ASUHAN KEPERAWATAN DEWASA DENGAN GANGGUAN SISTEM PENCERNAAN: PAROTITIS
1. 2. 3. (. . ". 0. 8.
DI SUSUN OLEH : KELOMPOK 3 AJ-2 B18 Hairun Puspah 13111123!1" #i$i% E%a Ira&a'i 13111123!2( Au)an Mu''a*in 13111123!3! N+,ia S 13111123!! Muhaa A/i 13111123!"" Lai/a'u/ Isnaini 13111123!0! Muhaa Sa/inra 13111123!! Kurnia i4as'ria 13111123!2
Program Studi Pendidikan Ner !aku"ta Ke#era$atan Uni%erita Air"angga Sura&a'a ()*+
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DA!TAR ISI
HALAMAN JUDUL DA5A6 ISI BAB I PENDAHULUAN 1.1. 1.1. La'a La'arr B/a B/a%a %an7 n7 1.2. 5uuan 1.3. 1.3. 6uu 6uusa san n Masa Masa/a /ah h BAB II 5INJAUAN PUS5AKA 2.1. 2.1. Ana'+ Ana'+ii isi+/ isi+/+7i +7i Par+'i Par+'iss 2.2. 2.2. D9i D9ini nisi si Par+ Par+'i 'i'i 'iss 2.3. 2.3. E'i+/ 'i+/+ +7i 2.(. 2.(. a%' a%'+r +r 6si 6si%+ %+ 2.. 2.. Pa'+ Pa'+9i 9isi si+/ +/+7 +7ii 2.". O# 2.0. 2.0. K/as K/asi9 i9i% i%as asii 2.8. 2.8. Mani Mani9 9s'a s'asi si K/in K/inis is 2.. 2.. P Pri% ri%saa saan n Dia7 Dia7n+ n+s' s'i% i% 2.1!. 2.1!. Pna'a/a%san Pna'a/a%sanaan aan 2.11. 2.11. Pn$7ahan Pn$7ahan 2.12. 2.12. K+p/i%asi K+p/i%asi 2.13. 2.13. Pr+7n+sis Pr+7n+sis 2.1(. Asuhan Kpra&a'an D&asa n7an Par+'i'is BAB III 5INJAUAN KASUS 3.1. 3.1. Pn7 Pn7%a %ai ian an 3.2. 3.2. Dia7 Dia7n+ n+sa sa Kp Kpra ra&a &a'a 'an n 3.3. 3.3. In' In'r r, ,ns nsii Kpra Kpra&a &a'a 'an n BAB I; PENU5UP (.1. (.1. Ksi Ksi pu/a pu/an n (.2. (.2. Pn Pnu'u u'up DA5A6 PUS5AKA
1 2 3 3 ( ( " " 0 8 8 11 12 13 1( 1 10 18 21 22 2" 2" 32 33 3" 3" 3" 30
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,A, I PENDAHU-UAN *.*.
-atar ,e"akang Parotitis Epidemika atau Mumps atau gondongan gondongan aa/ah sua'u
pn4a%i' nu/ar iana ss+ran7 'rin9%si +/h ,irus
4an7 n4ran7 %/nar /uah <%/nar par+'is> i an'ara '/in7a an rahan7 shin77a n4?a?%an p?n7%a%an paa /hr ?a7ian a'as a'au pipi ?a7ian ?a&ah . 2!1>. Par+ Par+'i 'i'i 'iss s> aa/ aa/ah ah %+n %+nis isii in9/a in9/aasi asi pa/in7 pa/in7 uu uu ari ari %/n %/nar ar sa/i,a@ sa/i,a@ naun naun in9%s in9%sii apa' apa' u7a u7a 'rai 'rai paa paa %/n %/nar ar sa/i,a sa/i,a /ain. /ain. Lsi Lsi ssnsi ssnsia/ a/ ari ari ups ups aa/ah in9/aasi %/nar sa/i,a an 'ru'aa pn4a%i' nu/ar pia'ri% 4an7 is?a?%an +/h ,irus. ,irus. S?/u S?/u i'u i'u%an %an ,a%sin ,a%sin par+'i par+'i'is 'is paa paa 'ahun 'ahun 1"0@ 1"0@ par+'i par+'i'is 'is pii%a rupa%an pn4a%i' 4an7 san7a' srin7 i'u%an paa ana%. Insins paa uur 1 'ahun 8 n7an pun$a% insins %/+p+% uur uur - 'ahun 'ahun.. S'/a S'/ah h i'u i'u%an %an ,a%sin ,a%sin par+'i par+'i'is@ 'is@ %ai %aian an par+'i par+'i'is 'is pii%a nai san7a' aran7. Par+'i'is aran7 'rai paa +ran7 'ua. Di n7ara ?ara' spr'i Ari%a an In77ris@ ra'a-ra'a iapa' %uran7 ari 1.!!! %asus pr 'ahun. Di%ian pu/a insins par+'i'is ?r7sr paa ana% ?sar an &asa ua sr'a n4?a?%an %aian /uar ?iasa i 'pa' %u/iah a'au 'pa' %ra. Masa Masa in%u?a in%u?asi si 'rai 'rain4 n4aa par+'i par+'i'is 'is an'ara an'ara 1(-21 1(-21 hari hari an asa asa in%u?asi ini ,irus apa' i'%si /a/ui sa/i,a. ;irus san7a' in9%sius paa 1 sapai 3 hari s?/u p?n7%a%an sapai 2 in77u s'/ah p?n7%a%an@ shin77a apa' ni?u/%an &a?ah i as4ara%a'. Br Brasa asar% r%an an ha/ ha/ 'rs 'rs?u ?u'@ '@ ip ip/a /aa ari ri
%hus %husus usn4 n4aa
a/a a/a
a%a a%a pn4 pn4a%i a%i'' Par+ Par+'i 'i'i 'iss ini ini pr/ pr/u u
pra% pra%' '% %
Asuha suhan n
Kp Kpra ra&a &a'a 'an n
sis' sis'
pn$rnaan. M/a/ui a%a/ah ini a%an %ai ?ahas 'n'an7 par+'i'is 4an7 /i /ipu pu'iC 'iC ana' ana'+ +ii 9isi+ 9isi+/+ /+7i 7i@@ 9i 9ini nisi si@@ 'i+ 'i+/+ /+7i 7i@@ pa'+ pa'+9is 9isi+ i+/+ /+7i 7i@@ O#@ O#@ %/asi9i%asi@ ani9s'asi par+'i'is@ pri%saan ia7n+s'i%@ pna'a/a%sanaan@ pn$7ahan@ %+p/i%asi@ an pr+7n+sis@ sr'a Asuhan %pra&a'an paa pasin n7an par+'i'is. 3
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*.0.
Rumuan Maa"a/ 1.2.1. Apa%ah pn7r'ian par+'i'is 1.2.2. Apa%ah 'i+/+7i ari par+'i'is 1.2.3. Apa%ah 9a%'+r rsi%+ ari par+'i'is 1.2.(. Apa%ah %/asi9i%asi ari par+'i'is 1.2.. Ba7aiana O# an pa'+9i+/+7is par+'i'is 1.2.". Apa%ah ani9s'asi %/inis par+'i'is 1.2.0. Ba7aiana pri%saan i7n+s'i% paa par+'i'is 1.2.8. Ba7aiana Pna'a/a%sanaan pasin n7an par+'i'is 1.2.. Ba7aiana pn$7ahan ari par+'i'is 1.2.1!. Apa%ah %+p/i%asi par+'i'is 1.2.11. Ba7aiana pr+7n+sis par+'is 1.2.12. Ba7aiana Asuhan %pra&a'an pasin n7an par+'i'is Tu1uan 1.3.1. 5uuan Uu S'/ah pr+ss p?/aaran@ iharap%an ahasis&a
apu /a%u%an Asuhan %pra&a'an sis' pn$rnaan paa %/in n7an Par+'ii'is. 1.3.2. 5uuan Khusus 1. Mn7'ahui pn7r'ian par+'i'is 2. Mn7'ahui 'i+/+7i ari par+'i'is 3. Mn7'ahui %/asi9i%asi ari par+'i'is (. Mn7'ahui 9a%'+r rsi%+ ari par+'i'is . Mn7'ahui O# an pa'+9i+/+7is par+'i'is ". Mn7'ahui ani9s'asi %/inis par+'i'is 0. Mn7'ahui pri%saan i7n+s'i% paa par+'i'is 8. Mn7'ahui pna'a/a%sanaan pasin n7an par+'i'is . Mn7'ahui pn$7ahan ari par+'i'is 1!. Mn7'ahui %+p/i%asi par+'i'is 11. Mn7'ahui pr+7n+sis par+'is 12. Mn7'ahui Asuhan %pra&a'an pasin n7an par+'i'is
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(. *
,A, II TIN2AUAN PUSTAKA Anatomi !iio"ogi Ke"en1ar -uda/
Gam&ar *: Ke"en1ar -uda/
K/nar /uah aa/ah %/nar au% ?r'anan@ 4an7 ?rar'i 'riri a'as 7a?un7an %/+p+% a/,+/i ?n'u% %an'+n7 an 4an7 ?n'u% /u?an7-/u?an7 %$i/. Sa/uran-sa/uran ari s'iap a/,+/us ?rsa'u un'u% ?n'u% sa/uran 4an7 /?ih ?sar an 4an7 n7an'ar s%r'n4a % sa/uran u'aa an /a/ui ini s$r' i'uan7%an % a/a u/u'. K/nar /uah 'riri ari s/-s/ pns%rsi sa/i,a. K/nar /uah 'r/'a% i s%i'ar r+n77a u/u'. K/nar /uah 4an7 u'aa ia/ah %/nar par+'is@ su?ani?u/aris an su?/in7ua/is. K/nar par+'is ia/ah 4an7 'r?sar. Sa'u is?/ah %iri an sa'u is?/ah %anan an 'r/'a% %a' i pan a7a% % ?a&ah '/in7a.
