ASUHAN KEPERAWATAN PADA NY. T DENGAN GANGGUAN SISTEM PERSYARAFAN: PERFUSI JARINGAN CEREBRAL TIDAK EFEKTIF DI RUANG IGD RUMAH SAKIT MARGONO SOEKARJO PURWOKERTO
Disajikan S!a"ai T#"as Pa$a P%!&aja'an S(as K)'a*a(an D*asa P'+"'a% Pn$i$ikan P'+,si N's STIKES M#-a%%a$ia- G+%!+n"
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LEMBAR PENGESAHAN
ASUHAN KEPERAWATAN PADA NY. T DENGAN GANGGUAN SISTEM PERSYARAFAN: PERFUSI JARINGAN CEREBRAL TIDAK EFEKTIF DI RUANG IGD RUMAH SAKIT MARGONO SOEKARJO PURWOKERTO
Telah die!"#"i $ada Ha%i&!a'((al:))))))))))).
Pe*+i*+i'( ,li'i,
Ke$ala R"a'( IGD
RSMS P"%-,e%!
RSMS P"%-,e%!
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/)))))))))).0
KATA PENGANTAR
De'(a' *e'1e+"! 'a*a Allah Ya'( Maha Pe'(aih da' *aha $e'1a1a'(. Se(ala Se(ala $"#i $"#i +a(i +a(i Allah Allah 1a'( 1a'( !elah !elah *eli*$ *eli*$ah, ah,a' a' %ah*a! %ah*a! da' ,a%"'ia2 ,a%"'ia2N1a N1a dala* dala* *e'1eleai,a' *e'1eleai,a'
la$%a' la$%a' $ada !ae Ke$e%a-a!a' Ke$e%a-a!a' De-aa De-aa 1a'( +e%#"d" +e%#"d"ll 3A"ha'
Ke$e%a-a!a' Ke$e%a-a!a' $ada N1. T De'(a' De'(a' *aalah *aalah ,e$e%a-a!a' ,e$e%a-a!a' $e%4"i $e%4"i #a%i'(a' #a%i'(a' 5e%e+%al 5e%e+%al !ida, e4e,!i4 di R"*ah Sa,i! Ma%(' Se,a%d# P"%-,e%!.6 Dala* Dala* ,ee*$ ,ee*$a!a' a!a' i'i $e'"li $e'"li *e'1a* *e'1a*$ai $ai,a' ,a' !e%i*a !e%i*a,a ,aih ih ,e$ada ,e$ada 1a'( 1a'( !e%h%*a! 7.
Ba$a, Be Be,!i Ha%1 a%1adi adi8 AMK ela," a," ,e$ala ala %"a %"a'( IGD IGD 1a' 1a'( !elah *e*+e%i ,ee*$a!a' ,e$ada $e'"li "'!", *e'(a*+il ,a" di % "a'( IGD RSUD Ma%(' Se,a%d# P"%-,e%!.
9.
Ba$a, A' A'i8 i8 S Ke$8 Ne% Ne% da da' Ba$ Ba$a, Sa4 Sa4%"di' S Ke$8 Ne% Ne% e ela," $e*+i*+i'(
A,ade*i,
1a'(
!elah
*e*+e%i,a'
+i*+i'(a'
da'
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Ba$a Ba$a, , A%i A%i,h ,h Ra!' Ra!'aa S Ke$ Ke$8N 8N ela ela," ," $e*+ $e*+i* i*+i +i'( '( dala dala* * $e'1 $e'1" ""' "'a' a' la$%a' i'i 1a'( de'(a' a+a% *e*+i*+i'( da' *e*+e%i $e'(a%aha'.
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Se(e Se(e'a 'a$ $ !a4 !a4 ,e$ ,e$e% e%aa-a! a!a' a' di% di%"a "a'( '( *a*a-a% a% RSU RSUD D Ma%( Ma%(' ' Se Se,a ,a%d %d# # P"%-, P"%-,e%! e%! a!a a!a +a'!"a +a'!"a' ' da' ,e%#aa ,e%#aa*a' *a'1a 1a ela*a ela*a $e'(a* $e'(a*+il +ila' a' ,a" ,a" +e%la'("'(
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I+" I+" da' +a$ +a$a, !e%5 !e%5i' i'!a !a de' de'(a' (a' e(al e(alaa $e'( e'(%+a %+a' 'a'' a''1a ela ela* *a i'i8 i'i8 !e%i*a,aih 1a'( elal" *e*+e%i,a' *!i=ai da' e*a'(a! "'!", ",e.
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Te*a Te*a'? '?!e !e*a *a' ' da' da' $iha $iha,? ,?$i $iha ha, , 1a'( 1a'( *e* *e*+a +a'! '!" " dala dala* * *e'1 *e'1el ele eai ai,a ,a' ' la$%a' +ai, e5a%a la'("'( *a"$"' !ida, la'("'(.
M"dah?*"daha' Allah SWT *e*+ala e(ala ,e+ai,a'. K%i!i, da' a%a' da%i $a%a $e*+a5a a'(a! $e'"li ha%a$,a' "'!", $e%+ai,a' la$%a' ela'#"!'1a. Se*(a la$%a' i'i +e%*a'4aa! +a(i ,i!a e*"a.A*i'.
P"%-,e%!8
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DAFTAR ISI
J"d"l ........................................... .................................................................. .............................................. ........................................................ ................................. Pe'(eaha' ............................................. .................................................................... .............................................. ............................................ ..................... Ka!a Pe'(a'!a% ............................................. .................................................................... ............................................................. ...................................... Da4!a% Ii ............................................ ................................................................... .............................................. ................................................. ..........................
BAB I
PENDAHULUAN............................... PENDAHULUAN........ .............................................. ........................................................ .................................
