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"Hipertensi merupakan salah satu penyebab terjadinya CKD, dan hipertensi juga merupakan komplikasi dari CKD yang dapat memperburuk kasus CKD. Perilaku tidak sehat masyarakat perkotaan di Indonesia sangat mempengaruhi kasus CKD maupun hipertensi. Karya Ilmiah Akhir Ners ini bertujuan untuk menganalisis intervensi pengontrolan tekanan darah untuk mencegah perburukan pada pasien CKD di Ruang Rawat IPD, Lantai 7 Zona A, RSUP Cipto Mangunkusumo. Metodologi yang digunakan adalah metode studi kasus dan analisa penelitian yang telah ada. Hasil analisa yang didapatkan menunjukkan bahwa intervensi pengontrolan tekanan darah dapat menurunkan sistolik dan diastolik. Pengontrolan yang dapat dilakukan oleh perawat adalah: memeriksa dan mengawasi tekanan darah harian pasien, mengajarkan bagaimana cara yang benar untuk mengecek tekanan darah secara manual ataupun digital di rumah, dan memberikan pendidikan kesehatan terkait: patofisiologi hipertensi pada CKD; resiko hipertensi pada CKD; pentingnya memantau dan mencatat tekanan darah setiap hari; pembatasan asupan garam; dan retriksi cairan.

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Hypertension is one of the causes of CKD, and it is a complication of CKD that can accelerate progression of renal disease. Unhealthy behaviors among urban communities in Indonesia greatly affect to CKD and hypertension. This final clinical nursing paper aimed to analyze blood pressure control intervention to preventing accelerating of progression to patient CKD in Internal Medicine Room Care, 7th floor Zone A, Cipto Mangunkusumo Hospital. The methods are case study and analyze existing research. Result shown that the intervention did significantly lower systolic and diastolic blood pressure. A nurse can control the blood pressure with many ways, they are: measure and monitor daily blood pressure of the patient, teaching the patient how to proper blood pressure measurement technique, and health education about: pathophysiology of hypertension on CKD; risk of hypertension on CKD; to measure and record his/her own blood pressure, whenever possible; salt restriction; and fluid restriction."

"Diabetes melitus merupakan kelompok penyakit yang disebabkan oleh gangguan sekresi insulin atau kerja insulin. Masalah psikososial seperti stres dan kecemasan pada klien dengan yang mengalami diabetes melitus sangat mempengaruhi status kesehatan dan perkembangan kesembuhan klien karena mempengaruhi kadar gula darah. Karya ilmiah akhir ners ini dilakukan untuk menganalisis implementasi asuhan keperawatan relaksasi otot progresif berdasarkan evidence based practice dalam mengatasi ketidakstabilan kadar gula darah pada klien dengan masalah diabetes melitus di ruang IPD lantai 7 zona A RSUP Cipto Mangunkusumo Jakarta Evaluasi tindakan diperoleh tehnik relaksasi otot progresif dapat menurunkan tingkat stres pada klien diabetes sehingga mampu menurunkan kadar gula darah.

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Diabetes mellitus is caused by secretory the impairment of insulin or function of insulin. Psychological problems such as stress and anxiety in patients with diabetes mellitus might influence health status and healing process due to high blood glucose.

This final clinical nursing paper aimed to analyze nursing care intervention of progressive muscle relaxation based on evidence based practice to overcome instability of blood glucose level in patient with diabetes mellitus at medical ward, 7th Floor Zone A, Cipto Mangunkusumo Hospital, Jakarta. Results shown that Progressive Muscle Relaxation can reduce stress in patient with diabetes mellitus and high blood glucose level."

"Pembatasan cairan merupakan salah satu cara yang digunakan untuk mengurangi kelebihan volume cairan akibat penurunan fungsi ginjal. Pembatasan cairan merupakan hal yang terberat yang dialami pasien gagal ginjal kronik selama menjalani hidup dengan hemodialisa. Penulisan karya ilmiah ini menggunakan evidence based practice dari jurnal ilmiah. Penulisan karya ilmiah ini bertujuan untuk menerapkan cognitive behavioral therapy terkait intervensi pembatasan cairan pada penderita gagal ginjal kronik yang menjalani hemodialisa. Hasil menunjukkan cognitive behavioral therapy efektif dalam meningkatkan kepatuhan pasien dalam melakukan pembatasan cairan. Pasien menunjukkan berat badan yang stabil, balance cairan seimbang, dan menunjukkan minat dan motivasi untuk melakukan pembatasan cairan.

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Fluid restriction is one of the means used to reduce excess fluid volume due to decreased renal function.Fluid restriction is the hardest part of patient’s life with during hemodialysis. This papers is to use evidence-based practice of scientific journals.

