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"ABSTRAKApendisitis merupakan salah satu kondisi bedah paling umum yang menyerang anak-anak dan orang dewasa. Insiden kejadian apendisitis menjadi fenomena yang perlu segera ditangani. Salah satu penatalaksanaan dari kasus apendisitis adalah appendiktomi. Masalah utama yang muncul pada pasien post appendiktomi adalah nyeri akut karena adanya luka operasi. Manajemen nyeri pasca operasi pada pasien anak diperlukan peran penting perawat dalam melakukan penilaian dan manajemen nyeri pasca operasi. Karya ilimiah ini bertujuan untuk menganalisis asuhan keperawatan pada pasien dengan nyeri post appendiktomi dengan penerapan teknik effleurage. Hasil penerapan teknik effleurage yang dilakukan pada klien dengan post appendiktomi dapat meningkatkan rasa nyaman dan mengurangi nyeri yang dirasakan oleh klien. Hasil karya ilmiah ini diharapkan dapat menambah pengetahuan dan menjadi salah satu evidence yang dikembangkan bagi penyedia pelayanan kesehatan mengenai penerapan teknik effleurage pada pasien anak dengan nyeri post appendiktomi.

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ABSTRACT

Appendicitis is one of the most common surgical conditions that occur in children and adults. The incidence of appendicitis is the phenomenon that needs to be addressed immediately. One of the management of appendix is appendectomy. The main problem that arises in the patients postoperative appendectomy is acute pain due to surgical injuries. Postoperative pain management in child patients is required the important role of nurses in conducting assessment and management of postoperative pain. This scientific work aims to analyze nursing care in patients with pain postoperative appendectomy using application of effleurage technique. The results of the application of effleurage techniques performed on the client with post appendectomy can increase the sense of comfort and reduce the pain felt by the client. This scientific work is expected to increase knowledge and become one of the evidence developed for healthcare providers regarding the application of effleurage techniques in child patients with pain postoperative appendectomy."

"Postoperative nausea and vomiting (PONV) merupakan efek samping yang terjadi selama 24-48 jam pertama setelah operasi laparatomi. PONV dapat memanjang dikarenakan beberapa faktor salah satunya penggunaan agen analgesik. Analisis dilakukan pada perempuan berusia 67 tahun post laparatomi dengan keluhan PONV yang memanjang lebih dari 48 jam setelah tindakan operasi dikarenakan penggunaan terapi analgesik epidural. Tujuan penulisan ini yaitu memaparkan hasil analisis asuhan keperawatan dengan penggunaan teknik akupresur perikardium 6 (P6) untuk menurunkan intensitas mual dan muntah pada pasien post laparatomi. Teknik akupresur perikardium 6 (P6) diberikan selama enam hari dari tanggal 14/04/2023 sampai 19/04/2023 dengan setiap kali tindakan dilakukan sebelum dan sesudah makan selama 5-10 menit. Hasil evaluasi menunjukan teknik Akupresur perikardium 6 (P6) terbukti efektif menurunkan intensitas mual dan muntah pada pasien pasca laparatomi dengan PONV. Kesimpulannya teknik akupresur perikardium 6 (P6) dapat dilakukan untuk menurunkan intensitas mual dan muntah pasca laparatomi dan intervensi ini dapat dilakukan secara mandiri dan tidak menimbulkan efek samping

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Postoperative nausea and vomiting (PONV) is a side effect that occurs during the first 24-48 hours after laparotomy. PONV can be prolonged due to several factors, one of which is the use of analgesic agents. The analysis was performed on a 67-year-old post-laparotomy woman with complaints of PONV that lasted more than 48 hours after surgery due to the use of epidural analgesic therapy. The purpose of this paper is to present the results of an analysis of nursing care using the pericardium 6 (P6) acupressure technique to reduce the intensity of nausea and vomiting in post-laparotomy patients. Pericardium 6 (P6) acupressure technique was given for six days from 14/04/2023 to 19/04/2023 with each action performed before and after eating for 5-10 minutes. The results of the evaluation showed that the pericardium 6 (P6) acupressure technique was proven effective in reducing the intensity of nausea and vomiting in post-laparotomy patients with PONV. In conclusion, the pericardium 6 (P6) acupressure technique can be performed to reduce the intensity of post-laparotomy nausea and vomiting and this intervention can be carried out independently and does not cause side effects."