BAB II STUDI PUSTAKA A. Pe'(e%!ia' Maalah Ke$e%a-a!a'........................................... Ke$e%a-a!a'.................................................................. ....................... B. E!i(i.......................... E!i(i................................................. .............................................. .............................................. ................................... ............ C. Pa!4iil(i..................... Pa!4iil(i............................................ ............................................... ............................................. ............................... .......... D. Fa,!% Fa,!% De*(%a4i De*(%a4i da' E$ide*il E$ide*il(i.... (i......... .......... .......... .......... .......... .............. ................... ................... ............. .... E. Ri-a1a! Keeha!a'....................... Keeha!a'.............................................. ............................................... ........................................... ................... F. Ri-a1a! Ri-a1a! Keeha!a' Keeha!a' Dah"l"... Dah"l"........ .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ............. ................. ........... G. Ri-a1a! Keeha!a' Kel"a%(a............................................ Kel"a%(a........................................................................ ............................ . H. Pla F"'(i'al Keeha!a'....................... Keeha!a'.............................................. ................................................ ......................... ..... I. Pe*e%i,aa' Pe*e%i,aa' Fii, Pe'"'#a'(.. Pe'"'#a'(....... .......... .......... .......... .......... .......... .......... .......... .............. ................... ................... ........... .. J. Pe'a!ala,a' Pe'a!ala,a'aa'&i'! aa'&i'!e%=e' e%=e'i..... i.......... .......... .......... .......... .......... .......... .......... ......... ............. ................... ................... ............. ....
BAB III STUDI KASUS A. Bida!a.......................................... Bida!a................................................................. ............................................................... ........................................ .. B. Pe'(,a#ia'....................................... Pe'(,a#ia'.............................................................. .............................................. ..................................... ................. ... 7. Kel"ha' U!a*a............................................ U!a*a................................................................... ............................................. ...................... 9. Ri-a1a! Ri-a1a! Pe'1a,i! Pe'1a,i! Se,a%a'(... Se,a%a'(........ .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ............ ....... . Ri-a1a! Ri-a1a! Keeha!a' Keeha!a' Dah"l"... Dah"l"........ .......... .......... ......... ......... .......... .......... .......... .......... .......... ............. ................. ........... ;. Ri-a1a! Ri-a1a! Keeha!a' Keeha!a' Kel"a%(a... Kel"a%(a........ .......... .......... .......... .......... .......... .......... .......... ........... ................ .................. ........ <. Pla F"'(i'al F"'(i'al ,eeha!a'... ,eeha!a'........ .......... .......... ......... ......... .......... .......... .......... .......... ........... ................ .................. ........ >. Pe*e%i,aa' Pe*e%i,aa' 4ii,...... 4ii,........... .......... .......... .......... .......... ......... ......... .......... .......... .......... .......... ............. .................. ................. ....... . Pe*e%i,aa' Pe*e%i,aa' $e'"'#a'(. $e'"'#a'(...... .......... ......... ......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ........... ........... ..... B. A'alia Da!a............................................ Da!a................................................................... ....................................................... ................................ C. I'!e%=e'i Ke$e%a-a!a'..................... Ke$e%a-a!a'............................................ .............................................. ...................................... ............... D. I*$le*e'!ai........................ I*$le*e'!ai............................................... .............................................. ................................................... ............................
E. E=al"ai........................................... E=al"ai.................................................................. .............................................. ..................................... ................. ...
