LAPORAN PENDAHULUAN DEMAM BERDARAH DENGUE (DBD) DI RUANG FLAMBOYAN RSUD DORIS DORI S SYILV SYI LVANUS ANUS PALANGKA PALANG KA RAYA RAYA
DISUSUN OLEH Nama NIM #rodi
: Firdaus Victor Victor : 2013.C.05a.0!" 2013.C.05a.0!" : S1 $%&%ra'ata(
YAYASAN EKA HARAP PALANGKA RAYA SEKOLAH TINGGI ILMU KESEHATAN PROGRAM STUDI S-1 KEPERAWATAN 2015 - 2016
). Ko!"# M"$%! 1. D%*i(isi a. D%mam +%rdara, m%ru&a-a( ma(i*%stasi -i(is /a( +%rat dari &%(/a-it ar+oirus. So%darmo Sumar(o 20054. +. D%(u% iaa, i(*%-si ar+oirus arthropod-borne virus) a-ut dituar-a( o%, (/amu- s&%si%s )%d%s. Hasa( us%&(o 20064. c. D%mam 7%rdara, D%(u% m%ru&a-a( &%(/a-it /a( dis%+a+-a( o%, irus d%(u% /a( t%rmasu- oo(a( ar+oirus m%aui iita( (/amu- )%d%s )%/&ti +%ti(a. Hida/at ). )8i8 )imu 200!4. 2. Etiooi #%(/%+a+ &%(/a-it D%mam 7%rdara, D%(u% adaa, irus D%(u%. Di I(do(%sia irus t%rs%+ut sam&ai saat i(i t%a, diisoasi m%(9adi s%roti&% irus D%(u% /a( t%rmasu- daam ru& 7 art,ro&%di+or(% irus%s ar+oirus%s4 /aitu DEN1 DEN2 DEN3 da( DEN.Nursaam Susia(i(rum 20054. #%(/a-it i(i dis%+a+-a( o%, irus D%(u% da( dituar-a( o%, (/amu- )%d%s. Di I(do(%sia di-%(a dua 9%(is (/amu- )%d%s /aitu: a. )%d%s )%/&ti 14 #ai( s%ri( dit%mu-a( 24 )daa, (/amu- /a( ,idu& di da%ra, tro&is t%rutama ,idu& da( +%r-%m+a( +ia- di daam ruma, /aitu di t%m&at &%(am&u(a( air 9%r(i, atau t%m&at &%(am&u(a( air di s%-itar ruma,. 34 N/amu- i(i s%&i(tas au tam&a- +%ruri- +%r+i(ti- +i(ti- &uti,. 4 7iasa(/a m%(iit &ada sia( ,ari t%rutama &ada &ai da( sor% ,ari. 54 ;ara- t%r+a( 100 m%t%r +. )%d%s )+o&ictus 14 <%m&at ,a+itat(/a di t%m&at air +%rsi,. 7iasa(/a di s%-itar ruma, atau &o,o(&o,o( s%&%rti &o,o( &isa( &a(da( -a%( +%-as. 24 M%(iit &ada 'a-tu sia( ,ari 34 ;ara- t%r+a( 50 m%t%r. am&%(a( < H 20064 3. $asi*i-asi a. D%ra9at I : D%mam dis%rtai %9aa -i(is ai( atau &%rdara,a( s&o(ta( u9i tur(i-%t &ositi* trom+osito&%(ia da( ,%mo-os%(trasi. +. D%ra9at II : D%ra9at I dis%rtai &%rdara,a( s&o(ta( di-uit atau &%rdara,a( ai( c. D%ra9at III : $%aaa( sir-uasi : (adi c%&at da( %ma, ,i&ot%(si -uit di(i( %m+a+ %isa,. d. D%ra9at IV : %(9ata( +%rat d%(/ut (adi da( t%-a(a( dara, tida- da&at diu-ur. =a( dis%rtai d%(a( D%(u% S,oc- Si(drom. Suriadi da( ita =uia(i 200"4. . Ma(i*%stasi -i(is a. D%mam ti(i s%am 56 ,ari +. #%rdara,a( t%rutama &%rdara,a( +a'a, -uit : &%t%c,i% %-imosis ,%matoma. c. E&ista-sis ,%mat%m%sis m%%(a ,%maturia. d. Mua mu(ta, tida- ada (a&su ma-a( diar% -o(sti&asi %. N/%ri otot tua( s%(di a+dom%( da( uu, ,ati *. Sa-it -%&aa . #%m+%(-a-a( s%-itar mata ,. #%m+%sara( ,ati im&a da( -%%(9ar %ta, +%(i(