S%r'n4a i'uan7%an % a/a u/u' /a/ui sa/uran par+'is a'au sa/uran S'nsn@ 4an7 ?ruara i pipi s?/ah a/a@ ?rhaapan n7an 7raha <+/ar> %ua a'as. Aa ua s'ru%'ur pn'in7 4an7 /in'asi %/nar par+'is@ 4ai'u ar'ri %ar+'is ='rna an sara9 $rania/ %'uuh . K/nar Su?ani?u/aris n+r ua ?sarn4a ssuah %/anar par+'is. 5r/'a% i ?a&ah %ua sisi 'u/an7 rahan7@ an ?ru%uran %ira%ira s?sar ?uah %nari. S%r'n4a i'uan7%an % a/a u/u' /a/ui sa/uran su?ani?u/aris a'au sa/uran har'+n@ 4an7 ?ruara i asar u/u'@ %a' 9rnu/u /in7ua. K/nar su?/in7ua/is aa/ah 4an7 'r%$i/. L'a%n4a i ?a&ah /iah i %anan an %iri 9rnu/u /in7ua an nuan7%an s%r'n4a % a/a asar u/u' /a/ui ??rapa uara %$i/. K/nar /uah ns%rsi sa/i,a s?a7ai rsp+n 'rhaap an'isipasi a%anan a'au aan4a a%anan ia/a u/u'. 6an7san7an /a/ui sara9 parasipa'is n7hasi/%an i/a'asi p?u/uh arah ia/a %/nar an n7a/ir%an sa/i,a. Sa/i,a i/i%i 'i7a 9un7si@ 4ai'u: a. Mun7%in%an a%anan i%un4ah +/h 7i7i an i?n'u% %a/a ?+/us@ 7upa/an 4an7 apa' i'/an. ?. P'4a/in@ n)i a/a sa/i,a n7u?ah %ar?+hira' nai a/'+sa. $. M/?a?%an /iah an ?a7ian a/a u/u'@ un7%in%an /iah ?r7ra% saa' ?i$ara. (. (
De3inii Mnuru' +n7 <2!!>@ Par+'i'is aa/ah sua'u praan7an paa
%/nar par+'is an rupa%an rsp+ns a'as in9%si +/h ,irus Para4=+,irus 4an7 n4ran7 %/nar /uah ian'ara '/in7a an rahan7 shin77a n4?a?%an p?n7%a%an paa /hr ?a7ian a'as a'au pipi ?a7ian ?a&ah. Pn4a%i' par+'i'is a'au 7+n+n7an aa/ah sua'u pn4a%i' nu/ar iana ss+ran7 'rin9%si +/h ,irus 4an7 n4ran7 %/nar /uah <%/nar par+'is> i an'ara '/in7a an rahan7 shin77a n4?a?%an p?n7%a%an paa /hr ?a7ian a'as a'au pipi ?a7ian ?a&ah .
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Par+'i'is pii%a <7+n+n7an> aa/ah sua'u in9%si ,irus nu/ar 4an7 n4?a?%an p?n7%a%an uni/a'ra/ a'au ?i/a'ra/ <%ua sisi> paa %/nar /iur isr'ai n4ri. Paa sa/uran %/nar /uah 'rai
%/ainan ?rupa p?n7%a%an s/
pi'/@
p/?aran
an
pn4u?a'an sa/uran . (. 0
Etio"ogi Pn4?a? ups aa/ah ,irus nis 6i?+nu$/i$ A$i <6NA>
Para4=+,irus. . U%uran ari par'i%/ para4=+,irus s?sar ! 3!! F. ;irus '/ah iis+/asi ari /uah@ arah@ urin@ +'a% an arin7an 'rin9%si /ain. ;irus ini a%'i9 a/a /in7%un7an 4an7 %rin7 'api ,irus ini han4a apa' ?r'ahan s/aa ( hari paa suhu %aar . Para4=+,irus apa' han$ur paa suhu ( G#@ +/h 9+ra/in@ 'r@ sr'a paparan $aha4a u/'ra,i+/' s/aa 3! 'i%. < Ma/+na+@ 2!!!@ a/a Suharians4ah@ 2!13>. ;irus asu% a/a 'u?uh /a/ui hiun7 a'au u/u'. . ;irus ?rp/i%asi paa u%+sa sa/uran napas a'as %uian n4?ar % %a/nar /i9a /+%a/ an ii%u'i ,iria uu s'/ah 12-2 hari <asa in%u?asi> 4an7 ?r/an7sun7 s/aa 3- hari. S/anu'n4a /+%asi 4an7 i'uu ,irus aa/ah %a/nar par+'is@ +,ariu@ pan%ras@ 'ir+i@ 7ina/@ an'un7 a'au +'a%. Masa pn4?aran ,irus ini aa/ah 2-3 in77u /a/ui ari /uah@ arah@ urin@ +'a% an arin7an 'rin9%si /ain. ;irus apa' iis+/asi ari sa/i,a "-0 hari s?/u asu% asa p?n7%a%an an hari ssuah un$u/n4a p?n7%a%an paa %a/nar /uah. Pnu/aran 'rai 2( a s?/u p?n7%a%an %a/nar /uah an 3 hari s'/ah p?n7%a%an n7hi/an7. Da/a %+nisi ini pasin 4an7 'rin9%si para4=+,irus ini nai ,iria@ %uian /i?a'%an %/nar sa/i,a@ an ii%u'i in,asi ari /i9+si' 4an7 nin7%a'@ (. 4
shin77a ni?u/%an p?n7%a%an an rasa sa%i'. <aharani@ 2!!> !aktor reiko Lansia@ sa%i' a%u'@ pnurunaan iuni'as@ pnurunan pr+u%si sa/i,a a%i?a'
hirasi
aupun
pn77unaan
+?a'-+?a'an
iun+suprsan
rupa%an 9a%'+r 4an7 ?rsi%+ 'in77i un'u% 'rain4a par+'i'is . Mnuru' Suharians4ah <2!13> pn4?a? par+'i'is aa/ah : 0
1. In3eki %iru atau &akteri e#erti : para4=+,irus @ 4$+?a$'riu 'u?r$u/+sis an u7a HI; 2. Pen'akit autoimun : spr'i Sinr+ S7rn Pn4?a?n4a 'ia% i%'ahui. Sinr+ ini srin7 i'anai n7an %%rin7an 4an7 ?r/?ihan i a'a@ u/u'@ hiun7@ ,a7ina@ an %u/i' 3. Pen'um&atan a"uran a"i%a : Pn4u?a'an un7%in is?a?%an +/h aan4a ?a'u sa/i,a@ p/u7 /nir@ a'au@ +/h 'u+r@ ?iasan4a ina%. Ba'u sa/uran sa/i,a@ u7a is?u' %a/%u/us sa/uran air /iur@ ?iasan4a 'r?n'u% ari susunan %a/siu@ ''api 'ia% nunu%%an aan4a nis 7an77uan %a/siu (. Pen'e&a& "ain'a : Sar%+i+sis@ a/nu'risi@ pn7+?a'an 6aiasi %an%r %pa/a an /hr apa' n4?a?%an praan7an %/nar par+'is@ K+nisi /ain apa' n4?a?%an %/nar par+'is un'u% ?sar@ ''api 'ia% 'rin9%si@ 'rasu%: ia?'s@ a/%+h+/is@ ?u/iia (.5.
Pato3iio"ogi Par+'i'is apa' 'rai paa sua usia. 5'api pa/in7 srin7 'rai
paa ana%-ana% ?rusia -1 'ahun@ 4ai'u 8 ari %asus par+'i'is 'rai paa ana% ana% ?rusia i?a&ah 1 'ahun. Dan aran7 s%a/i 'rai paa +ran7 'ua. Ana% a%an np'%an %%?a/an 'u?uh 'rhaap ,irus Par+4=+,irus ari i?un4a sapai usia 12-1 ?u/an saa. I'upun i%a i?u prnah nri'a 7+n+n7an a'au napa'%an iunisasi s?/un4a. Pnu/aran a'au pn4?aran ,irus apa' i'u/ar%an /a/ui %+n'a% /an7sun7@ pr$i%an /uah@ ?ahan un'ah@ un7%in n7an urin. ;irus asu% 'u?uh un7%in /a/ui hiun7 a'au u/u'. Pr+/i9rasis 'rai i par+'is a'au pi'/ 'ra%'us rspira'+r4 %uian 'rai ,iria@ an s/anu'n4a ,irus ?ria i arin7an %/nar a'au sara9. Ba7ian 4an7 pa/in7 'rsrin7 'r%na ia/ah 7/anu/a par+'is. Pra/anan pn4a%i' %/asi% iu/ai n7an a@ sa%i' %pa/a@ an+r=ia an a/ais. Da/a 2( a ana% n7/uh sa%i' '/in7a 4an7 ?r'a?ah n7an 7ra%an n7un4ah. Es+% harin4a 'apa% 7/anu/a par+'is ?sar 4an7 $pa' ?r'a?ah ?sar@ n$apai u%uran a%sia/ a/a 1-3 hari. Biasan4a a n7hi/an7 a/a 1-" hari an suhu nai n+ra/ s?/u hi/an7n4a p?n7%a%an %/nar. Ba7ian ?a&ah 8
aun '/in7a 'ran7%a' %a'as an %/uar +/h p?n7%a%an %/nar par+'is. P?n7%a%an apa' isr'ai n4ri h?a'. N4ri u/ai ?r%uran7 s'/ah 'r$apai p?n7%a%an a%sia/ ?r/an7sun7 %ira-%ira s/aa "1! hari. Biasan4a sa'u %/nar par+'is ?sar %uian ii%u'i 4an7 /ainn4a a/a ??rapa hari. Aa%a/an4a %anan an
%iri ?sar
?rsaaan. Par+'i'is uni/a'ra/ i'u%an %ira-%ira 2. Aan4a rsp+n in9/aasi sis'i% ?ri%an ani9s'asi pnin7%a'an suhu 'u?uh@ rsp+n %'ia%n4aanan sa%i' ?ri%an
ani9s'asi
%'ia%si?an7an
%pa/a an pnuhan
an+r=ia nu'risi.
