-$%a$ $t# !!r/a-#- *-r- ata !$%%a$t*a$ !!rta+a$#a$ $%'- $&ra"$,a '!9ara !r"a+a$"a+a$ '!+-$%%a t-*a# *aat /!rta+a$ t!r+a*a -$!#'- *a$ !!r/a-#- #!r'a#a$ ,a$% t!ra*(6&$'ta$t-$-*!'8 14). Kar!$a -t *- *a"a t/+ a#a$ !$# a#-$ /a$,a# *-'t&r'!ta/&"-# *a$ 'tr#tra" *-'!/t !$,a#-t *!%!$!rat- ,a$% !$,!/a/#a$ "a$'-a a#a$ !$%a#+-r- +-* *!$%a$ !-'&*! t!r-$a" (Dar&& *a$
Mart&$&8 1?4). P!$%%&"&$%a$ "a$'-a !$rt D!#!' *-#t- *ar- A-' (14) !$a*- t-%a #!"&&# ,a#$- : a. K!"&&# "a$'-a *-$- (<< > ;4 ta+$)8 !ra#a$ #!"&&# ,a$% /ar !a'#- "a$'-a /. K!"&&# "a$'-a (;< ta+$ #! ata'). 9. K!"&&# "a$'-a r!'-#& t-$%%-8 ,a-t "a$'-a ,a$% /!r'-a "!/-+ *ar- 70 ta+$ . K&$'! D!a/!t!' M!""-t' 1. D!-$-'- D-a/!t!' M!"-t' D-a/!t!' !"-t' !ra#a$ #!"a-$a$ !ta/&"-'! ,a$% #r&$-' t!ra**!-'-!$'- -$'"-$ ata r!t!$'- -$'"-$8 *- ta$*a- *!$%a$ t-$%%-$,a #!a*aa$ %"#&'a *ara+ (+-!r%"-#!-a) *a$ %"#&'a *a"a r-$! (%"#&'r-a) ata !ra#a$ '-$*r&a #"-$-' ,a$% *-ta$*a- *!$%a$ +-!r%"-#!-a #r&$-# *a$ %a$%%a$ !ta/&"-'! #ar/&+-*rat8 "!a# *a$ r&t!-$ '!+/$%a$ *!$%a$ #ra$%$,a '!#r!'- -$'"-$ '!9ara a/'&"t @ r!"at- *a$ ata a*a$,a %a$%%a$ $%'- -$'"-$. D-a/!t!' !""-t' !ra#a$ '!#!"&&# #!"a-$a$ +!t!r&%!$ ,a$% *-ta$*a- &"!+ #!$a-#a$ #a*ar %"#&'a *a"a *ara+ ata +-!r%"-#!-a (Ma$'&!r8 2000). D-a/!t!' !""-t' !ra#a$ '!#!"&&# #!"a-$a$ +!t!r&%!$ ,a$% *-ta$*a- &"!+ #!$a-#a$ #a*ar %"#&'a *a"a *ara+ ata +-!r%"-#!-a. (r$$!r *a$ S**art+8 2002). D-a/!t!' !""-t' !ra#a$ !$,a#-t '-'t!-'8 #r&$-'8 *a$ "t-a#t&r-a" ,a$% *-9-r-#a$ *!$%a$ +-!r%"-#!-a *a$ +-&%"-#!-a. ( Mar,8200) 2. Et-&"&%!/!raa a+"- /!r!$*aat /a+5a *!$%a$ /!rta/a+$,a r8 -$t&"!ra$'- t!r+a*a %"#&'a %a !$-$%#at8 a*- $t# %&"&$%a$ '-a "a$t *-!r"#a$ /ata' %"#&'a *ara+ ,a$% "!/-+ t-$%%- *ar-a*a &ra$% *!5a'a $&$ '-a "a$t. Pa*a NIDDM8 -$t&"!ra$'- %"#&'a a*a "a$'-a /!r#a-ta$ *!$%a$ &/!'-ta'8 a#t--ta' -'-# ,a$% /!r#ra$%8#ra$%$,a a''a &t&t8 !$,a#-t !$,!rta8 !$%%$aaa$ &/at&/ata$8 *-'a-$% #ar!$a a*a "a$'-a t!ra* !$r$a$ '!#r!'- -$'"-$ *a$ -$'"-$ r!'-'t!$. L!/-+ *ar- <0 "a$'-a *-ata' ;0 ta+$ ,a$% ta$a #!"+a$8 *-t!#a$ +a'-" T!' T&"!ra$'- B"#&'a
Ora" (TTBO) ,a$% a/$&ra". I$t&"!ra$'- %"#&'a -$- a'-+ /!" *aat *-#ata#a$ '!/a%a- *-a/!t!'. Pa*a '-a "a$t t!ra*- !$r$a$ a$ #!aa$ -$'"-$ t!rtaa a*a &'t r!'!t&r. Pa*a "a$'-a 9!$*!r$% t!ra*- !$-$%#ata$ /!rat /a*a$8 /#a$ #ar!$a !$%#&$''- #a"&r- /!r"!/-+ $a$ #ar!$a !r/a+a$ ra'-& "!a#&t&t *a$ !$r$a$ "a !ta/&"-'! /a'a". Ha" -$- *aat !$a*- a#t&r r!*-'&'-'- t!ra*-$,a *-a/!t!' !""-t'. P!$,!/a/ *-a/!t!' !""-t' a*a "a$'-a '!9ara *aat *-%&"&$%#a$ #! *a"a *a /!'ar : a. Pr&'!' !$a@#!$*ra$ (P!$r$a$ '!$'-t--ta' -$*ra !$%!9a8 !$r$a$ $%'- a$#r!a'8 *a$ !$r$a$ #a"-ta' -$'"-$ '!+-$%%a -$'"-$ t-*a# /!r$%'- *!$%a$ /a-#). /. Ba,a +-* ("-! 't,"!) ,a$% !"!# (/a$,a# a#a$8 ara$% &"a+ra%a8 -$ a"#&+&"8 *a$ "a-$"a-$.) K!/!ra*aa$ !$,a#-t "a-$8 '!r-$% !$*!r-ta 'tr!'' %a *aat !$a* !$,!/a/ t!ra*-$,a *-a/!t!' !""-t'. S!"a-$ -t !r/a+a$ $%'- -'-# ,a$% !$,!/a/#a$ #!"!t-+a$ *aat !$t- ta$*a *a$ %!a"a *-a/!t!' *a$ !$%+a"a$%- "a$'-a $t# !$9ar- /a$ta$ !*-'. K!"