"Stroke menjadi penyebab utama kecacatan dan penyebab kematian kedua di dunia. Sebanyak 87% kasus stroke yang terjadi merupakan stroke iskemik. Stroke merupakan penyakit neurologis yang dapat menyebabkan hilangnya kemampuan fungsi motorik pada sebagian atau seluruh bagian ekstremitas sebagai akibat kelemahan pada salah satu anggota tubuh yang disebut dengan hemiparese. Hemiparese yang tidak tertangani dapat menurunkan kualitas hidup klien paska perawatan stroke. Terapi yang dilakukan pada pasien stroke adalah latihan motoric yang bertujuan untuk mengembangkan, memelihara, dan memulihkan pergerakan. Salah satu latihan yang dapat diberikan terhadap klien stroke iskemik dengan hemiparese yaitu latihan RPS (Rentang Pergerakan Sendi) aktif asistif dengan menggunakan bola karet yang bertujuan untuk meningkatkan rentang pergerakan sendi, meningkatkan fungsi dan kekuatan otot, serta mencegah kontraktur. Karya ilmiah ini bertujuan memberikan gambaran analisis asuhan keperawatan pada klien stroke iskemik dan latihan rentang pergerakan sendi menggunakan bola karet. Intervensi latihan rentang pergerakan sendi (RPS) dilakukan selama 4 hari, 7 kali latihan dengan durasi 15 menit. Hasil evaluasi menunjukkan adanya peningkatan kekuatan otot. Oleh karena itu, intervensi RPS menggunakan bola karet sangat penting dan direkomendasikan untuk diterapkan oleh perawat kepada klien stroke iskemik dengan hemiparese.

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Stroke is the leading cause of disability and the second leading cause of the death in the world. As many as 87% of case are ischemic stroke. Stroke is a neurological disease that can cause loss of motoric function ability to some or all part of extremities. Loss of motoric function ability caused by weakness in a part of exstremities call as hemiparese. Untreated hemiparese can reduce the quality of life after stroke treatment.

Therapy performed on stroke iskemik clientt is intended to develop, maintain and restore moton by motor exercise. One of exercise can be done for stroke ischemic clients with hemiparesis is by providing active assistif ROM (Range Of Motion) exercise using rubber aimed to increase the range of joint movement, improve muscle function and strength, and prevent contracture.

This paper aimed to provide on analyzed nursing care on an ischemic stroke client with hemiparese with Range of Motion using rubber ball. ROM intervention was done for 4 days, 7 times with duration as much as 15 minutes. The result showed an increased of muscle strength. Therefore, ROM exercise is very important and recommended to be applied by nurse to stroke ischemic clients with hemiparesis."

"[ABSTRAKGangguan pada sistem endokrin merupakan masalah kesehatan yang cukup tinggi di Indonesia, khususnya Diabetes Melitus (DM) tipe 2 dengan prevalensinya mencapai 2,1% dari total penduduk, dengan 60% dari total prevalensi adalah kasus neuropati. Kadar glukosa darah yang tidak terkontrol menyebabkan tingginya kejadian komplikasi DM baik akut maupun kronis. Pencegahan komplikasi tersebut memerlukan penanganan yang tepat dari berbagai multidisiplin ilmu, salahsatunya adalah peran perawat ners spesialis medikal bedah kekhususan endokrin sebagai praktisi keperawaan untuk ikut memberikan asuhan melalui berbagai pendekatan teori keperawatan seperti penerapan model adaptasi Roy secara holistik menggunakan pengkajian perilaku dan stimulus sehingga tercapai perilaku adaptif. Selain itu penerapan praktek keperawatan berbasis pembuktian ilmiah (evidence based nursing) seperti senam kaki diabetes dapat menjadi acuan intervensi dalam mencegah terjadinya polineuropati dan komplikasi lanjut seperti ulkus diabetik. Sebagai agen pembaharu/inovator, perawat spesialis juga membuat inovasi tentang self health assesment dan booklet sahabat diabetes bagi para diabetesi untuk meningkatkan promosi kesehatan terhadap pengelolaan dan penatalaksanaan DM.

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ABSTRACTDisorders of the endocrine system is a health problem that is quite high in Indonesia, in particular diabetes mellitus (DM) type 2 prevalence was at 2.1% of the total population, with 60% of the total prevalence of neuropathy cases. Blood glucose levels are poorly controlled diabetes leading to high incidence of complications both acute and chronic. Prevention of these complications requires proper handling of various multidisciplinary, one of them is the role of medical-surgical nurse specialist nurses endocrine specificity as keperawaan practitioners to help provide care through a variety of approaches such as the application of nursing theory holistically Roy adaptation model uses behavioral assessment and stimulus in order to reach adaptive behavior, Besides the application of scientific evidence-based nursing practice (evidence-based nursing) such as diabetic foot gymnastics can be a reference for intervention in preventing the occurrence opolyneuropathy and further complications such as diabetic ulcers. As an agent reformer/innovators, nurse specialist also made innovations on health self-assessment and companion booklet diabetes for diabetics to improve health promotion for the management and treatment of diabetes., Disorders of the endocrine system is a health problem that is quite high in Indonesia, in particular diabetes mellitus (DM) type 2 prevalence was at 2.1% of the total population, with 60% of the total prevalence of neuropathy cases. Blood glucose levels are poorly controlled diabetes leading to high incidence of complications both acute and chronic. Prevention of these complications requires proper handling of various multidisciplinary, one of them is the role of medical-surgical nurse specialist nurses endocrine specificity as keperawaan practitioners to help provide care through a variety of approaches such as the application of nursing theory holistically Roy adaptation model uses behavioral assessment and stimulus in order to reach adaptive behavior, Besides the application of scientific evidence-based nursing practice (evidence-based nursing) such as diabetic foot gymnastics can be a reference for intervention in preventing the occurrence opolyneuropathy and further complications such as diabetic ulcers. As an agent reformer/innovators, nurse specialist also made innovations on health self-assessment and companion booklet diabetes for diabetics to improve health promotion for the management and treatment of diabetes.]"

