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"ABSTRAKKanker merupakan penyakit yang dapat menyebabkan gangguan nutrisi pada anak. Tujuan dari karya ilmiah akhir adalah menggambarkan aplikasi model konservasi Levine dalam melakukan asuhan keperawatan pada anak dengan kanker yang mengalami masalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh dan pencapaian kompetensi praktik spesialis keperawatan anak. Peran perawat yang dilakukan selama praktik residensi adalah sebagai pemberi asuhan, advokat, edukator, dan peneliti yang dilaksanakan dengan memperhatikan etik dan legal. Pendekatan model konservasi Levine menggunakan empat prinsip konservasi yaitu konservasi energi, integritas struktural, integritas personal, dan sosial. Empat prinsip konservasi tersebut diaplikasikan ke dalam proses keperawatan yang dimulai dengan pengkajian, trophicognosis, hipotesis, intervensi, dan evaluasi pada lima kasus kelolaan. Evaluasi yang didapat untuk masalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh adalah masalah teratasi sebagian ditandai dengan mual berkurang dan asupan makan meningkat. Model konservasi Levine dapat diaplikasikan pada anak dengan kanker dalam upaya konservasi energi dan peningkatan kualitas hidup anak.

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ABSTRACT

Children with cancer were potentially experienced nutritional imbalance. The purpose of the final report was to described the application of Levine Conservation Model in performing nursing care for children with cancer whom experienced problems nutritional imbalance, and achievement of residency competency for pediatric nursing. The role of the nurse performed during residency were conducted as direct nursing care, advocate, educator, and researcher based on professional, ethical and legal. Levine's model approach using four principles were conservation of energy, structural integrity, personal integrity, and social integrity. These conservation principles were applied to the nursing care since assessment, trophicognosis, hypothesis, intervention, and evaluation phases in five selected cases of patients. Organismic evaluation obtained for all nutritional imbalance problems were solved partially that can be measured from the lower level of nausea and the higher food intake. Levine conservation model may apply to nursing care in children with cancer who experienced nutritional problems to increase quality of life."

"Karya Ilmiah Akhir ini memberikan gambaran tentang pelaksanaan Program Residensi Ners Spesialis Keperawatan Anak. Tujuan penulisan Karya Ilmiah Akhir ini adalah memberikan gambaran penerapan Model Konservasi Levine dalam asuhan keperawatan pada anak dengan kanker yang mengalami masalah ketidakseimbangan nutrisi dan pencapaian kompetensi dalam praktik professional dan bertanggung gugat secara etik dan legal, memberikan asuhan dan manajemen asuhan keperawatan serta mengembangkan profesionalisme dalam peningkatan mutu pelayanan keperawatan. Terdapat lima kasus kelolaan yang menjadi pembahasan dalam karya ilmiah ini, dan dari kelima kasus terpilih ditemukan adanya masalah ketidakseimbangan nutrisi kurang dan lebih dari kebutuhan. Intervensi keperawatan yang diberikan didasarkan pada pinsip-prinsip konservasi, yaitu konservasi energi, integritas struktural, integritas personal dan integritas sosial. Hasil evaluasi berdasarkan respon organismik menunjukkan terdapat masalah yang teratasi, teratasi sebagian dan sudah menunjukkan perbaikan, belum teratasi serta tidak teratasi.

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This final report describes an implementation of Internship Pediatric Nursing Program. The purposes of this report are to provide an overview of Levine’s Conservation Model application on nursing care of children with cancer experiencing nutritional imbalance and of the competencies achievement within these three trajectories: professional, ethical and legal practice; care provision and management; professional development towards the quality of care improvement. This report presents five selected cases with nutritional imbalance problems: less and more than requirement. Nursing intervention were provide based on conservation principles: energy conservation, structural integrity, personal integrity and social integrity. Moreover, evaluation of the intervention based on organismic responses indicate that some problem were resolved, partially resolved with some improvement or unresolved."