!t-+a$8 !r" /a$%$ a*a a"a +ar- $t# /a$% a-r #!9-"8 *a$ -$ !#'- ,a$% '!r-$% !ra#a$ -$*-#at&r *-a/!t!' ,a$% $%#-$ t-*a# *-!r+at-#a$ &"!+ "a$'-a *a$ a$%%&ta #!"ar%a$,a #ar!$a !r!#a !r9a,a /a+5a +a" t!r'!/t a*a"a+ /a%-a$ *ar- r&'!' !$aa$ -t '!$*-r-. 3. K"a'--#a'a. D-a/!t!' !"-t' t-! I D!'tr#'- '!" /!ta8 $,a !$r' #! *!-'-!$'- -$'"-$ a/'&"t /a-# !"a"- r&'!' -$&"&%-# a$ -*-&at-#. Kara#t!r-'t-# D-a/!t!' M!"-t' t-! I: 1) M*a+ t!ra*- #!t&a'-*&'-' 2) P!$%&/ata$ +ar' *!$%a$ -$'"-$ 3) O$'!t a#t 4) -a'a$,a #r' <) -a'a$,a t!ra*- a*a r ,a$% a'-+ *a ;) !r+/$%a$ *!$%a$ HLADR3 *a$ DR4 7) D-*aat#a$ a$t-/&*- '!" -'"!t =) 10$,a a*a r-5a,at *-a/!t!' a*a #!"ar%a /. D-a/!t!' !"-t' t-! II : !rar-a'- "a- ,a$% r!*&-$a$ r!'-'t!$'- -$'"-$ *-'!rta- *!-'-!$'-$'"-$ r!"at- 'aa- ,a$% r!*&-$a$ %a$%%a$ '!#r!'- -$'"-$ /!r'aa r!'-'t!$'- -$'"-$. Kara#t!r-'t-# DM t-! II : 1) S#ar t!ra*- #!t&a'-*&'-' 2) P!$%&/ata$ t-*a# +ar' *!$%a$ -$'"-$
3) 4) <) ;) 7) =) )
O$'!t "a/at B!# ata t-*a# %!# -a'a$,a t!ra*- a*a r C 4< ta+$ T-*a# /!r+/$%a$ *!$%a$ HLA T-*a# a*a a$t-/&*- '!" -'"!t 30$,a a*a r-5a,at *-a/!t!' a*a #!"ar%a 100 #!/ar -*!$t-# t!r#!$a
4. Pat&-'&"&%Da"a r&'!' !ta/&"-'!8 -$'"-$ !!%a$% !ra$a$ !$t-$% ,a-t !a'##a$ %"#&'a #! *a"a '!" ,a$% *-%$a#a$ '!/a%a- /a+a$ /a#ar. I$'"-$ a*a"a+ 'at at ata +&r&$ ,a$% *-+a'-"#a$ &"!+ '!" /!ta * a$#r!a'. -"a -$'"-$ t-*a# a*a a#a %"#&'a t-*a# *aat a'# '!" *!$%a$ a#-/at %"#&'a a#a$ t!ta /!ra*a *- !/"+ *ara+ ,a$% art-$,a #a*ar %"#&'a *- *a"a *ara+ !$-$%#at. Pa*a D-a/!t!' !"-t' t-! 1 t!ra*- #!"a-$a$ '!#r!'- -$'"-$ &"!+ '!" /!ta a$#r!a'. Pa'-!$ *-a/!t!' t-! -$- !5ar-'- #!r!$ta$a$ %!$!t-# ,a$% !ra#a$ r!*-'&'-'- $t# #!r'a#a$ at&-$ '!" /!ta a$#r!a'. R!'&$ at&-$ *-a9 &"!+ a#t--ta' "-&'-t8 a$t-/&*- t!r+a*a '!" "a "a$%!r+a$' *a$ t!r+a*a -$'"-$ -t '!$*-r-. Pa*a *-a/!t!' !"-t' t-! 2 ,a$% '!r-$% t!ra*- a*a "a$'-a8 "a+ -$'"-$ $&ra" t!ta- "a+ r!'!t&r -$'"-$ ,a$% t!r*aat a*a !r#aa$ '!" ,a$% #ra$% '!+-$%%a %"#&'a ,a$% a'# #! *a"a '!" '!*-#-t *a$ %"#&'a *a"a *ara+ !$a*- !$-$%#at <. Ma$-!'ta'- K"-$-' K!"+a$ a'-!$ DM '!!rt- &"-r-a8 &"-*-'-a8 &"-a%-a a*a "a$'-a $,a t-*a# a*a. O'&t-# *-r!'-' a#-/at %"#&'r-a t!rt$*a *-'!/a/#a$ a/a$% %-$a" ,a$% t-$%%-8 *a$ *aat $9" #!"+a$ $&#tr-a *-'!rta- %a$%%a$ t-*r8 ata /a+#a$ -$#&$t-$!$'-a r-$. P!ra'aa$ +a' a*a a'-!$ DM "a$'-a #ra$% *-ra'a#a$8 a#-/at$,a !r!#a t-*a# /!r!a#'- a*!#at t!r+a*a *!+-*ra'-. Kar!$a -t t-*a# t!ra*- &"-*-'-a ata /ar t!ra* a*a 'ta*- "a$t. S!/a"-#$,a ,a$% '!r-$% !$%%a$%% a'-!$ a*a"a+ #!"+a$ a#-/at #&"-#a'- *!%!$!rat- #r&$-# a*a !/"+ *ara+ *a$ 'ara. Pa*a DM "a$'-a t!r*aat !r/a+a$ at&-'-&"&%- a#-/at r&'!' !$a8 '!+-$%%a %a/ara$ #"-$-'$,a /!rar-a'- *ar- #a'' ta$a %!a"a 'aa-
#a'' *!$%a$ #&"-#a'- ,a$% "a'. K!"+a$ ,a$% '!r-$% $9" a*a"a+ a*a$,a %a$%%a$ !$%"-+ata$ #ar!$a #atara#8 ra'a #!'!ta$ a*a t$%#a'!rta #!"!a+a$ &t&t ($!r&at- !r-!r) *a$ "#a a*a t$%#a- ,a$% '#ar '!/+ *!$%a$ !$%&/ata$ "a-. M!$rt Sart&$*&8 %!a"a%!a"a a#-/at DM a*a '-a "a$t ,a$% '!r-$% *-t!#a$ a*a"a+ : a. /. 9. *. !. . %. +. -. . #. ". . $. &. . .