Mnuru' Iss/?a$hr@ 12@ 4an7 'r'u/is a/a urna/ K UNHALU , n/as%an ?ah&a Paramyxovirus n4?a?%an pnin7%a'an I7 an I7M 4an7 apa' 'r'%si n7an ELISA < enzyme linked immunosorbent assay >. I7M nin7%a' paa s'aiu a&a/ in9%si < hari %ua sa%i' >@ n$apai pun$a%n4a a/a in77u pr'aa an ?r'ahan -" ?u/an. Iun+7/+?u/in un$u/ paa a%hir in77u pr'aa@ n$apai pun$a%n4a hin77a 3 in77u ana ?r'ahan suur hiup. Iu7/+?u/in A u7a nin7%a' saa' 'rain4a in9%si. Iuni'as ihu?un7%an n7an aan4a an'i?+i 4an7 n'ra/%an. M%anis iun s/u/r iu7a nu%un7 pa'h+7nsis pn4a%i' a%u' an %s?uhan. Spr'i in9%si ,irus sis'i% /ainn4a@ par+'i'is apa' n4?a?%an suprsi sn'ara hiprsnsi'i,i'as nis /a?a' 'rhaap an'i7n 4an7 '/ah i%na/ s?/un4a@ spr'i pr+'in 'u?r%u/in
(.5.
WOC
Pn4?aran An77+'a Para4=+,irus
E'i+/+7i an a%'+r 6si%+: - In9%si Karna Kuan Ba%'ri: Paramyxovirus, staphilococcus aureus, ;irus ups@ HI; - Pn4a%i' Au'+iun: SLE - Pn4u?a'an : 5u+r@ %a/%u/us - Pn4?a? Lain: Ma/nu'risi@ pn7+?a'an %an%r - Lansia - Ora/ h47in 4an7 ?uru% - 5ia% iunisasi us
Pnu/aran : - K+n'a% /an7sun7 n7an sa/i,a - Air r+p/' ?+rn - Bahan un'ah - Urin
Hiun7 an u/u' Pr+/i9rasi i Par+'ispi'/ 'ra%'us
;iria Knai%an 5i'r I7MI7 PAROTITIS Psi%+s+sia/
Mran7san7 hip+'a/aus an'ri+r
6sp+n in9/aasi sis'i% N4ri rahan7 ?/a%an7
Da@ n77i7i/
Pr+ss in9/aasi %a/nar /uah Ma/ais
Ksu/i'an n7un4ah an n/an In,asi /i9+si'
MK: Into"erani akti%ita
MK: Hi#ertermia
P?n7%a%an %/nar par+'is Mn%an rsp'+r n4ri N4ri rahan7 sp+n'an@ n4ri %pa/a@ n4ri +'+' 'ru'aa arah /hr
/isah
In9+rasi -
Pr+ss 'rain4a pn4a%i'
Kuran7 pn7'ahuan
An+r%sia MK: Ketidakeim&angan nutrii kurang dari ke&utu/an tu&u/
MK: Anieta Ksu/i'an ?r?i$ara
MK: De3iit Pengeta/uan
MK: Ham&atan Komunikai 6er&a"
1! MK: N'eri akut
(.+.
K"ai3ikai a. Par+'i'is Ka?uhan Ana%-ana% uah 'r%na par+'i'is %a?uhan 4an7 'i?u/
paa usia an'ara 1 ?u/an hin77a a%hir asa %ana%-%ana%.Ka?uhan ?rar'i s?/un4a ana% '/ah 'rin9%si ,irus %uian %a?uh /a7i. Mnuru' Nah/i/i <2!!> 4an7 'r'u/is ia/a ?u%u 7an77uan 7an77uan as'r+in's'ina/ n/as%an ?ah&a par+'i'is san7a' aran7 i'u%an paa ana% 4an7 ?ruur %uran7 ari 2 'ahun@ ha/ 'rs?u' %arna uun4a r%a asih i/i%i a'au i/inun7i +/h an'i?+i 4an7 ?ai%. Ana% 4an7 nri'a par+'i'is a%an i/i%i %%?a/an suur hiupn4a. Diana %%?a/an 'u?uh 'rhaap ,irus Par+4=+,irus iapa' ari i?un4a sapai usia 12-1 ?u/an saa. I'upun i%a i?u prnah nri'a 7+n+n7an a'au napa'%an iunisasi s?/un4a. ?. Par+'i'is A%u' Par+'i'is a%u' i'anai n7an rasa sa%i' 4an7 naa%@ %rahan an p?n7%a%an paa arah par+'is .
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(.7.
Mani3etai K"ini
Gam&ar (: Mani3etai K"ini Parotiti
5ia% sua +ran7 4an7 'rin9%si +/h ,irus Para4=+,irus n7a/ai %/uhan@ ?ah%an s%i'ar 3!-(! pnri'a 'ia% nunu%%an 'ana-'ana sa%i'. Naun i%ian r%a saa n7an pnri'a /ainn4a 4an7 n7a/ai %/uhan@ 4ai'u apa' nai su?r pnu/aran pn4a%i' 'rs?u'. Masa in%u?asi pn4a%i' par+'i'is s%i'ar 12-2 hari n7an ra'ara'a 10-18 hari. . Aapun 'ana an 7a/a 4an7 'i?u/ s'/ah 'rin9%si an ?r%?an7n4a asa in%u?asi apa' i7a?ar%an s?a7ai ?ri%u': a. S'aiu Pr++ra/ Mnuru' 5p/r <2!!>@ paa 'ahap a&a/ <1-3 hari> par+'i'is ?iasan4a
'i?a-'i?a@
s%ipun un7%in iahu/ui +/h
pri+
pr+r+a/ spr'i a/ais@ an+r%sia@ rasa n77i7i/@ a@ n4ri 12
'n77+r+%an@ an n4ri paa rahan7 hin77a ?a7ian ?/a%an7. Pnri'a par+'i'is n7a/ai 7a/a: a N4ri %'i%a n7un4ah a'au n/an@ 'ru'aa i%a n/an $airan asa <n4?a?%an iri'asi %/nar /uah>. Ji%a %/nar /uah isn'uh@ a%a a%an 'i?u/ n4ri. a/a par+'i'is un$u/ a/a &a%'u 12 sapai 2( hari s'/ah 'rin9%si .<69ra'@ 2!1!> ?. S'aiu P?n7%a%an S/anu'n4a 'rai p?n7%a%an %/nar par+'is 4an7 ia&a/i n7an p?n7%a%an sa/ah sa'u sisi %/nar %uian %ua %/nar
n7a/ai
p?n7%a%an.
P?n7%a%an
?iasan4a
?r/an7sun7 s%i'ar 3-0 hari %uian ?ran7sur n7pis. Paa 0- hari %u/i' ia'as par+'is n7a/ai ri'a. P?n7%a%an par+'is iarah pan '/in7a. Dia'as +'+' as'r i$%un7an ?/a%an7 ipan /ian7 '/in7a ?a7ian ?a&ah.. Kaan7 'rai p?n7%a%an paa %/nar i ?a&ah rahan7 an %/nar i ?a&ah /iah . Paa pria &asa aa/an4a 'rai p?n7%a%an ?uah )a%ar <'s'is> %arna pn4?aran /a/ui a/iran arah. Mnuru' 5p/r <2!!>@ paa s?a7ian ?sar pasin@ %/uhan u'aa aa/ah (.8.
