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"Pasien dengan tumor lambung post operasi gastrektomi total memiliki risiko malnutrisi karena akan ada perubahan asupan nutrisi pada pasien. Dalam rangka mencegah terjadinya malnutrisi, pasien perlu mendapat edukasi nutrisi yang intensif agar efikasi diri, kepuasaan diri, dan asupan nutrisi pasien tidak mengalami penurunan. Penulisan karya ilmiah ini bertujuan untuk mengidentifikasi pengaruh edukasi nutrisi secara intensif terhadap status nutrisi dan kemunculan dumping syndrome pada pasien post operasi gastrektomi. Hasil evaluasi menggunakan instrumen Malnutrition Screening Tools (MST) menunjukan bahwa pasien tidak berisiko malnutrisi (skor= 2), IMT dalam kategori normal (25 kg/m²), hasil lab menunjukan Hb= 12,8 g/dL, Ht= 36%, dan GDS= 138 mg/dL, dan gejala dumping syndrome tidak muncul. Intervensi edukasi nutrisi secara intensif ini dapat diaplikasikan oleh tenaga kesehatan seperti perawat, dokter, dan ahli gizi sebagai upaya untuk mencegah terjadinya malnutrisi pada pasien post operasi gastrektomi.

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Patients with gastric tumor after total gastrectomy have a risk of malnutrition because there will be changes in nutritional intake. In order to overcome malnutrition, patients need to receive intensive nutrition education so that self-efficacy, self-satisfaction and nutritional intake of patients do not decrease. This paper aims to identify the effect of nutrition education on nutritional status in patients postoperative total gastrectomy. The evaluation results using the Malnutrition Screening Instrument (MST) showed that patients were not at risk of malnutrition (score = 2), BMI in the normal category (25 kg / m2), result of biochemical showed Hb = 12.8 g / dL, Ht = 36%, and GDS = 138 mg / dL, and the dumping symptom syndrome did not occur. This intensive nutrition education intervention can be applied by health workers such as nurses as an effort to prevent the use of malnutrition in patients after total gastrectomy. "

"Fraktur merupakan salah satu masalah perkotaan akibat cedera fisik. Penatalaksanaan fraktur patologis cukup kompleks dan mengakibatkan imobilisasi yang lama. Tingkat kemampuan mobilisasi pasien pasca total hip replacement dapat ditingkatkan melalui therapeutic exercise yang meliputi latihan range of motion, angkle pump, quads statis dan gluteal statis, serta latihan ambulasi menggunakan alat bantu yang telah diajarkan selama masa rawat. Hasil latihan menunjukkan meningkatnya kemampuan mobilisasi secara bertahap dan aman. Therapeutic exercise merupakan latihan efektif untuk meningkatkan mobilisasi dan mendukung ambulasi. Perawat perlu meningkatkan pengetahuan dan kemampuan melakukan therapeutic exercise untuk meningkatkan mobilisasi dan dibarengi peningkatan status kesehatan dengan perbaikan masalah kesehatan pasca THR.

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The most frequent problem of urban health is fractures due to physical injuries. The management of pathological fracture is complex and leads to prolong immobilization. Patients ability level after total hip replacement surgery can be enhanced by therapeutic exercise that includes range of motion, ankle pump, quads and gluteal static exercise, and ambulatory exercises using walker in rehabilitation phase while hospital stays.

The results of exercise show patients ability had increased gradually and secure to perform mobilizations. Therapeutic exercise is an effective exercise to improve mobilization and support ambulation. Nurses need to improve their knowledge and ability to perform therapeutic exercise as treatment of mobilization and be accompanied by improved patient health status from potential health problems after total hip replacement."

