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"Karya Ilmiah Akhir ini memberikan gambaran tentang pelaksanaan Program Residensi Ners Spesialis Keperawatan Anak dalam bentuk kegiatan praktik Residensi I dan II. Karya Ilmiah Akhir ini bertujuan untuk memberikan gambaran aplikasi Model Konservasi Myra E. Levine pada asuhan keperawatan anak dengan penyakit infeksi dan pencapaian kompetensi baik sebagai pemberi asuhan, advocator, conselor, educator, colaborator, dan agen perubah selama praktik residensi. Ada lima kasus kelolaan yang menjadi pembahasan dalam karya ilmiah ini, dan dari kelima kasus terpilih ditemukan adanya masalah ketidakseimbangan nutrisi kurang dari kebutuhan. Intervensi yang diberikan berdasarkan pinsip-prinsip konservasi sudah mencakup semua masalah yang ditemukan pada klien, walaupun tidak semua masalah dapat terselesaikan Hasil evaluasi pada akhir perawatan dari trophicognosis ketidakseimbangan nutrisi kurang dari kebutuhan pada kelima kasus terpilih, menunjukkan ada yang teratasi, belum teratasi tetapi sudah menunjukkan perbaikan, dan ada juga yang belum teratasi.

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This final assignment provides an overview about the implementation residency practices of the specialist pediatric nurse program in the form practical activities residency I and II. The aim of this final assignment is provide overview application Conservation Model Myra E. Levine on nursing care of children with infectious diseases and the achievement of competencies such as a caregiver advocator, counselor, educator, collaborator, and change agents during practice. There are five cases that discussed in this final assignment, and of the five selected cases found a problem with imbalance nutrition less than demand. Interventions provided by conservation principles have covered all the problems found on the client, although not all problems can be resolved. The evaluation results of trophicognosis imbalance nutrition less than the needs of the five selected cases, indicating there are resolved, not resolved but has shown improvement, and there are also unresolved."

"Penyakit infeksi dan malnutrisi yang terjadi pada anak merupakan hubungan yang saling timbal balik. Anak dapat mengalami masalah ketidakadekuatan nutrisi sehingga diperlukan konservasi agar anak dapat beradaptasi. Karya ilmiah ini bertujuan memberikan gambaran asuhan keperawatan pada anak dengan menerapkan model konservasi Levine pada anak dengan infeksi yang mengalami ketidakadekuatan nutrisi. Asuhan keperawatan dilakukan melalui tahapan Levine yaitu pengkajian, merumuskan trophicognosis, merencanakan hipotesis, melaksanakan intervensi dan evaluasi respon organismik. Pembahasan dilakukan pada lima kasus, dengan hasil akhir menunjukkan bahwa anak mampu beradaptasi melalui konservasi terhadap perubahan yang terjadi namun evaluasi respon organismik berbeda tergantung pada kemampuan dan keparahan penyakit. Seorang perawat hendaknya memiliki kemampuan berpikir kritis dalam melaksanakan asuhan keperawatan.

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Infectious diseases and malnutrition in children have a reciprocal relationship. Children may experience inadequate nutritional problems. Therefore, conservation in children is important in adaptation. The aim of this paper was to provide an overview of nursing care in children which applied Levine's model of conservation on children with infections who experienced inadequate nutrition. Focus of the discussion was on the use of Levine's theory in meeting the chjldren's nutritional needs. Nursing care was done through the stages of assessment, trophicognosis formulation, hypotheses plan, implementation and evaluation of the organismic responses. The final result showed that the children were able to adapt through the conservation, however the evaluation of organismic responses different among them, depend on the ability and the severity of the disease. Nurses' critical thinking skills are important in implementing nursing care."