%su/i'an a%an@ n/an@ an ?r?i$ara. Pemerikaan Diagnotik Mnuru' MaharaniHai <2!!>@ ?ah&a ia7n+sis %/inis par+'i'is ?isa i'7a%%an ?rasar%an hasi/ anansa an ani9s'asi %/inis. An77rani an U'aa <2!12> u7a na?ah%an ?ah&a n7a%%an ia7n+sis par+'i'is 'ia% pr/u pri%saan /a?+ra'+riu@ %$ua/i i%a 7a/a %/inis 4an7 un$u/ 'ia% %/asi% un'u% par+'i'is. Mnuru' Pinn <10> 4an7 'r'u/is ia/a ?u%u 7an77uan 7an77uan as'r+in's'ina/ n/as%an ?ah&a pri%saan ia7n+s'i% par+'i'is /ipu'i pri%saan /a?+ra'+riu@ u/ah /u%+si' n+ra/ a'au 'rapa' /u%+pnia n7an /i9+si'+sis r/a'i9. S?a7ai pri%saan 'a?ahan apa' i/a%u%an complementfixing antibody test, neutralization test, is+/asi ,irus@ ui in'rara/@ an pn7u%uran %aar a4/as a/a sru. Dia7n+sis ups iasar%an
paa
ri&a4a'
paanan@
an
p?n7%a%an par+'is n7an rasa n4ri. Pn7asan /a?+ra'+riu ups 4an7 %has nai pn'in7 a/a sua'u &a?ah an a/a %asus-%asus 13
n7an 7a/a su?%/inis. 5s %husus /ipu'i is+/asi ,irus ari $u$ian 'n77+r+%an a'au hiun7@ 'i'r I7 @ 's I7M@ an 65-P#6 's'in7. <;i%as@ 2!!">. In9%si i%+n9irasi +/h is+/asi ,irus a'au asa nu%/a' ari spsin %/inis. Pri%saan sr+/+7i nunu%%an pnin7%a'an 'i'r I7 4an7 si7ni9i%an i an'ara spsin a%u' an %+n,a/sn a'au I7M an'i?+i ups p+si'i9. <;i%as@ 2!!">. ;irus Parain9/un)a 3 u7a apa' n4?a?%an par+'i'is an apa' n7hasi/%an rsp+n an'i?+i h'r+/+7 4an7 apa' pn7aruhi 's ups HAI. Ha/ ini pn'in7 un'u% n4in7%ir%an in9%si ini %'i%a n77una%an 's HAI un'u% nia7n+sa pn4a%i' ups. <;i%as@ 2!!"> (.9.
Penata"akanaan a. Pnri'a ra&a' a/an Pnri'a ?aru apa' ira&a' a/an ?i/a 'ia% aa %+p/i%asi <%aaan
uu $u%up ?ai%>. 1. Is'iraha' 4an7 $u%up 2. P?rian i' /una% an $airan 4an7 $u%up 3. K+prs panas in7in ?r7an'ian Pnrapan %+prs han7a' an in7in s'iap 2-3 a s/aa 1!-1 ni' a%an ?ran9aa'. Mnuru' Br%r <2!!(> 4an7 'r'u/is ia/a ?u%u 7an77uan 7an77uan as'r+in's'ina/ n/as%an ?ah&a 7a/a sip'+a'i% apa' i?ri%an %+prs panas a'au in7in an u7a i?ri%an ana/7'i%a. Mnuru' Muh/isin <2!1"> p?rian %+prs in7in <s> paa arah 47 ?n7%a% apa' ?ri%an 9% pa'i rasa shin77a apa' n7uran7i rasa sa%i'. San7%an p?rian %+prs han7a' paa arah 4an7 ?n7%a% apa' n7uran7i ?n7%a% an n4ri (. Mi%an'+sa a> Ana/7'i%-an'ipir'i% ?i/a pr/u 1> M'apir+n : ana% " ?u/an 2! !! 7hari a%siu 2 7hari 2> Paras'a+/ : 0@ 1! 7%7BBhari i?a7i a/a 3 +sis 3> Hinari p?rian aspirin paa ana% %arna p?rian aspirin ?risi%+ ni?u/%an Sinr+ 64 4ai'u s?uah pn4a%i' /an7%a naun a'i%an. O?a'-+?a'an ana% 4an7 'rapa' i ap+'i% ?/u 'n'u ??as ari aspirin. Aspirin 1(
srin7%a/i
is?u'
u7a
s?a7ai
sa/i$4/a'
a'au
a$'4/sa/i$4/i$ a$i. ?> Mu/'i,i'ain $> An'i?i+'i% > 5ia% ir%+nasi%an pn7+?a'an n7an an'i,irus 5. 5ia% aa +?a' %husus. ?. Pnri'a ra&a' inap Pnri'a n7an a 'in77i@ %aaan uu /ah@ n4ri %pa/a h?a'@ 7a/a sara9 pr/u ra&a' inap iruan7 is+/asi : 1. Di' /una%@ $air an 5K5P 2. Ana/7'i%-an'ipir'i% 3. Bri%an %+r'i%+s'r+i un'u% n$7ah %+p/i%asi. Mnuru' ;+/pa'+ <2!!(> 4an7 'r'u/is ia/a ?u%u 7an77uan 7an77uan as'r+in's'ina/ n4?u'%an ?ah&a p?rian %+r'+s'r+i s/aa 2-( hari an 2! / $+n,a/s$n'
7aa7/+?u/in
ipr%ira%an
apa'
n$7ah
'rain4a +r%i'is. S'/ah s?uh@ 's'is 4an7 'r%na un7%in a%an n$iu'. Jaran7 'rai %rusa%an 's'is 4an7 prann shin77a 'rai %anu/an.
1
(.*).
Penega/an
Mnuru' Spar% <2!1(>@ pn$7ahan par+'i'is ini apa' i/a%u%an n7an $ara@ 4ai'u: a> ?> $> >
#u$i 'an7an s$ara 'ra'ur n7an n77una%an sa?un an air 5u'up u/u' saa' ?a'u% an ?rsin Mn7uran7i %+n'a% n7an pnri'a 5ia% a%ai ?aran7-?aran7 pri?ai s$ara ?rsaa-saa un'u%
>
n7uran7i pn4?aran ,irus S7ra hu?un7i p'u7as %sha'an ?i/a 'ana an 7a/a sa%in
?uru% 9> ;a%sinasi MM6 san7a' 9%'i9 un'u% n$7ah par+'i'is Mnuru' Ma/+na+ <2!!!> 4an7 'r'u/is a/a urna/ K UNHALU
2!13> , pn$7ahan 'rhaap
par+'i'is
pii%a apa' i/a%u%an s$ara iunisasi pasi9 an iunisasi a%'i9. a. Pasi9 aa 7/+?u/in par+'i'is 'ia% 9%'i9 a/a n$7ah par+'i'is a'au n7uran7i %+p/i%asi. . A%'i9 P?rian ru'in ,a%sin par+'i'is hiup 4an7 i/ah%an. Ana% 4an7 i,a%sinasi ?iasan4a 'ia% n7a/ai a a'au ra%si %/inis /ain 4an7 apa' i'%si@ 'ia% n7%s%rsi ,irus@ an 'ia% nu/ar 'rhaap %+n'a% 4an7 rn'an. Jaran7 par+'i'is apa' ?r%?an7 0-1! hari ssuah ,a%sinasi. ;a%sin i$u an'i?+i paa s%i'ar " rsipin sr+n7a'i9 an pun4ai %anran pr+'%s'i9 s%i'ar 0 'rhaap in9%si par+'i'is a/aiah. Pr+'%si 'apa% ?ra%hir /aa. Paa sa'u &a?ah par+'i'is@ ??rapa ana% 4an7 '/ah iiunisasi n7an ,a%sin par+'i'is s?/un4a n7a/ai sa%i' 4an7 i'anai n7an a@ a/ais@ a/@ an rua p+pu/ar rah 4an7 /i?a'%an ?aan an 'un7%ai ''api n4/aa'%an '/apa% 'an7an an %a%i. 6ua ?ra%hir s%i'ar 2( a. 5ia% aa ,irus 4an7 iis+/asi ari ana% ini@ ''api %nai%an 'i'r an'i?+4 par+'i'is i'unu%%an.
1"
(.**.
