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"Kehamilan postterm adalah usia kehamilan yang memanjang sampai 42 minggu atau lebih yang dapat disebabkan oleh berbagai faktor seperti hormonal dan genetik. Meskipun angka kejadian kehamilan postterm sedikit, namun kehamilan postterm dapat memberikan dampak yang besar tehadap ibu dan janin. Oleh karena itu, penanganan kehamilan postterm dengan mengaplikasikan pendekatan yang efektif seperti Teori Model Keperawatan Need for Help sangat diperlukan dalam melakukan pengkajian, observasi dan tindakan yang cepat dan tepat selama proses persalinan. Selain itu, Theory of Unpleasant Symptoms dapat juga diaplikasikan untuk membantu mengurangi gejala-gejala ketidaknyaman dari segala aspek baik aspek fisik, psikologis, dan situasional selama proses persalinan. Kelima kasus kelolaan mengalami gejala-gejala ketidaknyaman yang saling mempengaruhi setiap gejala dan membutuhkan penanganan segera. Setelah dilakukan terminasi kehamilan melalui induksi persalinan, ditemukan hasil yang berbeda di setiap kasus. Kasus dua sampai lima setelah diinduksi maka dapat melalui persalinan secara pervaginam sedangkan kasus satu berakhir dengan tindakan seksio sesaria karena terjadi gawat janin. Peran perawat khususnya perawat spesialis maternitas sangat diperlukan pada masa terminasi kehamilan tersebut dalam memberikan asuhan keperawatan untuk mengatasi masalah pada ibu dengan dengan kehamilan postterm.

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Post-term pregnancy is a prolonged pregnancy period till 42 weeks or more that can be caused by varied factors such as hormonal and genetic. Although the incident rate is considerably small, it can bring negative impacts to mother and her baby. Thus, it is important to manage the post-term pregnancy by applying effective approaches such as Need for Help Nursing Theory to ensure rapid and precise assessment, observation and immediate intervention carried out during delivery process. In addition, The Theory of Unpleasant Symptoms can also be applied to minimize unpleasant symptoms either physically or psychologically and situational discomfort during the labor. The five study cases revealed that the mothers experienced unpleasant symptoms that affected each other and required immediate treatment. After termination with labor induction were conducted, different results were found among the cases. Case two to five after be indiuced, they gave birth trough vaginal birth, whil case one ended with caesarean section because of fetal distress. Nurse role especially maternity nursing specialist is imperative during the gravidity termination period in performing nursing care to overcome problems experienced by mother with post-term pregnancy."

"Karya ilmiah akhir ini disusun sebagai laporan dari praktik residensi spesialis keperawatan Matemitas yang berfokus pada penerapan teori keperawatan Need for Help Wiedenbach dan unpleasant symptoms pada kasus kehamilan ektopik terganggu. Tujuan penulisan laporan ini untuk memberikan gambaran pelaksanaan praktik Spesialis Keperawatan Matemitas dalam menjalankan perannya sebagai pemberi pelayanan keperawatan, edukator, konselor, advokat, pengelola, kolaborator, komunikator dan koordinator, agen perubah dan peneliti dalam memberikan asuhan keperawatan pada perempuan sepanjang periode kehidupannya dengan menerapkan teori keperawatan. Aplikasi teori keperawatan need for heap Wiedenbach dan unpleasant symptoms efektif dilakukan pada lima kasus ibu dengan kehamilan ektopik terganggu. Aplikasi teori tersebut berhasil membantu menyelesaikan masalah keperawatan difase akut maupun pemulihan. Setelah melaksanakan praktik residensi spesialis keperawatan matemitas, penulis mampu mencapai target kompetensi dengan baik.