"ABSTRAK Dehidrasi dapat menyebabkan terjadinya hipovolemia, kegagalan organ, danbahkan berakhir dengan kematian. Asuhan keperawatan yang berkualitas sangatdiperlukan dalam mengatasi masalah gangguan cairan pada anak. Karya ilmiahakhir ini bertujuan untuk memberikan gambaran aplikasi Model KonservasiMyra E. Levine dalam memberikan asuhan keperawatan pada anak dengan kankeryang mengalami ketidakseimbangan cairan. Intervensi berdasarkan modelkonservasi Levine yaitu mengkaji tanda-tanda dehidrasi, memantau adanyamuntah, diare dan demam, mengukur tanda-tanda vital, mengukur intake outputcairan dan melakukan analisis terhadap balance cairan. Evaluasi setelahdilakukan intervensi keperawatan pada kasus 1, 2, dan 3 masalah risikokekurangan volume cairan tubuh tidak terjadi, sedangkan pada kasus 4 sampaidengan 5, masalah ketidakseimbangan cairan teratasi. Rekomendasi karya ilmiahini adalah dalam memberikan asuhan keperawatan pada anak dengan kasushemato-onkologi yang mengalami ketidakseimbangan cairan kepada pasien dapatmenerapkan teori keperawatan model konservasi Myra E. Levine.ABSTRACT Dehydration can lead to hypovolemia, organ failure, and even death. Qualitynursing care is of high importance in addressing the problem of fluid imbalancein children. This paper aimed to describe the application of Levine?sConservation Model in providing nursing care to children with cancer whoexperience fluid imbalance. Based on this model, the interventions includereviewing signs of dehydration, monitoring vomiting, diarrhea, and fever,measuring vital signs, measuring the fluid intake and output and analyzing thefluid balance. After the nursing intervention, the problem of risk of body fluidvolume deficiency did not occur in cases number 1, 2, and 3; while in the casesnumber 4 and 5 in which fluid imbalance already happened, this imbalanceproblem was resolved. It can be concluded that Levine?s model is an effectiveapproach to manage the fluid imbalance problem in children with hematooncologycases.;Dehydration can lead to hypovolemia, organ failure, and even death. Qualitynursing care is of high importance in addressing the problem of fluid imbalancein children. This paper aimed to describe the application of Levine?sConservation Model in providing nursing care to children with cancer whoexperience fluid imbalance. Based on this model, the interventions includereviewing signs of dehydration, monitoring vomiting, diarrhea, and fever,measuring vital signs, measuring the fluid intake and output and analyzing thefluid balance. After the nursing intervention, the problem of risk of body fluidvolume deficiency did not occur in cases number 1, 2, and 3; while in the casesnumber 4 and 5 in which fluid imbalance already happened, this imbalanceproblem was resolved. It can be concluded that Levine?s model is an effectiveapproach to manage the fluid imbalance problem in children with hematooncologycases.;Dehydration can lead to hypovolemia, organ failure, and even death. Qualitynursing care is of high importance in addressing the problem of fluid imbalancein children. This paper aimed to describe the application of Levine?sConservation Model in providing nursing care to children with cancer whoexperience fluid imbalance. Based on this model, the interventions includereviewing signs of dehydration, monitoring vomiting, diarrhea, and fever,measuring vital signs, measuring the fluid intake and output and analyzing thefluid balance. After the nursing intervention, the problem of risk of body fluidvolume deficiency did not occur in cases number 1, 2, and 3; while in the casesnumber 4 and 5 in which fluid imbalance already happened, this imbalanceproblem was resolved. It can be concluded that Levine?s model is an effectiveapproach to manage the fluid imbalance problem in children with hematooncologycases.;Dehydration can lead to hypovolemia, organ failure, and even death. Qualitynursing care is of high importance in addressing the problem of fluid imbalancein children. This paper aimed to describe the application of Levine?sConservation Model in providing nursing care to children with cancer whoexperience fluid imbalance. Based on this model, the interventions includereviewing signs of dehydration, monitoring vomiting, diarrhea, and fever,measuring vital signs, measuring the fluid intake and output and analyzing thefluid balance. After the nursing intervention, the problem of risk of body fluidvolume deficiency did not occur in cases number 1, 2, and 3; while in the casesnumber 4 and 5 in which fluid imbalance already happened, this imbalanceproblem was resolved. It can be concluded that Levine?s model is an effectiveapproach to manage the fluid imbalance problem in children with hematooncologycases.;Dehydration can lead to hypovolemia, organ failure, and even death. Qualitynursing care is of high importance in addressing the problem of fluid imbalancein children. This paper aimed to describe the application of Levine?sConservation Model in providing nursing care to children with cancer whoexperience fluid imbalance. Based on this model, the interventions includereviewing signs of dehydration, monitoring vomiting, diarrhea, and fever,measuring vital signs, measuring the fluid intake and output and analyzing thefluid balance. After the nursing intervention, the problem of risk of body fluidvolume deficiency did not occur in cases number 1, 2, and 3; while in the casesnumber 4 and 5 in which fluid imbalance already happened, this imbalanceproblem was resolved. It can be concluded that Levine?s model is an effectiveapproach to manage the fluid imbalance problem in children with hematooncologycases."