"ABSTRAKKecelakaan dapat menyebabkan cedera pada manusia salahsatunya terjatuh dan menyebabkan fraktur dintaranya fraktur hip. Nyeri secara terus menerus dan resiko komplikasi membuat fraktur hip harus segera diatasi, salah satunya penangan dengan pembedahan yaitu total hip replacement. Klien dengan post operasi total hip replaceman beresiko untuk mengalami dislokasi dan masalah dalam mobilisasi jika tidak dilakukan pengawasan dengan baik dan benar. Oleh karena itu diperlukan penangan pasca pembedahan berupa pemberian edukasi untuk pencegahan dislokasi pada sendi pinggul dan latihan kekuatan otot serta latihan mobilisasi untuk meningkatkan kualitas hidup klien dengan total hip replacment. Pemberian edukasi pencegahan dislokasi dan pemberian latihan mobilisasi secara dini terbukti mampu mempercepat klien dalam melakukan mobilisasi secara mandiri yang ditulis dalam karya ilmiah ini.

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ABSTRACTAccidents can cause injury to humans one of them dropped and caused fracture hip. Continuous pain and the risk of complications make hip fracture should be addressed, one of which is surgical treatment with total hip replacement. Clients with postoperative total hip replaceman are at risk for dislocation and problems in mobilization if not supervised properly and properly. It is therefore necessary post-surgical handling in the form of providing education for the prevention of dislocation in hip joints and muscle strength training and mobilization exercises to improve the quality of life of clients with total hip replacment. The provision of education for the prevention of dislocation and the provision of early mobilization exercises proved able to accelerate the client in performing self-mobilization written in this scientific paper. "

"Pneumothorax iatrogenic merupakan suatu kondisi dimana terdapat udara pada rongga pleura yang disebabkan oleh tertusuknya paru saat prosedur medis dilakukan. Pneumothorax menyebabkan masalah ketidakefetifan pola napas. Salah satu penatalaksanaan untuk pasien dengan pneumothorax adalah pemasangan WSD. Karya ilmiah ini bertujuan untuk menganalisis intervensi pemberian posisi dan monitoring WSD pada pasien dengan pneumothorax yang dilakukan selama lima hari. Berdasarkan hasil evaluasi didapatkan berkurangnya keluhan sesak dan menurunnya frekuensi pernapasan pasien dari dari 36 x/menit hingga 24 x/menit, serta nyeri dapat terpantau. Positioning dan monitoring WSD dapat direkomendasikan sebagai tindakan untuk pasien pneumothorax dengan WSD.

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Iatrogenic pneumothorax is a condition where there is air in the pleural cavity caused by puncturing the lungs when a medical procedure is being carried out. Pneumothorax causes ineffective breathing patterns problems. One of treatment for pneumothorax is the using of WSD. This paper aimed to analyze positioning and WSD monitoring interventions in pneumothorax patients that was done for five days. Based on the evaluation results showed that shortness of breath decreased subjectively, respiratory rate decreased from 36 bpm till 24 bpm, and pain level monitored. Positioning and WSD monitoring intervention can be recommended as a nursing intervention to pneumothorax patients.  "

"[ABSTRAKGaster merupakan organ pencernaan yang salah satu fungsinya sebagai penampungmakanan. Keganasan dapat terjadi di sepanjang saluran pencernaan termasuk gaster.Operasi merupakan salah satu modalitas terapi yang dipakai sebagai terapi keganasangaster. Penderita keganasan gaster akan mengalami perubahan status gizi. Data mengenaigambaran status gizi pasien yang menjalani operasi keganasan gaster belum ada diRSCM.Jenis penelitian ini adalah deskriptif retrospektif dengan mengumpulkan data rekammedis pada pasien dengan diagnosis keganasan gaster yang menjalani operasi di RumahSakit dr Cipto Mangunkusumo selama periode tahun 2009 sampai dengan 2012.HASILDari 30 pasien yang didiagnosis keganasan gaster , didapatkan data yang lengkap 19(63,3 %). Penderita laki laki, usia tua dan jenis keganasan dominan pada penelitian inisesuai dengan penelitian Leonard A Laisang tahun 2008 dan kepustakaan.5,19Terdapat peningkatan jumlah operasi pada kegansan gaster dari tahun 2009 sampaidengan 2011 namun terjadi penurunan pada tahun 2012. Rerata waktu tunggu operasicukup lama sampai 14,15 hari sedangkan rerata lama rawat 28 hari. Kebanyakan pasienberdomisili di jabodetabek dan sepertiganya dari luar jawa. Jenis operasi kebanyakanadalah parsial gastrektomi baik dengan bypass atau tidak. Perbandingan rerata albumindan IMT saat masuk rumah sakit, sebelum operasi dan setelah operasi mengalamipenurunan. Sedangkan perbandingan rerata Total Limfosit Count saat masuk rumahsakit dan sebelum operasi mengalami penurunan dan meningkat kembali setelah operasi.Pada penelitian ini terdapat dua kali lipat pasien menderita malnutrisi dibandingkanpenelitian oeh Rofi dan Kalis.15,16Kelengkapan data mengenai status nutrisi pada status rekam medis sangat diperlukan.Hasil penelitian bersesuaian dengan kepustakaan dan penelitian sebelumnya.5,19 Lamanyamenunggu operasi dan lama rawat memerlukan perhatian khusus untuk menguranginya.

