LAPORAN PENDAHULUAN ASUHAN KEPERAWATAN KLIEN DENGAN PENYAKIT PARU OBSTRUKTIF KRONIK
OLEH: SRI YUNIARTI YUNIARTI
PPN 14251
MARIANA PEREIRA
PPN 14212
RUSMYATI RUSMYATI
PPN 14242 LEURA
PROGRAM PROFESI NERS XIII SEKOLAH TINGGI ILMU KESEHATAN IMMANUEL BANDUNG 2015
KONSEP DASAR PENYAKIT
1.
Pengertian
a.
PPOK
Mer!" !"
#a$a a$a
%e! %e!& &'a(
)a*))a*
+a*)
&e&# e&#e*)ar(,
#er)era"a* $ara $ar, $a* "e'ar Par. Ga*))a* +a*) #e*-,*) a$a'a( Br*"(,-,% O/%-r"-, E&#(+%e&a $a* A%-(&a Br*",a'e. B'a3". . M. Ma-a%%ar,*.E. . 16678. /.
Sa- "*$,%, $,&a*a a',ra* $ara #a$a #ar -er%&/a- %e3ara -er% &e*er%. Pr%e% #e*+a",- ,*, a$a'a( %er,*)"a', "&/,*a%, $ar, 2 a-a 7 "*$,%, "*$,%, /er," /er,"-- ,*, Br*" Br*"(,(,-,% ,% O/%-r O/%-r"-, "-, Kr*,% Kr*,% E&#(+ E&#(+%e&a %e&a $a* A%-(&a A%-(&a Br*",a'e8 Br*",a'e8 $e*)a* %a- #e*+e/a/ #e*+e/a/ #r,&er $a* +a*) 'a,* a$a'a( "&#',"a%, $ar, #e*+a",- #r,&er.E*))ra& #r,&er.E*))ra& B. 16698.
2.
Klai!i"ai a.
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E&'$(e&a
Per/a Per/a(a* (a* a*a-& a*a-&,% ,% #are*" #are*",& ,& #ar #ar +a*) +a*) $,-a*$ $,-a*$a, a, #e'e/a #e'e/ara* ra* $,*$,* $,*$,*) ) a';e'% $"-% a';e'ar,% $a* $e%-r"%, $,*$,*) a';e'ar ).
At$&a Br#n"iale
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PENYEBAB PPOK a.
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Br*",-,% Kr*,% 18
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Fa"-r -a" $,"e-a(,
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78
Mer""
48
P'%, $ara
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3
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ani!etai "lini E&'$(e&a /an %r#n"$iti "r#ni GABARAN M'a, -,&/'
EPHYSEA U%,a 70 40 -a(*
BRONKHITIS 20 70 -a(* /a-" a",/a-
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PENATALAKSANAAN
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Me&e',(ara "e#a-e*a* !a'a* *aa% $e*)a* &e*r*"a* %#a%&e /r*"% $a* &e&/er%,("a* %e3re- +a*) /er'e/,(a*
28
Me&e',(ara "eee"-,a* #er-"ara* )a%
78
Me*3e)a( $a* &e*)/a-, ,*e"%, %a'ra* #er*aa%a*
48
Me*,*)"a-"a* -'era*%, 'a-,(a*.
58
Me*3e)a( a$a*+a "&#',"a%, )a)a' *aa% a"- $a* %-a-% a%&a-,"%8
98
Me*3e)a( a''er)e*,r,-a%, !a'a* *aa%
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78
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48
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ASUHAN KEPERAWATAN
1.
Peng"aian
a. R,?a+a- a-a a"-r #e**!a*) :
5
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3.
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Mer"" &er#a"a* a"-r #e*+e/a/ -a&a.
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T,*))a' a-a /e"er!a $, area $e*)a* #'%, $ara /era-.
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R,?a+a- a'er), #a$a "e'ar)a
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R,?a+a- A%-(&a #a$a a*a"
R,?a+a- a-a a$a*+a a"-r #e*3e-% e"%a%er/a%, : <
A'er)e*.
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S-re%% e&%,*a'.
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A"-,;,-a% ,%," +a*) /er'e/,(a*.
<
P'%, $ara.
