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"Kista endometriosis atau chocolate cyst adalah tumor jinak yang sering terjadi pada sistem reproduksi perempuan saat ini. Perempuan dengan masalah ini akan mengalami gangguan pada kualitas hidup seorang perempuan baik secara fisik, psikospiritual, lingkungan maupun sosiokultural. Resiko lainnya adalah timbulnya keganasan pada sistem reproduksi. Tujuan dari laporan ini adalah memberikan gambaran tentang pelaksanaan praktik residensi ners spesialis yaitu pengelolaan kasus klien kista endometriosis dengan pendekatan studi kasus yang menerapkan teori comfort dan loss & grief. Asuhan diberikan untuk mengatasi ketidaknyamanan yang dialami klien baik secara fisik, psikospiritual, lingkungan dan sosiokultural, pada saat penatalaksanaan pembedahan dilakukan pada klien. Pemilihan konsep teori keperawatan comfort yang dielaborasi dengan teori loss & grief dapat saling melengkapi sehingga asuhan yang diberikan dapat lebih maksimal.

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Endometriosis cyst or chocolate cyst is a benign tumor that often occurs in the female reproductive system currently. Women with this problem will experience impaired of life quality physically, psycho-spiritually, environmentally and socio-culturally. Another risk is the incidence of malignancies in the reproductive system. The purpose of this report was to provide an overview of the implementation of nurse specialist residency practice, namely case management of clients with endometriosis cysts with an approach of a case study applying the comfort and loss and grief theory. Care was given to overcome the discomfort experienced by clients physically, psycho-spiritually, environmentally and socio-culturally, during the surgery management was performed to the client. The selection of comfort nursing theory concept elaborated with loss and grief theory can complete each other so that the care provided can be maximized."

"Nyeri persalinan merupakan kodisi yang fisiologis yang dialami oleh semua ibu bersalin termasuk ibu bersalin dengan stillbirth. Nyeri dapat berupa sakit pada pinggang, daerah erut dan menjalar ke paha. Penanganan nyeri non farmakologi merupakan hal yang penting salah satunya dengan counterpressure dan terapi relaksasi nafas dalam. Penanganan nyeri non farmakologi ini dapat meminimalisir risiko alergi terhadap beberapa terapi farmakologi. Tujuan dari penulisan ini adalah melaporkan hasil uji coba kombinasi counterpressure dan terapi relaksasi nafas dalam pada ibu bersalin kala satu. Uji coba dilakukan pada lima kasus ibu pada kala satu dengan stillbirth di mana ibu kehilangan satu faktor passenger sebagai syarat proses persalinan. Penerapannya dimulai dengan penjelasan terlebih dahulu mengenai konsep counterpressure dan teknik relaksasi nafas dalam pada pasien dan pendamping kemudian demonstrasi. Teknik ini diterapkan pada lima ibu dengan stillbirth pada kala satu aktif. Kombinasi dai kedua metode ini terbukti dapat mengurangi nyeri dan klien mengatakan lebih nyaman dan rileks saat dilakukan counterpressure dan teknik relaksasi nafas dalam. Didapatkan juga respiration rate dan tekanan darah ibu dalam batas normal.Labor pain is a physiological condition experienced by all maternity mothers including mothers giving birth with stillbirth. Pain can be a pain in the waist, abdomen and spread to the thighs. Non-pharmacological pain management is an important thing, one of them is counterpressure and deep breathing relaxation therapy. This non-pharmacological pain management can minimize the risk of allergies to several pharmacological therapies. The purpose of this paper is to report the results of a combination of counterpressure trials and deep breath relaxation therapy in first-time maternity mothers. The trial was carried out in five cases of mothers at a time with a stillbirth in which the mother lost one factor passenger as a condition for labor. The application begins with an explanation first about the concept of counterpressure and deep breathing relaxation techniques in patients and companions then demonstrations. This technique is applied to five mothers with a stillbirth when one is active. The combination of the two methods is proven to reduce pain and the client says it is more comfortable and relaxed when counterpressure and deep breathing relaxation techniques were performed.