Katara# B"a#&a R!t-$&atBata" '!"r+ /a*a$ Prr-t' V"a! I$!#'- /a#t!r- #"-t I$!#'- ar *- #"-t D!rat&atN!r&at- !r-!r N!r&at- -'!ra" A-&tr&U"#' N!r&tr&-# P!$,a#-t %-$a" P!$,a#-t !/"+ *ara+ !r-!r P!$,a#-t #&r&$!r P!$,a#-t !/"+ *ara+ &ta# H-!rt!$'-
;. P!$ata"a#'a$aa$ P!$ata"a#'a$aa$ *a"a *-a/!t!' !"-t' t!r/a%- !$a*- 28 ,a#$- : !$ata"a#'a$aa$ '!9ara !*-' *a$ !$ata"a#'a$aa$ '!9ara #!!ra5ata$. P!$ata"a#'a$aa$ '!9ara !*-' a*a"a+ '!/a%a- /!r-#t:
a. O/at H-&%"-#!-# &ra" 1) B&"&$%a$ S"&$-"r!a @ '"&$," r!a' O/at -$- a"-$% /a$,a# *-%$a#a$ *a$ *aat *-#&/-$a'-#a$ *!$%a$ &/at %&"&$%a$ "a-$8 ,a-t /-%a$-*8 -$+-/-t&r a"a %"#&'-*a'! ata -$'"-$. O/at %&"&$%a$ -$- !$,a- !!# taa !$-$%#at#a$ r&*#'- -$'"-$ &"!+ '!" '!" /!ta a$#r!a'8 #ar!$a -t !$a*- -"-+a$ taa ara !$*!r-ta DM t-! II *!$%a$ /!rat /a*a$ ,a$% /!r"!/-+a$. O/at > &/at ,a$% /!r!*ar *ar- #!"&&# -$- a*a"a+: a) B"-/!$#"a-*a (<%@ta/"!t). /) B"-/!$#"a-*a -9r&$-!* (< %@ta/"!t).
9) B"-#a'-*a (=0 %@ta/"!t). *) B"-#-*&$ (30 %@ta/"!t). 2) B&"&$%a$ -%a$-* @ M!t&r-$ O/at -$- !$,a- !!# taa !$%ra$%- %"#&'a +at-8 !!r/a-#- a/-"a$ %"#&'a *ar- ar-$%a$ (%"#&'a !r-!r). D-a$r#a$ '!/a%a- &/at t$%%a" a*a a'-!$ *!$%a$ #!"!/-+a$ /!rat /a*a$. 3) B&"&$%a$ I$+-/-t&r A"a B"#&'-*a'! M!$,a- !!# taa !$%+a/at !$,!raa$ %"a *'a"ra$ !$9!r$aa$8 '!+-$%%a *aat !$r$#a$ #a*ar %"a '!'*a+ a#a$. !ra$aat $t# a'-!$ *!$%a$ #a*ar %"a a'a ,a$% a'-+ $&ra". /. I$'"-$ 1) I$*-#a'- -$'"-$ Pa*a DM t-! I ,a$% t!r%a$t$% a*a -$'"-$ /-a'a$,a *-%$a#a$ Ha$ M&$&9&&$!$t I$'"-$ (40 UI *a$ 100 UI@" -$!#'-)8 ,a$% /!r!*ar a*a"a+ A9tra-*. I$!#'- -$'"-$ %a *-/!r-#a$ #!a*a !$*!r-ta DM t-! II ,a$% #!+-"a$%a$ /!rat /a*a$ '!9ara *ra't-'. Fa$% t-*a# /!r+a'-" *!$%a$ !$%%$aa$ &/at > &/ata$ a$t- DM *!$%a$ *&'-' a#'-a"8 ata !$%a"a- #&$tra-$*-#a'- *!$%a$ &/at > &/ata$ t!r'!/t8 /-"a !$%a"a- #!t&a'-*&'-'8 +-!r&'&"ar8 *a$a '-*&'-' "a#tat8 'tr!'' /!rat #ar!$a -$!#'- '-'t!-#8 a'-!$ &!ra'- /!rat8 5a$-ta +a-" *!$%a$ %!a"a DM %!'ta'-&$a" ,a$% t-*a# *aat *-#&$tr&" *!$%a$ !$%!$*a"-a$ *-!t. 2) G!$-' I$'"-$ a) I$'"-$ #!ra 9!at G!$-' > !$-'$,a a*a"a+ r!%"ar -$'"-$8 9r-'ta"-$ -$#8 *a$ '!-"!$t!. /) I$'"-$ #!ra '!*a$% G!$-' > !$-'$,a a*a"a+ NPH (N!tra" Pr&ta-$! Ha%!r*&$) 9) I$'"-$ #!ra "a/at G!$-' > !$-'$,a a*a"a+ PI (Pr&ta-$! -$9 I$'"-$) S!*a$%#a$ $# !$ata"a#'a$aa$ '!9ara #!!ra5ata$ a*a"a+ '!/a%a /!r-#t: a. D-!t Sa"a+ 'at -"ar taa !$%!"&"aa$ DM a*a"a+ !r!$9a$aa$ a#a$. Wa"a$ t!"a+ !$*aat t!$ta$% !$,"+a$ !r!$9a$aa$ a#a$a$8 "!/-+ *ar- <0 a'-!$ t-*a# !"a#'a$a#a$$,a. P!$*!r-ta DM '!/a-#$,a !!rta+a$#a$ !$ *-!t '!-/a$%8 *!$%a$ #&&'-'- -*!a"$,a '!#-tar ;= #ar/&+-*rat8 20 "!a# *a$ 12 r&t!-$. Kar!$a -t *-!t ,a$% t!at $t# !$%!$*a"-#a$ *a$