<
I*e"%, %a'ra* *aa%.
Pe&er,"%aa* ,%," : a.
Ma*,e%-a%, "',*," Pe*+a",- Par O/%-r"-, Kr*," : •
Pe*,*)"a-a* $,%#*ea.
•
Pe*))*aa*
--<--
a"%e%r,
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Pe*r*a* /*+, *aa%.
•
Ta",#*ea.
Ge!a'a +a*) &e*e-a# #a$a #e*+a",- $a%ar
A%-(&a
Ba-" &*)",* #r$"-, a-a ** #r$"-,8 $a* #era%aa* $a$a %e#er-, -er,"a-.
Me*),
%aa- ,*%#,ra%,
&a#* e"%#,ra%,
+a*)
$a#a-
-er$e*)ar -a*#a %-e-%"#.
Per*aa%a* 3#,*) (,$*).
Ke-a"-a* $a* $,are%,%.
Br*"(,-,%
Ba-" #r$"-, $e*)a* %#-& /er?ar*a #-,( "ea/< a/a* +a*) /,a%a*+a -er!a$, #a$a #a), (ar,.
I*%#,ra%, r*"(, "a%ar $a* ?(eCC,*).
Se%a" *aa%
Br*"(,-,% -a(a# 'a*!-8
Pe*a&#,'a* %,a*%,%
Pe&/e*)"a"a* && a-a /'e /'a-er% $,%e/a/"a* 'e( e$e&a a%,%-e&," +a*) -er!a$, %e/a)a, a",/a- $ar, "r #'&*a'8.
6
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Pe*a&#,'a* ,%," "r% $e*)a* $a$a /arre' 3(e%- $,a&e-er -(ra"% a*-er,r #%-er,r &e*,*)"a- %e/a)a, a",/a- (,#er,*'a%, #ar<#ar8.
2.
Fa%e e"%#,ra%, &e&a*!a*).
E&#(+%e&a -a(a# 'a*!-8
H,#"%e&,a $a* (,#er"a#*,a.
Pe*a&#,'a* %e/a)a, #,*" #er%
ar,
PEMERIKSAAN DIAGNOSTIK
Te%- aa' #ar 18
Ka#a%,-a% ,*%#,ra%, &e*r*
28
@'&e re%,$ : &e*,*)"a- #a$a e&#(+%e&a /r*"(,-,% $a* a%-(&a
78
FE@1 %e'a' &e*r* $era!a- /%-r"%, #r)re%, Pe*+a",- Par O/%-r"-, Kr*,"
48
F@ a?a' *r&a' → &e*r* #a$a /r*3(,-,% $a* a%-&a.
58
TL *r&a' %a&#a, &e*,*)"a- %e$a*) #re$&,*a* #a$a e&#(+%e&a8.
Tra*%er )a% "a#a%,-a% $,%,8. Pa$a Pe*+a",- Par O/%-r"-, Kr*," Tra*%er )a% re'a-, /a,". Pa$a e&#(+%e&a : area #er&"aa* )a% &e*r*. ↓ Tra*%er )a% "a#a%,-a% $,%,8.&e*r*
Dara( : H/ $a* He&a-"r,- &e*,*)"a- #a$a #',%,-e&,a %e"*$er. &'a( $ara( &era( &e*,*)"aE $a* --a' I)E %er& &e*,*)"a-. A*a',%a Ga% Dara( → )a)a' *aa% "r*,%. P'%e "%,&e-r, → SaO2 "%,)e*a%, &e*r*. E'e"-r',- &e*r* 'e( "are*a #e&a"a,a* $er,-,"a #a$a 3r #'&*a'e.
A*a',%a Ga% Dara( PaO2 &e*r* PO2 &e*,*)"a- %er,*) &e*r* #a$a a%-&a. PH *r&a' a%,$%,% a'"a'%,% re%#,ra-r," r,*)a* %e"*$er.
7
S#-& : Pe&er,"%aa* )ra&
"&a*"'-r a$a*+a ,*e"%, 3a&#ra*.
K&a* #a-)e* : S-re#-333% #*e&*,ae. He&#(+'% ,*'e*Cae. Mrae''a 3a-arr(a',%.