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This final scientific report aimed to report the clinical practice of maternity nursing specialist which focus on the application of Wiedenbach’s theory of the need for help and Unpllleasant Symptoms theory in the nursing care to clients ruptured ectopic pregnancy. The purpose of this report is to describe the implementation of maternity nursing specialist practices in their role as care giver, educator, counselor, advocate, collaborator, communicator, coordinator, innovators and researchers. The competencies also achieved through application of nursing theory in the nursing care. The application of Wiedenbach's theory of need for help and unpleasant symptoms theory in the nursing care was effective to resolve client’s ruptured ectopic pregnancy in acute and recovery phase. After finishing residential practice of maternity nursing specialist, the competencies was achieved with a good result."

"Kematian ibu yang terjadi selama kehamilan sebagian besar disebabkan oleh perdarahan, hipertensi dalam kehamilan, infeksi, partus lama/macet dan abortus. Fenomena tersebut mendorong profesi keperawatan untuk terus mengembangkan ilmu sejalan dengan tuntutan masyarakat terhadap pelayanan kesehatan yang berkualitas. Laporan ini bertujuan menggambarkan pelaksanaan praktek residensi keperawatan maternitas selama satu tahun meliputi asuhan keperawatan pada masa childbearing normal dan resiko tinggi, bayi baru lahir normal dan resiko tinggi, perempuan yang mengalami masalah reproduksi dan ginekologi ditatanan klinik maupun di komunitas. Residen juga melakukan asuhan keperawatan pada kasus dengan focus of interest yaitu abortus inkomplit dengan mengaplikasikan teori need for help yang dikombinasikan dengan teori unpleasant symtomps. Selain itu, laporan ini juga memaparkan tentang kegiatan pencapaian kompetensi perawat spesialis maternitas melalui penerapan peran sebagai pemberi perawatan, pendidik, konselor, koordinator, komunikator, advokat serta agen perubahan dan peneliti.

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Maternal deaths that occur during pregnancy are mostly caused by bleeding, hypertension in pregnancy, infection, old / stuck particles and abortion. This phenomenon encourages the nursing profession to continue to develop knowledge in line with the demands of society to quality health services. This report aims to describe the implementation of a one-year maternity nursing residency practice covering normal and high-risk childbearing nursing care, normal and high-risk newborns, women with reproductive and gynecological problems in clinical and community settings. The resident also performs nursing care in a case with a focus of interest ie an incomplete abortus by applying the need for help theory in combination with the unpleasant symtomps theory. In addition, this report also describes the activities of the achievement of nursing specialist maternity competence through the application of roles as carers, educators, counselors, coordinators, communicators, advocates and agents of change and researchers."

"ABSTRAK Tingginya angka kematian ibu saat ini salah satunya disebabkan oleh adanya komplikasi pada saat kehamilan dan persalinan Ners spesialis keperawatan maternitas mempunyai peran penting dalam mencegah kematian baik ibu maupun janin Laporan ini bertujuan untuk memberikan gambaran pelaksanaan praktik ners spesialis keperawatan maternitas meliputi asuhan keperawatan pada masa prenatal intranatal postnatal dan bayi baru lahir normal dan berisiko serta mengenai masalah kesehatan reproduksi perempuan Residen juga memberikan asuhan keperawatan dengan focus penerapan teori need for help dari Wiedenbach pada ibu dengan terminasi kehamilan karena preeklamsia berat Hasil menunjukkan bahwa penanganan segera dan terminasi kehamilan sesuai dengan indikasi dapat mencegah komplikasi dan kegawatan pada ibu dan bayi serta mencegah terjadinya Sindrom HELLP dan Eklamsia Penerapan teori model keperawatan Need For Help efektif untuk diaplikasikan pada kasus terminasi kehamilan karena preeklamsia berat Pencapaian kompetensi perawat spesialis keperawatan maternitas dilakukan dengan penerapan peran perawat secara komprehensif.ABSTRACT One of the causes of high maternal mortality rate is the complications of pregnancy and labor A maternity nursing specialist has an important role to prevent maternal and fetal death This report aimed to provide an overview of the implementation of maternity nursing specialist practice including nursing care of normal and high risk prenatal intranatal postnatal and newborn as well as women rsquo s health Resident also provided nursing care focused on the application of Wiedenbach Need for Help Theory on mothers with pregnancy termination due to severe preeclampsia Results showed that the immediate management and pregnancy termination as indicated could prevent complications and maternal and infant distress as well as prevent HELLP Syndrome and eclampsia The application of Wiedenbach Need for Help Model Theory was effective to be applied on cases of pregnancy termination due to severe preeclampsia The maternity nursing specialist competencies were achieved by applying a nurse rsquo s roles comprehensively."