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"[ABSTRAKKesehatan reproduksi merupakan masalah yang perlu diperhatikan dalam meningkatkan kesehatan perempuan. Ners spesialis keperawatan maternitas mempunyai peranan untuk mencapai upaya tersebut. laporan ini bertujuan menggambarkan praktik residensi ners spesialis keperawatan maternitas meliputi asuhan keperawatan pada masa prenatal, intranatal, dan post natal serta masalah reproduksi perempuan. Residen juga melakukan asuhan keperawatan dengan fokus penerapan model konsep need for help Wiedenbach dan Lost and grief Kubler Ross pada ibu bersalin dengan IUFD. masalah keperawatan yang mungkin muncul diakitkan dengan tahapan persalinan yang dibutuhkan klien. perbedaan yang terjadi pada klien berkaitan dengan psikologisnya yaitu dapat beradaptasi dengan cepat dan mengalami tahap penerimaan lebih cepat, dan ada yang proses penerimaannya membutuhkan waktu yang lama dan mengalami tahap tawar menawar serta penolakan yang lebih lama. selama praktik residensi ini kompetensi yang tercapai menjadikan pengalaman yang berarti dalam peningkatan keterampilan residen maternitas.

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ABSTRACTReproductive health is an issue that needs to be consideredto improve women's health. maternity nursing specialist has a role to achieve this goal. this report aimed to describe the residency practice of maternity nursing specialist, including prenatal, intranatal, and post natal nursing care and female reproductive problems. resident also performed nursing care focussed on the aplication of wiedenbach need for help and kubler ross lost and grief conceptual model on intrapartum mother with IUFD. nursing problems that arose were associated with the stages of labor complained of by the client. the diffrencess that occur on the clients were related to their psycological condition, some clients were able to adapt quickly and experience a faster acceptance stage, while some clients look a long process of acceptance and experiened a longer bargaining and refusal phase. during this residency practice the achieved competencies become a mainingful expeience in improving the skills of maternity resident., Reproductive health is an issue that needs to be consideredto improve women's health. maternity nursing specialist has a role to achieve this goal. this report aimed to describe the residency practice of maternity nursing specialist, including prenatal, intranatal, and post natal nursing care and female reproductive problems. resident also performed nursing care focussed on the aplication of wiedenbach need for help and kubler ross lost and grief conceptual model on intrapartum mother with IUFD. nursing problems that arose were associated with the stages of labor complained of by the client. the diffrencess that occur on the clients were related to their psycological condition, some clients were able to adapt quickly and experience a faster acceptance stage, while some clients look a long process of acceptance and experiened a longer bargaining and refusal phase. during this residency practice the achieved competencies become a mainingful expeience in improving the skills of maternity resident.]"

"Kemampuan dalam bidang pengetahuan, ketrampilan dan sikap harus dimiliki oleh seorang perawat spesialis keperawatan maternitas. Kemampuan ini diperlukan supaya seorang perawat spesialis keperawatan maternitas dapat memberikan pelayanan kepada masyarakat baik secara mandiri maupun berkolaborasi. Seorang perawat spesialis keperawatan maternitas dalam memberikan pelayanan kepada masyarakat berperan sebagai seorang pelaksana, pendidik, konsultan, advokat, pengelola asuhan keperawatan maternitas, peneliti, kolaborator, komunikator dan koordinator, serta pembaharu dalam bidang keperawatan maternitas. Laporan ini menguraikan kegiatan pencapaian kompetensi selama praktek residensi dengan fokus penerapan teori keperawatan "Need for Help" dan Loss & Grief pada ibu intra partum dengan kematian janin. Kompetensi yang diharapkan dapat tercapai selama praktek dan teori keperawatan "Need for Help" dan Loss & Grief dapat diterapkan pada penanganan kasus intra partum dengan intra uterine fetal death.