!$9!%a+ a%ar /!rat /a*a$ t-*a# !$a*- /!r"!/-+a$ *!$%a$ 9ara : Kra$%- #a"&r-8 #ra$%- "!a#8 #&$''- #ar/&+-*rat #&"!#8 +-$*ar- a#a$a$ ,a$% a$-'8 !r/a$,a# #&$''- '!rat. /. O"a+ra%a O"a+ra%a '!"a-$ *aat !$%&$tr&" #a*ar %"a *ara+ #ar!$a !/at -$'"-$ /!#!ra "!/-+ !!#t-. O"a+ra%a %a !/a$t !$r$#a$ /!rat /a*a$8 !!r#at a$t$%8 *a$ !$%ra$%'tr!''. a%- a'-!$ DM !"a##a$ &"a+ra%a *!$%a$ t!ratr a#a$ "!/-+ /a-#8 t!ta- a$%a$ !"a##a$ &"a+ra%a ,a$% /!rat > /!rat. 7. K&"-#a'K&"-#a'- *-a/!t!' !""-t' *-#"a'--#a'-#a$ !$a*- a#t *a$ #r&$-'. Fa$% t!ra'# *a"a #&"-#a'- a#t a*a"a+ +-&%"-#!-a8 *-a/!t!' #!t&a'-*&'-' (DKA)8 *a$ +,!r%",9!-9 +,!r&'&"ar $&$#!t&9-9 9&a (HHN6). Fa$% t!ra'# *a"a #&"-#a'- #r&$-' a*a"a+ r!t-$&at*-a/!t-98 $!r&at- *-a/!t-98 $!r&at-8 *-'"--*!-a8 *a$ +-!rt!$'-. a. K&"-#a'- a#t D-a/!t!' #!t&a'-*&'-' a*a"a+ a#-/at ,a$% /!rat *ar- *!-9-t -$'"-$ ,a$% /!rat a*a ar-$%a$ a*-&'!8 &t&t '#!"!ta"8 *a$ +!ar. Gar-$%a$ t!r'!/t t!ra'# 'a$%at '!$'-t-! t!r+a*a #!#ra$%a$ -$'"-$. DKA *aat *-9!t'#a$ &"!+ -$!#'- ( !$,a#-t) /. K&"-#a'- #r&$-': 1) R!t-$&at- *-a/!t-9 L!'- a"-$% a5a" ,a$% t-/" a*a"a+ -#r&a$!r-' a*a !/"+ r!t-$a. T!r*aat "a /a%-a$ -'#!-#8 ,a-t r!t-$a a#-/at /!r#ra$%$,a a"-ra$ *ara+ r!t-$a. R!'&$ t!r+a*a -'#!-# r!t-$a -$- a*a"a+ !/!$t#a$ !/"+ *ara+ /ar8 t!ta- !/"+ *ara+ t!r'!/t 'a$%at ra+ '!+-$%%a *a+ !9a+ *a$ *aat !$%a#-/at#a$ !r*ara+a$ -tr!&'. P!r*ara+a$ -$- /-'a !$%a#-/at#a$ a/"a'-& r!t-$a ata /!r"a$% ,a$% !$%a#-/at#a$ #!/taa$ !ra$!$. 2) N!r&at- *-a/!t-9 L!'- r!$a" ,a$% #+a' *ar- $!r&at- *-a/!t-9 a*a"a+ %"&!r"&'#"!r&'-' ,a$% $&*"ar ,a$% t!r'!/ar *-#!*a %-$a" ,a$% *-'!/t '-$*r& K&!"'t-!"W-"'&$. B"&!r"&'#"!r-&'-' $&*"ar *-#a-t#a$ *!$%a$ r&t!-$r-a8 !*!a *a$ +-!rt!$'-. L!'- '-$*r& K&!"'t-!"W-"'&$ *-t!#a$ +a$,a a*a DM. 3) N!r&at N!r&at- *-a/!t-9 t!ra*- a*a ;0 > 70 -$*--* DM. $!r&at*-a/!t-9 ,a$% a"-$% '!r-$% *-t!#a$ a*a"a+ $!r&at- !r-!r *a$ at&$&-9.
4) D-'"-*!-a L-a "+ !r'!$ -$*--* *!$%a$ DM !$%a"a- *-'"--*!-a. <) H-!rt!$'H-!rt!$'- a*a a'-!$ *!$%a$ DM t-! 1 !$$##a$ !$,a#-t %-$a"8 -#r&a"/-$r-a8 ata r&t!-$r-a. Pa*a a'-!$ *!$%a$ DM t-! 28 +-!rt!$'- /-'a !$a*- +-!rt!$'- !'!$'-a". H-!rt!$'- +ar' '!9!at $%#-$ *-#!ta+-$ *a$ *-ta$%a$- #ar!$a /-'a !!r/!rat r!t-$&at-8 $!r&at-8 *a$ !$,a#-t a#r&a'#"ar. ;) Ka#- *-a/!t-9 A*a t-%a a9t&r ,a$% /!r!ra$ *a"a #a#- *-a/!t-9 ,a-t $!r&at-8 -'#!-a8 *a$ '!'-'. -a'a$,a ata'- +ar' *-"a##a$. H-"a$%%$,a '!$'&r- a*a #a#- !$%a#-/at#a$ traa *a$ &t!$'-a" $t# "#'. P!r/a+a$ -#r&a'#"!r *a$ a#r&a'#"!r *aat !$%a#-/at#a$ -'#!-a ar-$%a$ *a$ '!'-'. N!r&at-8 -'#!-a8 *a$ '!'-' /-'a !$,!/a/#a$ %a$%r!$! *a$ ata'-. 7) H-&%"-#!-a H-&%"-#!-a a*a"a+ #!a*aa$ *!$%a$ #a*ar %"#&'a *ara+ * /a5a+ ;0 %@*"8 ,a$% !ra#a$ #&"-#a'- &t!$'-a" t!ra-$'"-$ ata &/at +-&%"-#!-# &ra". P!$,!/a/ +-&%"-#!-a a*a a'-!$ '!*a$% !$!r-a !$%&/ata$ -$'"-$ !#'&%!$ ata +-&%"-#!-# &ra".