This papers is aim to apply cognitive behavioral therapy interventions related to fluid restriction in patients with CKD stage 5 undergoing hemodialysis.

The results showed cognitive behavioral therapy is effective in improving patient compliance in conducting fluid restriction. Patients showed a stable weight, balance fluid balance, and show an interest and motivation to perform fluid restriction."

"Pembatasan pemasukan cairan pada pasien gagal ginjal kronik tahap akhir perlu diperhatikan untuk mencegah komplikasi seperti hipervolemia, dan komplikasi pada sistem kardiovaskuler, namun 50% pasien tidak mematuhi aturan pembatasan cairan. Faktor yang mempengaruhi pasien dalam menjalani terapi pembatasan cairan antara lain usia, jenis kelamin, pengetahuan, demografi, aspek psikososial, support sistem dan kemauan. Tujuan penelitian ini adalah pengaplikasian evidence based nursing pembatasan cairan pada pasien gagal ginjal kronik dengan hemodialisa. Metode yang digunakan adalah dengan cara menyingkirkan segala macam jenis minuman yang berada pada meja pasien kecuali sejumlah air mineral yang dibutuhkan pasien. Jika pasien memaksa mengonsumsi minuman dari luar maka kurangi minuman yang tersedia dengan jumlah yang dikonsumsi dari luar. Lakukan edukasi terkait komplikasi dari kelebihan volume cairan jika pasien tidak mampu mengontrol rasa haus dan tidak disiplin untuk melakukan pembatasan cairan. Selanjutnya, basahi bagian bibir dan mulut tanpa harus minum jika pasien mulai merasa haus. Hasil menunjukan dengan pengawasan dan pemberian edukasi, pasien mulai patuh dengan terapi pembatasan cairan. Pengaplikasian evidence base memberikan hasil positif. Hal yang perlu diperhatikan yaitu saat melakukan pembatasan cairan perlu diperhatikan tanda-tanda dehidrasi.

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Fluid restriction in End Stage Renal Disease patient needs for attention to prevent complications, such as hipervolemia and cardiovascular complication. However, 50% of patients don’t adhere to the fluid restriction guide. Factors influence patients during fluid restriction therapy are age, gender, knowledge level, demography, psychosocial, support system, and willingness. This report aimed to apply evidence based nursing of fluid restriction in chronic kidney disease with hemodialysis.

The method was applied by eliminating additional drinks on patient desk unless the amount of required water. If patient intended to excess fluid intake, hence the required water should be eliminated as the amount of extra fluid intake. Education was done related to complications of body fluid excess if patient were not able to control thirsty and to be discipline of fluid restriction. Patient lips could be given water without drinking.

Result shown that fluid restriction and education influence patient adherence. Evidence based practice shown the positive impact. In addition, it is also important to pay attention to the clinical signs of dehydration."

"Kebiasaan dalam jangka waktu yang lama akan pola diet yang tidak sehat pada masyarakat perkotaan menjadi salah satu faktor resiko terjadinya hipertensi. Penyakit ini menjadi salah satu faktor penyebab kerusakan ginjal yang dapat mengakibatkan gagal ginjal kronik. Pasien gagal ginjal kronik sering terjadi kelebihan volume cairan akibat kerusakan fungsi filtrasi glomerolus. Oleh karena itu perlu dilakukan pembatasan cairan yang ketat, efektif dan efesian untuk mencegah terjadinya komplikasi dengan upaya pemantauan intake dan output cairan. Penulisan karya ilmiah ini menggunakan metode studi kasus dengan menggunakan fluit intake output chart dan dibuktikan bahwa pemantauain ini efektif untuk menangani kelebihan volume cairan dibuktikan dengan tidak bertambahnya komplikasi yang terjadi pada pasien.

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Long lasting habits of unhealthy diet in urban society is becoming one of hypertension risk factor. This disease has become a factor causing kidney damage, which can lead to chronic kidney failure. Chronic kidney failure patients commonly experience volume overload due to damage in glomerular filtration function. Hence, fluid restriction is needed as effective and efficient to prevent complication by monitoring fluid intake and output. This scientific writing uses case study method by using fluid intake-output chart to prove that this monitoring method is effective in handling fluid overload by looking at the occurrence of complication in patient."

"Gagal jantung kongestif adalah ketidakmampuan jantung untuk memompa darah secara adekuat untuk memenuhi kebutuhan metabolisme tubuh. Gaya hidup kurang sehat yang sering ditemukan pada masyarakat perkotaan dapat menjadi penyebab gagal jantung kongestif. Karya Ilmiah Akhir Ners ini bertujuan untuk menganalisis asuhan keperawatan yang diberikan pada pasien gagal jantung kongestif di ruang rawat penyakit dalam lantai 7 Zona A gedung A RSUPN Dr. Cipto Mangunkusumo. Pengenalan latihan napas lambat dalam untuk meningkatkan sensitivitas baroreflek arteri perlu diberikan pada perawat dan pasien.