"Periode postpartum merupakan periode kritis pada kesehatan maternal. Peningkatan prevalensi persalinan gemelli menjadi tantangan tersendiri bagi perawat maternitas untuk memberikan asuhan yang paripurna. Studi kasus dilakukan dengan fokus penerapan teori Self Care dan Unpleasant Symptoms (TOUS) pada asuhan keperawatan ibu postpartum dengan gemelli. Aplikasi teori difokuskan pada kelima kasus yang berfokus pada pengkajian gejala ketidaknyamanan dan kemampuan perawatan diri ibu postpartum dengan gemelli. Intervensi keperawatan yang optimal dan sesuai dapat membantu klien mencapai kemandirian dalam perawatan diri sendiri dan pencapaian kenyamanan pada periode postpartum. Ibu postpartum dengan gemelli harus memiliki self dan time management yang baik agar perawatan postpartum menjadi optimal.

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Postpartum period is a critical period of maternal health. Inreasing prevalence of twin delivery is a challenge for maternity nurse to serve holistic care. Case study is applied with focus on the application of Self Care theory and Theory of Unpleasant Symptoms (TOUS) on nursing care in postpartum women with twin. The application of Self Care and TOUS effectively applied to five cases that focused on identification unpleasant symptoms and self care ability of postpartum women with twin. Optimum and appropriate interventions could help client to receive self care independently and feel comfort during postpartum period. Postpartum mother with twin should have appropriate self and time management so that optimum postpartum self care will be reached."

"Karya Ilmiah Akhir ini merupakan analisis dan rangkaian kegiatan praktik residensi ners spesialis keperawatan maternitas, dengan penerapan teori keperawatan konservasi Levine dan unpleasant symptoms pada proses keperawatan ibu hamil dengan preeklampsia berat. Teori konservasi Levine memungkinkan individu untuk beradaptasi guna mempertahankan integritasnya dengan hasil akhir berupa konservasi. Fokus utama konservasi adalah keseimbangan antara suplai dan kebutuhan energi agar terjaga seluruh aspek keutuhan individu. Sedangkan teori unpleasant sympthom digunakan dalam mengurangi gejala - gejala ketidaknyamanan dengan cara meningkatkan pemahaman terhadap sekumpulan gejala ketidaknyamanan dari berbagai konteks dan menyediakan informasi yang bermanfaat serta memberikan dampak negatif dari gejala ? gejala ketidaknyamanan. Laporan akhir residensi juga memaparkan pencapaian target kompetensi dan berusaha memodifikasi hambatan yang dihadapi selama praktik.

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The final paper is an analysis of maternity nursing practice spesialist with the application Concervation Levine and unpleasant symptoms on nursing process with severe preeclampsia pregnant women. Levine conservation theory allows individuals to adapt in order to maintain its integrity with the final result of conservation. The main focus of conservation is a balance between supply and demand, in order to keep all aspects of individual integrity. While unpleasant theory sympthom use in reducing the symptoms - symptoms of discomfort by increasing the understanding of the group of symptoms of discomfort from a variety of contexts and provide useful information and that had a negative impact on the symptoms - symptoms of discomfort. The final report also describes residency achievement of competence and attempt to modify the constraints faced during practice."

