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"ABSTRAK Laporan Praktek Residensi Spesialis Keperawatan Maternitas Dengan Penerapan Teori Need For Help Wiedenbach, Self Care Orem Dan Caring Swanson Pada Ibu Dengan Preeklampsia Abstrak Angka kematian ibu di Indonesia masih tinggi yaitu sebesar 359/100.000 kelahiran hidup. Pada tahun 2013 tercatat 27.1 penyebab kematian ibu disebabkan karena hipertensi pada kehamilan yang merupakan urutan kedua penyebab kematian ibu di Indonesia setelah pendarahan. Angka kematian ibu akibat preeklamsia di Indonesia adalah antara 9,8 - 25 . Perawat sebagai bagian dari tenaga kesehatan memiliki peran untuk memberikan asuhan keperawatan yang komprehensif untuk memantau dan memonitor kondisi ibu.Kasus kelolaan ada lima, namun dijelaskan secara terperinci pada satu kasus kelolaan. Hasil yang diperoleh dari keempat klien berusia < 20 tahun, satu kasus kehamilan yang kedua dan empat kasus kehamilan pertama, dua kasus dengan eklampsia, dan tiga kasus dengan preeklampsia berat, terdapat edema, dan protein urin lebih dari positif satu. Kelima kasus dilakukan pembedahan seksio sesaria, tiga kasus beresiko tinggi mengalami post partum blues. Fase akut menggunakan pengkajian dengan model konsep need for help Wiedenbach, sedangkan fase pemulihan menggunakan teori self care Orem dan caring Swanson. Pada fase akut pasien mengalami masalah gangguan perfusi jaringan serebral, intoleransi aktivitas, resiko cidera pada janin dan kecemasan. Sedangkan pada fase pemulihan pasien mengalami gangguan rasa nyaman nyeri, hambatan mobilitas fisik, defisit perawatan diri, kecemasan, dan resiko tinggi koping individu tidak efektif.Ketiga teori keperawatan ini dapat diterapkan pada pasien dengan preeklampsia untuk penanganan masalah emergensi pada fase akut dan peningkatan kenyamanan, perawatan diri setelah operasi dan peningkatan koping yang efektif untuk penanganan pada masa pemulihan bagi ibu dan bayinya. Kata Kunci: preeklampsia, need for help Wiedenbach, self care Orem, caring Swanson ABSTRACT Report Of Specialist Practice Residency Maternity Nursing Theory And Concept With The Application Of Need For Help Wiedenbach, Self Care Orem Dan Caring Swanson In Mother With Preeklampsia. Abstract Maternal mortality rate in Indonesia is 359 100,000 live births. On 2013 the prevalence of maternal mortality rate cause of on the pregnant woman is 27,1 . This is the second maternal death in Indonesia after bleeding. Maternal mortality death caused by preeclampsia in Indonesia is between 9.8 25 . Nurse as a part of the health workers has a role to give comprehensive nursing care to monitor the condition of the motherFrom five cases founded, only one case was explain in details. There are four clients with age less than 20. On that case it was found one case on the second second pregnancy, four cases on the first pregnancy, two cases with eclampsia, and three cases with severe preeclampsia, five with cases with high blood pressure, edema, and urine protein more than positive one . Five cases were done section cesarean, three high risk caused post partum blues. The acute phase using assessment with the model concept of Wiedenbach, while the recovery phase using Orem self care and caring Swanson theory. On the acute phase the clients having a problems with tissue perfusion problems, activity intolerance, fetal risk and anxiety. While in the recovery phase of patients experiencing painful discomfort, physical imobility, self care deficit, anxiety, and high risk of ineffective individual coping.These nursing theories can be applied to patients with preeclampsia for the emergency problems in the acute phase and improved self care after surgery and effective coping enhancement for recovery treatment for mother and baby. Keywords reeclampsia, concept of Wiedenbach, self care Orem, caring Swanson"