BAB I PEMBAHASAN............................ PEMBAHASAN................................................... .............................................. ....................................... ................ BAB PENUTUP............................... PENUTUP...................................................... .............................................. .............................................. ....................... DAFTAR PUSTAKA.................................. PUSTAKA......................................................... .......................................................... ................................... ....
BAB I PENDAHULUAN
S!%,e S!%,e adalah i'd%* ,li'i 1a'( a-al !i*+"l'1a !i*+"l'1a *e'dada, *e'dada, $%(%ei4 5e$a! +e%"$a de4i5i! 'e"%l(i! 4,al da' (l+al 1a'( +e%la'("'( 9; #a*&le+ih a!a" la'("'( *e'i*+"l,a' ,e*a!ia'./Ma'#e% 89@@@0 S!%,e adalah hila'('1a hila'('1a 4"'(i !a, e5a%a *e'dada, 1a'( dia,i+a!,a' leh (a'(("a' "$lai da%ah ,e +a(ia' !a,./B%"''e% S"dda%!h89@@@0 S!%,e S!%,e he*%a he*%a(i5 (i5&& !%,e !%,e +e%da% +e%da%ah ah adalah adalah !%,e !%,e 1a'( 1a'( dia,i+ dia,i+a!, a!,a' a' ,a%e'a ,a%e'a ada'1a $e%da%aha' a,i+a! $e5ah'1a a!a" %+e,'1a di'di'( $e*+"l"h da%ah. S!%,e '' hae*%a(i5& i,e*i5& i'4a%, adalah !%,e 1a'( dia,i+a!,a' leh +!%",i =a5"la% /!h%*+" da' e*+l"0 ehi'((a *e'(a,i+a!,a' i5he*i5& i'4a%,. O+!%" O+!%",i ,i da$a! da$a! !e%#ad !e%#adii ,a%e'a ,a%e'a e*+l" e*+l" 1a'( 1a'( *e%"$a *e%"$a,a' ,a' a,i+a! a,i+a! da%i da%i $e*+e, $e*+e,"a' "a' da%ah8 $la,8 a!e%*a!a 4%a(*e' le*a,& 5ede%a. E*+li !a, ,e+a'1a,a' +e%aal da%i #a'!"'( e,"'de% !e%hada$ i'4a%, *i5a%d d' 4i+%ili a!%i"*. S!%,e !%*+!i, da$a! #"(a !e%#adi ede*a 5e%e+%al $ai4 da' *e'i'(,a!,a' TIK $ada !i!i, he%'iai da' ,e*a!ia' e!elah !%*+!i, !e%#adi $ada a%ea 1a'( l"a. /H"dda, Gall8 7>: 9<;? 9<>0. S!%,e adalah i'd%*a ,li'i 1a'( a-al !i*+"l'1a *e'dada, $%(%ei4 5e$a! +e%"+ah de4i5i! 'e"%l(i! l5al a!a" (l+al 1a'( +e%la'("'( 9; #a* a!a" le+ih8 la'("'( *e'i*+"l,a' ,e*a!ia'8 e*a!a?*a!a die+a+,a' leh (a'(("a' $e%eda%a' da%ah !a, '' !%a"*a!i,. S!%,e di+a(i *e'#adi d"a 1ai!" !%,e he*%a(i, da' '' he*%a(i,. Ada$"' e!il(i da%i !%,e adalah !%*+i e%e%al8 e*+li e%e+%al8 $e%da%aha' i'!%a,%a'ial. Se,i!a% 7< !%,e i,e*i, die+a+,a' leh !%,e !% ,e la,"'a%. I,e*ia I,e*ia e%e+%"* e%e+%"* die+a+,a' die+a+,a' leh +e%,"%a'(' +e%,"%a'('1a 1a ali%a' da%eah 1a'( +e%la'("'( +e%la'("'( ela* ela*aa +e+e +e+e%a %a$a $a de!i de!i, , a*$a a*$aii +e+e +e+e%a %a$a $a *e'i *e'i!8 !8 a$a+ a$a+il ilaa +e%la +e%la'( '(" "'( '( le+ih le+ih da%i da%i +e+e%a$a *e'i! 8 *a,a !e%#adi i'4a%,. Pe%da%aha' i'!%a,%a'i"* da$a! !e%#adi di #a%i'(a' !a, i!" e'di%i/ $a%e',i*8 %"a'( "+a%a5h'id8 a!a" %a"'( "+d"%a a!a" e$id"% e$id"%a. a. Se+a(i Se+a(ia' a' +ea% +ea% $e%da% $e%da%aha aha' ' i'!%a, i'!%a,%a' %a'i"* i"* +e%,ai +e%,ai!a' !a' de'(a' de'(a' hi$e%! hi$e%!e' e'i. i. Pe%da%aha' "+a%a5h'id +iaa'1a !e%#adi a,i+a! a'e"%i*a a,"la% /Be%%10.
BAB II STUDI PUSTAKA
A. Pn"'( Pn"'(ian ian Masa& Masa&aa- K)' K)'a*a( a*a(an an
7.
Maalah ,e$e%a-a!a' "!a*a Pe%4"i #a%i'(a' 5e%e+%al !ida, e4e,!i4 adalah $e'"%"'a' ,ada% ,i(e' e+a(ai a,i+a! da%i ,e(a(ala' dala* *e*elliha%a #a%i'('a di !i'(,a! ,a$ile%.
9.
Maalah ,e$e%a-a!a' lai' adalah Ke%"a,a' *+ili!a 4ii, adalah ,e!e%+a!aa' dala* $e%(e%a,a' 4ii, $ada +a(ia' !"+"h !e%!e'!" a!a" $ada a!" a!a" le+ih e,!%e*i!a.
B. E(i+&+"i
7.
Pe%4 Pe%4" "i #a%i #a%i' '(a' (a' 5e%e 5e%e+ +%al %al !ida !ida, , e4e, e4e,!i !i44 : ,e!i ,e!id da,e a,ei* i*+a +a' '(a' "$ "$lai lai da' ,e+"!"ha' ,i(e' a. Hi$=le*ia +. Hi$e%=le*ia 5. Ali% Ali%a' a' a%!e% a%!e%ii !e%ha !e%ha*+ *+a! a! d. Pe'i Pe'i'( '(,a ,a!a !a' ' *aal *aalah ah e. Red", Red",ii *e,a'i *e,a'i da%i ali%a ali%a' ' da%ah da%ah =e'a =e'a da' a!a" a!a" a%!e%i a%!e%i 4. Hi$=e'!ilai (. Ke%" Ke%"a a,a ,a' ' !%a' !%a'$ $% %!a !ai i ,i ,i(e (e' ' *ele *ele-a -a!i !i *e*+ *e*+%a %a' ' ,a$i ,a$ile le%% da' da' a!a" a!a" al=ela% h. Tida, e+a'di'( e+a'di'( a'!a%a =e'!ilai =e'!ilai de'(a' de'(a' ali%a' ali%a' da%ah i.
Pe'" Pe'"%" %"'a 'a' ' ,' ,'e e'! '!%a %ai i H+ H+ da% da%ah ah
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Ke%"a,a' *+ili!a 4ii, : ,e%"a,a' 'e"% =a5"la%
C. Ba(asa Ba(asan n Ka'ak( Ka'ak(' 'is( is(ik ik
7. Pe%4"i Pe%4"i #a%i'( #a%i'(a' a' 5e%e+ 5e%e+%al %al !ida, !ida, e4e, e4e,!i4 !i4 a.
A+'%*ali!a +e%+i5a%a
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Pe%"+aha' %ea,i $"$il
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Kele*aha' e,!%e*i!a& $a%alie
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Pe%"+aha' !a!" *e'!al
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S"li! *e'ela'
4.
Pe%"+aha' %e$' *!%i,
9. Ke%" Ke%"a, a,a' a' *+ *+il ili!a i!a 4ii, 4ii, a.
P!"% !"+"h !ida, !a+il ela*a *ela,",a' a,!i=i!a %"!i'
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Ke!e%+a!aa' ,e*a*$"a' *ela,",a' ,e!%a*$ila' *!%i, hal"
d.
Tida, ada ,%di'ai (e%a,& (e%a,a' !ida, %i!*i
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Ke!e%+a!aa' ROM
4.