"Pembedahan Open Reduction and Internal Fixation menimbulkan pembengkakan jaringan dan nyeri hebat pada area pembedahan. Salah satu upaya nonfarmakologis mengurangi pembengkakan dan nyeri adalah melakukan elevasi bagian distal yang dilakukan pembedahan. Tujuan penelitian untuk mengetahui pengaruh elevasi 20 derajat terhadap pembengkakan dan tingkat nyeri pada pasien pascabedah Open Reduction and Internal Fixation ekstremitas bawah. Penelitian dilakukan dengan desain quasi eksperimental rancangan two group pretest-posttest with control group dengan subyek penelitian sebanyak 34 responden yang dibagi menjadi kelompok intervensi dan kelompok kontrol. Pengukuran circumference pembengkakan menggunakan pita meter dan tingkat nyeri dengan skala Numeric Rating Scale. Penggunaan uji statistik dengan uji T dependen, uji T independent dan korelasi Pearson. Hasil penelitian terdapat perbedaan yang signifikan selisih rerata penurunan circumference pembengkakan sebesar 1,93 cm dan tingkat nyeri sebesar 1,29 antara kelompok intervensi dan kelompok kontrol. Elevasi 20 derajat ekstremitas bawah dapat menjadi alternatif tindakan keperawatan mandiri dalam menurunkan pembengkakan dan nyeri.

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Surgery for Open Reduction and Internal Fixation causes tissue swelling and severe pain in the surgical area. One nonpharmacological effort to reduce swelling and pain is to perform distal elevation in the area of surgical. The purpose of this study was to determine the effect of a 20 degrees elevation on swelling and the level of pain in patients after surgery for Open Reduction and Internal Fixation of the lower extremities. The study with a quasi-experimental design of two group pre-test and post-test with control group with 34 subjects was divided into intervention and control groups. Swelling circumference measurements using tape meters and the level of pain with the scale of the Numeric Rating Scale. This study used dependent T test, independent T test and Pearson correlation. The results of the study showed that there were significant differences in the mean difference in the swelling circumference of 1.93 cm and the pain level of 1.29 between the intervention group and the control group. Elevation of 20 degrees of lower extremity can be an alternative for nursing intervention in reducing swelling and pain."

"[ABSTRAKPrevalensi pasien dengan gangguan sistem kardiovaskular semakin meningkat. Perawat diharapkan memiliki kontribusi dalam penanganan pasien dengan gangguan sistem kardiovaskular dengan menjalankan peran sebagai pemberi asuhan, pendidik, peneliti dan inovator. Praktik residensi spesialis keperawatan medical bedah yang telah dilaksanakan selama 1 tahun (2 semester) bertujuan untuk melakukan penerapan dan pendalaman pada peran-peran tersebut dengan pendekatan model 14 pemenuhan kebutuhan dasar manusia Virginia Henderson. Peran sebagai pemberi asuhan diterapkan pada 30 pasien dengan berbagai gangguan kardiovaskular dan satu pasien kasus kelolaan utama dengan NSTEMI. Peran sebagai pendidik dijalankan dengan pembimbingan perawat sejawat dan mahasiswa keperawatan. Peran sebagai peneliti dijalankan dengan menerapkan tindakan keperawatan berbasis pembuktian ilmiah (evidence-based nursing) yaitu tindakan dukungan sosial keluarga dan intimasi untuk menurun tingkat persepsi nyeri pada pasien infark miokard. Peran sebagai inovator dijalankan dengan menerapkan pengembangan media edukasi pada pasien dengan alat kesehatan yang dipasang dalam tubuh. Hasil analisis praktik menunjukan bahwa 14 KDM Henderson efektif digunakan sebagai pendekatan dalam asuhan keperawatan pada pasien dengan gangguan sistem kardiovaskular. Penerapan tindakan dukungan keluarga dan intimasi efektif dalam penurunan tingkat persepsi nyeri pasien infark miokard. Media edukasi berupa leaflet dapat meningkatkan pemahaman pasien dengan alat medis yang terpasang dalam tubuhnya.