"Kunjungan anak-anak yang memiliki berbagai keluhan kesehatan serius ke rumah sakit, seringkali tidak tertolong pada 24 jam pertama, dan menyebabkan kematian. Faktor potensial yang dapat mengakibatkan tingginya angka kematian anak yaitu keterlambatan atau kegagalan, dalam mengidentifikasi gejala anak yang mengalami kegawatdaruratan. Kegawatdaruratan pada anak didefinisikan sebagai sebuah kondisi yang mengancam kesehatan anak karena suatu penyakit atau cedera parah, serta dapat menyebabkan kerusakan permanen. Masalah kegawatdaruratan pada anak salah satunya dapat berkaitan dengan kasus hematologi. Gejala yang ditimbulkan dari permasalahan kegawatdaruratan hematologi sangat beragam. Perawat memainkan peran penting dalam mengidentifikasi, memantau, dan memanajemen keluhan dan gejala anak secara spesifik. Theory of Unpleasant Symptoms (TOUS), telah dikembangkan untuk meningkatkan pemahaman tentang gejala yang dialami oleh pasien. Pengaplikasian TOUS pada pelaksanaan asuhan keperawatan anak dengan kondisi gawat darurat, khususnya kasus hematologi, layak untuk ditelaah.

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Visits of children with serious health complaints to the hospital are often not helped in the first 24 hours and cause death. Potential factors that can lead to high child mortality rates are delays or failures in identifying the symptoms of children who are experiencing an emergency. An emergency in a child is defined as a condition that threatens a child's health due to a severe illness or injury and can cause permanent damage. One of the emergency problems in children can be related to hematological cases. The symptoms caused by emergency hematology problems are very diverse. Nurses are essential in identifying, monitoring, and managing the child's complaints and symptoms. The Theory of Unpleasant Symptoms (TOUS) has been developed to improve understanding of the symptoms experienced by patients. The application of TOUS in implementing pediatric nursing care with emergency conditions, especially hematological cases, deserves to be studied."

"Kehamilan diharapkan dapat berlangsung aman dan lancar hingga melahirkan. Akan tetapi wanita hamil sangat beresiko mengalami penyulit atau komplikasi yang tidak diinginkan, salah satunya adalah abortus inkomplit. Fenomena tersebut mendorong profesi keperawatan untuk terus mengembangkan ilmu sejalan dengan tuntutan masyarakat terhadap pelayanan kesehatan yang berkualitas. Laporan ini bertujuan menggambarkan pelaksanaan praktek residensi keperawatan maternitas selama satu tahun, meliputi asuhan keperawatan pada masa childbearing normal dan resiko tinggi, bayi baru lahir normal dan resiko tinggi, perempuan yang mengalami masalah reproduksi dan ginekologi di tatanan klinik maupun di komunitas. Residen juga melakukan asuhan keperawatan pada kasus focus of interest yaitu abortus inkomplit dengan mengaplikasikan teori need for help yang dikombinasikan dengan teori social support. Laporan ini juga mengemukakan hambatan dan dukungan pada pelaksanaan praktek residensi. Selain itu, laporan ini juga memaparkan tentang kegiatan pencapaian kompetensi perawat spesialis maternitas melalui penerapan peran sebagai pemberi perawatan, pendidik, konselor, koordinator, komunikator, advokat, agen perubahan dan peneliti.

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Pregnancy is expected to take place safely and smoothly until delivery. However, pregnant women are particularly at risk to experience complications or unwanted complications, one of which is an incomplete abortion. This phenomenon encourages the nursing profession to continue to develop in line with the science community demands for quality health care. This report aims to describe the implementation of maternity nursing practice residency for one year, covers nursing care during the childbearing normal and high-risk, normal newborns and high-risk women who have problems in reproductive and gynecological clinic and in the community structure. Resident also performs nursing care on a case that is the focus of interest by applying the theory of incomplete abortion need for help is combined with the theory of social support. The report also noted the barriers and support the implementation of the practice residency. In addition, this report also describes about the activities of achievement of competencies through the application maternity nurse specialist role as caregiver, educator, counselor, coordinator, communicator, advocate, change agent and researcher."