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5. #ato*isiooi a. Virus D%(u% a-a( masu- -%daam tu+u, m%aui iita( (/amu- )%d%s )%%&t/ da( -%mudia( a-a( +%r%a-si d%(a( a(ti+od/ da( t%r+%(tu-a, -om&%-s irus a(ti+odi daam sir-uasi a-a( m%(a-ti*asi sist%m -om&%m%(. )-i+at a-ti*asi C3 da(C5 a-a( di%&as C3a da( C5a 2 &%&tida +%rda/a u(tu- m%%&as-a( ,istami( da( m%ru&a-a( m%diator -uat s%+aai *a-tor m%(i(i(/a &%rm%a+iitas di(di( &%m+uu, dara, da( m%(,ia(-a( &asma m%aui % (dot% di(di( itu. +. <%r9adi(/a trom+osito&%(ia m%(uru((/a *u(si trom+osit da( m%(uru((/a *a-tor -oauasi &rotro+i( *a-tor V VII I> > da( *i+ri(o%( 4 m%ru&a-a( *a-tor &%(/%+a+ t%r9adi(/a &%rdara,a( ,%+at t%rutama &%rdara,a( saura( astroi(t%sti(a &ada DHF. c. =a( m%(%(tu-a( +%rat(/a &%(/a-it adaa, &%rm%a+iitas di(di( &%m+uu, dara, m%(uru((/a oum% &asma t%r9adi(/a ,i&ot%(si trom+osito&%(ia da( diat%sis ,%morai- %(9ata( t%r9adi s%cara a-ut. d. Niai ,%mato-rit m%(i(-at +%rsamaa( d%(a( ,ia((/a &asma m%aui %(dot% di(di( &%m+uu, dara,. da( d%(a( ,ia((/a &asma -i%( m%(aami ,i&oo%mi-. )&a+ia tida- diatasi +isa t%r9adi a(o-sia 9ari(a( asidosis m%ta+oi- da( -%matia(. Suriadi da( ita =uia(i 200"4. ". #at'a/ D%mam +%rdara, D%(u% D7D
6. #%m%ri-saa( La+? Dia(osti- <%st a. Dara, %(-a& : ,%mo-os%(trasi ,%mato-rit m%(i(-at 20 @ atau %+i,4 trom+osito&%(ia 100.000?mm 3 atau -ura(4 +. S%rooi u9i HI ,%mouti(atio( i(,i+itio( t%st4 c. o(t%( tora-s : %*usi &%ura. Suriadi da( ita =uia(i 200"4. !. $om&i-asi a. E(s%*ao&ati d%(u% +. $%ai(a( i(9a c. Ud%m &aru. Hadi(%oro H Sri %8%-i 20054. A. #%(o+ata( da( #%(c%a,a( a. #%(o+ata( #%(ataa-sa(aa( u(tu- -i%( D%mam 7%rdara, D%(u% adaa, &%(a(a(a( &ada d%ra9at I ,i(a d%ra9at IV. D%ra9at I da( II 14 #%m+%ria( caira( /a( cu-u& d%(a( i(*us L d%(a( dosis 65 m?- 77?,ari u(tu- a(a- d%(a( +%rat +ada( -ura( dari 10- atau +%rsama di+%ri-a( orait air +ua, atau susu s%cu-u&(/a atau &%m+%ria( caira( daam 'a-tu 2 9am a(tara ai( s%+aai +%ri-ut : a4 100 m?- 77?2 9am u(tu- a(a- d%(a( 77 B 25 - +4 65 m?- 77?2 9am u(tu- a(a- d%(a( 77 2"30 - c4 "0 m?- 77?2 9am u(tu- a(a- d%(a( 77 310 - d4 50 m?- 77?2 9am u(tu- a(a- d%(a( 77 150 - 24 #%m+%ria( o+at a(ti+ioti- a&a+ia ada(/a i(*%-si s%-u(d%r 34 #%m+%ria( a(ti&i%riti-a u(tu- m%(uru(-a( &a(as. 4 )&a+ia ada &%rdara,a( ,%+at ma-a +%ri-a( dara, 15 cc?- 77?,ari. D%ra9at III 14 #%m+%ria( caira( /a( cu-u& d%(a( i(*us L d%(a( dosis 20 m?- 77?9am a&a+ia ada &%r+ai-a( a(9ut-a( &%+%ria( L 10 m?- 77?9am 9i-a (adi da( t%(si tida- sta+i a(9ut-a( 9uma, caira( +%rdasar-a( -%+utu,a( daam 'a-tu 2 9am di-ura(i caira( /a( suda, masu-. 24 #%m+%ria( &asma atau &asma %-s&a(d%r d%-stra( L 4 s%+a(/a- 10 m?- 77?9am da( da&at diua( ma-sima 30 m? - 77 daam 2 9am a&a+ia s%t%a, 1 9am &%ma-aia( L 20 m?- 77?9am -%adaa( t%-a(a( dara, -ura( dari !0 mmH da( (adi %ma, ma-a +%ri-a( caira( /a( cu-u& +%ru&a i(*us L d%(a( dosis 20 m?- 77?9am 9i-a +ai- a(9ut-a( L s%+aaima(a &%r,itu(a( s%a(9ut(/a. 34 )&a+ia 1 9am &%m+%ria( 10 m?- 77?9am -%adaa( t%(si masi, m%(uru( da( di+a'a, !0 mmH ma-a &%(d%rita ,arus m%(da&at-a( &asma %-s&a(d%r s%+a(/a- 10 m?-77?9am diua( ma-sima 30 m ?- 77?2 9am +ia +ai- a(9ut-a( L s%+aaima(a &%r,itu(a( diatas D%ra9at IV 14 #%m+%ria( caira( /a( cu-u& d%(a( i(*us L d%(a( dosis 30 m?-77?9am a&a+ia -%adaa( t%-a(a( dara, +ai- a(9ut-a(( L s%+a(/a- 10 m?-77?9am.