"Masalah nutrisi merupakan permasalahan yang sering dihadapi oleh anak kanker. Tujuan penulisan Karya Ilmiah Akhir ini adalah memberikan gambaran pelaksanaan Praktik Residensi Keperawatan Anak kanker yang mengalami masalah nutrisi dengan mengaplikasikan Model Konservasi Levine. Dalam pencapaian kompetensi sebagai Ners Spesialis Keperawatan Anak residen telah menjalankan peran sebagai pemberi asuhan keperawatan, peran koordinasi dan kolaborasi, pembuatan keputusan etik, advocator, dan innovator. Aplikasi Model Konservasi Levine tertuang dalam lima kasus terpilih, dimana trophicognosis yang umum ditemukan adalah ketidakseimbangan nutrisi kurang atau lebih dari kebutuhan tubuh. Intervensi diberikan berdasarkan empat prinsip konservasi. Hasil evaluasi terhadap trophicognosis ketidakseimbangan nutrisi menunjukkan adanya peningkatan terhadap kemampuan konservasi energi. Model Konservasi Levine dapat diterapkan pada klien anak dengan kanker yang mengalami masalah nutrisi. Pencapaian kompetensi dalam praktik residensi keperawatan anak telah memperkaya dan meningkatkan pengetahuan serta keterampilan klinis residen.

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Nutritional problem is commonly faced by children with cancer. The aim of this final assignment was to provide Nursing Practice Residency implementation of children with cancer which have nutritional problems by applying Levine Conservation Model. Competencies that had been made included providing nursing care, coordination and collaboration, ethical decision making, advocator and innovator. Levine Conservation Model was applied in five selected cases and the trophicognosis commonly found was imbalanced nutrition supply of the body needs. Interventions were given based on the four principles of conservation, that are conservation of energy, conservation of structural integrity, conservation of personal integrity, and conservation of social integrity. Evaluation of nutritional imbalance trophicognosis showed an increase in energy conservation ability. Levine Conservation Model can be applied to children with cancer who have a nutrition problem. Achievement of competence in the practice residency of nursing children have enriching and improving knowledge and clinical skills of resident."

"Demam merupakan gejala yang sering dialami anak dengan penyakit infeksi. Kondisi demam tinggi berdampak merugikan anak. Demam tinggi membuat anak tidak nyaman dan orang tua cemas serta meningkatkan kebutuhan kalori dan cairan. Oleh karena itu dibutuhkan asuhan keperawatan model konservasi. Penulisan Karya Ilmiah Akhir ini bertujuan memberikan gambaran kegiatan pelaksanaan praktik residensi ners spesialis anak, gambaran aplikasi model konservasi dalam asuhan keperawatan demam pada anak yang mengalami penyakit infeksi. Model Konservasi Levine berfokus pada konservasi energi, integritas struktrur, personal dan sosial untuk mencapai keutuhan. Berdasarkan 5 kasus yang dibahas, intervensi yang diberikan untuk trophicognosis peningkatan suhu tubuh (demam) antara lain mengupayakan penurunan suhu tubuh, mempertahankan lingkungan sejuk dan nyaman, meningkatkan istirahat, memberikan asupan cairan dan nutrisi adekuat serta menurunkan kecemasan anak dan orang tua menggunakan konsep family centered care. Model Konservasi dapat diterapkan dalam asuhan anak demam. Disarankan untuk lebih meningkatkan upaya konservasi integritas personal dan sosial melalui pendidikan kesehatan pada keluarga.

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Fever is a symptom that is often experienced by children with infectious diseases. High fever conditions adversely affects children. High fever makes the child uncomfortable and parent’s anxiety and also increase calorie and fluid needs. Therefore, the child needs nursing care such as conservation model by Levine. This scientific final assignment to provide an overview of the implementation of the activities of child specialist nurse practice, an overview of applications of conservation models in nursing care of fever in children with infectious diseases. Levine Conservation Model focuses on energy conservation, structure integrity, personal and social to achieve wholeness. Based on 5 cases discussed, interventions given to trophicognosis increased body temperature (fever), which are to seek a decrease in body temperature, maintaining comfortable environment, improve rest, provide adequate nutrition and fluid intake as well as decrease the anxiety of children and parents using the concept of family-centered care. Conservation Model can be applied in the care of fever children. It is recommended to further enhance the conservation of personal integrity and social health through the family education."

"Karya ilmiah akhir ini membahas tentang penerapan model Konservasi Levine dalam pemberian asuhan keperawatan pada pada anak dengan gangguan pernapasan. Infeksi saluran pernapasan akut merupakan suatu gangguan pulmonal yang memiliki efek samping hipoksemia dan kegagalan pernapasan melalui pemberian asuhan keperawatan dengan menerapkan prinsip konservasi untuk mempertahankan keseimbangan energi, konservasi integritas struktural, personal dan sosial. Beberapa masalah keperawatan yang ditemukan antara lain gangguan pertukaran gas, ketidakefektifan pola napas dan ketidakefektifan bersihan jalan napas. Model Konservasi diharapkan menjadi acuan praktik keperawatan pada pada anak dengan gangguan pernapasan.