S"li! +e%+ali,
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Pe%"+aha' (a1a +e%#ala' /*ial'1a
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Pe'"%"'a' -a,!" %ea,i
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Uaha 1a'( ,"a! "'!", $e%"+aha' (e%a, /$e'i'(,a!a' $e%ha!ia' dala* a,!i=ii!a lai'8 *e'('!%l $%ila,"8 45" dala* !ida, *a*$" +e%a,!i=i!a0
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D. Pa(+ Pa(+,i ,isi si+& +&+" +"ii
7. Pe%4"i Pe%4"i #a%i'( #a%i'(a' a' !ida, !ida, e4e,!i e4e,!i44 Pe%da%aha' e%e+%al da$a! !e%#adi di l"a% d"%a*e!e% /he*%a(i e,!%ad"%al a!a" e$id"%al08 e$id"%al08 di+a-ah di+a-ah d"%a*e!e% d"%a*e!e% /he*%a(i /he*%a(i "+d"%al08 "+d"%al08 di %"a'( "+a%a5h'id "+a%a5h'id /he*%a(i "+a%a5h'id08 a!a" dala* "+!a'i !a, /he*a!*a i'!%ae%e+%al0. He*%a(i e%e+%al / $e5ah'1a $e*+"l"h da%ah e%e+%al de'(a' $e%da%aha' ,edala* #a%i'(a' !a,a!a" %"a'( e,i!a% !a, 0 1a'( a,i+a!'1a *e'1e+a+,a' $e'(he'!ia' "$lai da%ah ,e!a,8 1a'( *e'1e+a+,a' ,ehila'(a' e*e'!a%a !" $e%*a'e' (e%a,a' +e%4i,i%8 +e%4i,i%8 *e*%i *e*%i +i5a%a a!a" e'ai Pe%da%aha' Pe%da%aha' da$a! de'(a' 5e$a! *e'i*+"l,a' (e#ala 'e"%l(i ,a%e'a !e,a'a' $ada !",!"% a%a4
di dala dala* * !e'( !e'(, ,%a, %a,.1a .1a'( '( *e'1 *e'1e+ e+a+ a+,a ,a' ' #a%i #a%i'( '(a' a' !a, !a,?!e ?!e%# %#ad adii perubahan perfusi jaringan serebral.
9. Ke%" Ke%"a, a,a' a' M+ M+il ili! i!a a Fii Fii, , Pe5ah Pe5ah'1 '1aa $e*+ $e*+"l "l"h "h da%a da%ah h *e'1 *e'1e+ e+a+ a+,a ,a' ' "$l "$la1 a1 O9 da' da' da%ah da%ah ,e !a, !a, *e'"%"' 1a'( *e'1e+a+,a' i5he*ia e%e+%al da' "$la1 ,e 1a%a4 $"a! *e'"%" *e'"%"' ' da' *e'1e+ *e'1e+a+, a+,a' a' $a%ali $a%alii i ehi'(( ehi'((aa !e%#adi !e%#adi gangguan mobilitas fisik
E. Fak(+' Fak(+' D%+" D%+"'a,i 'a,i $an E)i$%i+ E)i$%i+&+"i &+"i
Pada Pada !%,e !%,e he*%a he*%a(i, (i, /i,e* /i,e*i, i, 0 (e#ala (e#ala "!a*a' "!a*a'1a 1a adalah adalah !i*+"l !i*+"l'1 '1aa de4i5i! 'e"%l(i a5a%a *e'dada, didah"l"i (e#ala $%ad*%al !e%#adi $ada -a,!" i!i%ah i!i%aha! a! &+a'(" &+a'("' ' $a(i $a(i da' ,eada ,eada%a' %a' +iaa'1 +iaa'1aa *e'"%" *e'"%"' ' ,e5"al ,e5"alii +ila +ila e*+l" e*+l" 5","$ +ea% +iaa'1a !e%#adi $ada "ia 7< !ah"' . Ge#ala 'e"%l(i 1a'( !i*+"l +e%(a'!"'( $ada +e%a! %i'(a''1a (a'(("a' $e*+"l"h da%ah da' l,ai'1a !a'da (e#ala !%,e a,"! da$a! da$a! +e%"$a : a. Kel"*$"ha' Kel"*$"ha' -a#ah & a'((!a a'((!a +ada' +ada' / he*i4a%e he*i4a%ee e 0 1a'( !i*+"l !i*+"l *e'dada,. *e'dada,. +. Ga'(("a' e'i+ili!a $ada a!" a!a" le+ih a'((!a +ada' 5. Pe%"+a Pe%"+aha' ha' *e'dad *e'dada, a, !a!" !a!" *e'!al *e'!al d.
A4aia / +i +i5a%a !i !ida, la la'5a% 8 ," ,"%a'('1a "5 "5a$a' da da' ,e ,e"li!a' *e*aha*i "5a$a' 0.
e. A!a,ia 4. Dia! Dia!%i %iaa / +i5a +i5a%a %a $el $el & 5ede 5edell 0 (. e%!i( e%!i( 8*"al 8*"al 8 *"'! *"'!ah ah da' da' '1e%i '1e%i ,e$a ,e$ala la h. A*a A*a% %i i 4"(a 4"(a%% / ,e+" ,e+"!a !aa' a' 1a'( 1a'( +e%l +e%lal al" " de'( de'(a' a' 5e$a 5e$a!! 0!e% 0!e%#a #adi di !a'$ !a'$aa $e%i'(a!a' . /*a'#e%89@@@0.
F. Ri*aa Ri*aa(( KsKs-a(a a(an n Ska'a Ska'an" n"
Paie' Paie' da!a'( de'(a' de'(a' ,el"ha ,el"ha' ' $! $! #a!"h #a!"h 9 ha%i ha%i 1a'( 1a'( lal"8 lal"8 !ida, !ida, ada%8 ada%8 %i-a1a! ,e#a'(8 DM8 hi$e%!e'i.