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ABSTRACTThe prevalence of patients with cardiovascular disorders is increasing. Nurses are expected to contribute on management of patients with cardiovascular disorders by running their roles as a care giver, educator, researcher and innovator. Residency clinical practice of medical-surgical nursing specialist had been carried out for 1 year (2 semesters) and aimed to implement and explore these roles with 14 Basic Human Needs Virginia Henderson Model approach. The role as a care giver was applied to 30 patient with various cardiovascular disorders and a patient with NSTEMI as the primary case. The role as an educator was performed by educating patients, nurses, and nursing students. The role as a researcher was carried out by applying the evidence-based nursing, Family Social Support and Intimacy to Pain Perception on Patient with Acute Miocard Infarc. The role as an innovator was executed by applying the development of educational media in patients with medical devices implantated in the body. The analysis showed that the 14 basic human needs can be applied effectively in nursing care for patient with cardiovascular diseases. Social support and intimacy as effective to decrease pain perception on patient with myocardial infarction. In addition Media education in the form of leaflets can improve understanding of a patient with a medical instrument implantated in his body., The prevalence of patients with cardiovascular disorders is increasing. Nurses are expected to contribute on management of patients with cardiovascular disorders by running their roles as a care giver, educator, researcher and innovator. Residency clinical practice of medical-surgical nursing specialist had been carried out for 1 year (2 semesters) and aimed to implement and explore these roles with 14 Basic Human Needs Virginia Henderson Model approach. The role as a care giver was applied to 30 patient with various cardiovascular disorders and a patient with NSTEMI as the primary case. The role as an educator was performed by educating patients, nurses, and nursing students. The role as a researcher was carried out by applying the evidence-based nursing, Family Social Support and Intimacy to Pain Perception on Patient with Acute Miocard Infarc. The role as an innovator was executed by applying the development of educational media in patients with medical devices implantated in the body. The analysis showed that the 14 basic human needs can be applied effectively in nursing care for patient with cardiovascular diseases. Social support and intimacy as effective to decrease pain perception on patient with myocardial infarction. In addition Media education in the form of leaflets can improve understanding of a patient with a medical instrument implantated in his body.]"

"ABSTRAKSaat ini jumlah kasus positif Covid-19 baik nasional maupun global terus meningkat. Covid-19 tidak hanya menyerang usia dewasa namun juga anak-anak. Anak-anak di bawah usia 3 tahun dan anak-anak dengan penyakit jantung adalah kelompok yang paling banyak ditemui terinfeksi Covid-19. Covid-19 dapat menyebabkan gangguan oksigenasi yang serius pada pasien anak hingga menyebabkan gagal nafas. Pemberian ventilasi invasive melalui tindakan intubasi merupakan bagian dari airway management dalam upaya optimalisasi patensi jalan nafas. Efek samping dari tindakan ini adalah timbulnya masalah kebersihan jalan nafas pada pasien akibat menurunnya fungsi pembersihan jalan nafas secara spontan. Studi kasus ini bertujuan untuk memaparkan hasil analisis asuhan keperawatan pada pasien post operasi total koreksi & PDP terpasang ventilator dengan penerapan suctioning. Hasil studi kasus ini mendapatkan empat diagnosa keperawatan. Ketiga diagnosa keperawatan tersebut diantaranya: 1) Gangguan ventilasi spontan b.d ketidakseimbangan ventilasi perfusi; 2) Ketidakefektifan bersihan jalan nafas b.d kondisi mukus berlebihan; 3) Kelebihan volume cairan b.d edema paru; 4) Resiko keterlambatan perkembangan b.d penyakit kronis: kelainan jantung bawaan.

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ABSTRACT

At present, the number of positive cases of Covid-19 both nationally and globally continues to increase. Covid-19 is not only attacks adults but also children. Children under the age of 3 years and children with heart diseases are the most vulnerable groups that frequently infected by Covid-19. Covid-19 resulting in severe oxygenation disorders in pediatric patients and causing respiratory failure. Invasive ventilation procedure through intubation is one of airway management as the effort to optimize airway patency. The side effect of this procedure prompting ineffective airway clearance due to the decrease of spontaneous airway cleansing function. This case study aims to describe the results of the nursing care analysis in post-total repair surgery patient and COVID-19 suspect with ventilator with the application of suctioning method. The result of this case study unveil four nursing diagnoses: 1) Impaired spontaneous ventilation related to ventilation-perfusion mismatch; 2) Ineffective airway clearance related to the excessive mucous condition; 3) Excess fluid volume related to pulmonary congestion or edema; 4) Risk for delayed development related to chronic disease: congenital heart disease."