Ra$,'), : T(ra - AP $a* 'a-era'8. H,#er,*'a%, #ar<#ar #e&/e%ara* !a*-*) $a* /e*$*)a* area #ar<#ar. Pa$a e&#(+%e&a #ar : a. D,%-e*%, /. D,ara)&a 'e-a"
re*$a(
$a*
&e*$a-ar. 3. Ra*) $ara re-r%-er*a' - 'a-era'8. $. a*-*) -a&#a" &e&a*!a*) $a* &e*+e&#,-.
Br*")ra& : &e**!""a* $,'a-a%, /r*"% "'a# /r*"(,a'e #a$a e"%#,ra%, "a-.
EKG. Ke'a,*a* EKG +a*) #a',*) $,*, a$a'a( r-a%, 3'3" ?,%e !a*-*). B,'a %$a( -er$a#a- Kr P'&*a' -er$a#a- $e;,a%, a"%,% "e "a*a* $a* P< #'&*a' #a$a (a*-ara* II III $a* a@F. @'-a%e RS re*$a(. D, @1 ra%, RS 'e/,( $ar, 1 $a* $, @9 @1 ra%, RS "ra*) $ar, 1. Ser,*) -er$a#aRBBB ,*"&#'e-.
8
La,*<'a,* #er' $,"a!, Bera- /a$a* ra-a
A"ti3ita
/an
Itira$at Ge!a'a
Ke'e-,(a* "e'e'a(a* &a'a,%e Ke-,$a"&a&#a* &e'a""a* a"-,;,-a% %e(ar,<(ar, "are*a %', /er*aa%. Per' -,$r $a'a& #%,%, $$" 3"# -,*),. D,%#*ea
Ta*$a
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Sir"4lai Ge!a'a Ta*$a
Pe&/e*)"a"a* #a$a e"%-re&,-a% /a?a( Pe*,*)"a-a* -e"a*a* $ara(. Pe*,*)"a-a* re"e*%, !a*-*) D,%-e*%, ;e*a 'e(er %,a*%,% #er,er
Integrita eg# Ge!a'a-a*$a a"anan+)airan Ge!a'a
A*%,e-a% "e-a"-a* $a* #e"a ra*)%a*) Ma'&*-a( Na% &a"a* &e*r* "e-,$a"&a&#a* &a"a* "are*a $,%-re%% #er*aa%a* Pe*r*a*a* BB &e*e-a# e&#,%e&a8 $a* #e*,*)"a-a* BB
Ta*$a
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/er"er,*)a-
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BB
#e*r*a* &a%%a -H(giene Ge!a'a
Ta*$a Perna!aan Ge!a'a
Pe*r*a*
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/a*-a*
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Ta*$a
R,?a+a- P*e&*,a r,?a+a- "e'ar)a $e,%,e*%, a'a a*-,-r,#%,* Re%#,ra%, 3e#a- $a*)"a' /,a%a &e'a&/a- a% e"%#,ra%, &e&a*!a*) $e*)a* &e*$e*)"r *aa% /,/,r e&#,%e&a8 Pe*))a*aa* -- Ba*- #er*aa%a* Da$a /are'' 3(e%- )era"a* $,ara)&a &,*,&a'. B*+, *aa% R*", ?(eeC,*) re$# Per"%, (+#er%*r #a$a area #ar $ara -er!e/a" $a* $a#a !)a re$##e"a" "are*a a$a*+a 3a,ra*8. Ke%',-a* /,3ara 64 5 "a',&a- 0 S,a*%,% /,/,r $a* $a%ar "" !ar, -a/(.
9
Se"4alita Intera"i #ial Ge!a'a -a*$a
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10
5.
ANALISA DAN SINTESA DATA NO DATA 1. S: K',e* &e*)a-a"a* %e%a" *aa%. Da$a %e#er-, -er-e"a*"e-,$a"&a&#a* *-" /er*aa%. O: 1. Jar*a "',- #er,er 3,a*%,%. 2. RR : 72 &e*,-. 7. Naa% #e*$e". 4. Pe*))a*aa* - /a*- #er*aa%a* 5. S,a*%,% /,/,r $a* $a%ar "" !ar, -a/(.