G. Ri*aa( Ri*aa( Ks-a(a Ks-a(an n Da-#&# Da-#&#
Paie' Paie' *e*$"'1 *e*$"'1ai ai %i-a1a! %i-a1a! DM da'
%i-a1a %i-a1a!! hi$e%!e hi$e%!e'i 'i . Paie' Paie' +el"*
$e%'ah di%a-a! di%"*ah a,i! da' ha'1a *e*e%i,a,a' di%i ,ed,!e% de'(a' alaa' $"i'( da' *"al da' di+e%i +a! a'!i hi$e%!e'i8 $ie' *e'(,'"*i +a! a'!i+i!i,.
H. Ri*aa( Ri*aa( Ks-a(a Ks-a(an n K&#a' K&#a'"a "a
Kel"a%(a !ida, ada 1a'( *e'de%i!a $e'1a,i! e$e%!i 1a'( dide%i!a $aie'.
I. P+&a P+&a F#n F#n"s "si+ i+na na&& Ks Ks-a -a(a (an n
a.
A,!i=i!a&i!i%aha! Ge#ala : ,elelaha' e,!%i*8 ,ele*aha'8 *alaie8 (a'(("a' !id"% /(eliah Ta'da : ,ele*aha' !!8 $e'"%"'a' %e'!a'( (e%a,
+.
Si%,"lai Ge#ala : Ri-a1a! hi$e%!e'i la*a Ta'da : Hi$e%!e'i8 'adi ,"a!8 ede*a e,!%e*i!a +a-ah8 $i!!i'( ede*a de!i,8 ,"li! $"5a!
5.
I'!e(%i!a e( Ge#ala : Fa,!% !%e /4i'a'5ial8 $e%aaa' !a, +e%da1a8 !a, ada ,e,"a!a'0 Ta'da : a'ie!a8 (eliah
d.
Eli*i'ai Ge#ala Ge#ala : $e'"%" $e'"%"'a' 'a' 4%e,"e' 4%e,"e'i i "%i'e8 "%i'e8 li("% li("%ia8 ia8 a'"%ia8 a'"%ia8 a+d*e a+d*e' ' ,e*+"' ,e*+"'(8 (8 ,'!i$ai Ta'da : $e%"+aha' -a%'a "%i'e ,"'i'( $e,a!8 li("%ia 9@@ 55&9; #a*
e.
Ma,a'a'&5ai%a' Ge#ala : $e'i'(,a!a' +e%a! +ada' /ede*a08 *"al *"'!ah Ta'da : $e%"+a(a' !"%(% ,"li!&,ele*+a+a'8 ede*a e,!%e*i!a +a-ah
4.
Ne"%e'%i Ge#ala : a,i! ,e$ala&$"i'(8 ,%a* !! Ta'da : (a'(("a' !a!" *e'!al: $e'"%"'a' !i'(,a! ,eada%a' /,eada%a $%0
(.
N1e%i ,e'1a*a'a' Ge#ala : '1e%i $a'(("l. Sa,i! ,e$ala&$"i'( Ta'da : (eliah
h.
Pe%'a$aa' Ge#ala : 'a$a $e'de,8 di$'ea
Ta'da : 'a$a dala* da' 5e$a! /,"*a"l08 $e'i'(,a!a' 4%e,"e'i&,edala*a' i.
I'!e%a,i ial Ge#ala : !a, *a*$" +e,e%#a "'!", *e*$e%!aha',a' 4"'(i $e%a' +iaa'1a dala* ,el"a%(a
J. P%' P%'iks iksaan aan Fisik Fisik Pn#nj Pn#njan" an"
a.
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Pe*e%i,aa' la+%a!%i"* !a'((al ; '=e*+e% 9@@
Je'i $e*e%i,aaa' Hae*(l+i' Le",i! He*a!,%i! E%i!%i! T%*+i! MC MCH MCHC P%!ei' !!al Al+"*i' Gl+"li' Na!%i"* Kali"* Al+"*i' Gl+"li' SGOT SGPT U%e"* da%ah
'ilai 778> 7>@@ 97 98; 99.@@@ 98; 89 8;@ ;8>9 8@ 7; <8< ;8>9 8@ 9> 7 ;@8
'%*al 7?7> (&dl <@@@?7@@@@ P ;@?; - ?; P ;8?9 7?> >8>?8 8
Gl",a e-a,!" K%ea!i'i' da%ah Aa* "%a!
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9@@ @8?789 98;?<8
Pe*e%i,aa' USG Hail : I'"4iie'i %e'al $"$le
BAB III STUDI KASUS
A. Bi+$a(a Na*a
: N1. T
Ala*a!
: Re*$ah & Ba!"%ade'8 +a'1"*a
U*"%
: >7 !ah"'
Pe,e%#aa'
: IRT
Je' Je'i Kel Kela* a*i' i'
: Pe%e Pe%e* *$"a' $"a'
A(a*a
: Ila*
B. Pn"kajian 70 Kel"ha Kel"ha' ' "!a*a: "!a*a: $e'"%" $e'"%"'a' 'a' ,eada ,eada%a' %a' 90 Ri-a1a! Ri-a1a! Keeha!a' Keeha!a' Se,a%a'( Se,a%a'( Ri-a1a! Ri-a1a! Keeha!a' Keeha!a' Se,a%a'( Se,a%a'( Paie' da!a'( de'(a' ,el"ha' $! #a!"h 9 ha%i 1a'( lal"8 !ida, ada%8 %i-a1a! ,e#a'(8 DM8 hi$e%!e'i. TD: 7@&@ **H(8 N: 9 &*e'i!8 RR: 9; &*e'i! 0 Ri-a Ri-a1a 1a!! Keeh Keeha!a a!a' ' Dah"l Dah"l" " Paie' *e*$"'1ai %i-a1a! DM da' %i-a1a! hi$e%!e'i . Paie' +el"* $e%'ah di%a-a! di%"*ah a,i! da' ha'1a *e*e%i,a,a' di%i ,ed,!e% de'(a' alaa' $"i'( da' *"al da' di+e%i +a! a'!i hi$e%!e'i8 $aie' *e'(,'"*i +a! a'!i+i!i,. ;0 Ri-a1a Ri-a1a!! Keeh Keeha!a' a!a' Kel"a% Kel"a%(a (a : Kel"a%(a !ida, ada 1a'( *e'de%i!a $e'1a,i! 1a'( a*a e$e%!i $aie'. <0 Pe*e Pe*e%i %i, ,aa aa' ' Fii Fii, , a.