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A maternal nursing specialist must be well knowledgeable, possess good relevant skills and attitudes to be able to provide good health service to the society both independently and through collaboration. A maternal nursing specialist play an important role as a health practitioner, an educator, a consultant, an advocate, a communicator, an administrator in maternal nursing care, a researcher, a collaborator, a communicator and coordinator, and a reformer in maternal nursing. This report ellaborates the activities in attempts to achieve the intended competence during the resident practice, focused on the application of nursing theories '' Need for Help'' and '' Losss and Grief'' on mothers with intra partum and fetal death. This expected competence can be put into practice in handling a case of intra partum with intra urine fetal death."

"[ABSTRAKPelayanan keperawatan merupakan bagian integral dari pelayanan kesehatan dan masalah kesehatan reproduksi perempuan menjadi bagian yang tak terpisahkan dari sistim pelayanan kesehatan secara keseluruhan. Residen keperawatan maternitas dalam melaksanakan perannya dituntut mampu memberikan asuhan keperawatan sesuai dengan kebutuhan masyarakat di berbagai tatanan pelayanan kesehatan. Dalam upaya memberikan asuhan keperawatan, residen mengelola tujuh pasien dengan kista ovarium di dua rumah sakit yang berbeda dengan menggunakan pendekatan teori Adaptasi Roy. Dari ketujuh kasus tersebut, lima kasus jenis kista coklat dengan karakteristik munculnya keluhan dipengaruhi oleh siklus menstruasi dan dua kasus lain berjenis kista denoma. Dengan adanya berbagai perubahan dalam diri penderita kista ovarium, maka teori keperawatan Adaptasi Roy dianggap tepat diterapkan pada pasien dengan kista ovarium. Laporan akhir residensi juga memapartkan capaian 100% untuk target kompetensi pada tiga lahan praktek dan berusaha memodifikasi setiap hambatan yang ada selama pelaksanaan praktik residensi.

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ABSTRACTNursing service is an integral part of healthcare services and women's reproductive health problems become an integral part of the overall healthcare system. Maternity nursing resident in performing its role is demanded to provide nursing care in accordance with the needs of the community in a variety of healthcare structures. In providing nursing care, resident managed seven patients with ovarian cysts at two different hospitals using Roy Adaptation Theory approach. Of the seven cases, five cases were chocolate cyst type characterized by the emergence of complaints influenced by menstrual cycle and two other cases were denoma cyst. Since ovarian cysts patients experienced various changes, Roy Adaptation Nursing Theory was considered appropriate to be applied on patients with ovarian cysts. The final report also described the achievement of 100% of the target competencies in the three fields of practice and try to modify any existing obstacles during the residency practice., Nursing service is an integral part of healthcare services and women's reproductive health problems become an integral part of the overall healthcare system. Maternity nursing resident in performing its role is demanded to provide nursing care in accordance with the needs of the community in a variety of healthcare structures. In providing nursing care, resident managed seven patients with ovarian cysts at two different hospitals using Roy Adaptation Theory approach. Of the seven cases, five cases were chocolate cyst type characterized by the emergence of complaints influenced by menstrual cycle and two other cases were denoma cyst. Since ovarian cysts patients experienced various changes, Roy Adaptation Nursing Theory was considered appropriate to be applied on patients with ovarian cysts. The final report also described the achievement of 100% of the target competencies in the three fields of practice and try to modify any existing obstacles during the residency practice.]"

"[ABSTRAKAngka kematian ibu saat ini masih tinggi yang disebabkan karena komplikasi pada kehamilan dan persalinan, oleh karena itu perlunya peran tenaga kesehatan yang terkait termasuk perawat maternitas untuk memberikan pelayanan kesehatan profesional. Perawat spesialis maternitas dituntut mampu menjalankan perannya secara komprehensif. Laporan ini bertujuan untuk menggambarkan praktik residensi ners spesialis maternitas meliputi asuhan keperawatan pada masa prenatal, intranatal, dan postnatal normal dan berisiko serta bayi baru lahir normal dan berisiko, serta perempuan dengan masalah reproduksi dan ginekologi. Residen juga melakukan asuhan keperawatan dengan focus penerapan teori need for help dan comfort pada ibu bersalin dengan persalinan memanjang. Hasil menunjukkan bahwa kedua model efektif dapat diterapkan pada keenam kasus ibu bersalin dengan persalinan memanjang. Pencapaian kompetensi perawat spesialis maternitas dilakukan dengan penerapan peran perawat secara komprehensif.