2.
S: K',e* &e*)a-a"a* %e'a' ,*),* /a-" $a* %%a( /er*aa%. O: 1. B*+, *aa% : R*", ?(eeC,*) re$#. 2. Per"%, (+#er%*r #a$a area #ar. 7. Ba-" &e*e-a# $e*)a* #r$"%, %#-& 8 4. S,a*%,% 5. Ge',%a( 9. Per/a(a* re"e*%, $a* ,ra&a *aa%
7.
O: K',e* (a*+a &a"a* /e/era#a %e*$" $ar, &a"a*a* +a*) $,%a!,"a*. S: K',e* &e*)e'( %e%a" *aa% #a$a ?a"- &a"a*
ETIOLOGI E$e&a %#a%&e /r*"% #e*,*)"a-a* %e3re- /r*",'% ↓ O/%-r"%, /r*",'% a?a' a%e e"%#,ra%, ↓ U$ara -er#era*)"a# $a'a& a';e'% ↓ Te"a*a* O2 re*$a( -e"a*a* O2 &e*,*)"a↓ Ga*))a* #er-"ara* )a% E$e&a %#a%&e /r*"% #e*,*)"a-a* %e3re- /r*",'% ↓ Pera$a*)a*,*'a&a%, ↓ S#-& &e*,*)"a↓ Ba-" ↓ Ber%,(a* !a'a* *aa% -,$a" ee"-,
ASALAH Ga*))a* #er-"ara* )a%
Ber%,(a* !a'a* *aa% -,$a" ee"-,
I*'a&a%, Ga*))a* #e&e*(a* *-r,%, ↓ "ra*) $ar, I*e"%, "e/-(a* -/( ↓ Le"%,- &e*,*)"a↓ I&* &e*r* ↓ K&a* #a-()e* $a* e*$)e* $,a%),-&a"ra) ↓ A*re"%,a ↓ Ga*))a* #e&e*(a* *-r,%, "ra*) $ar, "e/-(a* -/(
11
4.
S : /,a%a*+a "',e* &e*)e'( %e%a" *aa%. O:
E$e&a %#a%&e /r*"% #e*,*)"a-a* %e3re- /r*",'% ↓
P'a *aa% ee"-,
-,$a"
O/%-r"%, /r*",'% a?a' a%e e"%#,ra%, ↓ E$e&a -er#era*)"a# $a'a& a';e', ↓ Se%a" *aa% *a#a% #e*$e" ↓ P'a *aa% -,$a" ee"-,
*.
DIAGNOSA KEPERAWATAN
•
Ga*))a* #er-"ara* )a% /er(/*)a* $e*)a* #e&/a-a%a* !a'a* *aa% "e'e'a(a* -- #er*aa%a* #e*,*)"a-a* #r$"%, &"% a-a %#a%&e /r*"%.
•
Ber%,(a* !a'a* *aa% -,$a" ee"-, /er(/*)a* $e*)a* "e-,$a"a$e"a-a* /a-" #e*,*)"a-a* #r$"%, &"%#e*,*)"a-a* %e"re%, 'e*$,r
•
Ga*))a* "e/-(a* *-r,%, "ra*) $ar, "e/-(a* -/( /er(/*)a* $e*)a* "e-,$a"a$e"a-a* ,*-a"e *-r,%, %e"*$er -er(a$a# #e*,*)"a-a* "er!a #er*aa%a* a-a "e%',-a* &a%"a* ra' %e"*$er $ar, a*re"%,a.
• -.
P'a *aa% -,$a" ee"-, /er(/*)a* $e*)a* "e'e'a(a* -- #er*aa%a*.
Peren)anaan
Pere*3a*aa* &e',#-, #e*+%*a* #r,r,-a% -!a* $a* "r,-er,a (a%,' $ar, &a%,*)<&a%,*) &a%a'a( +a*) $,-e&"a*.
T!a* Pe*a-a'a"%a*aa* •
Me*)ra*), )e!a'a $a* &e*,*)"a-"a* "a',-a% (,$#.
•
Pe&e',(araa* *)%, #ar +a*) #-,&a' $a'a& ?a"- %,*)"a- $a* #a*!a*).