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ABSTRACTGaster is a digestive organ that is one of its functions as a container for food. Malignancymay occur along the digestive tract, including the stomach. Operation is one that is usedas a therapeutic modality therapy of gastric malignancy. Patients with gastric malignancywill change the nutritional status. Data on the picture of the nutritional status of patientswho underwent surgery for gastric malignancy not yet available at RSCM.METHODThis research is a descriptive retrospective medical record by collecting data on patientswith a diagnosis of gastric malignancy who underwent surgery at the Hospital Dr. CiptoMangunkusumo during the period from 2009 to 2012.THE RESULTOf the 30 patients diagnosed with gastric malignancy, obtained complete data 19(63.3%). Patients men, old age and type of malignancy dominant in this study isconsistent with research Leonard A Laisang 2008 and literature. 5.19There are an increasing number of operations on gastric malignancy from 2009 to 2011but decreased in 2012. The mean waiting time operation long enough to 14.15 days, whilethe average length of 28 days. Most patients live in Jabodetabek and a third from outsideJava. This type of surgery is mostly partial gastrectomy with bypass or not. A comparisonof the albumin and BMI at admission, before surgery and after surgery decreased.Meanwhile, the average ratio of Total Lymphocyte Count on admission and beforesurgery decreased and increased again after the operation. In this study, there are two-foldcompared to patients suffering from malnutrition research by Rofi and Kalis.15,16CONCLUSIONCompleteness of data on nutritional status on the status of medical records is needed.Results consistent with the literature study and research previously.5,19 The waiting list ofsurgery and length of stay require special attention to reduce it.;BACKGROUNDGaster is a digestive organ that is one of its functions as a container for food. Malignancymay occur along the digestive tract, including the stomach. Operation is one that is usedas a therapeutic modality therapy of gastric malignancy. Patients with gastric malignancywill change the nutritional status. Data on the picture of the nutritional status of patientswho underwent surgery for gastric malignancy not yet available at RSCM.METHODThis research is a descriptive retrospective medical record by collecting data on patientswith a diagnosis of gastric malignancy who underwent surgery at the Hospital Dr. CiptoMangunkusumo during the period from 2009 to 2012.THE RESULTOf the 30 patients diagnosed with gastric malignancy, obtained complete data 19(63.3%). Patients men, old age and type of malignancy dominant in this study isconsistent with research Leonard A Laisang 2008 and literature. 5.19There are an increasing number of operations on gastric malignancy from 2009 to 2011but decreased in 2012. The mean waiting time operation long enough to 14.15 days, whilethe average length of 28 days. Most patients live in Jabodetabek and a third from outsideJava. This type of surgery is mostly partial gastrectomy with bypass or not. A comparisonof the albumin and BMI at admission, before surgery and after surgery decreased.Meanwhile, the average ratio of Total Lymphocyte Count on admission and beforesurgery decreased and increased again after the operation. In this study, there are two-foldcompared to patients suffering from malnutrition research by Rofi and Kalis.15,16CONCLUSIONCompleteness of data on nutritional status on the status of medical records is needed.Results consistent with the literature study and research previously.5,19 The waiting list ofsurgery and length of stay require special attention to reduce it., BACKGROUNDGaster is a digestive organ that is one of its functions as a container for food. Malignancymay occur along the digestive tract, including the stomach. Operation is one that is usedas a therapeutic modality therapy of gastric malignancy. Patients with gastric malignancywill change the nutritional status. Data on the picture of the nutritional status of patientswho underwent surgery for gastric malignancy not yet available at RSCM.METHODThis research is a descriptive retrospective medical record by collecting data on patientswith a diagnosis of gastric malignancy who underwent surgery at the Hospital Dr. CiptoMangunkusumo during the period from 2009 to 2012.THE RESULTOf the 30 patients diagnosed with gastric malignancy, obtained complete data 19(63.3%). Patients men, old age and type of malignancy dominant in this study isconsistent with research Leonard A Laisang 2008 and literature. 5.19There are an increasing number of operations on gastric malignancy from 2009 to 2011but decreased in 2012. The mean waiting time operation long enough to 14.15 days, whilethe average length of 28 days. Most patients live in Jabodetabek and a third from outsideJava. This type of surgery is mostly partial gastrectomy with bypass or not. A comparisonof the albumin and BMI at admission, before surgery and after surgery decreased.Meanwhile, the average ratio of Total Lymphocyte Count on admission and beforesurgery decreased and increased again after the operation. In this study, there are two-foldcompared to patients suffering from malnutrition research by Rofi and Kalis.15,16CONCLUSIONCompleteness of data on nutritional status on the status of medical records is needed.Results consistent with the literature study and research previously.5,19 The waiting list ofsurgery and length of stay require special attention to reduce it.]"