"[ABSTRAKPermasalahan kesehatan selama masa kehamilan membutuhkan perhatian dari petugas kesehatan sehingga proses kehamilan dan persalinan dapat berjalan selamat. Peran Ners spesialis keperawatan maternitas sangat diperlukan dalam upaya pencegahan dan penanggulangan masalah tersebut. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran pelaksanaan praktik residensi ners spesialis keperawatan maternitas dan memberikan gambaran fokus penerapan model konsep need for help Wiedenbach pada fase akut dan self care Orem pada fase pemeliharaan. Evaluasi yang diharapkan pada fase akut adalah kontraksi berhenti, dan tidak adanya tanda-tanda kegawatan maternal dan janin. Evaluasi pada fase pemeliharaan yaitu peningkatan kemandirian klien. Penerapan model dan konsep keperawatan need for help dan self care terbukti bermanfaat mengatasi kontraksi dalam kehamilan sehingga bisa di aplikasikan dalam proses asuhan keperawatan kontraksi dalam kehamilan.

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ABSTRACTHealth problems during pregnancy require the attention of health professionals so that the process of pregnancy and childbirth can be safe. The role of maternity nursing specialist is indispensable in the prevention and control of the problem. This final scientific work aimed to provide an overview of the implementation of maternity nursing specialist residency practice and describe the application of Wiedenbach Need for Help Conceptual Model in the acute phase and Orem Self Care Conceptual Model in the maintenance phase. The expected evaluation in the acute phase was the contraction stopped, and there were no signs of maternal and fetal distress. The evaluation in the maintenance phase was the increase of the client independency. The application of Need for Help and Self Care Nursing Model and Concept has been proved beneficial to overcome the preterm contraction, so that these models can be applied in the nursing care process of preterm contraction., Health problems during pregnancy require the attention of health professionals so that the process of pregnancy and childbirth can be safe. The role of maternity nursing specialist is indispensable in the prevention and control of the problem. This final scientific work aimed to provide an overview of the implementation of maternity nursing specialist residency practice and describe the application of Wiedenbach Need for Help Conceptual Model in the acute phase and Orem Self Care Conceptual Model in the maintenance phase. The expected evaluation in the acute phase was the contraction stopped, and there were no signs of maternal and fetal distress. The evaluation in the maintenance phase was the increase of the client independency. The application of Need for Help and Self Care Nursing Model and Concept has been proved beneficial to overcome the preterm contraction, so that these models can be applied in the nursing care process of preterm contraction.]"

"Praktik residensi keperawatan maternitas diselenggarakan untuk menghasilkan perawat maternitas yang menguasai aplikasi teori keperawatan maternitas dan memiliki keterampilan khusus untuk melakukan perawatan maternitas baik di rumah sakit maupun di komunitas. Laporan residensi ini menjelaskan tentang pelaksanaan praktik residensi maternitas, peran dan fungsi perawat maternitas, pencapaian kompetensi praktik dan upaya untuk memodifikasi hambatan yang dihadapi. Laporan residensi ini fokus pada penerapan teori need for help Wiedenbach dan self care Orem pada ibu hamil dengan tuberculosis multi drug resistance. Perawat maternitas perlu meningkatkan pengetahuan dan keterampilan klinik secara berkelanjutan sehingga mampu meningkatkan kualitas asuhan keperawatan maternitas.

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Maternity nursing practice residency organized to produce nurse of maternity who master the application of nursing theory and have special skills to do a good maternity care in hospitals and in the community. This residency final report describes the implementation of the practice residency maternity, roles and functions of nurses maternity, the attainment of practice and attempts to modify the barriers. Focus of this final report is application of theory need for help Wiedenbach and self care Orem in pregnant women with tuberculosis multi drug resistance. Nurse maternity needs to improve knowledge and clinical skills on an ongoing basis to improve the quality of maternity nursing care. "