Kom#"ikai K'r/i?a'an sis' sara9 pusa' a/a ?n'u% nin7i'is
asp'i% aa/ah 4an7 pa/in7 srin7@ 'rai 'anpa 7a/a paa ! sapai "! pasin. a/a nin7i'is 'rai sapai 1 pasin an ?ru?ah 'anpa s*u/a 3 sapai 1! hari. Oran7 &asa i/i%i risi%+ /?ih 'in77i un'u% %+p/i%asi ini i?anin7%an ana%-ana%@ an /a%i-/a%i /?ih srin7 i?anin7%an ana% prpuan <n7an rasi+ 3:1>. Par+'i'is un7%in 'ia% aa i s?an4a% ! pasin i%ian. Pn4a%i' +'a% aa/ah aran7 <%uran7 ari 2 pr 1!!@!!! %asus ups>. <i/rs@ ' a//@ 2!11. a/a Pin%?++%@ 2!12> *. Meningioene3a"iti
K+p/i%asi ini rupa%an %+p/i%asi 4an7 srin7 paa asa ana%. Insin 4an7 s?narn4a su%ar ipr%ira%an %arna in9%si su?%/inis s4s' sara9 sn'ra/@ spr'i i?u%'i%an +/h p/+si'asis $airan sr?r+spina/@ '/ah i/ap+r%an /?ih ari " pnri'a n7an par+'i'is. Mani9s'asi %/inis 'rai paa /?ih ari 1! pnri'a. Insin nin7+ns9a/i'is par+'i'is s%i'ar 2!1!!.!!! %asusC 1! ari %asus ini 'rai paa pnri'a /?ih 'ua ari 2! 'ahun. An7%a +r'a/i'as aaah s%i'ar 2. Oran7 /a%i-/a%i 'r%na 'i7a sapai /ia %a/i /?ih srin7 aripaa &ani'a. Par+'i'is rupa%an sa/ah sa'u ari pn4?a? nin7i'is asp'i% 4an7 pa/in7 srin7. Pa'+7nsis nin7+ns9a/i'is par+'i'is '/ah iurai%an s?a?a7ai <1> in9%si prir nur+n an <2> ns9a/i'is pas$ain9%si n7an i/inasi. Paa 'ip pr'aa par+'i'is srin7 un$u/ ?rsaaan a'au n4r'ai ns9a/i'is. Paa 'ip % ua@ ns9a/i'is n4r'ai par+'i'is paa s%i'ar 1! hari. Par+'i'is un7%in paa ??rapa %asus 'ia% aa. S'n+sis a*uu%'us an hir+s9a/us '/ah ihu?un7%an n7an in9%si par+'i'is. Mn7in%si%an ,irus par+'i'is % a/a 'pai paa uur n4usui '/ah n7hasi/%an /si 4an7 srupa. Mnin7+ns9a/i'is par+'i'is s$ara %/inis 'ia% apa' i?a%an ari nin7i'is s?a? /ain. Aa %%a%uan /hr san7@ ''api
10
pri%saan n+r+/+7is /ain ?iasan4a n+ra/. #airan sr?r+spina/ <#SS> ?iasan4a ?risi s/ %uran7 ari !! s/3@ &a/aupun %aan7%aan7 u/ah s/ apa' /?ihi 2.!!!. s/n4a hapr s/a/u /i9+si'@ ?r?a n7an nin7i'is asp'i% n'r+,irus@ iana /u%+si' p+/i+r9+n%/ar srin7 n+inasi paa a&a/ pn4a%i'. ;irus par+'i'is apa' iis+/asi ari $airan sr?r+spina/ paa a&a/ pn4a%i'. (. Orkiti; E#ididimiti
Or$hi'is aa/ah %+p/i%asi pa/in7 uu paa /a%i-/a%i s'/ah asa pu?r'as. Pn4a%i' ini 'rai s?an4a% ! paa /a%i-/a%i s'/ah asa pu?r'as@ ?iasan4a s'/ah par+'i'is@ 'api pn4a%i' ini un7%in nahu/uin4a@ 'rai s$ara srpa%@ a'au 'rai snirian. <i/rs@ 2!11>. K+p/i%asi ini aran7 'rai paa ana% /a%i-/a%i prapu?r'as ''api srin7 <1(-3> paa raa an +ran7 &asa. 5s'is pa/in7 srin7 'rin9%si n7an a'au 'anpa piiii'isC piiii'is apa' u7a 'rai snirian. Jaran7 aa hir+%/. Or%i'is ?iasan4a n4r'ai par+'i'is a/a 8 hari a'au s%i'arn4aC +r%i'is apa' u7a 'rai 'anpa ?u%'i aan4a in9%si %/nar /uah. Paa s%i'ar 3! pnri'a %a 's'is 'r%na. Mu/ain4a ?iasan4a naa%@ n7an %nai%an suhu@ n77i7i/@ n4ri %pa/a@ ua/@ an n4ri pru' ?a&ahC ?i/a 's'is %anan 'r/i?a'@
appnisi'is
apa'
i%san%an
s?a7ai
%un7%inan
ia7n+s'i%. 5s'is 4an7 'r%na nai n4ri an ?n7%a%@ an %u/i' 4an7 ?r%a'an a an rah. 6a'a-ra'a /aan4a aa/ah hari. S%i'ar 3!-(! 's'is 4an7 'r%na a'r+9i. an77uan 9r'i/i'as ipr%ira%an s%i'ar 13@ ''api in9r'i/i'as a?s+/u' un7%in aran7. .
18
0. Oo3oriti N4ri p/,is an %sa%i'an i'u%an paa s%i'ar 0 paa
pnri'a &ani'a pas$a pu?r'as. 5ia% aa ?u%'i aan4a 7an77uan 9r'i/i'as. 4. Ne3riti ;iruria '/ah srin7 i/ap+r%an. Paa sa'u pn/i'ian +ran7 &asa@ %/ainan 9un7si 7ina/ 'rai %aan7-%aan7 paa s'iap pnri'a@ an ,irria 'r'%si paa 0. r%unsi %'r/i?a'an 7ina/ paa ana% ?/u i%'ahui. N9ri'is 4an7 a'i%an@ 'rai 1!-1( hari ssuah par+'i'is@ '/ah i/ap+r%an. 5. Prankreatiti
Pan%ra'i'is aa/ah aran7@ 'api aa%a/an4a 'rai 'anpa par+'i'isC h4pr7/4$ia aa/ah 'p+rr an ?rsi9a' r,rsi?/. <i/rs@ 2!11> +. Miokarditi
Mani9s'asi an'un7 4an7 srius san7a' aran7@ ''api in9%si rin7an i+%ariu un7%in /?ih srin7 aripaa 4an7 i%'ahui. 6%aan
/%'r+%ari7ra9i
nunu%%an
pru?ahan-pru?ahan@
%?an4a%an prsi s7n S5@ paa 13 +ran7 &asa paa sa'u sri. K'r/i?a'an i%ian apa' n/as%an n4ri pr%+riu@ ?rai%aria@ an %//ahan %aan7-%aan7 i'u%an paa raa an +ran7 &asa n7an par+'i'is. 7. Matiti
K+p/i%asi ini 'ia% /a)i paa asin7-asin7 nis %/ain.
1
8. Ketu"ian
5u/i sara9 apa' 'rai uni/a'ra/@ aran7 ?i/a'ra/C &a/aupn insinn4a rnah <1:1.!!!>@ par+'i'is aa/ah pn4?a? u'aa 'u/i sara9 uni/a'ra/. Khi/an7an pnn7aran un7%in sn'ara a'au prann. 9. Kom#"ikai Oku"er
K+p/i%asi ini /ipu'i dakrioadenitis, p?n7%a%an 4an7 n4ri@ ?iasan4a ?i/a'ra/@ ari %/nar /a%ria/isC neuritis optic papillitis!n7an 7a/a-7aa ?r,ariasi ari %hi/an7an pn7/iha'an sapai %%a?uran rin7an n7an pn4?uuhan a/a 1!-2! hariC uveokeratitis, ?iasan4a uni/a'ra/ n7an 9+'+9+?ia@ %/uar air a'a@ %hi/an7an pn7/iha'an $pa' an pn4?uhan a/a 2! hariC skleritis, tendonitis, n7an a%i?a' %s+9'a/usC an trobosis vena sentral" *). Artriti
A'ra/7ia 4an7 isr'ai n7an p?n7%a%an an %rahan sni rupa%an %+p/i%asi 4an7 aran7C ?iasan4a pn4?uhann4a spurna. **. Em&rio#ati Parotiti
5ia% aa ?u%'i 4an7 %ua' ?ah&a in9%si i?u n$rai aninC %un7%inan hu?un7an n+%aria/ 9i?r+/as'+sis ?/u i'7a%%an. Par+'i'is (.*(.
paa
a&a/
%hai/an
na?ah
p/uan7
a?+r'us.
Prognoa Pr+7n+sis %s/uruhan ups n7an 'anpa %+p/i%asi aa/ah san7a' ?ai%. Pr+7n+sis pasin n7an ns9a/i'is uun4a ?ai%@ naun@ %rusa%an nur+/+7is an %a'ian apa' 'rai. Di/ap+r%an an7%a %aian ns9a/i'is ups s?sar %asus pr 1!!! %asus ups 4an7 i/ap+r%an. S*u/a prann aran7 'rai@ san7%an /ap+ran %asus ns9a/i'is an7%a %a'ian ra'a-ra'a 1@(. M4/i'is sn'ara a'au p+/4nuri'is aran7. S%i'ar 1! ari sua pasin 4an7 'rin9%si ?r%?an7 a/a ?n'u% nin7i'is rin7an@ 4an7 su/i' i?a%an n7an nin7i'is ?a%'ri. 2!
(.*0.
Au/an Ke#era$atan De$aa dengan Gangguan Sitem Penernaan: Parotiti a. Pn7%aian 1. In'i'as pasin Da'a +7ra9i@ Par+'i'is apa' 'ri paa sua usia@ ''api
$nrun7 n4ran7 ana%-ana% 4an7 ?ruur -1 'ahun@ san7a' aran7 i'u%an paa ana% 4an7 ?rusia %uran7 ari 2 'ahun %arna uun4a r%a asih i/i%ii/inun7i +/h an'i?+4 4an7 ?ai%. Ana% 4an7 prnah nri'a par+'i'is a%an i/i%i %%?a/an suur hiupn4a. 2. K/uhan u'aa Biasan4a %/in a%an n7/uh a@ sa%i' %pa/a@ an n4ri rahan7 ?a7ian ?/a%an7 saa' n7un4ah. 3. 6i&a4a' pn4a%i' s%aran7 Biasan4a %/in a%an n7/uh a@ sa%i' %pa/a@ n4ri rahan7 ?a7ian ?/a%an7 saa' n7un4ah@ p?%a%an i su?ani?u/a an aa%a/an4a isr'ai %a%u rahan7 . (. 6i&a4a' pn4a%i' s?/un4a Apa%ah %/in prnah nri'a par+'i'is s?/un4a@ aa%ah pn4a%i' /ain spr'i DM@ H5@ pn4a%i' nu/ar@ //. . 6i&a4a' K/uar7a Aa%ah %/uar7a 4an7 prnah n7a/ai pn4a%i' ini s?/un4a. ". 6i&a4a' /in7%un7an: Aa%ah pasin par+'i'is i s%i'ar 'pa' 'in77a/n4a 0. Pri%saan 9isi%: a> Kaaan uu : ?iasan4a %/in 'apa% /ah ?> B1 Bra'hin7 Na9as n+r+rspira'+r4@ 66 12-2! =ni'@ iraa 'ra'ur@ 'ia% aa ssa% na9as@ 'ia% aa prna9asan $upin7 hiun7@ 'ia% aa r'ra%si inin7 aa@ suara na9as n+ra/. $> B2 B/++ Biasan4a %/in a%an n7a/ai 'a%i%ari %arna 9% ari n4ri 4an7 irasa%an@ Pr%usi: ?un4i 4an7 ihasi/%an rup@ aus%u/'asi: i'u%an ?un4i an'un7 S1 an S2 'un77a/. > B3 Brain Ksaaran #+p+s Mn'is@ #S (@@" > B( B/ar 5ia% aa 7an77uan@ naun paa %+p/i%asi +r%i'is
4an7 'r%na un7%in a%an n$iu'. Jaran7 'rai %rusa%an 's'is 4an7 prann shin77a n4?a?%an %anu/an <;+/pa'+n@ 2!!(>. 9> B B+&/ N4ri '/an@ na9su a%an nurun@ Mu/u' 'apa% %rin7@ ?isin7 usus a/a ?a'as n+ra/ <-12 =ni'>. 5ia% 'ra?a s%i?a/a 7> B" B+n 5ia% n7a/ai %'r?a'asan 7ra%@ 6OM a%'i9 h> In'7un' 5rapa' 'ana-'ana in9/aasi i ara su?ani?u/a ?rupa %rahan paa %u/i'@ pra?aan panas@ p?saran ara s%i'ar an n4ri '%an. ?. Dia7n+sa Kpra&a'an 1. N4ri a%u' ?rhu?un7an
n7an
?i+/+7i$a/
inur4
a7n'
. 2. Hipr'ri ?rhu?un7an n7an pnin7%a'an /au 'a?+/is: pr+ss in9/aasi. 3. K'ia%si?an7an
nu'risi
%uran7
ari
%?u'uhan
'u?uh
?rhu?un7an n7an ?i+/+7i$a/ inur4 a7n' @ an+r%sia $. In'r,nsi N+. 1.