BAB III PEMBAHASAN
A. K&$'! A'+a$ K!!ra5ata$ B!r&$t-# 1. P!$%#a-a$ a. I*!$t-ta' DM a*a a'-!$ '-a "a$t $,a t!ra*- a*a '-a ;0 ta+$ *a$ $,a a*a"a+ DM t-! II ($&$ -$'"-$ *!!$*!$) ata t-! DMTTI /. K!"+a$ taa DM a*a '-a "a$t $%#-$ 9# '#ar #ar!$a '!r-$% t-*a# #+a' *a$ a'-t&at-# (9&$t&+$,a: #!"!a+a$8 #!"!"a+a$8 !$r$8 t!ra*- -$!#'- -$&r8 #!/-$%$a$ a#t ata *!r!'-). 9. R-5a,at !$,a#-t *a+" T!ra*- a*a !$*!r-ta *!$%a$ DM ,a$% "aa *. R-5a,at !$,a#-t '!#ara
%$ Pa*a $,a a'-!$ *ata$% #! RS *!$%a$ #!"+a$ %a$%%a$ !$%"-+ata$ #ar!$a #atara#8 ra'a #!'!ta$ a*a t$%#a- '!rta #!"!a+a$ &t&t ($!r&at- !r-!r) *a$ "#a a*a t$%#a- ,a$% '#ar '!/+ *!$%a$ !$%&/ata$ "a-. !. R-5a,at !$,a#-t #!"ar%a Da"a a$%%&ta #!"ar%a t!r'!/t 'a"a+ 'at a$%%&ta #!"ar%a a*a ,a$% !$*!r-ta DM 2. P!!r-#'aa$ J-'-# a. S!" (P!r/a+a$ '!") S!" !$a*- "!/-+ '!*-#-t8"a+ *a$ #ra$$,a !$a*- "!/-+ /!'ar8 /!r#ra$%$,a "a+ 9a-ra$ t/+ *a$ /!r#ra$%/,a 9a-ra$ -$tra'!". /. S-'t! -$t!%!$ K"-t #!r-t a#-/at #!+-"a$%a$ "!a#8 #"-t #!r-$% *a$ 9at *a$ t!r*aat /-$t-#/-$t-# +-ta a#-/at !$r$$,a a"-ra$ *ara+ #!#"-t *a$ !$r$$,a '!"'!" ,a$% !r&*#'- -%!$8 ## a*a art!$%a+ *a$ #a#- !$a*- t!/a" *a$ ra+. Pa*a &ra$% /!r'-a ;0 ta+$ ra/t 5aa+ !$-$%#at8 ra/t !$--'@/&ta# *a$ 5ar$a ra/t #!"a/8 #!"!$ar #!r-$%at /!r#ra$% "a+ *a$ $%'-$,a. 9. S-'t! '#"!r K!9!ata$ *a$ #!#ata$ #&$tra#'- &t&t '#!"!ta" /!r#ra$% !$%!9-"a$ &t&t #ar!$a !$r$$,a '!ra/t &t&t. Pa*a &t&t &"&' t-*a# /!%-t /!r!$%ar+. *. S-'t! !$*!$%ara$ Pr!'/-a#'-' (!$r$$,a !$*!$%ara$ a*a "a$'-a) !/ra$ t-a$!$a*- a"tr&- !$,!/a/#a$ a't&'#"!r&'-'8 !$##a$ '!r!$ '!+-$%%a !$%!ra' #ar!$a !$-$%#at$,a #!rat-$ !. S-'t! !$%"-+ata$ 1) Kar!$a /!r/!$t# '!r-'8 '-$%t+!r -" t-/" '#"!r&'-' *a$ +-"a$%$,a r!'&$ t!r+a*a '-$ar8 "!$'a !$a*- #!r+8 !$-$%#at$,a a/a$% !$%"-+ata$ (*a,a a*ata'- t!r+a*a #!%!"aa$ "!/-+ "a/at8 ''a+ !"-+at %!"a). 2) H-"a$%$,a a#&&*a'- !$r$$,a "aa$% a$*a$% #ar!$a /!r#ra$%$,a "a' a$*a$%a$. 3) M!$r$$,a *a,a !/!*a#a$ 5ar$a +-a ata /-r a*a '#a"a. . S-'t! !r$aa'a$ Ot&t&t&t !r$aa'a$ #!+-"a$%a$ #!#ata$ *a$ !$a*#a#8!$r$$,a a#t--ta' '-"-a8 ar #ra$% !"a't-'8 a"!&"- #ra$% !"!/ar /-a'a$,a *a$ "a+ /!r#ra$%. O#'-%!$ a*a art!r- !$r$ !$a*- 7< H%. Kar/&$ &#'-*a a*a art!r- t-*a# /!r%a$t#!aa$ /at# /!r#ra$%. %. S-'t! Kar*-&a'#"!r
+.
-.
.
#.
".
Kat/ a$t$% !$!/a" *a$ !$a*- #a#. K!aa$ a$t$% !&a *ara+ !$r$ 1 !rta+$. K!+-"a$%a$ &/'t-'-ta' !/"+ *ara+8 t!#a$a$ *ara+ !$-$%#at a#-/at !$-$%#at$,a r!'-'t!$'- !/"+ *ara+ !r-!r. S-'t! Ba'tr&-$t!'t-$a" K!+-"a$%a$ %-%-8 -$*ra !$%!9a !$r$8 !'&a%' !"!/ar8 ra'a "aar !$r$8 a'a "a/$% !$r$ 5a#t !$%&'&$%a$ "a/$%8 !r-'ta"t-# "!a+ '!+-$%%a '!r-$% t!ra*- #&$'t-a'-8 +at- a#-$ !$%!9-". S-'t! P!r#!-+a$ B-$a" !$%!9-"8 $!r&$ !$a*- atr&-8 a"-ra$ *ara+ #! %-$a" !$r$ 'aa- <08 "a -"tra'- %"!r"' !$r$ 'aa- <08 $%'t/"' /!r#ra$% '!+-$%%a #ra$% a !!#at#a$ r-$!8 r&t!-$r-a /!rta/a+8 a/a$% %-$a" t!r+a*a %"#&'a !$-$%#at8 #aa'-ta' #a$*$% #!-+ !$r$ #ar!$a &t&t ,a$% "!a+8 r!#!$' /!r#!-+ !$-$%#at8 #a$*$% #!-+ '"-t *-#&'&$%#a$8 a*a &ra$% t!ra*- !$-$%#ata$ r!t!$'- r-$ *a$ !/!'ara$ r&'tat (7< '-a *-ata' ;0 ta+$). S-'t! R!r&*#'S!"at "!$*-r a%-$a !$r$@#!r-$%8 !$9-t$,a &ar- *a$ t!r'8 atr&- a,*ara t!'t-' a'-+ *aat !r&*#'- !'#-$ a*a$,a !$r$a$ '!9ara /!ra$%'ra$%'r8 *&r&$%a$ '!#' !$!ta 'aa'-a 70 ta+$ a'a" #&$*-'- #!'!+ata$ /a-#. S-'t! E$*&#r-$ Pr&*#'- '!a +&r&$ !$r$8 $%'- arat-r&-* *a$ '!#r!'-$,a t-*a# /!r/a+8 /!r#ra$%$,a A6TH8 TSH8 JSH *a$ LH. M!$r$$,a a#t--ta' t-r&-* '!+-$%%a "a !ta/&"-'! t/+ (MR) !$r$. M!$r$$,a r&*# a"*'t!ra$8 a. !$r$$,a '!#r!'-8 +&r&$ %&*a*8 r&%!'t!r&$8 !'tr&%!$ *a$ t!'t&'t!r&$. S-'t! S!$'&rR!a#'- !$a*- "a/at #ra$% '!$'-t- t!r+a*a '!$t+a$ (/!rat &ta# !$r$ '!#-tar 1020)