"ABSTRAKMasyarakat di perkotaan memiliki karakteristik yang bervariasi dan kompleks. Keadaan tersebut menyebabkan adanya beberapa masalah yang terjadi, diantaranya kondisi sosial ekonomi masyarakat. Sosial ekonomi yang rendah dapat berdampak pada masalah kesehatan, salah satunya gizi kurang pada anak usia prasekolah. Penulisan karya ilmiah ini bertujuan untuk memberikan gambaran tentang analisis intervensi edukasi nutrisi menggunakan metode storytelling dengan media video dan boneka tangan. Metode pelaksanaan yang digunakan ialah studi kasus pada tiga keluarga kelolaan dengan masalah gizi kurang pada anak usia prasekolah. Intervensi unggulan yang dilakukan adalah edukasi nutrisi dengan metode storytelling mengenai sayuran. Hasil evaluasi menunjukkan pengetahuan mengenai sayuran meningkat, keluarga dengan anak usia prasekolah mau makan sayuran dan adanya peningkatan berat badan pada klien. Metode storytelling disarankan dimasukkan ke dalam intervensi edukasi oleh perawat dalam memberikan informasi terkait nutrisi dengan menggunakan media dan cerita.

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ABSTRACTPeople in urban areas have varied and complex characteristics. The situation causes some problems that occur, including socio-economic conditions of society. Low socioeconomic impact on health problems, one of which is less nutrition in preschoolers. The purpose of this paper was give an overviewof the analysis of nutrition education intervention using storytelling method with video media and hand puppets. The implementation method used is a case study of three managed families with malnutrition problems in preschoolers. The main nursing intervention is nutrition education using storytelling method about vegetables. Evaluation results show that knowledge about vegetables is increasing, families with preschoolers want to eat vegetables and weight gain on clients. The storytelling method is suggested to be included into educational interventions by nurse in providing nutritional information using media and stories."