"Kehamilan ektopik merupakan kondisi kehamilan berisiko tinggi di mana sel telur yang dibuahi berimplantasi di luar rongga rahim. Kondisi ini mempengaruhi 1- 2 dari semua kehamilan dan merupakan ancaman yang signifikan bagi wanita. World Health Organization WHO mencatat bahwa 1:200 kasus KET merupakan penyebab kematian maternal utama di negara maju dengan 60.000 kasus per tahun. Di Amerika 1 dari 100 kehamilan mengalami kehamilan ektopik dan 95 terjadi di tuba. Penulisan ini bertujuan untuk mendiskripsikan penerapan keperawatan self care dan unpleasant symptoms pada pelaksanaan asuhan keperawatan klien dengan kehamilan ektopik. Pertisipan dalam studi kasus ini sebanyak lima klien KET yang dirawat di RSUD Cibinong dan RSUPN Cipto Mangunkusumo. Klien dengan kehamilan ektopik terganggu dibawah ke rumah sakit dengan keluhan nyeri perut bagian bawah dan perdarahan intraabdomen yang mengakibatkan penurunan kadar hemoglobin dan resiko syok hipovelemik sehingga perlu dilakukan tindakan emergensi yaitu salpingektomi. Kondisi ini menimbulkan nyeri sehingga klien mengalami ketidakmampuan merawat diri secara mandiri. Teori self care dan unpleasant symptoms diaplikasikan untuk membantu mengatasi masalah klien baik secara fisiologis, psikologis maupun situasional serta memandirikan klien dalam perawatan dirinya.

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Ectopic pregnancy is a high risk pregnancy condition in which the fertilized egg implanted outside the uterine cavity. This condition affects 1 2 of all pregnancies and is a significant threat to women. The World Health Organization WHO notes that 1 200 cases of KET are the leading cause of maternal mortality in developed countries with 60,000 cases per year. In America 1 in 100 pregnancies have ectopic pregnancy and 95 occur in the tuba. This writing aims to describe the application of nursing self care and unpleasant symptoms on the implementation of nursing care clients with ectopic pregnancy.

The participants in this case study were five KET clients treated at RSUD Cibinong and RSUPN Cipto Mangunkusumo. Clients with ectopic pregnancy are impaired below to the hospital with lower abdominal pain and intra abdominal hemorrhage resulting in a decrease in hemoglobin level and the risk of hypovelemic shock, so emergency measures of salpingectomy are necessary. This condition causes pain so that clients experience inability to care for themselves independently. Self care and unpleasant symptoms theory is applied to help solve client problems both physiologically, psychologically and situational as well as establishing clients in self care."