3. P!!r-#'aa$ D-a%$&'t-# T!'t a. B"#&'a *ara+ '!5a#t /. Ka*ar %"#&'a *ara+ a'a 9. T!' t&"!ra$'- %"#&'a Kr-t!r-a *-a%$&'t-# WHO $t# *-a/!t!' !""-t' a*a '!*-#-t$,a 2 #a" !!r-#'aa$: a. B"#&'a "a'a '!5a#t C200 %@*" (1181 &"@L) /. B"#&'a "a'a a'a C140 %@*" (78= &"@L)
9. B"#&'a "a'a *ar- 'a!" ,a$% *-a/-" 2 a #!*-a$ '!'*a+ !$%#&$''- 7< %r #ar/&+-*rat (2 a &'t ra$*-a" () C 200 %@*" 4. D-a%$&'a K!!ra5ata$ a. Ba$%%a$ $tr-'-: #ra$% *ar- #!/t+a$ t/+ /!r+/$%a$ *!$%a$ !$-$%#ata$ !ta/&"-'! r&t!-$8 "!a#. /. K!#ra$%a$ &"! 9a-ra$ /!r+/$%a$ *!$%a$ &'&t-# *-r!'-' *-ta$*a*!$%a$ t%&r #"-t !$r$ *a$ !/ra$ #a'a #!r-$%. 9. Ba$%%a$ -$t!%r-ta' #"-t /!r+/$%a$ *!$%a$ !r/a+a$ 'tat' !ta/&"-# ($!r&at- !r-!r) *-ta$*a- *!$%a$ %a$%r!$ a*a !tr!-ta'. *. K!"!"a+a$ /!r+/$%a$ *!$%a$ #&$*-'- -'-# ,a$% #ra$%. !. R-'-#& t-$%%- -$!#'- /!r+/$%a$ *!$%a$ %"#&'a *ara+ ,a$% t-$%%-. . R!'-#& t!ra*- -$r, /!r+/$%a$ *!$%a$ !$r$a$ !$%"-+ata$. <. I$t!r!$'- Da$ Ra'-&$a" a. Ba$%%a$ $tr-'-: #ra$% *ar- #!/t+a$ t/+ /!r+/$%a$ *!$%a$ !$-$%#ata$ !ta/&"-'! r&t!-$8 "!a# Tujuan: S!t!"a+ *-/!r-#a$ a'+a$ #!!ra5ata$ *-+ara#a$ #!/t+a$ $tr-'- a'-!$ *aat t!r!$+-. Kr!"ra Ha#$: 1) Pa'-!$ *aat !$9!r$a "a+ #a"&r- ata $tr-!$ ,a$% t!at 2) !rat /a*a$ 'ta/-" ata !$a/a+a$ #! ara+ r!$ta$% /-a'a$,a In!"r%"n# T-/a$% /!rat /a*a$ '!'a- -$*-#a'-. T!$t#a$ r&%ra *-!t8 &"a a#a$ *a$ /a$*-$%#a$ *!$%a$ a#a$a$ ,a$% *aat *-+a/-'#a$ #"-!$. A'#"tra'- /-'-$% ''8 9atat $,!ra/*&!$ ata !rt #!/$%8 a"8 $ta+ *a$ !rta+a$#a$ #!a*aa$ a'a '!'a- -$*-#a'-. !r-#a$ a#a$a$ 9a-r ,a$% !$%a$*$% $tr-'- *a$ !"!#tr&"-t. S!"a$t$,a !/!r-#a$ a#a$a$ ,a$% "!/-+ a*at. I*!$t--#a'- a#a$a$ ,a$% *-'#a-. L-/at#a$ #!"ar%a *a"a !r!$9a$aa$ a#a$.
O/'!ra'-
ta$*a
Ra#&na$ M!$%#a- !a'#a$ a#a$a$ ,a$% a*!#at. M!$%-*!$t--#a'-#a$ #!#ra$%a$ *a$ !$,-a$%a$ *ar- #!/t+a$ t!ra!t-#.
H-!r%"-#!-8 %a$%%a$ #!'!-/a$%a$ 9a-ra$ *a$ !"!#tr&"-t !$r$#a$ &t-"-ta' ata $%'- "a/$% (*-'t!$'- ata -"!' ara"-t-#). P!/!r-a$ a#a$a$ !"a"- &ra" "!/-+ /a-# *-/!r-#a$ a*a #"-!$ 'a*ar *a$ $%'%a'tr&-$t!'t-$a" /a-#.
K!ra 'aa *a"a !r!$9a$aa$ a#a$a$. M!$-$%#at#a$ ra'a #!t!r"-/ata$$,a8 !/!r-$&ra'- a*a #!"ar%a $t# !a+a#!/t+a$ $tr-'- #"-!$. +-&%"-#!-a Pa*a !ta/&"-' #a/&r+-*rat (%"a *ara+ a#a$
(!r/a+a$ t-$%#at #!'a*ara$8 #"-t "!/a ata *-$%-$8 *!$,t $a*- 9!at8 "aar8 !#a ra$%'a$%8 9!a'8 'a#-t #!a"a8 '-$%).
/!r#ra$% *a$ '!!$tara t!ta *-/!r-#a$ t!ta *-/!r-#a$ -$'"-$8 a#a t!ra*- +-&%"-#!-a t!ra*- ta$a !!r"-+at#a$ !r/a+a$ t-$%#at #!'a*ara$.
/. K!#ra$%a$ &"! 9a-ra$ /!r+/$%a$ *!$%a$ &'&t-# *-r!'-' *-ta$*a*!$%a$ t%&r #"-t !$r$ *a$ !/ra$ #&'a #!r-$%. Tujuan: S!t!"a+ *-/!r-#a$ a'+a$ #!!ra5ata$ *-+ara#a$ #!/t+a$ 9a-ra$ ata +-*ra'- a'-!$ t!r!$+ Kr!"ra Ha#$: Pa'-!$ !$$##a$ +-*ra'- ,a$% a*!#at *-/#t-#a$ &"!+ ta$*a -ta" 'ta/-"8 $a*- !r-!r *aat *-ra/a8 tr%&r #"-t *a$ !$%-'-a$ #a-"!r /a-#8 +a"ara$ r-$ t!at '!9ara -$*--* *a$ #a*ar !"!#tr&"-t *a"a /ata' $&ra". In!"r%"n# Ka- r-5a,at #"-!$ '!+/$%a$ *!$%a$ "aa$,a ata -$t!$'-ta' *ar- %!a"a '!!rt- $ta+ *a$ !$%!"ara$ r-$! ,a$% /!r"!/-+a$.
Pa$ta ta$*ata$*a -ta"8 9atat a*a$,a !r/a+a$ t!#a$a$ *ara+ &rt&'tat-#.
Pa$ta &"a $aa' '!!rt- a*a$,a !r$aa'a$ K''a" ata !r$aa'a$ ,a$% /!r/a #!t&$.
Pa$ta r!#!$'*a$ #a"-ta' !r$aa'a$8 !$%%$aa$ &t&t /a$t $aa'8 a*a$,a !r-&*! a$!a *a$ '-a$&'-.