"Salah satu masalah terbesar pada lansia adalah ketidakseimbangan nutrisi nurang dari kebutuhan tubuh. KIAN ini bertujuan untuk memaparkan hasil asuhan keperawatan pada lansia dengan ketidakseimbangan nutrisi nurang dari kebutuhan tubuh. Metode yang digunakan dalam KIAN ini berupa intervensi keperawatan. Asuhan keperawatan dilakukan di PSTW Budi Mulia 1, DKI Jakarta dengan melakukan intervensi unggulan, yaitu manajemen nutrisi melalui monitoring rutin dan pemberian suplemen berbasis protein kedelai selama 4 minggu. Monitoring rutin dan pemberian suplemen berbasis protein kedelai dilakukan kepada tiga lansia dengan kategori MNA ketidakseimbangan nutrisi kurang dari kebutuhan tubuh. Hasil yang didapat setelah pemberian intervensi selama 4 minggu pada lansia adalah terdapat penambahan pada berat badan dan lingkar lengan atas masing-masing lansia. Terdapat penambahan berat badan dan lingkar lengan atas lansia sebanyak 1 kg dan 1 cm pada klien kelolaan, sedangkan resume 1, 2 kg dan 1,5 cm, dan 3 kg dan 2 cm pada resume 2. KIAN ini menyarankan adanya anggaran khusus untuk memfasilitasi suplemen berbasis protein kedelai yang disediakan oleh Dinas Sosial dan keluarga.

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One of the biggest problems in the elderly are imbalance nutrition less than body requirement. The purpose of this paper is describing the results of the nursing care of the elderly with imbalance nutrition less than body requirement. The interventional methode was used in this paper. The intervention, management nutrition, had been done in PSTW Budi Mulia 1 Cipayung, DKI Jakarta by routine monitoring and giving soy based protein for 4 weeks. Routine monitoring and giving soy based protein was done to three elderly who categorized malnutrition by screening MNA. The results were additions to the weight and arm circumference on each senior, 1 kg dan 1 cm on first client, 2 kg and 1,5 cm on second client, and 3 kg and 2 cm on third client, after administration of intervention. This paper suggested the additional budgeting for facilate elderly the soy based protein by Sosial Department and family."

"Gagal jantung diakibatkan oleh gangguan struktur atau fungsi jantung yang merusak kemampuan ventrikel untuk mengisi atau memompa darah. Gagal jantung paling banyak ditemukan pada masyarakat perkotaan akibat gaya hidup yang tidak sehat, seperti merokok, mengkonsumsi makanan berlemak, kurang aktivitas, dan stress. Intoleran aktivitas merupakan salah satu masalah keperawatan yang ditemukan pada pasien gagal jantung, dimana klien merasa cepat lelah saat beraktivitas akibat pasokan darah dan oksigen ke organ terganggu. Karya ilmiah ini bertujuan untuk menganalisis asuhan keperawatan masyarakat perkotaan pada pasien gagal jantung kronik dengan penerapan intervensi latihan aktivitas fisik secara bertahap. Metode yang digunakan berupa studi kasus dengan satu pasien kelolaan berusia 60 tahun, berjenis kelamin wanita yang diberikan intervensi latihan aktivitas fisik secara bertahap selama 6 hari. Hasil intervensi berupa peningkatan aktivitas klien dari bedrest sampai berjalan 80 langkah, tanpa sesak maupun kelelahan. Intervensi latihan aktivitas fisik secara bertahap direkomendasikan untuk diterapkan di unit layanan keperawatandengan kondisi pasien stabil atau sudah melewati fase akut, untuk mengatasi intoleran aktivitas pada pasien gagal jantung kronik.

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Heart failure is caused by impairment in cardiac structure or function which disrupts ventricle capacity to load or pump blood. Heart failure commonly affects urban community with unhealthy lifestyle, including smoking, fat consumption, lack of physical activity, and stress. Activity intolerance is a nursing diagnosis that may be established for patient with heart failure in which client feels easily fatigued following activities due to altered supply of blood and oxygen into body organs.

This paper aimed to analyze urban community nursing care on patient with chronic heart failure by implementation of gradual physical exercise. The study method was case study of 60 year old female patient who was provided with gradual physical exercise for 6 days long.