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ABSTRACTMaternal mortality rate is still high due to pregnancy and labor complication, therefore the role of health professionals including maternity nurses is needed to provide a professional health care. Maternity nursing specialists are demanded to be able to perform their roles comprehensively. This report aimed to describe the residency practice of maternity nursing specialist including nursing care of normal and high risk prenatal, intranatal, and postnatal as well as normal and high risk newborns, and women with reproductive and gynecological problems. Resident also performed nursing care focused on the application of Wiedenbach Need for Help and Kolcaba Comfort Theory on intrapartum mothers with prolonged labor. Results showed that both models could be applied effectively to the six cases of intrapartum mothers with prolonged labor. The achievement of maternity nursing specialist competencies was conducted by the implementation of the nurse's roles comprehensively., Maternal mortality rate is still high due to pregnancy and labor complication, therefore the role of health professionals including maternity nurses is needed to provide a professional health care. Maternity nursing specialists are demanded to be able to perform their roles comprehensively. This report aimed to describe the residency practice of maternity nursing specialist including nursing care of normal and high risk prenatal, intranatal, and postnatal as well as normal and high risk newborns, and women with reproductive and gynecological problems. Resident also performed nursing care focused on the application of Wiedenbach Need for Help and Kolcaba Comfort Theory on intrapartum mothers with prolonged labor. Results showed that both models could be applied effectively to the six cases of intrapartum mothers with prolonged labor. The achievement of maternity nursing specialist competencies was conducted by the implementation of the nurse's roles comprehensively.]"

"Program residensi spesialis keperawatan maternitas dilakukan dalam rangka menerapkan peran dan fungsi perawat maternitas pada asuhan keperawatan secara profesional. Laporan ini bertujuan memberi gambaran pelaksanaan praktik residensi ners spesialis keperawatan maternitas, meliputi asuhan keperawatan sistem reproduksi perempuan normal dan resiko tinggi di klinik dan komunitas. Adapun kasus focus of interest yang dikelola selama melakukan praktik residensi adalah penerapan teori model keperawatan self care dan comfort pada ibu post partum dengan payudara bengkak, dengan tujuan kenyamanan disertai kemampuan merawat diri. Dengan demikian, penerapan teori model self care dan comfort merupakan pendekatan tepat untuk kenyamanan dan memandirikan klien. Residen membahas kesenjangan asuhan keperawatan dibandingkan teori, menguraikan peran dan fungsi perawat, mengemukakan hambatan serta dukungan pelaksanaan praktek residensi.

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Specialist maternity nursing residency program conducted in order to implement the roles and functions of nurses in the maternity nursing care in a professional manner. This report aims to illustrate the implementation of specialist nursing practice residency for nurses in maternity nursing specialist namely the nursing care for normal and high risk female reproductive system in clinic and community. The focus of interest case administered during a residency practice is the application of the theory of self care and comfort model of nursing in postpartum mothers with breast engorgement, with the goal of comfort with selfcare skills. Thus, the application of theoretical models of self care and comfort is the right approach to client’s convenience and self help. Resident discusses the gaps in nursing care compared to the theory, outlines the roles and functions of nurses, and exposes the barriers and support in the implementation of residency practice."

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Retensi urin postpartum merupakan ketidakmampuan mengosongkan kandung kemih secara spontan setelah melahirkan dengan residu urin lebih dari 200 ml. Komplikasi yang dapat terjadi yaitu distensi kandung kemih, kontraksi uterus terhambat, perdarahan, otot detrusor melemah, kateterisasi intermiten dan disfungsi berkemih permanen. Penatalaksanaan keperawatan pada retensi urin postpartum dengan memberikan asuhan keperawatan secara holistik menggunakan studi kasus dan penerapan teori keperawatan. Penerapan teori self care Orem dan comfort Kolcaba pada lima kasus retensi urin postpartum dengan membahas permasalahan yang dialami dan menguraikan peran perawat pada kasus tersebut, dengan tujuan kebutuhan kenyamanan dan kemandirian pasien dapat terpenuhi. Kejadian retensi urin dapat diatasi dengan menerapkan evidence based nursing practice kegel excercise dan bladder training. Studi kasus yang dilakukan pada lima ibu postpartum yang mengalami retensi urin didapatkan bahwa kegel exercise dan bladder training mampu mengatasi retensi urin secara signifikan, menurunkan tingkat nyeri, dan meningkatkan self care.