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The end scientific work is about the application of the Levine's Conservation model in the provision of nursing care to children with respiratory disorders. Respiratory infection acute is a pulmonary disorder that has a side effect of hypoxemia and respiratory failure. The side effects of hypoxemia and respiratory failure can be minimized through the provision of nursing care by applying the principle of conservation of energy to maintain balance, conservation of structural integrity, personal and social. Some nursing problems were found among other disorders of gas exchange, breathing pattern ineffective airway clearance and ineffectiveness. This Conservation model is expected to be a reference of nursing practice in children with respiratory disorders."

"[ABSTRAKAnak dan remaja yang menderita kanker sering mengalami gangguan tidur yang dapat menyebabkan penurunan daya tahan tubuh dan mempengaruhi kualitas hidup. Tujuan penulisan karya ilmiah akhir ini untuk memberikan gambaran penerapan Model Konservasi Levine dalam asuhan keperawatan pada anak dengan kanker yang mengalami gangguan tidur serta pencapain kompetensi sebagai pemberi asuhan, advocator, conselor, educator, colaborator serta inovator selama praktik residensi. Terdapat lima kasus kelolaan yang menjadi pembahasan dalam karya ilmiah ini dan teridentifikasi masalah tidur yaitu gangguan pola tidur dan gangguan kurang tidur. Intervensi keperawatan yang diberikan didasarkan pada prinsip-prinsip konservasi, yaitu konservasi energi, integritas struktural, integritas personal dan integritas sosial. Hasil evaluasi berdasarkan respon organismik menunjukkan ada masalah yang teratasi, teratasi sebagian dan menunjukkan perbaikan serta belum teratasi. Residen merekomendasikan penerapan Model Konservasi Levine dalam asuhan keperawatan pada anak dengan kanker yang mengalami masalah gangguan tidur dengan intervensi sleep hygiene dan terapi komplementer pemberian madu sebelum anak tidur untuk mencapai hasil asuhan yang optimal.

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ABSTRACTChildren and adolescents with cancer often experience sleep disorders that can lead to a decrease in the immune system and affect the quality of life. The purpose of this report is provide an overview Levine's Conservation Model application on nursing care of children with cancer experiencing sleep patterns and of the competencies such as a caregiver, advocator, counselor, educator, collaborator, and inovator during practice. There are five cases which being discussed on this scientific work and from five selected cases founded sleep disorders such as sleep patterns and sleep disturbances. Nursing intervention based on conservation principles such as energy conservation, structural integrity, personal integrity and social integrity. Moreover, evaluation of the intervention based on organismic responses indicate that some problem were resolved, partially resolved with some improvement or unresolved. Resident recommended the applicaton Levine's Conservation Model on nursing care of children with cancer experiencing sleep disorders with the intervention of sleep hygiene and the provision of complementary therapies giving honey before children's sleep to achieve optimal results. , Children and adolescents with cancer often experience sleep disorders that can lead to a decrease in the immune system and affect the quality of life. The purpose of this report is provide an overview Levine’s Conservation Model application on nursing care of children with cancer experiencing sleep patterns and of the competencies such as a caregiver, advocator, counselor, educator, collaborator, and inovator during practice. There are five cases which being discussed on this scientific work and from five selected cases founded sleep disorders such as sleep patterns and sleep disturbances. Nursing intervention based on conservation principles such as energy conservation, structural integrity, personal integrity and social integrity. Moreover, evaluation of the intervention based on organismic responses indicate that some problem were resolved, partially resolved with some improvement or unresolved. Resident recommended the applicaton Levine’s Conservation Model on nursing care of children with cancer experiencing sleep disorders with the intervention of sleep hygiene and the provision of complementary therapies giving honey before children’s sleep to achieve optimal results. ]"

"Karya ilmiah akhir ini memberikan gambaran tentang pelaksanaan program residensi Ners Spesialis Keperawatan Anak dalam bentuk kegiatan praktik residensi I dan II. Karya ilmiah ini bertujuan untuk memberikan gambaran aplikasi Model Konservasi Levine pada asuhan keperawatan anak dengan penyakit infeksi dan pencapaian kompetensi baik sebagai pemberi asuhan, pendidik, advokad, konsultan, dan pembaharu selama praktik residensi. Menurut Model Konservasi Levine , tropicognosis risiko kerusakan integritas kulit : luka tekan merupakan gangguan dari konservasi integritas struktur. Lima kasus kelolaan terpilih ditemukan adanya masalah risiko kerusakan integritas kulit. Intervensi yang diberikan berdasarkan empat prinsip konservasi yaitu mengkaji faktor risiko kerusakan integritas kulit menggunakan skala Braden Q, menjaga kebersihan dan perawatan kulit, memberikan perubahan posisi pasien, memberikan nutrisi yang adekuat, edukasi serta kolaborasi pemberian terapi. Hasil evaluasi akhir dari trophicognosis risiko kerusakan integritas kulit pada lima kasus kelolaan terpilih menunjukkan tidak terjadi kerusakan integritas kulit : luka tekan.