"Masalah kekurangan volume cairan dan elektrolit sebagian besar terjadi pada anak dengan penyakit diare. Anak yang mengalami kekurangan volume cairan dan elektrolit memerlukan konservasi untuk dapat beradaptasi dalam memperbaiki kondisi tubuhnya sehingga dapat mencapai proses penyembuhan secara wholeness. Karya ilmiah akhir ini membahas tentang aplikasi model konservasi Levine dalam pengelolaan asuhan keperawatan pada anak dengan kekurangan volume cairan dan elektrolit. Metode yang digunakan adalah studi kasus, dimana terdapat lima kasus yang diaplikasikan dengan menggunakan model konservasi. Hasil pengkajian dengan menggunakan prinsip konservasi, pada kelima kasus semua mengalami trophicognosis kekurangan volume cairan dan elektrolit. Intervensi yang dilakukan untuk mengatasi masalah tersebut yang utama adalah pemberian dan pemantauan asupan cairan dan elektrolit secara adekuat. Hasil pengamatan respon organisme pada akhir perawatan menunjukkan empat kasus mampu beradaptasi dan mencapai wholeness, sedangkan satu kasus tidak mencapai wholeness. Hal ini ditunjukkan oleh keberhasilan dalam mengatasi trophicognosis, yaitu ada yang sudah teratasi, belum teratasi tetapi sudah menunjukkan perbaikan, dan ada juga yang tidak teratasi.

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Most of fluid and electrolyte deficit in children are caused by diarrhea. Children who have deficit of fluid and electrolyte need conservation to adapt and to heal the body. Thus, the wholeness healing is achieved. This study is aims to clarify the application of Levine Conservation Model in nursing care of children with fluid and electrolyte deficit. To accomplish this study, case study method was conducted with five cases. Assessment with conservation principle found that all cases are trophicognosis deficit of fluid and electrolyte. The main intervention is giving and observing intake fluid and electrolyte tightly. In the end of treatment, the result showed that four of five cases were able to adapt and achieve the wholeness healing. This result showed the accomplishment of against the trophicognosis, which consist of solved completely, solved incomplete and unsolved."

"Karya Ilmiah Akhir ini memberikan gambaran tentang pelaksanaan Program Residensi Ners Spesialis Keperawatan Anak dalam bentuk kegiatan praktik Residensi I dan II. Karya Ilmiah Akhir ini bertujuan untuk memberikan gambaran aplikasi Model Konservasi Myra E. Levine pada asuhan keperawatan anak dengan penyakit infeksi dan pencapaian kompetensi baik sebagai pemberi asuhan, advocator, conselor, educator, colaborator, dan agen perubah selama praktik residensi. Menurut model konservasi Levin, trophicognosis peningkatan suhu tubuh (demam) merupakan gangguan pada integritas struktur. Intervensi keperwatan dilakukan untuk mengkonservasi integritas struktur tersebut, yang berdampak pada konservasi energi, integritas personal dan integritas sosial. Pada kondisi demam intervensi yang dilakukan adalah mempertahankan agar lingkungan tetap nyaman dan sejuk, mengurangi aktivitas yang melelahkan, meningkatkan istirahat, memberikan asupan nutrisi yang adekuat. Konsep lain yang diterapkan dalam asuhan keperawatan dengan demam ini adalah konsep family centered care (FCC), kemudian melaksanakan ners spesialis sebagai inovator, residen melaksanakan proyek inovasi berupa pembuatan format dischar planning dan optimalisasi ruang bermain.