The result suggested an improvement in client's activity from bed rest to be able to walk 80 steps, without exertional dyspnea and fatigue. Gradual physical exercise is recommended to be applied in nursing unit for patient with a stable condition or surviving the acute phase, in order to manage activity intolerance in patient with chronic heart failure."

"Prosedur penggantian sendi lutut Total Knee Replacement dilakukan pada penderita Osteoarthritis yang tidak dapat ditangani dengan metode non-pembedahan. Setelah dilakukan prosedur pembedahan, klien umumnya akan mengalami nyeri akut yang menjadi salah satu masalah keperawatan yang muncul pada klien post operasi. Nyeri akut dapat ditangani secara farmakologi menggunakan obat-obatan analgesic sesuai dengan tingkat nyeri dan secara non-farmakologi menggunakan beberapa terapi modalitas. Salah satu terapi modalitas yang banyak digunakan untuk mengurangi nyeri yaitu teknik relaksasi nafas dalam. Teknik relaksasi nafas dalam dengan perhitungan 4-2-8 tarik nafas selama empat detik, tahan dua detik, dan hembuskan selama delapan detik terbukti dalam memberikan efeknya terhadap penurunan skala nyeri dan meningkatkan kenyamanan pada klien post pembedahan penggantian sendi lutut yang dibahas pada penulisan karya ilmiah ini.

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Total Knee Replacement procedure is performed on Osteoarthritis patients who can not be treated by non-surgical methods. After the surgical procedure is done, the client will generally experience acute pain which is becomes one of the nursing problems that appear on postoperative clients. Acute pain can be treated pharmacologically using analgesic medication according to the level of pain and non-pharmacologically using some of modallities therapies.

One of the many modallities therapies used to reduce pain is deep breathing relaxation technique. The deep breathing relaxation technique with 4-2-8 calculations breath for four seconds, hold for two seconds, and exhale for eight seconds is proven to have an effect to decrease the pain scale and improve comfort of the postoperative total knee replacement surgical clients which is discussed on this scientific paper."

"Gaya hidup tidak sehat pada masyarakat perkotaan menjadi penyebab diabetes mellitus. Diabetes melitus merupakan penyakit multi sistem dengan karakteristik hiperglikemia yang disebabkan gangguan produksi atau penggunaan insulin, yang dapat mempengaruhi dalam proses penyembuhan luka. Luka kronis seperti abses sering terjadi pada pasien DM. Debridemen dan perawatan luka yang tepat dapat mencegah terjadinya komplikasi seperti amputasi. Karya Ilmiah Akhir Ners ini menggunakan metode studi kasus yang bertujuan untuk menganalisis intervensi keperawatan pada pasien DM dan abses brachialis dengan balutan cutimed sorbact untuk mencegah infeksi dan mempercepat proses penyembuhan luka di RSUP Fatmawati. Hasil analisis dengan menggunakan indikator skor Bates-Jensen selama 5 hari perawatan menunjukkan penyembuhan luka yang baik, dari skor 33 menjadi 30. Diharapkan perawat dapat mengkaji karakteristik luka dan menentukan jenis balutan luka yang tepat untuk mengoptimalkan penyembuhan luka.

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Unhealthy lifestyle may eventually lead to diabetes mellitus in urban community. Diabetes mellitus is a multisystem disease which characterized by hyperglycaemia due to impairment of insulin production/usage that also affects wound healing. Chronic wound such as abscess usually affects patient with Diabetes Mellitus. Debridement and wound care should be properly implemented to prevent further complications, such as amputation. This paper used case study method and aimed to analyse nursing intervention on patient with Diabetes Mellitus and Brachialis Abscess by applying Cutimed Sorbact to prevent infection and promote wound healing in RSUP Fatmawati. The result demonstrated a proper wound healing as indicated by Bates-Jansen scores which decreased from 33 to 30 following the intervention in 5 consecutive days. Nurses are recommend to be able to assessmend wound characteristic determine the proper type of wound dressing to optimized wound healing."