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This final assignment provides an overview about the implementation residency practices of the specialist pediatries nurse program in the form practical activities residency I and II. The aim of this final assignment is provide overview application conservation model Levine on nursing care of children with infectiosus diseases and the achicvement of competencies such as a caregiver, educator, advocator, counselor, and change agents during practice residency. According Levine conservation models, trophicognosis risk of damage to integrity of the skin pressure sores is a disorder the conservation of structural integrity. The five selected cases, indicating risk of damage to skin integrity. Intervention given bassed on the four principles of conservation the examined risk of damage to integrity skin using the Braden scale Q, hygiene and skin care, providing patient position changes, adequate nutrition, education and collaboration therapy. The evaluation results of trophicognosis the risk of damage to skin integrity on selected five cases showd no damage to skin integrity pressure sores."

"[ABSTRAKAnak malnutrisi membutuhkan energi cukup besar untuk memenuhi kebutuhan metabolisme tubuh. Karya Ilmiah Akhir bertujuan menggambarkan aplikasi model konservasi Levine pada anak dengan penyakit infeksi yang mengalami malnutrisi. Intervensi yang diberikan pada kelima kasus menggunakan empat prinsip konservasi energi yaitu menilai status nutrisi pasien, memonitor intake dan output, mengajarkan keluarga tentang pemberian nutrisi melalui NGT serta kolaborasi dengan tim gizi dalam menentukan kebutuhan nutrisi pasien. Evaluasi menunjukkan adanya peningkatan status nutrisi pada beberapa kasus dengan penyakit penyerta. Model konservasi Levinedapat digunakan dalam memberikan asuhan keperawatan pada anak malnutrisi dengan mempertimbangkan adanya penyakit penyerta yang mengakibatkan tidak tercapainya wholeness.

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ABSTRACTChildren with malnutrition need much energy to fulfill the needs of the body?s metabolism. The final scientific paper aims to describe the application of Levine?s conservation model to children with infectious diseases and malnutrition. The interventions which are given to those 5 cases use 4 conservation principles of energy that is evaluating the status of nutrition of patient, monitoring the intake and ouput, educating the family how to give the nutrition via NGT and collaborating with nutrition team to specify the needs of nutrition of patient. The evaluation shows that there is the rise of nutrition status to some cases with comorbidities. The Levine?s conservation model can be used to give nursing care to children with malnutrition by considering the comorbidities which make the wholeness tough to reach.;Children with malnutrition need much energy to fulfill the needs of the body?s metabolism. The final scientific paper aims to describe the application of Levine?s conservation model to children with infectious diseases and malnutrition. The interventions which are given to those 5 cases use 4 conservation principles of energy that is evaluating the status of nutrition of patient, monitoring the intake and ouput, educating the family how to give the nutrition via NGT and collaborating with nutrition team to specify the needs of nutrition of patient. The evaluation shows that there is the rise of nutrition status to some cases with comorbidities. The Levine?s conservation model can be used to give nursing care to children with malnutrition by considering the comorbidities which make the wholeness tough to reach., Children with malnutrition need much energy to fulfill the needs of the body’s metabolism. The final scientific paper aims to describe the application of Levine’s conservation model to children with infectious diseases and malnutrition. The interventions which are given to those 5 cases use 4 conservation principles of energy that is evaluating the status of nutrition of patient, monitoring the intake and ouput, educating the family how to give the nutrition via NGT and collaborating with nutrition team to specify the needs of nutrition of patient. The evaluation shows that there is the rise of nutrition status to some cases with comorbidities. The Levine’s conservation model can be used to give nursing care to children with malnutrition by considering the comorbidities which make the wholeness tough to reach.]"