Pe*e%i,aa' !a'da?!a'da =i!al : ? TD : 7@&@ **h( ? N
: 9 &*
? RR
:9@ &*
Pe*e%i,aa' GCS Keada%a' S$%8 E7 M; 7 Keadaa' "*"* #ele,
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:
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•
M"l"!
•
Lehe% Lehe% : !ida, !ida, !e%a+a !e%a+a ,ele'# ,ele'#a% a% !hi%i !hi%id8 d8 a!a"$"' a!a"$"' li*4e8 !e%a+a !e%a+a a%!e%i a%!e%i
: *",a *"l"! ,e%i'(
5a%!i •
Dada :
Pa%"
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dada
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: S"$el8 da!a%
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: A,%al A,%al ha'(a! ha'(a!88 ,"li! ,"li! le*+ le*+a+ a+ !e%a+ !e%a+aa ha'( ha'(a!8 a!8 !"%( !"%(% % ,"li! ,"li!
da' CRT 9 de!i,8 !ida, ada $a%ee8 $aie' le*ah8 %e4le, $a!l(i da' %e4le, 4iil(i ada.
C.
Ana&isa Da(a
NO 7. 99? 7@?@
DATA
D : ?
PATHWAY Hi$e%!e'i
D : TD 7@&@ **H(
ETIOLOGI MASALAH Ke!ida,ei*+a'(a' Pe%4"i
"$la1 O9 C*$%ei
N : 7@@ &*'!
$e*+"l"h
RR : 9; &*'!
da%ah
#a%i'(a' !ida, e4e,!i4
S : 8 CRT : d!,
Keada%a'
adila!ai $e*+"l"h da%ah
$% GCS > E7 M;
Pe'i'(,a!a' TIK
7 P le*ah
K'#"'(!i=a
Pe5ah $e*+"l"h da%ah
a'e*i A,%al ha'(a! S"a%a 'a4a
Pe'"%"'a' ali%a' da%ah e%e+%al
=ei,"le% Pe%4"i #a%i'(a' e%e+%al !ida, e4e,!i4
9. 99? 7@?@
D : ?
Hi$e%!e'i
D : TD 7@&@ **H(
C*$%ei
N : 7@@ &*'!
$e*+"l"h
RR : 9; &*'!
da%ah
S : 8 Paie' !a*$a, le*ah
adila!ai $e*+"l"h da%ah
Paie' ha'1a !id"%a'
Pe'i'(,a!a' TIK
Ke%"a,a'
Ke%"a,a'
'e"%=a,"le%
*+ili!a 4ii,
Pe5ah $e*+"l"h da%ah
Pe'"%" Pe'"%"'a' 'a' ali%a' ali%a' da%ah e%e+%al
S"$la1 a%a4 $"a!
Pa%alii
Ga'(("a' *+ili!a 4ii,
D. Pna(a&aksanaan< Pna(a&aksanaan< In('=nsi K)'a*a(an
NO 3
Dia"n+sa
T#j#an
P',#si
NOC:
a. Pn"kajian:
? S!a!" i%,"lai
ja'in"an
P&anin"
? Pa'!a" TT
? S!a!" 'e"%l(i
s'!'a& ($k
? Ke*a*$"a' ,('i!i4
,k(i,
/TD8Nadi8"h"8da' %e$i%ai0 ? Ka#i
? Pe%4"i #a%i'(a' $e%i4e%
","%a'8+e'!",8,ee*e!%i' $"$il
T#j#an
? Ka#i ada'1a
? Me'"'#",' !a!" i%,"lai8di!a'dai d( i'di,a!%
,eada%a'8%ie'!ai ? Ka#i $e%(e%a,a'
/'ilai 7?<:
*!%i,8!'" !!
e,!%e*8eda'((8%i'(a'8!ida,
? Pa'!a" TIK8%e$'
ada (a'(("a'08TD dala* %e'!a'( 1a'( diha%a$,a'8!ida,
'e"%l(i ? Pa'!a" !e,a'a' !e,a'a' $e%4"i
ada hi$!e'i %!!a!i,
e%e+%al
? Me'"'#",a' ,e*a*$"a'
? Pa'!a" !a!" 5ai%a'
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i'di,a!%/'ilai 7?<08
? Kla+%a!i4 $ii,a' $ii,a' ,e$ala
+e%,*"'i,ai d( #ela e"ai
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de'(a' "ia8 *e'"'#",a'
*e*$e%!aha',a' $e%4"i
$e%ha!ia'8 ,'e'!%i8da'
e%e+%al
e%ie'!ai *e*$%e i'4%*ai
7. 5.
K'#sakan NOC : %+!i&i(as ,isik −
i'(
=i!al
i('
e+el"*&e"d e+el"*&e"dah ah la!iha' la!iha' da'
Ji'! Ji'! *=e*e *=e*e'! '! :
liha! $aie' aa! la!iha'
a5!i=e −
M+ili!1 le=el
−
Sel4 5a%e : ADL
−
T%a'4e%
9.