24 )&a+ia -%adaa( t%(si m%m+uru- ma-a ,arus di&asa(. 2 saura( i(*us% d%(a( tu9ua( satu u(tu- L 10 m?-++?19am da( satu(/a &%m+%ria( &aasma %-s&a(d%r atau d%tra( L s%+a(/a- 20 m?-77?9am s%am 1 9am. 34 )&a+ia -%adaa( masi, 9ua +uru- ma-a +%ri-a( &asma %-s&a(d%r 20 m?-77?9am. 4 )&a+ia masi, t%ta& m%m+uru- ma-a +%ri-a( &asma %-s&a(d%r 10 m?-77?9am diua(i ma-simu( 30 m?-77?29am. 54 ;i-a s%t%a, 2 9am &%m+%ria( &asma da( L tida- m%(u(9u-a( &%r+ai-a( ma-a -o(sutasi-a( -%+aia( a(ast%si u(tu- &%ru tida-(/a di&asa( c%(tra as-u%r &r%ssur% atau CV#. Hida/at ) )8i8 )imu 200!4. +.
#%(c%a,a( )da 3 cara &%m+%ra(tasa( %ctor 1. Foi( *ocus Daam -%adaa( -risis %-o(omi s%-ara( i(i da(a t%r+atas ma-a -%iata( *oi( ,a(/a dia-u-a( +ia ,asi &%(/%idi-a( %&id%moois +utu+utu m%m%(u,i crit%ria 2. )+atisasi Dia-sa(a-a( di d%sa? -%ura,a( %(d%mis t%rutama di s%-oa, da( t%m&att%m&at umum. 3.
1. $o(s%& Dasar )su,a( $%&%ra'ata(. )su,a( -%&%ra'a'ata( adaa, ti(da-a( ma(diri &%ra'at &ro*%ssio(a m%aui -%r9asama d%(a( -i%( da( t%(aa -%s%,ata( ai( daam m%m+%ri-a( )su,a( -%&%ra'ata( s%suai i(-u& '%'%(a( da( ta(u( 9a'a+(/a. -us(a(to 2004.