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This final assignment provides an overview about the implementation residency practices of the specialist pediatric nurse program in the form practical activities residency I and II. The aim of this final assignment is provide overview application Conservation Model Myra E. Levine on nursing care of children with infectious diseases and the achievement of competencies such as a caregiver advocator, counselor, educator, collaborator, and change agents during practice residency. According to Levin conservation models, trophicognosis increase in body temperature (fever) is an interference with the integrity of the structure. Nursing interventions undertaken to conserve the integrity of these structures, which have an impact on energy conservation, personal integrity and social integrity. In the intervention condition of fever is to preserve the environment in order to stay comfortable and cool, reducing the exhausting activity, increased rest, providing adequate nutrition. Another concept that is applied in nursing care with a fever is the concept of family centered care (FCC), then carry out specialist nurses as an innovator, a resident carrying out innovation projects making planning and optimization dischar format playroom."

"Anak sangat rentan mengalami ketidakseimbangan cairan karena memiliki proporsi air tubuh yang lebih besar di ruang ekstraseluler. Tujuan penulisan karya ilmiah akhir ini adalah memberikan gambaran penerapan model konservasi Levine dalam proses asuhan keperawatan pada klien anak dengan ketidakseimbangan cairan. Dan memberikan gambaran penerapan tehnik distraksi meremas bola lunak dalam mengontrol nyeri anak selama insersi kateter intravena. Model konservasi Levine digambarkan pada 5 kasus kelolaan. Masalah keperawatan yang muncul pada 4 kasus adalah kekurangan volume cairan dan 1 kasus kelebihan volume cairan. Intevensi keperawatan yang diberikan berdasarkan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal dan konservasi integritas sosial. Evaluasi yang didapatkan pada kelima kasus tersebut adalah masalah kekurangan volume cairan teratasi dan masalah kelebihan volume cairan teratasi sebagian. Selanjutnya pada penerapan tehnik distraksi meremas bola lunak pada anak yang dilakukan insersi intravena didapatkan skor nyeri anak berkurang. Hal ini membuktikan bahwa tehnik distraksi meremas bola lunak efektif mengontrol nyeri saat insersi intravena pada anak.

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Children are very susceptible to experience fluid imbalances due to their body composition which have a greater proportion of body water in the extracellular space. The paper aims to illustrate the application of the Levine conservation model in the process of nursing care to a child with fluid imbalance. This paper also provides an overview of softball squeezing distraction techniques to control children's pain during intravenous catheter insertion. Levine s conservation model is described in five cases. In general, four cases were related to a lack of fluid volume and one case related to excess fluid volume. The nursing intervention was given based on the four conservation principles: energy, structural integrity, personal integrity, and social integrity. The evaluation obtained from the five cases informs that the problem of lack of fluid volume resolved, and the problem of the excess fluid volume was partially resolved. Furthermore, in applying softball squeezing distraction techniques to children who have intravenous insertions, the child s pain score was decreased. Softball squeeze distraction techniques are proved to control pain effectively during intravenous insertion in children."

"ABSTRAK Karya ilmiah akhir ini mengintegrasikan model konservasi Levine pada lima kasus terpilih anak dengan masalah oksigenasi. Tujuannya adalah menggambarkan penerapan model konservasi Levine dalam asuhan keperawatan anak dengan masalah oksigenasi dan pengaruh penerapan posisi semirecumbent pada anak dengan masalah oksigenasi. Model konservasi Levine telah memberikan panduan berpikir yang sistematis dalam pemberian asuhan keperawatan. Pelaksanaan asuhan keperawatan dengan mengintegrasikan model konservasi Levine dapat diterapkan pada anak yang mengalami masalah oksigenasi. Pengaturan posisi semirecumbent dapat meningkatkan saturasi oksigen anak dengan masalah oksigenasi. Pengaturan posisi semirecumbent diharapkan dapat menjadi salah satu intervensi pada pasien anak dengan masalah oksigenasi. Kata kunci: Masalah oksigenasi, anak, model konservasi Levine, posisi semirecumbent. ABSTRACT The final scientific paper integrates Levine 39 s conservation model in five selected cases in nursing care of children with oxygenation problems. The purpose is to describe the application of the Levine conservation model in nursing care of children with oxygenation problems and the effect of applying semirecumbent positions on children with oxygenation problems. Levine 39 s conservation model has provided a systematic thinking guide in nursing care. Implementation of nursing care by integrating Levine conservation model can be applied to children with oxygenation problems. Semirecumbent position can increase the oxygen saturation of children with oxygenation problem. Semirecumbent positioning is expected to be one of the interventions in pediatric patients with oxygenation problems. "