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Congestive heart failure is inability of the heart to pump blood adequately to meet the need of body metabolism. Unhealthy lifestyle which is often found in urban communities can be the cause of congestive heart failure. This final clinical nursing report aimed to analyze nursing care for patient with congestive heart failure in an Internal Medicine Ward, 7th Floor Zone A, Dr. Cipto Mangunkusumo Hospital. Introducing of Slow Deep Breathing Exercise to increase arterial baroreflex sensitivity is required both for nurses and patients."

"[ABSTRAK Sesak nafas merupakan keluhan yang umum terjadi pada penderita gagal jantungkongestif akibat penumpukan cairan. Pemberian semifowler derajat menjadi salahsatu intervensi untuk mengurangi rasa sesak dan mencegah komplikasi akibat sesak.Karya ilmiah akhir ners ini bertujuan menganalisis keefektifan pemberian posisitidur 45 derajat dalam mengurangi sesak nafas pada penderita gagal jantungkongestif dengan pemberian posisi tidur 45 derajat. Implementasi ini dilakukanselama pasien mengeluh sesak nafas. Hasil perawatan selama lima harimenunjukkan bahwa pasien melaporkan terjadinya penurunan sesak nafas selamapemberian posisi tidur 45 derajat. Hal tersebut ditunjukkan dengan adanyapenurunan laju pernafasan 4-6 kali permenit. Karya Ilmiah akhir ners inimerekomendasikan perlu dilakukan penelitian terkait efektivitas intervensi yangdilakukan dengan melihat perbedaan antara sebelum dan sesudah pemberian posisi45o,90o, dan orthopnea.ABSTRACT Breathlessness is a common symptom in patient with congestive hearth failure

that caused by fluid retention. The semifowler position is one of the intervention

to reduce the breathlessness and prevent the complications due to breathlessness.

The aim of this study was to analyzing the effectiveness of 45 degrees position in

reducing breathlessness in patient with congestive hearth failure. Implementation

was performed while the patient had breathlessness. Results showed that patients

reported a decrease in breathlessness during 45 degrees positions. Which was

indicated by a decrease in respiratory rate 4-6 times per minute. This result

suggest to perform research that identify the difference between before and after

administration of 45o,90o, and orthopnea.;Breathlessness is a common symptom in patient with congestive hearth failure

that caused by fluid retention. The semifowler position is one of the intervention

to reduce the breathlessness and prevent the complications due to breathlessness.

The aim of this study was to analyzing the effectiveness of 45 degrees position in

reducing breathlessness in patient with congestive hearth failure. Implementation

was performed while the patient had breathlessness. Results showed that patients

reported a decrease in breathlessness during 45 degrees positions. Which was

indicated by a decrease in respiratory rate 4-6 times per minute. This result

suggest to perform research that identify the difference between before and after

administration of 45o,90o, and orthopnea.;Breathlessness is a common symptom in patient with congestive hearth failure

that caused by fluid retention. The semifowler position is one of the intervention

to reduce the breathlessness and prevent the complications due to breathlessness.

The aim of this study was to analyzing the effectiveness of 45 degrees position in

reducing breathlessness in patient with congestive hearth failure. Implementation

was performed while the patient had breathlessness. Results showed that patients

reported a decrease in breathlessness during 45 degrees positions. Which was

indicated by a decrease in respiratory rate 4-6 times per minute. This result

suggest to perform research that identify the difference between before and after

administration of 45o,90o, and orthopnea.;Breathlessness is a common symptom in patient with congestive hearth failure

that caused by fluid retention. The semifowler position is one of the intervention

to reduce the breathlessness and prevent the complications due to breathlessness.

The aim of this study was to analyzing the effectiveness of 45 degrees position in

reducing breathlessness in patient with congestive hearth failure. Implementation

was performed while the patient had breathlessness. Results showed that patients

reported a decrease in breathlessness during 45 degrees positions. Which was

indicated by a decrease in respiratory rate 4-6 times per minute. This result

suggest to perform research that identify the difference between before and after

administration of 45o,90o, and orthopnea., Breathlessness is a common symptom in patient with congestive hearth failure

that caused by fluid retention. The semifowler position is one of the intervention

to reduce the breathlessness and prevent the complications due to breathlessness.

The aim of this study was to analyzing the effectiveness of 45 degrees position in

reducing breathlessness in patient with congestive hearth failure. Implementation

was performed while the patient had breathlessness. Results showed that patients

reported a decrease in breathlessness during 45 degrees positions. Which was

indicated by a decrease in respiratory rate 4-6 times per minute. This result

suggest to perform research that identify the difference between before and after

administration of 45o,90o, and orthopnea.]"