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#%m%ri-saa( *isi- m%i&uti i(s&%-si &a&asi aus-utasi da( &%r-usi dari u9u( ram+ut sam&ai u9u( -a-i. 7%rdasar-a( ti(-ata( atau rad%4 D%mam 7%rdara, D%(u% -%adaa( *isi- a(a- adaa, s%+ai +%ri-ut: 14 rad% I : -%sadara( -om&osm%(tis -%adaa( umum %ma, ta(data(da ita da( (adi %ma,. 24 rad% II : -%sadara( -om&os m%(tis -%adaa( umum %ma, da( &%rdara,a( s&o(ta( &%t%-i% &%rdara,a( usi da( t%i(a s%rta (adi %ma, -%ci da( tida- t%ratur. 34 rad% III : -%sadara( a&atis som(o%(t -%adaa( umum %ma, (adi %ma, -%ci da( tida- t%ratur s%rta t%(si m%(uru(. 4 rad% IV : -%sadara( -oma ta(data(da ita : (adi tida- t%ra+a t%(si tida- t%ru-ur &%r(a&asa( tida- t%ratur %-str%mitas di(i( +%r-%ri(at da( -uit tam&a- +iru. Sist%m i(t%um%(t 14 )da(/a &%t%-ia &ada -uit turor -uit m%(uru( da( mu(cu -%ri(at di(i( da( %m+a+. 24 $u-u sia(osis?tida- 34 $%&aa da( %,%r $%&aa t%rasa (/%ri mu-a tam&a- -%m%ra,a( -ar%(a d%mam *us/4 mata a(%mis ,idu( -ada( m%(aami &%rdara,a( %&ista-sis4 &ada rad% II III IV. #ada muut dida&at-a( +a,'a mu-osa muut -%ri( t%r9adi &%rdara,a( usi da( (/%ri t%a(. S%m%(tara t%(oro-a( m%(aami ,i&%r%mia &,ari( &ada rad% II III IV4. 4 Dada 7%(tu- sim%tris da( -ada(-ada( t%rasa s%sa-. #ada *oto t,ora t%rda&at ada(/a caira( /a( t%rtim+u( &ada &aru s%+%a, -a(a( %*usi &%ura4 ra%s G4 o(c,i G4 /a( +iasa(/a t%rda&at &ada rad% III da( IV. 54 )+dom%( M%(aami (/%ri t%-a( #%m+%sara( ,ati ,%&%tom%ai4 asit%s. "4 E-str%mitas. 64 )-ra di(i( s%rta t%r9adi (/%ri otot s%(di s%rta tua(.
2. Dia(osa $%&%ra'ata( Dia(osa -%&%ra'ata( adaa, &%r(/ataa( /a( 9%as m%(%(ai status -%s%,ata( atau masaa, a-tua atau r%si-o daam ra(-a m%(i(d%(ti*i-asi da( m%(%(tu-a( i(t%r%(si -%&%ra'ata( u(tu- m%(ura(i m%(,ia(-a( atau m%(c%a, masaa, -%s%,ata( -i%( /a( ada ada ta(u( 9a'a+(/a.
3. #%r%(ca(aa( $%&%ra'ata( #%r%(ca(aa( -%&%ra'ata( adaa, &%r(/ataa( si(-at daam &%rtim+a(a( &%ra'at m%(am+ar-a( r%s&o( &asi%( &ada masaa, -%s%,ata( a-tua da( r%si-o Nursaam 20014. %(ca(a -%&%ra'ata( #ada a(a- d%(a( &%(/a-it i(*%-si D%mam 7%rdara, D%(u% m%(urut Nursaam 2005 o( Do(a L 2003 da( Do%(%s Mari/(( E. d-- 1AAA. adaa, : a. Dia(osa -%&%ra'ata( 1 #%(i(-ata( su,u tu+u, ,i&%rt%rmia4 +%r,u+u(a( d%(a( i(*%-si irus.
c. Dia(osa $%&%ra'ata( 3 a(ua( &%m%(u,a( -%+utu,a( (utrisi -ura( dari -%+utu,a( tu+u, +%r,u+u(a( d%(a( mua mu(ta, tida- ada (a&su ma-a(.
24 Li+at-a( -%uara daam m%m%(u,i -%+utu,a( a(a- asio(a: 7a(tua( -%uara m%m+uat a(a- m%rasa ama( s%cara mori da( *isi- s%rta m%m+a(tu &%ra'at daam m%m%(u,i -%+utu,a( &asi%(. 34 D%-at-a( da( sia&-a( aataat /a( di+utu,-a( di d%-at a(a- asio(a: M%muda,-a( &asi%( da&at m%(am+i -%&%rua((/a. . Eauasi $%&%ra'ata( Eauasi &%r-%m+a(a( -%s%,ata( &asi%( da&at dii,at dari ,asi(/a tu9ua((/a adaa, u(tu- m%(%ta,ui s%9au, ma(a tu9ua( &%ra'ata( da&at dica&ai da( m%m+%ri-a( um&a( +ai- t%r,ada& asu,a( -%&%ra'ata( /a( di+%ri-a(. La(-a,a(-a, %auasi : 14 Da*tar tu9ua(tu9ua( &asi%(. 24 La-u-a( &%(-a9ia( a&a-a, &asi%( da&at m%a-u-a( s%suatu. 34 7a(di(-a( a(tara tu9ua( d%(a( -%mam&ua( &asi%(. 4 Dis-usi-a( d%(a( &asi%( a&a-a, tu9ua( da&at t%rca&ai atau tida-.
Da*tar #usta-a E**%(d/ C,rista(ti% 1AA5 #%ra'ata( #asi%( DHF EC: ;a-arta $%iat 7udi )((a 1AA1 #ros%s $%&%ra'ata( EC: ;a-arta. Do%(o%s ME 2001 dia(osa -%&%ra'ata( EC: ;a-arta.