"Anak selama dirawat rentan mengalami berbagai masalah kesehatan termasuk kerusakan integritas kulit. Tujuan penulisan Karya Ilmiah Akhir ini adalah memberikan gambaran aplikasi Model Konservasi Levine dalam asuhan keperawatan dan gambaran pencapaian kompetensi serta peran perawat dalam asuhan keperawaatan pada anak yang berisiko mengalami kerusakan integritas kulit. Model Konservasi Levine berfokus pada peningkatan adaptasi melalui prinsip konservasi untuk mencapai keutuhan diri. Hasil evaluasi didapatkan bahwa integritas kulit semua kasus kelolaan dapat terjaga. Hal ini menunjukkan bahwa Model Konservasi Levine dapat diaplikasikan pada pasien yang berisiko mengalami kerusakan integritas kulit. Asuhan keperawatan dilaksanakan oleh residen dengan melaksanakan perannya sebagai pemberi asuhan, pendidik, pengelola asuhan, advokat, peneliti dan agen pembaharu.

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Children over the treated susceptible to a variety of health problems including damage to skin integrity. The purpose of this final scientific writing is to give an overview of applications Levine’s Conservation Model in nursing care and description of the achievement of competence and the role of nurses in the care in children at risk of damage to the integrity of the skin. Levine’s Conservation Model focuses on improving adaptation through conservation principles to achieve wholeness. Evaluation results showed that all cases of skin integrity can be maintained under management. This suggests that the Levine's Conservation Model can be applied to patients at risk of damage to the integrity of the skin. Carried out by the resident nursing care by carrying out its role as caregivers, educators, care managers, advocates, researchers and innovators agent. "

"Karya Ilmiah Akhir ini merupakan gambaran pelaksanaan kegiatan praktik keperawatan ners spesialis anak selama satu tahun yang dimulai dari tanggal 3 Oktober 2011 sampai dengan 20 April 2012 yang menerapkan peran dan fungsi dari ners spesialis keperawatan anak. Karya Ilmiah Akhir ini memfokuskan pada aplikasi Teori Konservasi Levine dalam asuhan keperawatan klien anak yang mengalami peningkatan suhu tubuh di ruang perawatan penyakit infeksi. Pengkajian yang dilakukan meliputi konservasi energi, konservasi integritas struktur, konservasi integritas personal dan konservasi integritas sosial. Tropikognosis dan justifikasi yang dirumuskan meliputi dari keempat konservasi tersebut. Hipotesa, planning dan implementasi disesuaikan dengan konservasi energi, konservasi integritas struktur, konservasi integritas personal dan konservasi integritas sosial. Dari hasil evaluasi didapatkan bahwa kelima kasus klien terpilih yang mengalami peningkatan suhu tubuh setelah diberikan asuhan keperawatan, didapatkan hasil 5 klien semuanya terbebas dari demam dan semuanya pulang dengan kondisi bebas demam. Selanjutnya dalam memberikan asuhan keperawatan pada klien anak, residen merekomendasikan untuk menerapkan prinsip caring, atraumatic care, family centered care dan upaya pencegahan infeksi nosokomial dengan cara bekerja sesuai dengan standar operasional prosedur dan standar asuhan keperawatan serta memperhatikan prinsip sterilitas dan teknik aseptik yang dapat dilakukan dengan tindakan cuci tangan dengan handrub. Sebagai inovator residen melakukan modifikasi ruang tindakan menjadi ruangan yang bernuansa anak untuk meminimalkan atraumatic care dan residen juga melakukan discharge planning dimulai dari pasien baru sampai pasien pulang dan membuat media penkes sebagai media untuk melakukan pendidikan kesehatan pada orang tua dan keluarga pasien.

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This final scientific paper is a clinical nursing practice report of pediatrics nurse specialist practice that is conducted for one year from 3rd October 2011 until 20th April 2012 by applying the role and function of pediatrics nurse specialist. The paper is focusing on the application of Levine’s conservation theory into nursing care of children suffering from hyperthermia in infection ward. The assessment that is performed including conservation of energy, the structure of conservation integrity, personal integrity conservation, and social integrity conservation. Tropicognoses and justification, which are formulated including the fourth areas of conservation. Hipotesa, plan, and implementation are customized with conservation of energy, the structure of conservation integrity, personal integrity conservation, and social integrity conservation. Based on the conducted evaluation, it was resulted that from five chosen clients who suffering from hypothermia, after receiving nursing care they were recover from hyperthermia and discharged home with normal body temperature. Moreover, in providing nursing care to children, resident recommends to apply the principal of caring, atraumatic care, family centered care and effort preventing nosocomial infection by working based on standard operating procedure and nursing care standard, and also applying sterile principal and aseptic technique by washing hand with handrub. As an innovator, resident modified the intervention room as a child room with some decorations in order to minimize atraumatic care. The resident was also made a discharge planning with starting from obtaining new patient until discharging home, and provided health education for parents and family of clients."