K'"l! ai,a ai,a' ' de'( de'(a' a' !e%a$ !e%a$ii 4ii, 4ii, !e'!a !e'!a'( '(
%e'5a' %e'5a'aa
a*+" a*+"la laii
e"ai ,e+"!"ha'.
$e%4%*a'5e K%i!e%ia Hail :
M'i!%
.
Ba'!"
7.
Klie' *e'i *e'i'( '(,a ,a!!
dala* dala*
,lie ,lie' ' "'!" "'!", , *e'( *e'((" ("'a 'a,a ,a' '
a,!i a,!i4i 4i!a !a
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4ii,.
5e(ah !e%hada$ 5ede%a.
9.
*e'(e%!i ;. !"#" !"#"a' a'
da%i a%i
$e' $e'i'( i'(,a!a ,a!a' '
$aie' a!a" a!a " !e'a(a ,eeha!a'
*+ili!a .
lai' !e'!a'( !e,'i, a*+"lai. *e*=e%+ <.
alia aliai, i,a' a'
$e%a $e%aaa' aa'
dala dala* *
La!ih $aie'
dala*
$e*e'"ha'
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,e+" ,e+"!" !"h ha'
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dala*
+e%$i'dah. ;.
A#a%,a'
ADL ADL
>. *e*$e%a
e5a e5a%a %a
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E. I%)&%n(asi Wak(#
IMPLEMENTASI
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? Keada%a' S$% GCS : E7 M; 7
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SOAP
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KET
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SOAP
S :? O : TD 7@&@ **H( N : 7@@ &*'! RR : 9; &*'! S : 8 Paie' !a*$a, le*ah Paie' ha'1a !id"%a' A : Maalah ,e%"a,a' *+ili!a 4ii, +el"* !e%a!ai P : ? Pa'!a" KU ? Pa'!a" TT ? Ka#i ,e,"a!a' !! ? Pa'!a" !a!" 'e"%l(i ? Be%i $ii 1a'( '1a*a' ? Be%i li'(,"'(a' 1a'( !e'a'( ? Be%i !e%a$i e"ai $%(%a* Ce4 97 (%8 %a'!i' 97 (%8 +%ai'a5! 97 a*$8 $i%ae!a* 9 (%
BAB I>
KET
PEMBAHASAN
A. Pn" Pn"ka kaji jian an
Pe'(,ai#ia' dila,",a' $ada !a'((al 99 O,!+e% 9@@ $","l 7;.7< WIB. Da!a 1a'( da$a! di$e%leh da%i $e'(,a#ia' i'i 1ai!" $e'(,a#ia' Ai%-a1 di da$a!,a' !ida, !ida, ada *aalah *aalah da' !ida, !ida, ada "*+a! "*+a!a' a' #ala' #ala' 'a4a8 'a4a8 $e'(,a $e'(,a#ia #ia' ' +%ea!h +%ea!hi'( i'( dida dida$a $a!, !,a' a' RR : 9; &*e &*e'i 'i!8 !8 $e%( $e%(e% e%a, a,a' a' di'd di'di' i'( ( dada dada i*e! i*e!%i %i88 "a%a "a%a $a%" $a%" =ei,"le%. Pe'(,a#ia' 5i%5"la!i' dida$a!,a' TD : 7@&@ **H(8 N : 9 &*e'i!8 CRT : de!i,8 !ida, ia'i. Da%i hail -a-a'5a%a de'(a' ,el"a%(a $aie'8 di$e%leh da!a +ah-a $aie' *e*$"'1ai %i-a1a! hi$e%!e'i.
B. Ana& Ana&is isa a Da( Da(a a
Da%i Da%i hai haill a'al a'alia ia da!a da!a da%i da%i $e'( $e'(,a ,a#i #ia' a'88 $e'" $e'"li li *e'e *e'e*" *",a ,a' ' 9 *aal *aalah ah ,e$e%a-a!a' ,e$e%a-a!a' 1ai!" $e%4"i #a%i'(a' #a%i'(a' 5e%e+%al 5e%e+%al !ida, e4e,!i4 da' ,e%"a,a' ,e%"a,a' *+ili!a 4ii,. Maalah "!a*a "!a*a adalah $e%4"i #a%i'(a' 5e%e+%al !ida, e4e,!i4. Me'"%"! Na'da /9@@>0 +a!aa' ,a%a,!e%i!i, "'!", dia('a $e%4"i #a%i'(a' 5e%e+%al !ida, e4e,!i4 1ai!" : a.
A+'%*ali!a +e%+i5a%a
+.
Pe%"+aha' %ea,i $"$il
5.
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d.
Pe%"+aha' !a!" *e'!al
e.
S"li! *e'ela'
4.
Pe%"+aha' %e$' *!%i,
C. In( In('= '=n nsi si
Pe%e'5 Pe%e'5a'a a'aa' a' *e'((a *e'((a*+a *+a%,a %,a' ' *e'(e' *e'(e'ai ai !"#"a' !"#"a' 1a'( 1a'( diha%a$ diha%a$,a' ,a' da' %e'5a' %e'5a'aa !i'da, !i'da,a' a' 1a'( 1a'( a,a' a,a' dila," dila,",a' ,a' !e%hada !e%hada$ $ $aie' $aie' e"ai e"ai ,e+"!" ,e+"!"ha' ha' +e%da +e%daa%, a%,a' a' dia('a ,e$e%a-a!a'. 7.
Pe4"i #a%i'(a' 5e%e+%al !ida, e4e,!i4 De'(a' *eliha! da!a N1. T *a,a diha%a$,a' $e%4"i #a%i'(a' da$a! !e%a!ai *ial'1a de'(a' *e%e$' *!%i,'1a8 *e'(,a#i ,ele*aha' !!.
9.
Ke%"a,a' * *+ili!a 4i 4ii, +d +d $e $e'"%"'a' ,e ,e,"a!a'8 ,e ,e'dali8 da' *aa !! /,e%"a,a' *","l,ele!al0.