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Postpartum urinary retention is the inability to empty the bladder spontaneously after giving birth with more than 200 ml urine residue. Complications that can occur are distention of the bladder, obstructed uterine contractions, bleeding, weak detrusor muscles, intermittent catheterization and permanent voiding dysfunction. Nursing management in postpartum urinary retention by providing nursing care holistically uses case studies and the application of nursing theory. Application of self care Orem and Comfort Kolcaba theory in five cases of postpartum urine retention by discussing the problems experienced and outlining the role of nurses in the case, with the aim of comfort and independence of patients can be fulfilled. Urinary retention can be overcome by applying evidence based nursing practice kegel excercise and bladder training. Case studies conducted on five postpartum mothers who experienced urinary retention found that kegel exercise and bladder training were able to overcome urinary retention significantly, reduce pain levels, and improve self care.

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"ABSTRAKIntrauterine fetal death (IUFD) adalah janin yang mati dalam rahim dengan berat 500 gram atau lebih atau kematian janin dalam rahim pada kehamilan 20 minggu atau lebih. Terdapat beberapa faktor penyebab IUFD yaitu maternal, fetal, dan plasenta. Kematian janin akan berdampak pada fisik maupun psikologis ibu sehingga dapat memengaruhi adaptasi mereka terhadap lingkungan. Teori adaptasi Roy dan Loss and Grieving Kubler  Ross  mengkaji  dan  menganalisa secara mendalam respon seseorang dalam beradaptasi terhadap perubahan serta membantu seseorang dalam mencapai adpatasinya baik secara fisiologis maupun psikologis. Penerapan teori  adaptasi Roy dan Kubler  Ross  dalam lima  kasus ini ditemukan masalah keperawatan berkaitan dengan fisik dan psikologis. Diagnosa yang muncul pada ibu post partum dengan IUFD sesuai dengan literatur diantara nya gangguan rasa nyaman nyeri, berduka dan kehilangan, gangguan istirahat dan tidur, defisit nutrisi, inefektif menyusui, resiko infeksi, gangguan keseimbangan volume cairan. Hasil intervensi yang dilakukan berdasarkan prinsip adaptasi Roy dan Loss and Grieving Klubler Ross pada kelima kasus menunjukkan bahwa aplikasi teori tersebut berhasil membantu menyelesaikan masalah keperawatan dan meningkatkan adaptasi dan mekanisme koping klien.

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ABSTRACTIntrauterine fetal death (IUFD) is a dead fetus in the womb with the weight 500 grams or more or death of the fetus in the womb at 20 weeks or more. There are several factors causing IUFD that is maternal, fetal, and placenta. Fetal death will have an impact on the physical and psychological mothers so as to influence their adaptation to the environment. Roy and Loss and Grieving's adaptation theory Kubler Ross examines and analyzes in depth a person's response to adaptation to change and helps one achieve his or her adaptation both physiologically and psychologically. The application of the theory of adaptation Roy and Kubler Ross in these five cases found nursing problems related to physical and psychological. Diagnosis that occurs in the post-partum mother with IUFD in accordance with the literature between the discomfort of pain,loss and grieving, rest and sleep disorders, nutritional deficits, inefective breastfeeding, infection risk, disturbance of fluid volume balance. The results of the intervention based on Roy's adaptation principle and Loss and Grieving Klubler Ross in the five cases indicate that the application of the theory successfully helped solve nursing problems and improve client's coping and adaptation mechanisms.

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