Dia7n+sa Kpra&a'an
5uuan an Kri'ria Hasi/
N4ri a%u' S'/ah i/a%u%an ?rhu?un7an n7an 'ina%an %pra&a'an ?i+/+7i$a/ inur4 a7n' s/aa 3 = 2( a . - Pain' $+n'r+/ - Kpuasan pasin: ana7n n4ri
In'r,nsi Mana7n N4ri <1(!!>: 1. O?sr,asi n4ri %/in s$ara %+prhnsi9 'rasu% s%a/a@ /+%asi@ %ara%'ris'i%@ urasi@ 9r%unsi@ %ua/i'as an 9a%'+r prsipi'asi. 2. M+ni'+r 'ana-'ana ,i'a/ %/in. 3. 5in7%a'%an is'iraha' pasin. (. K+/a?+rasi%an n7an +%'r a/a p?rian ana/7'i%.
Kri'ria hasi/: 1. Mapu n7+n'r+/ n4ri <'ahu pn4?a? n4ri@ apu n77una%an '%ni% n+n-9ara%+/+7i un'u% n7uran7i n4ri>. 2. M/ap+r%an ?ah&an4ri ?r%uran7
22
n7an n77una%an anan n4ri. 3. Mapu n7na/i n4ri . (. Mn4a'a%an rasa n4aan s'/ah n4ri ?r%uran7. 2.
Hipr'ri S'/ah i/a%u%an ?rhu?un7an n7an 'ina%an %pra&a'an pnin7%a'an /au s/aa 1 = 2( a 'a?+/is: pr+ss NO#: in9/aasi. - Pnurunan suhu 'u?uh
1. Pn7'ahuan pasin an %/uar7a 'n'an7 $ara nurun%an suhu 'u?uh. 2. Anur%an %/uar7a un'u% ?a'asi a%'i9i'as pasin. 3. A'ur /in7%un7an 4an7 %+nusi9. Kri'ria hasi/: (. Bri %+prs n7an air 1. %/in apu in7in paa arah n/as%an %?a/i a%si/a@ /ipa' paha an 'p+ra/ pnii%an %sha'an ?i/a 'rai panas. 4an7 i?ri%an. . Anur%an %/uar7a un'u% 2. Mapu 'r+'i,asi a%ai%an pa%aian 4an7 apa' un'u% /a%sana%an n4rap %rin7a' spr'i %a'un. pn/asan 4an7 '/ah ". anur%an %/uar7a un'u% i?ri%an. /a%u%an assa7 paa %'ri'as n77una%an in4a% %a4u pu'ih. 0. K+/a?+rasi n7an +%'r a/a p?rian an'ipir'i%.
3.
K'ia%si?an7an S'/ah i/a%u%an nu'risi %uran7 ari 'ina%an %pra&a'an %?u'uhan 'u?uh s/aa 3 = 2( a ?rhu?un7an n7an NO#: %'ia%apuan S'a'us nu'risi: in'a% n/an a%anan@ a%anan an inuan biological in#ury agent inflamation Kri'ria hasi/: salivary gland!" in'a% a%anan an inuan pr+ra/ a*ua'
5rapi nu'risi <112!>: 1. M+ni'+r in'a% a%ananinuan pasin an hi'un7 in'a% %a/+ri pr hari 4an7 ssuai n7an pasin. 2. 5n'uan a%anan 4an7 ssuai n7an ?ua4a an a7aa pasin 3. 5n'u%an a%anan sis+9' 4an7 uah i'/an ?a7i pasin. (. Pi/ih%an sup/n nu'risi 4an7 $+$+%. . D+r+n7 in'a% a%anan 4an7 'in77i %a/siu an %a/iu <4an7 $+$+% ?a7i pasin>. ". Pas'i%an ii' 4an7 i?ri%an 'in77i sra' un'u% $7ah %+ns'ipasi. 23
0. Sai%an a%anan 4an7 nari% /ipu'i '%s'ur@ &arna an a$an4a. 8. La%u%an +ra/ h47in s?/u a%an an ssuai %?u'uhan . M+ni'+r hasi/ /a?+ra' . E,a/uasi E,a/uasi 4an7 iharap%an s'/ah napa'%an in'r,nsii aa/ah : 1. Pr?ai%an ?ran u%+sa +ra/. 2. Pnuhan nu'risi +p'ia/ ssuai 'in7%a' '+/ransi ini,iu. 3. 5rai pnurunan rsp+n n4ri. (. Suhu 'u?uh %?a/i n+ra/.
2(
,A, III TIN2AUAN KASUS
5n A ira&a' i ruan7 is+/asi 6SUA n7an %/uhan suah sin77u s?/u M6S@ ?aan a@ n4ri is%i'ar /hr an '/in7a %anan@ n4ri saa' n/an@ %pa/a pusin7 an 'ia% na9su a%an. 5apa% paa pipi s?/ah %anan ?n7%a% an %u/i' %rahan. Pasin ?ri &arna ?iru paa pipin4a 4an7 ?n7%a%. Pasin n7a'a%an 7i7in4a 'ia% sa%i'. Pasin ian'ar +/h is'rin4a@ 3 hari 4an7 /a/u pasin suah ?r+?a' %pus%sas naun %/uhan pasin 'ia% ?r%uran7. Hasi/ pri%saan ,i'a/ si7n: 5D : 13! ! H7@ suhu : 3 !#@ H6 : 1!! = ni'. 66 : 22 %a/i ni'. BB s?/u sa%i': 8 %7@ BB sa%i' : 3 an 5B : 1" $ s%a/a n4ri 0.* Pengka1ian PROGRAM STUDI PENDIDIKAN NERS !AKU-TAS KEPERAWATAN UNI6ERSITAS AIR-ANGGA
-EM,AR PENGKA2IAN KEPERAWATAN
5an77a/ M6S 5an77a/ Pn7%aian 123(" Ja Pn7%aian Par+'i'is A%u'
: 2 Mar' 2!1" : 1 Apri/ 2!1"
Ja Masu% N+. 6M
: 1".!! IB :
: !8.!! IB
Dia7n+sa Masu%
:
IDENTITAS
1. Naa Pasin 2. Uur 3. Su%u Ban7sa Sura?a4a (. A7aa . Pnii%an ". P%raan 0. A/aa'
: 5n. A : 3 'ahun : Ja&aIn+nsia
Pnan77un7 a&a? Bia4a : Naa : N4. S A/aa' :Mu/4+r+
: Is/a : SMA : Ku/i ?an7unan : Mu/4+r+ Sura?a4a
RIWAYAT PENYAKIT SEKARANG
1. K/uhan U'aa : N4ri is%i'ar /hr an '/in7a %iri@ n4ri saa' n/an@ %pa/a pusin7@ an 'ia% na9su a%an 2. 6i&a4a' Pn4a%i' S%aran7 : K/in n7/uh suah sin77u s?/u M6S@ ?aan a@ n4ri is%i'ar /hr an '/in7a %anan@ n4ri saa' n/an@ %pa/a pusin7 an 'ia% na9su a%an. 5apa% paa pipi s?/ah %anan ?n7%a% an %u/i' %rahan. P asin ?ri &arna ?iru paa pipin4a 4an7 ?n7%a%. Pasin n7a'a%an 7i7in4a 'ia% sa%i'. Pasin
2
ian'ar +/h is'rin4a@ 3 hari 4an7 /a/u pasin suah ?r+?a' %pus%sas naun %/uhan pasin 'ia% ?r%uran7. RIWAYAT PENYAKIT DAHULU
1. Prnah ira&a' : 4a 'ia% 2. 6i&a4a' pn4a%i' %r+ni% an nu/ar 4a 6i&a4a' %+n'r+/ : 6i&a4a' pn77unaan +?a' : Para$'a+/ 3. 6i&a4a' a/r7i 4a (. 6i&a4a' +prasi 4a
%apan ia7n+sa :QQQQ 'ia% nisQQQQQQQQ
'ia% 'ia%
nisQQQQQQQQ %apanQQQQQQQQ
RIWA nri'a par+'i'is 1 hari 4an7 /a/u O,SER6ASI DAN PEMERIKSAAN !ISIK *. Tanda tanda %ita" S : 3!# N : 1!!=ni' 5 :13!!H7 Ksaaran #+p+s Mn'is Apa'is K+a (. Sitem Perna3aan a. K/uhan : Ba'u% S%r' :QQ.. arna :.......... ?. Iraa na9as $. Jnis . Suara na9as
. A/a' ?an'u napas
Masa/ah Kpra&a'an : Hi#ertermi 66 : 2!=ni' S+n+/n
S+p+r
ssa% pr+u%'i9
n4ri &a%'u na9as 'ia% pr+u%'i9 K+nsis'nsi :...................... Bau :.................................. 'ra'ur 'ia% 'ra'ur Dispn+ Kusau/ #h4n S'+%s ;si%u/r Br+n%+ ,si%u/r Masa/ah Kpra&a'an : 6+n%i h)in7 4a 'ia% Jnis................... /+&............../p
Lain-/ain : 0. Sitem Kardio %aku"er a. K/uhan n4ri aa ?. Iraa an'un7 S1S2 'un77a/ $. Suara an'un7
. #65 : 2 'i% . A%ra/ han7a' ?asah 9. J;P n+ra/ Lain-/ain : 0. Sitem Per'ara3an a. #S : (" ?. 69/%s 9isi+/+7is $. 69/%s pa'+/+7is . K/uhan pusin7 . Pupi/ 9. S$/raK+nun$'i,a
4a r7u/r 4a n+ra/ 7a//+p
'ia% ir7u/r 'ia% urur /ain-/ain.....