T"#"a' 1a'( diha%a$,a' adalah ,e%"a,a' *+ili!a 4ii, da$a! !e%a!ai a'!a%a lai' de'(a' M'i!%i'( =i!al i(' e+el"*&e"dah la!iha' da' liha! $aie' aa! la!iha'8 +a'!" ,lie' "'!", *e'(("'a,a' !'(,a! aa! +e%#ala' da' 5e(ah !e%hada !e%hada$ $ 5ede%a 5ede%a88 la!ih la!ih $aie' $aie' dala* dala* $e*e'" $e*e'"ha' ha' ,e+"!" ,e+"!"ha' ha' ADL ADL e5a%a e5a%a *a'di% *a'di%ii e"ai e"ai ,e*a*$ ,e*a*$"a' "a'88 +e%i,a +e%i,a' ' ala! +a'!" +a'!" #i,a #i,a $aie' $aie' *e*e%l" *e*e%l",a' ,a'88 *e'(a# *e'(a#a%, a%,a' a' $aie' $aie' +a(ai* +a(ai*a'a a'a *e%"+a *e%"+ah h $ii $ii da' +e%i,a +e%i,a' ' +a'!"a +a'!"a' ' #i,a #i,a di$e%l",a'.
? Pe*e%i,aa' 5a$i!i:
Ma!a
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Teli'(a
: !ida, ada di5ha%(e
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:Hid"'( !ida, ada di5ha%(e8
M"l"!
:ada e,%e!8 *"l"! !ida, ia'i
Dada
:
? Re!%a,i di'di'( dada i*e!%i ? Me'(("',a' !! +a'!" $e%'a4a' ? Te%da$a! le'di% 1a'( "li! d,el"a%,a'8 %e4le, +a!", *e'"%"'
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:
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a. Radi Radil l( ( /CT /CT S5a S5a' ' Head Head00 a. Ga*+ Ga*+a%a a%a' ' S!% S!%,e ,e He* He*% %a( a(i, i, +. Ta*$a, (a*+a%a' $e%da%aha' "+a%a5h'id di44" 5. Ta*$ Ta*$a, a, (a* (a*+a +a%a %a' ' a!%4 a!%4ii e%e+ e%e+%i %i
BAB > PENUTUP
A.
Ksi%)#&an
Se!elah $e'"li *ela,",a' a"ha' ,e$e%a-a!a' ela*a 9; #a* $ada $aie' N1.T de'(a' *aalah ,e$e%a-a!a' $e%4"i #a%i'(a' 5e%e+%al !ida, e4e,!i4 da' ,e%"a,a' *+ili!a 4ii, di R"a'( IGD RSMS P"%-,e%!8 $e'"li *e'5+a *e'a%i, ,ei*$"la' e+a(ai +e%i,"! : 7.
Pada *aalah ,e$e%a-a!a' $e%4"i #a%i'(a' 5e%e+%al !i !ida, e4e, e4e,!i !i48 48
e!e e!ela lah h
dila dila," ,",a ,a' '
!i'd !i'da, a,a' a'
de'( de'(a' a'
*ia *ial' l'1a 1a
de'( de'(a' a'
*e%e *e%e$ $' '
4ii,
!"#"a'1a'(
*!%i,'1a8 *e'(,a#i ,ele*aha' !!. 9.
Pada
*aalah
,e$e%a-a!a'
*+ili!a
diha diha%a$ %a$,a ,a' ' adal adalah ah da$a da$a!! !e%a! !e%a!ai ai a'!a a'!a%a %a lai' lai' de'( de'(a' a' M'i M'i! !%i %i'( '( =i!al =i!al i(' i(' e+el e+el"* "*&e &e" "da dah h la!i la!iha ha' ' da' da' liha liha!! $ai $aie' e' aa! aa! la!i la!iha ha'8 '8 +a'! +a'!" " ,lie ,lie' ' "'!" "'!", , *e'(("'a,a' !'(,a! aa! +e%#ala' da' 5e(ah !e%hada$ 5ede%a8 la!ih $aie' dala* $e*e'"ha' ,e+"!"ha' ADL ADL e5a%a *a'di%i e"ai ,e*a*$"a'.
B.
Sa'an
Me'#adi $e%a-a! %"a'(a' !ida,lah *"dah8 +"!"h ,e5e%*a!a'8 ,e!eli!ia'8 e%!a !a'((a$ !e%hada$ ,el"ha' $aie'. Se%!a di!"'!"! "'!", +e%!a'(("'( #a-a+ !e%hada$ !i'da,a' 1a'( !elah dila,",a' !e%hada$ e*"a $aie'.
DAFTAR PUSTAKA
B%"''e% S"dda%!8 9@@@8 Keperawatan 9@@@8 Keperawatan Medikal Bedah EGC Bedah EGC :Ja,a%!a C%-i'8 9@@@8 Buku 9@@@8 Buku Saku Patofisiologi. Patofisiologi. EGC : Ja,a%!a H"da, Gall8 7>8 Keperawaran 7>8 Keperawaran Kritis =l"*e Kritis =l"*e II EGC8 Ja,a%!a L'( L' ( BC8 7>8 7>8 Perawatan Medikal Bedah 2 8 Ya1aa' i,a!a' Al"*'i Pe'didi,a' Ke$e%a-a!a' Pad#a#a%a' 8 Ba'd"'( Ma'#e% A%i48 9@@@8 Kapita 9@@@8 Kapita Selekta Kedokteran Edisi 3 . 3 . Madia Ae5"la$i". FKUI : Ja,a%!a Na'da8 9@@>. Panduan 9@@>. Panduan Diagnosa Diagnosa Keperawatan Nanda Definisi dan Aplikasi . Pe'e%+i! P%i*a Medi,a.