"[Integrasi teori model need for help Wiedenbach dengan self care Orem pada asuhan keperawatan pasien dengan mola hidatidosa menjadi kerangka kerja praktik Residensi keperawatan maternitas selama satu tahun. Laporan ini bertujuan untuk memberikan gambaran asuhan keperawatan pada kehamilan normal dan resiko tinggi, perempuan yang mengalami masalah reproduksi, dan ginekologi pada tatanan klinik atau komunitas. Hasil Residensi menunjukan bahwa kedua model tersebut efektif dan efesien dalam membantu mengatasi permasalahan pasien dengan mola hidatidosa. Pencapaian kompetensi Perawat Spesialis Maternitas dilakukan melalui penerapan peran Perawat secara komprehensif., Integration theory models Wiedenbach need for help with self-care Orem on nursing care of patients with hydatidiform mole into the framework of maternity nursing practice residency for one year. This report aims to provide an overview of nursing care in the normal and high-risk pregnancy, women who have reproductive problems, and gynecology at the clinic or community order. Residency results showed that both models are effective and efficient in helping to overcome the problems of patients with hydatidiform mole. Achievement of competence Specialist Nurse Maternity Nurse role is done through the implementation of a comprehensive manner.]"

"Perawat spesialis maternitas berperan dalam menurunkan Angka Kematian Ibu AKI akibat komplikasi kehamilan dan persalinan. Salah satu peran perawat adalah memberikan asuhan keperawatan yang komprehensif dengan mengidentifikasi dan mengatasi masalah pasien perdarahan post partum dengan pedekatan teori keperawatan. Penerapan model need for help Wiedenbach diterapkan pada fase akut untuk mefasilitasi ibu mengatasi masalah perdarahan yang dialami dan teori self care Orem diterapkan pada fase pemulihan untuk memfasilitasi pasien meningkatkan kemampuan dalam merawat dirinya. Lima kasus kelolaan pasien memiliki masalah yang berbeda beda sesuai hasil pengkajian model need for help Wiedenbach dan self care Orem. Kasus yang dilaporkan adalah pasien perdarahan post partum akibat retensio plasenta dengan keluhan perdarahan aktif, lemas, pusing. Masalah keperawatan yang ditemukan pada fase akut adalah perdarahan, kurang volume cairan, resiko gangguan perfusi jaringan, kecemasan, sedangkan masalah keperawatan pada fase pemeliharaan adalah defisit perawatan diri, risiko cidera, nyeri, kecemasan, dan berduka. Intervensi keperawatan yang dilakukan pada fase akut adalah untuk mengatasi masalah kegawatan dengan menghentikan perdarahan dan resusitasi cairan. Sedangkan intervensi keperawatan pada fase pemulihan adalah untuk meningkatkan kemandirian pasien dalam melakukan perawatan dirinya. Evaluasi yang didapatkan adalah perdarahan teratasi dan pasien mandiri dalam melakukan perawatan dirinya

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The Final Report of residential of Maternity Nursing Specialist which focus on application Theori of need for Help Wiedenbach and Self Care orem of Women with Post Partum Haemorhagae AbstrackMaternity nursing specialists have role in reducing maternal mortality due to complication of pregnancy and childbirth. One of the nurses 39 roles is to provide comprehensive nursing care by identifying and resolving patient problems with postpartum hemorrhage using nursing theories. The application of "the need for help" Wiedenbach theory in the acute phase is to facilitate mother in overcoming the bleeding problem and "the self care" Orem theory is applied in the recovery phase to facilitate patient having self care. Five cases of postpartum hemorrhage patients have different problems according to the results of "the need for help" theory of Wiedenbach and "self care" theory of Orem.

Reported cases were postpartum hemorrhage patients due to placental retention with active bleeding, weakness and dizziness complaints. Nursing problems found in the acute phase are bleeding, lack of fluid volume and risk of tissue perfusion disorders, while the problems in the recovery phase are self care deficits, risk of injury, pain, anxiety and grief. In the acute phase, nursing interventions is conducted to overcome emergency problem by stopping bleeding and fluid resusitation. While in the recovery phase, the nursing interventions is conducted to facilitate patients in doing self care. Evaluation obtained is bleeding resolved and having self care patients. "

"[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.]"