panas
in7in
nin7%a'
nurun
pa'//a ?a?ins%4 4a Is+%+r anis
'ri$ps ?u)ins%4 'ia% Anis+%+r i%'rus
Masa/ah Kpra&a'an : -
?i$ps %rni7
%rin7
Masa/ah Kpra&a'an : N'eri akut
Dia'rQQ..
2"
7. an77uan panan7an 4a h. an77uan pnn7aran 4a i. an77uan pn$iuan 4a . Isi'raha'5iur : 0. JaHari 4. Sitem #erkemi/an a. K?rsihan Brsih ?. K/uhan Kn$in7 N+%'uri r+ss ha'uri Disuria 6'nsi Anuria $. Pr+u%si urin : 2!!! /hari . Kanun7 %ih : M?sar N4ri '%an . In'a% $airan +ra/ : 2!!! $$hari 9. A/a' ?an'u %a''r 4a Jnis :............. Lain-/ain :
'ia% J/as%anQQ.. 'ia% J/as%anQQ.. 'ia% J/as%anQQ.. an77uan 'iur : 'ia% K+'+r In%+n'innsia P+/iuria O/i7uria Hsis'nsi
Masa/ah Kpra&a'an :-
arna : %unin7 rnih Bau : %has 4a 'ia% 4a 'ia% parn'ra/ : 1!!! $$hari 'ia% Sa% 'an77a/ : .........
5. Sitem #enernaan Masa/ah a. Mu/u' ?rsih %+'+r ?r?au ?. Mu%+sa /?a? %rin7 s'+a'i'is Kpra&a'an : $. 5n77+r+%an sa%i' n/an %su/i'an n/an Ketidakeim&angan n4ri '%an p?saran '+nsi/ nutrii kuran dari . A?+n'7an7 %?un7 as$i's N4ri '%an 4a 'ia% Lu%a +prasi aa 'ia% 5an77a/ +prasi : ............. Jnis +prasi :.............. L+%asi : ................ Kaaan : Drain aa 'ia% Ju/ah :........... arna :................... K+nisi ara s%i'ar insrsi :............... . Pris'a/'i% :"-1!=ni' 9. BAB : 1 =hari 5ra%hir 'an77a/ : 1 Apri/ 2!1" K+nsis'nsi %ras /una% $air /nirarah 7. Di' paa' /una% $air h. Na9su a%an ?ai% nurun r%unsi: 2=hari ,i. P+rsi a%an ha?is 'ia% ha?is K'ran7an : p+rsi Lain-/ain: +. Sitem muku"o ke"eta" dan integumen a. Pr7ra%an sni5 ??as 5 ?. K%ua'an +'+' 5
'r?a'as
5
$. K/ainan %s'ri'as 4a . K/ainan 'u/an7 ?/a%an7 4a . ra%'ur 4a 9. 5ra%si spa/% 7ips 4a 7. K+par'n s4nr+ 4a h. Ku/i' i%'ri% sian+sis i. 5ur7+r ?ai% %uran7 . Lu%a 'ia% aa /uas : .........
'ia% 'ia% 'ia% 'ia% 'ia% %rahan /% ?rsih
Masa/ah Kpra&a'an : -
hiprpi7n'asi %+'+r
20
Lain-/ain: 7. Sitem Endokrin Masa/ah Kpra&a'an : P?saran %/na' '4r+i 4a 'ia% N'eri Akut P?saran K/nar 7'ah ?nin7 4a 'ia% Hip+7/i%ia 4a 'ia% Hipr7/i%ia 4a 'ia% Lu%a 7an7rn 4a 'ia% Lain-/ain: p?saran %/nar par+'is@ %rahan paa ara su?ani?u/a@ pra?aan panas@ an n4ri '%an PENGKA2IAN PSIKOSOSIAa. Prspsi %/in 'rhaap pn4a%i'n4a #+?aan 5uhan hu%uan ?. E%sprsi %/in 'rhaap pn4a%i'n4a Murun7ia 7/isah $. 6a%si saa' in'ra%si %++pra'i9 . an77uan %+nsp iri 4a Lain-/ain: -
Masa/ah %pra&a'an : /ainn4a
'7an7 arahnan7is 'ia% %++pra'i9 $uri7a 'ia%
PERSONA- H
%aan7- %aan7 %aan7- %aan7
'ia% prnah 'ia% prnah
Masa/ah Kpra&a'an :-
Masa/ah Kpra&a'an : -
PEMERIKSAAN PENUN2ANG >-a&oratorium;Radio"ogi; EKG; USG ? -a& : H? 127/ B# 12.!!! P#; (! 5r+?+si' 2!!.!!! I7M An'i ?+4 Mups p+si'i9 EKG : N+ra/ Sinus 6i' BB s?/u sa%i' : 8 %7 @ BB sa%i' : 3 %7 TERAPI In9us 6L 1!!!$2(a In%si An'rain 3=1apu/ In%si #9'ria=+n 2=1 7r PO : Para$'a+/ 3=1 'a?' B$+ # 1=1 'a?/' DATA TAM,AHAN -AIN : @ TINDAKAN OPERASI : -
28
Sura?a4a@ 1 Apri/ 2!1"
< Nurs R >
2
Ana"ia Data
NO.
DA5A
E5IOLOI
MASALAH
1
DS: Bi+/+7i$a/ inur4 a7n' N4ri a%u' Pasin n7/uh n4ri is%i'ar n/an@ %pa/a pusin7. DO: - 5apa% in9/aasi an %rahan paa pipi ?a7ian %anan ?a&ah. - N4ri '%an paa arah in9/aasi n7an s%a/a n4ri . - Ku/i' 'ra?a han7a'
2
DS: Pasin n7/uh 'ia% na9su a%an@ n4ri saa' n/an DO: - 5apa% in9/aasi an %rahan paa pipi ?a7ian %anan ?a&ah. - BB s?/u sa%i' : 8 %7@ BB sa%i' : 3%7 an 5B : 1" $ - BMI sa%i' : 1@( - Ma%an 2=hari - Pnurunan asupan a%anan <1( p+rsi>.
K'ia%apuan K'ia%si?an7an nu'risi n/an a%anan@ %uran7 ari %?u'uhan biological in#ury agent 'u?uh inflamation salivary gland!"
3.
DS: Pasin n7/uh a suah sin77u 4an7 /a/u. DO : - Suhu : 3! # - 5D 13!! H7 - Nai 1!!=ni' - Baan 'ra?a han7a'. - B#: 12.!!!
pnin7%a'an /au 'a?+/is: pr+ss in9/aasi.
Hipr'ri
0.(. Diagnoa Ke#era$atan Brasarr%an ana/isa a'a ia'as@ un$u/ ia7n+sa %pra&a'an ?rasar%an
uru'an pri+ri'as %pra&a'an 4ai'u:
3!
a.N4ri a%u' ?rhu?un7an n7an ?i+/+7i$a/ inur4 a7n' ?. Hipr'ri ?rhu?un7an n7an pnin7%a'an /au 'a?+/is: pr+ss in9/aasi. $.K'ia%si?an7an nu'risi %uran7 ari %?u'uhan 'u?uh ?rhu?un7an n7an K'ia%apuan n/an a%anan@ biological in#ury agent inflamation salivary gland!"
31
0.0. Inter%eni Ke#era$atan
N+.