"ABSTRAK Angka kematian ibu (AKI) merupakan salah satu indikator penting dari derajatkesehatan masyarakat. AKI menggambarkan jumlah wanita meninggal dari suatupenyebab kematian terkait dengan gangguan kehamilan atau penanganannya selamakehamilan, melahirkan dan selama nifas. Kasus perdarahan sebagai penyebab utamakematian ibu dapat terjadi pada masa kehamilan, persalinan dan masa nifas. Salahsatu penyebab perdarahan diantaranya adalah plasenta previa. Plasenta previamerupakan salah satu keadaan yang menjadi penyebab perdarahan yang memerlukantindakan segera tenaga kesehatan terkait dengan kondisi ibu dan janin yangdikandungnya. Perawat sebagai salah satu tenaga kesehatan yang memberikan asuhankeperawatan secara komprehensif berperan dalam melakukan pemantauan secaraberkesinambungan kondisi ibu dan janin serta proses persalinan yang akan dihadapi .Tujuan penulisan laporan KIA ini adalah menjelaskan tentang aplikasi konsep danteori keperawatan dalam pemberian asuhan keperawatan pada ibu hamil denganplasenta previa totalis,serta menjelaskan peran perawat maternitas sebagai pemberiasuhan keperawatan, educator, konselor, advokator, pengelola, kolaborator, agenpembaharu (innovator), komunikator dan koordinator serta peneliti dalammemberikan asuhan keperawatan pada ibu hamil dengan plasenta previa. Pemilihankonsep dan teori keperawatan berdasarkan kepada kontek klien yang dalam kondisimengalami komplikasi yang berakibat kecemasan, dibutuhkan pendekatan perawatyang mampu memberikan asuhan secara komprehensif. Oleh karena itu konsep danteori need for help Wiedenbach dan teori of caring Swanson tepat digunakan dalampemberian asuhan keperawatan pada ibu hamil dengan plasenta previa totalis.Dengan harapan kondisi ibu hamil dengan plasenta previa totalis tetap optimal,mampu beradaptasi secara fisik maupun pskologis serta siap terhadap proses persalinan yang akan dihadapi. ABSTRACT The maternal mortality rate (MMR) is one of important indicators of the communityhealth. MMR describes the number of women death caused by problems associatedwith pregnancy or the treatment during pregnancy, childbirth and postpartum period.Hemorrhagic cases as the main cause of maternal death occur during pregnancy,childbirth and postpartum period. One of hemorrhagic causes is placenta previa.Placenta previa is a condition that causes bleeding which requires healthprofessionals? immediate interventions related to the maternal and fetal condition. Anurse as one of health professionals who provides a comprehensive nursing care has arole in monitoring continuously the maternal and fetal condition as well as the laborand birth process. The purpose of this final scientific work was to explain about theapplication of the nursing concepts and theories in providing nursing care to pregnantwomen with placenta previa totalis, as well as to explain the role of maternity nursesas a caregiver, an educator, a counselor, an advocate, a manager, a collaborator, aninnovator, a communicator and a coordinator as well as a researcher in providingnursing care to pregnant women with placenta previa. The selection of nursingconcepts and theories was based on the context of the client experiencedcomplications causing anxiety, nurses? approach that can provide comprehensive carewas needed. Therefore, Wiedenbach need for help concept and theory and Swansontheory of caring were appropriate to be used in the provision of nursing care topregnant women with placenta previa totalis. Hopefully the conditions of pregnantwomen with placenta previa totalis remain optimal, able to adapt physically and psychologically and ready to face the labor process. ;The maternal mortality rate (MMR) is one of important indicators of the communityhealth. MMR describes the number of women death caused by problems associatedwith pregnancy or the treatment during pregnancy, childbirth and postpartum period.Hemorrhagic cases as the main cause of maternal death occur during pregnancy,childbirth and postpartum period. One of hemorrhagic causes is placenta previa.Placenta previa is a condition that causes bleeding which requires healthprofessionals? immediate interventions related to the maternal and fetal condition. Anurse as one of health professionals who provides a comprehensive nursing care has arole in monitoring continuously the maternal and fetal condition as well as the laborand birth process. The purpose of this final scientific work was to explain about theapplication of the nursing concepts and theories in providing nursing care to pregnantwomen with placenta previa totalis, as well as to explain the role of maternity nursesas a caregiver, an educator, a counselor, an advocate, a manager, a collaborator, aninnovator, a communicator and a coordinator as well as a researcher in providingnursing care to pregnant women with placenta previa. The selection of nursingconcepts and theories was based on the context of the client experiencedcomplications causing anxiety, nurses? approach that can provide comprehensive carewas needed. Therefore, Wiedenbach need for help concept and theory and Swansontheory of caring were appropriate to be used in the provision of nursing care topregnant women with placenta previa totalis. Hopefully the conditions of pregnantwomen with placenta previa totalis remain optimal, able to adapt physically and psychologically and ready to face the labor process. "