"Karya ilmiah akhir disusun sebagai laporan praktik residensi ners spesialis keperawatan maternitas yang menggambarkan pencapaian kompetensi ners spesialis keperawatan maternitas dengan fokus pada aplikasi teori keperawatan need for help dan symptom management pada ibu hamil dengan preeklampsia berat. Kompetensi ners spesialis keperawatan maternitas diwujudkan dengan penerapan peran dan fungsi perawat sebagai pemberi pelayanan keperawatan, advokat. manajer, rehabilitator, komunikator, edukator, kolaborator, dan agen perubah. Aplikasi teori keperawatan need for help Wiedenbach dan symptom management Humphreys pada ibu hamil dengan preeklampsia berat dapat mengatasi masalah keperawatan selama fase akut dan pemeliharaan.

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This final report is created as a report of maternity nursing specialist residency practice which describes the achievement of maternity nursing specialist's competencies focused on the application of 'need for help' and 'symptom management' nursing theory to pregnant women with severe preeclampsia. The competencies of a maternity nursing specialist were actualized by the implementation of roles and functions as a nursing care provider, an advocate, a manager, a rehabilitator, a communicator, an educator, a collaborator, and a change agent The application of Wiedenbach's 'need for help' nursing theory and Humphreys theory of symptom management to pregnant w9men with severe preeclampsia could solve the nursing problems during acute and maintenance phase."

"Integrasi teori model need for help Wiedenbach dengan self care Orem pada asuhan keperawatan klien dengan abortus inkomplet menjadi kerangka kerja praktik residensi keperawatan maternitas selama setahun. Laporan ini bertujuan untuk memberikan gambaran asuhan keperawatan pada child bearing normal dan risiko tinggi, bayi baru lahir normal dan risiko tinggi, perempuan yang mengalami masalah reproduksi dan ginekologi, yang dilaksanakan pada tatanan klinik maupun komunitas. Hasil residensi menunjukkan bahwa kedua model tersebut efektif dan efisien dalam membantu mengatasi permasalahan lima klien dan keluarga dengan abortus inkomplet. Pencapaian kompetensi perawat spesialis maternitas dilakukan melalui penerapan peran perawat secara komprehensif.

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Integration of theoretical model Wiedenbach "need for help" with Orem "self care" in nursing care to clients with incomplete abortion became framework of maternal health nursing specialist student practice for a year. This report aims to provide an overview of nursing care at risk of normal child bearing and high-risk, normal newborns and high risk, women who experience reproductive problems and gynecology, which conducted at the clinical and community setting. It showed that both models were effective and efficient to five clients and family in solving their problems. The nurse specialist maternity competencies were achieved through applying nurse roles comprehensively."

"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. "

"Karya ilmiah akhir ini disusun sebagai laporan dari praktik residensi spesialis keperawatan Maternitas yang berfokus pada penerapan teori keperawatan Need for Help Wiedenbach dan Comfort Kolcaba pada asuhan keperawatan ibu yang mengalami partus lama Tujuan penulisan laporan ini untuk memberikan gambaran pelaksanaan praktik Spesialis Keperawatan Maternitas 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 help Wiedenbach dan Theory of Comfort Kolcaba efektif dilakukan pada enam ibu dengan partus lama Aplikasi teori tersebut berhasil membantu menyelesaikan masalah keperawatan dan meningkatkan kenyamanan klien selama persalinan Setelah melaksanakan praktik residensi spesialis keperawatan maternitas penulis mampu mencapai target kompetensi dengan baik Kata kunci asuhan keperawatan partus lama teori keperawatan 'comfort' teori keperawatan 'need for help'

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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 Kolcaba's theory of comfort in the nursing care to clients who experience prolonged labour 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 Kolcaba's theory of comfort in the nursing care was effective to resolve client's health problem and increased the comfort of the mother during labour After finishing residential practice of maternity nursing specialist the competencies was achieved with a good result Keyword nursing process nursing theory of comfort nursing theory of need for help prolonged labour "