Dia7n+sa Kpra&a'an
5uuan an Kri'ria Hasi/
In'r,nsi
1. N4ri a%u' ?rhu?un7an n7an ?i+/+7i$a/ inur4 a7n' @ i'anai n7an: DS: Pasin n7/uh n4ri is%i'ar /hr an '/in7a %anan@ n4ri saa' n/an@ %pa/a pusin7. DO: - 5apa% in9/aasi an %rahan paa pipi ?a7ian %anan ?a&ah. - N4ri '%an paa arah in9/aasi n7an s%+r n4ri (-. - Ku/i' 'ra?a han7a'
S'/ah i/a%u%an Mana7n N4ri 'ina%an %pra&a'an <1(!!>: s/aa 3 = 2( a 1. O?sr,asi n4ri %/in NO#: s$ara %+prhnsi9 - Pain' $+n'r+/ 'rasu% s%a/a@ - Kpuasan pasin: /+%asi@ %ara%'ris'i%@ ana7n n4ri urasi@ 9r%unsi@ %ua/i'as an 9a%'+r Kri'ria hasi/: prsipi'asi. 1. Mapu 2. M+ni'+r 'ana-'ana n7+n'r+/ n4ri ,i'a/ %/in <'ahu pn4?a? 3. 5in7%a'%an is'iraha' n4ri@ apu pasin. n77una%an (. K+/a?+rasi%an n7an '%ni% n+n+%'r a/a 9ara%+/+7i un'u% p?rian ana/7'i%. n7uran7i n4ri>. 2. M/ap+r%an ?ah&an4ri ?r%uran7 n7an n77una%an anan n4ri. 3. Mapu n7na/i n4ri . (. Mn4a'a%an rasa n4aan s'/ah n4ri ?r%uran7.
2. Hipr'ri ?rhu?un7an n7an pnin7%a'an /au 'a?+/is: pr+ss in9/aasi@ 4an7 i'anai n7an : DS: Pasin n7/uh a suah sin77u 4an7 /a/u. DO : - Suhu : 3! # - 5D 13!! H7
S'/ah i/a%u%an 1. 'ina%an %pra&a'an s/aa 1 = 2( a NO#: Pnurunan suhu 'u?uh 2. Kri'ria hasi/: 1. %/in apu n/as%an %?a/i pnii%an
Pn7'ahuan pasin an %/uar7a 'n'an7 $ara nurun%an suhu 'u?uh. Anur%an %/uar7a un'u% ?a'asi a%'i9i'as pasin. 3. A'ur /in7%un7an 4an7 %+nusi9. (. Bri %+prs n7an air in7in
32
-
Nai 1!!=ni' Baan 'ra?a han7a'. B#: 12.!!!
%sha'an 4an7 paa arah a%si/a@ i?ri%an. /ipa' paha an 2. Mapu 'p+ra/ ?i/a 'rai 'r+'i,asi un'u% panas. /a%sana%an . Anur%an %/uar7a pn/asan 4an7 un'u% a%ai%an '/ah i?ri%an. pa%aian 4an7 apa' n4rap %rin7a' spr'i %a'un. ". anur%an %/uar7a un'u% /a%u%an assa7 paa %'ri'as n77una%an in4a% %a4u pu'ih. 0. K+/a?+rasi n7an +%'r a/a p?rian an'ipir'i%.
3. K'ia%si?an7an nu'risi S'/ah i/a%u%an 5rapi nu'risi <112!>: %uran7 ari %?u'uhan 'u?uh 'ina%an %pra&a'an 1. M+ni'+r in'a% n7an 9a%'+r rsi%+ s/aa 3 = 2( a a%ananinuan %'ia%apuan n/an NO#: pasin an hi'un7 a%anan@ biological in#ury S'a'us nu'risi: in'a% in'a% %a/+ri pr hari agent inflamation salivary a%anan an 4an7 ssuai n7an gland!, i'anai n7an: inuan pasin. 2. 5n'uan a%anan DS: Kri'ria hasi/: 4an7 ssuai n7an Pasin n7/uh 'ia% na9su in'a% a%anan an ?ua4a an a7aa a%an@ n4ri saa' n/an. inuan pr+ra/ pasin a*ua' 3. 5n'u%an a%anan DO: sis+9' 4an7 uah - 5apa% in9/aasi an i'/an ?a7i pasin %rahan paa pipi (. pi/ih%an sup/n ?a7ian %anan ?a&ah. nu'risi 4an7 $+$+% - TBB : "8 %7@ 5B : 1" . +r+n7 in'a% $ a%anan 4an7 'in77i %a/siu an %a/iu <4an7 $+$+% ?a7i pasin> ". Pas'i%an ii' 4an7 i?ri%an 'in77i sra' un'u% $7ah %+ns'ipasi 0. sai%an a%anan 4an7 nari% /ipu'i '%s'ur@ &arna an
33
a$an4a. 8. La%u%an +ra/ h47in s?/u a%an an ssuai %?u'uhan 9. M+ni'+r hasi/ /a?+ra'
3(
,A, I6 PENUTUP 4.*. Keim#u"an Pn4a%i' par+'i'is a'au 4an7 ?iasa is?u' 7+n+n7an <ups>
rupa%an sua'u pn4a%i' nu/ar iana ss+ran7 'rin9%si +/h ,irus 4an7 n4ran7 %/nar /uah <%/nar par+'is> i an'ara '/in7a an rahan7 shin77a n4?a?%an p?n7%a%an paa /hr ?a7ian a'as
a'au
pipi
?a7ian
?a&ah.
a/a
4an7
i'i?u/%an
?rupa
p?n7%a%an@ rasa sa%i'@ %rahan@ an %/?u'an paa sa/uran %/nar /uah@ naun u7a 'rai %/ainan ?rupa p/?aran an pn4u?a'an sa/uran. an77uan par+'i'is $nrun7 n4ran7 ana%-ana% i?a&ah usia 1 'ahun . Dahu/u %aaan ini srin7 'r/iha' paa pasin 4an7 napa' pra&a'an ari +prasi a?+n@ ''api s%aran7 %hasus ini '/ah aran7 'r/iha'@ han4a %aan7-%aan7 'r/iha' paa par+'i'is %r+nis r%urn@ ''api 'ia% ssrin7 4an7 ipr%ira%an. 4.(. Saran
Ban4a% %+p/i%asi 4an7 i'i?u/%an +/h praan7an %/nar sa/i,a ini shin77a harus sini un7%in pnan7anan ia&a/i n7an ?r?a7ai 's /a?+ra'+riu@ isusu/ paa p?rian an'i?i+'i%@ pna?ahan ,+/u $airan a/a 'u?uh@ hin77a a%hirn4a iaa%an +prasi.
DA!TAR PUSTAKA
Anar'+@ O?i. <2!1>. Pn4a%i' Mnu/ar i S%i'ar Ana. Ja%ar'a:Pus'a%a I/u Ss'a
3
An77raniu'aa. <2!12>. +n+n7an . Dnpasar: PPDS IKA K UNUD Dia%ss '7/ 3 ar' 2!1" a 22:10. 5rsia i /in%: h''p:ppsi%a9%unu.$+7+n+n7an-ups-a'au-par+'i'is. An77rani@ M/isa@ D&i Lin77a U'aa@ I M " $ondongan Mumps atau Parotitis!. Ba7SM IKA K UNUD-6SUP San7/ah Dnpasar. Dia%ss ari
h''p:ppsi%a9%unu.$+7+n+n7an-ups-a'au-par+'i'is paa
?u/an apri/ 2!1" An+ni+us. <2!1!>. Mups . Kupu/an 69ra' an Kar4a 5u/is K+%'ran. Br%r M. '.a/. <2!!(>. A$u' Par+'i'is +//+&in7 Si''in7 P+si'i+n Nur+sur7i$a/ Pr+$urs: 6,i& +9 i, #ass. J Nur+sur7 Ans'hsi+/. 1"<1>:231Januari 2!!( Bu/$h$%@ Bu'$hr D+$h'ran. <2!13>. Nursin7 In'r,n'i+n #/assi9i$a'i+n . "'h Ei'i+n. USA: E/s,ir M+s?4 #n'rs 9+r Disas #+n'r+/ an Pr,n'i+n
<#D#>.
<2!1>@
Mups.
h''p:&&&.$$.7+,ups,a$$ina'i+n.h'/. Dia%ss '7/ 1 ar' 2!1". D9ni@ rain L. <2!12>. Mumps. In: 6uss// S'/@ #hi99 Ei'+r: Ms$ap 69rn$. Dia%ss ari h''p:i$in.s$ap.$+ paa ?u/an Apri/ 2!1" Dp%s 6I. <2!!8>. Mumps parotitis Epidemika!" P+an Pn7+?a'an Dasar i Pus%sasC 2!!0. Ja%ar'a Dp%s 6I. i?s+n@ J+hn. <2!!8>. isi+/+7i an Ana'+i M+rn un'u% Pra&a' Eisi 2. Pnr?i' Bu%u K+%'ran@ E# : Ja%ar'a. Hran Kai'sura. <2!1(>. NANDA In'rna'i+na/ Nursin7 Dia7n+ss: D9ini'i+n an #/assi9i$a'i+n@ 2!1-2!10. 1!'h i'i+n. O=9+r: i/4 B/a$%&// Iss/?a$hr@ %%. Harris+n@ <1>. Prinsip-Prinsip I/u Pn4a%i' Da/a. Ja%ar'a: E#. MaharaniHai. <2!!>. Mups Uni/a'ra/ Paa Pasin 6aa. Ora/ Mi$in Dn'a/ J+urna/.
;+/. 1 N+.2 Jun-D$ 2!!C1-.Sura?a4a: a%u/'as
K+%'ran i7i Uni,rsi'as Air/an77a. Dia%ss 'an77a/ 3 Mar' 2!1" a
23:33.
5rsia
i
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