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Ra#&na$ M!/a$t !!r#-ra#a$ #!#ra$%a$ &"! t&ta". A*a$,a r&'!' -$!#'!$%a#-/at#a$ *!a *a$ #!a*aa$ +-!r!ta/&"-# ,a$% !$-$%#at#a$ #!+-"a$%a$ a-r. H-&&"!- *-a$-!'ta'-#a$ &"!+ +-&t!$'*a$ ta#-#ar*-a. P!r#-raa$ /!rat r-$%a$$,a +-&&"!- 'aat t!#a$a$ *ara+ '-'t&"-# tr$ 10 H% *ar- &'-'- /!r/ar-$% #! **# ata /!r*-r-. P!r" !$%!"ar#a$ a'a #ar/&$at !"a" !r$aa'a$ ,a$% !$%+a'-"#a$ #&!$'a'a"#a"&'-' r!'-rat&r-' t!r+a*a #!a*aa$ #!t&a'-*&'-'. Naa' /a a'!t&$ *-'!/a/#a$ !!9a+a$ a'a a'!t&a'!tat *a$ +ar' /!r#ra$% /-"a #!t&'-' t!r#&r!#'-. H-!r%"-#!-a *a$ a'-*&'-' !$,!/a/#a$ &"a *a$ r!#!$'- !r$aa'a$ $&ra". A#a$ t!ta!$-$%#ata$ #!ra !r$aa'a$8 !r$aa'a$ *a$%#a" *a$ 9!at '!rta '-a$&'-' !ra#a$ -$*-#a'*ar#!"!"a+a$ !r$aa'a$ ata #!+-"a$%a$ #!aa$ !"a"- #&!$'a'- a*a a'-*&'-'. D!a8 !$%%-%-"8 *a$ *-a+&r!'-' a*a"a+
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+a" t!ra*- a*a r&'!' -$!#'-8 *!a *!$%a$ #"-t #!!ra+a$8 #!r-$% !ra#a$ ta$*a *!+-*ra'-. Ka- $a*- !r-!r8 !$%-'-a$ #a-"!r8 M!ra#a$ -$*-9at&r t-$%#at *!+-*ra'- ata tr%&r #"-t8 *a$ !/ra$! #&'a. &"! '-r#"a'- ,a$% a*!#at.
9. Ba$%%a$ -$t!%r-ta' #"-t /!r+/$%a$ *!$%a$ !r/a+a$ 'tat' !ta/&"-# ($!r&at- !r-!r) *-ta$*a- *!$%a$ %a$%r!$ a*a !tr!-ta'. Tujuan: S!t!"a+ *-/!r-#a$ a'+a$ #!!ra5ata$ *-+ara#a$ t-*a#t!ra*#&"-#a'-. Kr!"ra Ha#$: 1' M!$$#a$ !$-$%#ata$ -$t!%r-ta' #"-t 2' M!$%+-$*ar- 9-*!ra #"-t In!"r%"n# I$'!#'- #"-t t!r+a*a !r/a+a$ 5ar$a8 tr%&r8 a'#"!r8 !r+at-#a$ #!!ra+a$. U/a+ &'-'- '!t-a 2 a /!r- /a$ta"a$ a*a t&$&"a$ t"a$% P!rta+a$#a$ a"a' #!r-$% *a$ /!/a' "-ata$ !r- !ra5ata$ #"-t '!!rt- !$%%$aa$ "&t-&$ La##a$ !ra5ata$ "#a *!$%a$ t!#$-# a'!t-# A$r#a$ a'-!$ $t# !$a%a a%ar ## t!ta !$*!# M&t-a'- #"-!$ $t# a#a$ a#a$a$ TKTP
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*. K!"!"a+a$ /!r+/$%a$ *!$%a$ #&$*-'- -'-# ,a$% #ra$%. Tujuan: S!t!"a+ *-/!r-#a$ a'+a$ #!!ra5ata$ *-+ara#a$ #!"!"a+a$ *aat t!rata'-. Kr!"ra Ha#$: 1' M!$%-*!$t--#a'-#a$ &"a #!"!t-+a$ '!t-a +ar-. 2' M!$%-*!$t--#a'- ta$*a *a$ %!a"a !$-$%#ata$ a#t--ta' !$,a#-t ,a$% !!$%ar+- t&"!ra$'- a#t--ta'. (' M!$%$%#a#a$ !$-$%#ata$ t-$%#at !$!r%-.
)' M!$$##a$ !r/a-#a$ #!aa$ $t# /!rart-'-a'- *a"a a#t--ta' ,a$% *--$%-$#a$.
In!"r%"n# D-'#'-#a$ #!/t+a$ a#a$ a#t--ta'. at a*5a" !r!$9a$aa$ *a$ -*!$t--#a'- a#t--ta' ,a$% !$-/"#a$ #!"!"a+a$. D-'#'-#a$ !$,!/a/ #!"!t-+a$ '!!rt$,!r- '!$*-8 !$r$a$ !-'-!$'- t-*r8 !$-$%#ata$ a,a ,a$% *-!r"#a$ $t# ADL. a$t !$%-*!$t--#a'- &"a !$!r%- *a$ /at r!$ta$% #!"!t-+a$. S#a"a 010 (0t-*a# "!"a+8 10 'a$%at #!"!"a+a$)
Ra#&na$ P!$*-*-#a$ *aat !/!r-#a$ $t# !$-$%#at#a$ t-$%#at !'#-$ #"-!$ 'a$%at "!a+.
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D!$%a$ !$%!ta+- !$,!/a/ #!"!t-+a$8 *aat !$,'$ a*5a" a#t--ta'.