•
Pe*3e)a(a* $a* #e*a*)a*a* e"%a%er/a%,.
•
Me*)ra*), #er/r"a* *)%, #ar %e-,a# -a(**+a.
Kr,-er,a Ke/er(a%,'a* : •
Ber"ra*)*+a )e!a'a %e%a" *aa%.
12
•
Ber"ra*)*+a re"e*%, $a* 'a&a*+a e"%a%er/a%,.
•
Me&/a,"*+a aa' #ar.
•
Me*r**+a )e!a'a #%,"')," $e#re%, "e3e&a%a*8.
•
Me&#er/a,", "a',-a% (,$#.
•
Da#a- &e'a""a* a"-,,-a% %e(ar,<(ar,.
13
DIAGNOSA
1.
KEPERAWATAN Ga*))a* #er-"ara*
TU6UAN
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17
DAFTAR PUSTAKA
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17
DAFTAR PUSTAKA
A'%a)a H$ A/$' M"-+ 16658. Da%ar Da%ar I'& Pe*+a",- Par. A,r'a*))a U*,;er%,-+ Pre%%. Sra/a+a.
A&,* &(a&&a$ H$ A'%a)a. 16>68. Pe*)a*-ar I'& Pe*+a",- Par. A,r'a*))a U*,;er%,-+ Pre%%. Sra/a+a.
B'a3M a3/. 16678. '.3"&a* Sre*%e*% Me$,3a' %r),3a' Nr%,*) A P(%+3#%,3')+3 A##ra3(. J.B. Sa*$er% &#a*+. P(,'a#,$e'#,a.
Bar/ara E*)ra&. 16668. Re*3a*a A%(a* Ke#era?a-a* Me$,"a' Be$a(. @'. 1. Pe*er/,- EG. a"ar-a.
Mar+',* E $e*)e%. 20008. Re*3a*a A%(a* "e#era?a-a* Pe$&a* *-" Pere*3*aa* #e*$"&e*-a%,a* Pera?a-a* Pa%,e*. EG.a"ar-a.
Se#ar&a* Sar?* Ja%#a$!,. 16608. I'& Pe*+a",- Da'a& ,',$ II. Ba'a, Pe*er/,FKUI. a"ar-a.
S+';,a A*$er%* Pr,3e Lrra,*e M3ar-+ J,'%*. 16658. Pa-,%,'), K*%e# K',*,% Pr%e% < Pr%e% Pe*+a",-. EG. a"ar-a.
DAFTAR PUSTAKA
A'%a)a H$ A/$' M"-+ 16658. Da%ar Da%ar I'& Pe*+a",- Par. A,r'a*))a U*,;er%,-+ Pre%%. Sra/a+a.
A&,* &(a&&a$ H$ A'%a)a. 16>68. Pe*)a*-ar I'& Pe*+a",- Par. A,r'a*))a U*,;er%,-+ Pre%%. Sra/a+a.
B'a3M a3/. 16678. '.3"&a* Sre*%e*% Me$,3a' %r),3a' Nr%,*) A P(%+3#%,3')+3 A##ra3(. J.B. Sa*$er% &#a*+. P(,'a#,$e'#,a.
Bar/ara E*)ra&. 16668. Re*3a*a A%(a* Ke#era?a-a* Me$,"a' Be$a(. @'. 1. Pe*er/,- EG. a"ar-a.
Mar+',* E $e*)e%. 20008. Re*3a*a A%(a* "e#era?a-a* Pe$&a* *-" Pere*3*aa* #e*$"&e*-a%,a* Pera?a-a* Pa%,e*. EG.a"ar-a.
Se#ar&a* Sar?* Ja%#a$!,. 16608. I'& Pe*+a",- Da'a& ,',$ II. Ba'a, Pe*er/,FKUI. a"ar-a.
S+';,a A*$er%* Pr,3e Lrra,*e M3ar-+ J,'%*. 16658. Pa-,%,'), K*%e# K',*,% Pr%e% < Pr%e% Pe*+a",-. EG. a"ar-a.
Y*% Fa,%a'. 16628. P'&*'), K',*,". Ba),a* P'&*'), FKUI. a"ar-a.
18
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