M!$%-*!$t--#a'- 5a#t $9a# !$!r%- *a$ #!"!"a+a$ !/a$t *a"a !r!$9a$a#a$ a#--ta' $t# !a#'-a"#a$ #&$'!ra'!$!r%- *a$ r&*#t--ta'. !r-#a$ a#t--ta' a"t!r$at- *!$%a$ M!$9!%a+ #!"!"a+a$ ,a$% /!r"!/-+. !r-&*! -'t-ra+at ,a$% 9#@ ta$a *-%a$%%. Pa$ta $a*- 8 r!#!$'- $aa'8 '!rta M!$%-$*-#a'-#a$ t-$%#at a#t--ta' ,a$% *aat t!#a$a$ *ara+ '!/!" *a$ '!*a+ *-t&"!ra$'- '!9ara -'-&"&%-'. !"a##a$ a#t--ta'. T-$%#at#a$ art-'-a'- #"-!$ *a"a M!$%#-$#a$ #!!r9a,aa$ *-r-@ +ar%a *-r!"a##a$ a#t--ta' '!+ar-+ar- '!'a- ,a$% &'-t- '!'a- t-$%#at a#t--ta' ,a$% #!/t+a$. *aat *-t&"!ra$'-. Aar#a$ $t# !$%-*!$t--#a'- ta$*a M!/a$t *a"a !$%a$t-'-a'- t!ra*-$,a *a$ %!a"a ,a$% !$$##a$ #!"!t-+a$ ,a$% /!r"!/-+a$. !$-$%#ata$ a#t--ta' !$,a#-t *a$ !$%ra$%- a#t--ta'8 '!!rt- *!a8 !$r$a$ /!rat /a*a$8 #!"!t-+a$ a#-$ !/r#. !. R-'-#& t-$%%- -$!#'- /!r+/$%a$ *!$%a$ %"#&'a *ara+ ,a$% t-$%%-. Tujuan: S!t!"a+ *-/!r-#a$ a'+a$ #!!ra5ata$ *-+ara#a$ t-*a# t!ra*ta$*ata$*a -$!#'- Kr!"ra Ha#$: 1' T-*a# a*a r/&r8 #a"&r8 *&"&r8 t&r8 $%'-&"!'-a. 2' T!ra*- !r/a+a$ %a,a +-* $t# !$9!%a+ t!ra*-$,a -$!#'-. In!"r%"n#
Ra#&na$
O/'!ra'- ta$*ata$*a -$!#'- *a$ !ra*a$%a$ '!rt- *!a8 #!!ra+a$8 a*a$,a ' a*a "#a8 't r"!$8 r-$! 5ar$a #!r+ ata /!r#a/t. T-$%#at#a$ a,a !$9!%a+a$ *!$%a$ !"a##a$ 99- ta$%a$ ,a$% /a-# a*a '!a &ra$% ,a$% /!r+/$%a$ *!$%a$ a'-!$ t!ra'# a'-!$$,a '!$*-r-. P!rta+a$#a$ t!#$-# a'!t-# a*a r&'!*r -$a'-.
Pa'-!$ $%#-$ a'# *!$%a$ -$!#'- ,a$% /-a'a$,a t!"a+ !$9!t'#a$ #!a*aa$ #!t&a'-*&'-' ata *aat !$%a"a- -$!#'$&'&#&-a". M!$9!%a+ t-/"$,a -$!#'- $&'&#&-a".
Ka*ar %"#&'a ,a$% t-$%%- *a"a *ara+ a#a$ !$a*- !**-a t!r/a-# *a"a !rt/+a$ #a$. !r-#a$ !ra5ata$ #"-t *!$%a$ t!ratr S-r#"a'- !r-!r /-'a t!r%a$%% *a$ *a$ '$%%+'$%%+8 a'a'! *a!ra+ !$!at#a$ a'-!$ a*a !$-$%#ata$ r-'-#& t"a$% ,a$% t!rt!#a$8 a%a #"-t t!ta t!ra*-$,a #!r'a#a$ a*a #"-t. #!r-$%8 "-$!$ #!r-$% *a$ t!ta #!$9a$%. !r-#a$ t-'! *a$ t!at 't a*a M!$%ra$%- !$,!/ara$ -$!#'-. t!at ,a$% *a+ *-a$%#a $t# !$a$%a$ 't ata '!9r!t ,a$% "a-$$,a. .
R!'-#& t!ra*- -$r, /!r+/$%a$ *!$%a$ !$r$a$ !$%"-+ata$. Tujuan: S!t!"a+ *-/!r-#a$ a'+a$ #!!ra5ata$ *-+ara#a$ t-*a# t!ra*-$r, Kr!"ra *a#$: 1' Daat !$$##a$ t!ra*-$,a !r/a+a$ !r-"a# $t# !$r$#a$ a9t&r r-'-#& *a$ $t# !"-$*$%- *-r- *ar- 9-*!ra. 2' M!$%/a+ "-$%#$%a$ '!'a- -$*-#a'- $t# !$-$%#at#a$ #!aa$a$.
In!"r%"n# H-$*ar#a$ "a$ta- ,a$% "-9-$.
Ra#&na$ La$ta- "-9-$ *aat !$,!/a/#a$ r-'-#& at+ a*a a'-!$. B$a#a$ /!* ,a$% r!$*a+. M!!r*a+ a'-!$ $t# $a-# *a$ tr$ *ar- t!at t-*r. Or-!$ta'-#a$ #"-!$ *!$%a$ ra$%a$. La$'-a *a,a -$%at$,a '*a+ !$r$8 '!+-$%%a *-!r"#a$ &r-!$ta'- ra$%a$ a%ar "a$'-a /-'a !$,!'a-#a$ *-r- t!r+a*a ra$%a$. a$t #"-!$ *a"a !"a##a$ a#t--ta' La$'-a '*a+ !$%a"a- !$r$a$ *a"a '!+ar-+ar-'-#8 '!+-$%%a *a"a !"a##a$ a#t--ta' '!+ar- *-!r"#a$ /a$ta$ *ar- &ra$% "a-$'!'a- *!$%a$ ,a$% *aat *-t&"!ra$'-
a$t a'-!$ *a"a a/"a'- ata K!t!r/ata'a$ a#t--ta' !r/a+a$ &'-'#&$*-'- "a$'-a.
DA+TAR PUSTAKA
t!r%a$t
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6ar!$-t&8 L,$*a Ga""8 17. Buku Saku Diagnosa Keperawatan edisi 6 alih bahasa YasminAsih. Ga#arta : EB6. D&!$%!'8 Mar-",$ E8 Rencana Asuhan Keperawatan Pedoman untuk Perencanaan dan Pendokumentasian Perawatan Pasien edisi 3 alih bahasa !ade Kariasa" #i !ade Sumarwati. Ga#arta : EB68 1. I#ra8 A-$a" " Buku A$ar lmu Pen%akit Dalam & Diabetes !ellitus Pada 'sia (an$ut $ilid )disi ketiga" Ga#arta : JKUI8 1;. K'+ar-,a*-.2010. Asuhan Keperawatan pada Klien (an$ut 'sia. Ga#arta : Sa"!/a M!*-#a L!9#$&t!8 A$$!tt! B!-'"!r8 Pengka$ian *erontologi alih bahasa Aniek !ar%unani. Ga#arta:EB68 17. Mar, ara*!r&8 Mar, W-"r-* *a$ Fa#&/' S-'5a$*-. 200. Klien *angguan )ndokrin& Seri Asuhan Keperawatan. Ga#arta : EB6 S!"t!r8 Sa$$! 68 r!$*a B /ar!8 Buku A$ar Keperawatan !edikal Bedah Brunner + Suddarth )disi , -ol alih bahasa /. Y. Kuncara" Andr% /artono" !onica )ster" Yasmin asih" Ga#arta : EB68 2002.
