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Abstrak :
Ibu dengan seksio sesarea akan menghadapi berbagai macam permasalahan kesehatan, baik masalah fisik maupun psikologis. Permasalahan fisik yang sering terjadi antara lain post operatif ileus yang menyebabkan nyeri "gas pain", distress yang memperlama hari rawat serta meningkatkan resiko infeksi. Hal ini terjadi akibat efek samping anestesi, operasi di abdomen, trauma dan stress operasi. Penelitian ini merupakan penelitian dengan design quasi experimental pretest posttest with control group yang bertujuan untuk mengetahui efektivitas mengunyah penmen karet dalam meningkatkan motilitas saluran cerna (frekuensi bising usus, mual/muntah, kembung dan flatus) di RSUD Koja. Populasi adalah semua ibu yang melahirkan dengan seksio sesarea di RSUD Koja. Jumlah sampel dalam penelitian ini 75 orang yang terdiri dari 37 orang kelompok perlakuan dan 38 orang kelompok kontrol yang pengambilannya dengan cara quota sampling. Uji homogenitas responden antara kelompok perlakuan dan kelompok kontrol didapatkan hasil kedua kelompok homogen (p> 0,05). Analisis efektivitas mengunyah permen karet terhadap frekuensi bising usus dilakukan dengan menggunakan uji t, sedangkan mual/muntah, kembung dan flatus diukur setiap 30 menit dan dianalisis dengan distribusi frekuensi. Hasil penelitian ini menunjukkan bahwa terdapat perbedaan rata-rata frekuensi bising usus diantara kedua kelompok setelah mengunyah permen karet (p=0,00, x 0,05) Baik pada kelompok perlakuan maupun kelompok kontrol tidak ditemukan kejadian mual/muntah dan kembung setelah intervensi, namun demikian pada kelompok perlakuan kejadian mual/muntah lebih cepat hilang satu jam. Mengunyah penmen karet juga memberi efek flatus lebih cepat (13,5%) dibanding dengan yang tidak mengunyah permen karet. Dengan demikian dapat disimpulkan bahwa mengunyah permen karet dapat meningkatkan motilitas saluran cerna. Berdasarkan hasil penelitian ini disarankan untuk memotivasi klien post operasi untuk mengunyah permen karet sebab mengunyah permen karet efektif dalam meningkatkan motilitas saluran cema, simple, mudah ditoleransi, aman dan murah.

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Women with caesarean section will face many health problems physiologically and psychologically. One of the most common physical problems is post ileuses operative such as gas pain, distress and which may causes longer durations of inpatient stay, higher rates of hospital-acquired infection. This problem occurs due to side effect of the anesthesia, abdomen surgery, trauma and the surgical stress. This study used a quasi experimental pretest posttest with control group design to identify the effectiveness of chewing gum toward gastro intestinal tract motility (frequency of bowel wheezing, nausea/vomiting, bloating and flatus) at RSUD Koja. The study included all women in labor at RSUD Koja. A total of 75 women as sample were divided into two groups; 37 women as intervention group and 38 women as control group. They were taken by quota sampling. The result shown that the characteristic between both groups is equal (p 0, 05) it's mean that the both group are homogeny. The study of effectiveness of chewing gum towards bowel sounds frequencies was analyzed by using t test. Whereas, nausea/vomiting, bloating and flatus that has been taken observation every 30 minute were analyzed by distribution frequencies. The study has shown that there are any differences in average of bowel sounds frequencies between intervention group and control group (p.1.00, cc 0.05): Nausea/vomiting and flatus did not appear in both groups after intervention. However reducing the nausea/vomiting in intervention group faster one hour than groups control. The passage of flatus in the gum chewing groups is after intervention obtained 13,5% and than it did not happen in control groups. This study proved that the intervention increase gastro intestinal tract motility. The study recommends motivate post-operation clients to chewing gum because chewed gum speeds recovery post operatif ileus by stimulating bowel motility. The chewing gum is simple, easily tolerate no complication and inexpensive easy method of stimulating intestinal motility.

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ABSTRAK
Mual muntah dan gangguan pengecapan merupakan efek samping kemoterapi yang dialami oleh pasien kanker yang berdampak terhadap gangguan nutrisi. Edukasi dengan metode dan media yang efektif dapat membantu meningkatkan pengetahuan dan self care pasien untuk mengurangi mual muntah dan gangguan pengecapan. Tujuan: untuk mengetahui cost effectiveness edukasi berulang dan booklet dengan edukasi tunggal dalam mengurangi mual muntah dan gangguan pengecapan pasca kemoterapi. Metode: Desain penelitian quasi eksperimen dengan pre-post test design dan pengukuran dilakukan pada hari kedua setelah kemoterapi. Pengambilan sampel menggunakan consecutive sampling dengan jumlah sampel sebanyak 38 pasien kanker ginekologi di RS. Kanker Dharmais Jakarta. Analisa data menggunakan wilcoxon test dan paired t test. Hasil: Penelitian menunjukkan adanya perbedaan bermakna (p value < 0,05) setelah diberikan edukasi baik pada kelompok edukasi berulang dan booklet maupun kelompok edukasi tunggal dalam membantu meningkatkan kemampuan pasien untuk mengurangi keluhan mual muntah dan gangguan pengecapan. Rekomendasi : pemberian edukasi dengan frekuensi satu kali dengan menggunakan media penyuluhan lembar balik lebih efektif dibandingkan dengan pemberian edukasi berulang dan booklet. Perawat sebaiknya dapat memberikan edukasi dengan metode dan media yang tepat serta cost effectivenes dalam meningkatkan kemampuan perawatan diri pasien.

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ABSTRACT
Nausea, vomiting and disturbance of taste is a chemotherapy side effect which is experienced by cancer patients that lead to nutritional deficiencies. Education with effective methods and media can help to improve patient’s knowledge and selfcare to relieve nausea, vomiting and taste disturbance. Purpose: to determine the cost effectiveness recurrent education and booklet with single education in relieving nausea, vomiting and taste disturbance after chemotherapy. Methods: The study design quasi-experimental with pre-post test design and the measurement is performed on the second day after chemotherapy. Sampling test taken by using Consecutive sampling with 38 cancer gynaecology patients at Dharmais Cancer Hospital Jakarta. Data analysis uses Wilcoxon Test and Paired T Test. Results: The results showed significant differences (p value <0.05) after being given education both in recurrent education group and booklet also single education group in helping to improve the patient's ability to relieve complaints of nausea, vomiting and tasting disturbance. Recommendation: Education Provision with one frequency by using flipchart media counceling is more effective than recurrent education and booklets. Nurses should be able to provide education with appropriate methods and cost effectivenes in improving patient’s self care ability.

Abstrak :
ABSTRAK Kehamilan pada remaja dapat menimbulkan dampak bagi kesehatan ibu dan janin diantaranya : Preeklamsi, anemia, infeksi, abortus dan kelahiran bayi berat badan lahir rendah. Lembaga Save the Children melaporkan setiap tahun ada 13 juta anak dari ibu dengan kehamilan remaja atau 11% dari seluruh persalinan di dunia. Perawat Spesialis Maternitas mempunyai peran yang sangat strategis untuk mengatasi masalah ibu primipara remaja yang menghadapi persalinan dengan komplikasi Preeklampsi Berat dan kelahiran Bayi Berat Badan Lahir Rendah dengan mengunakan aplikasi Model Teori Keperawatan Need For Help Wiedenbach Dan Becoming A Mother Mercer. Tujuan penulisan laporan ini adalah untuk Memberikan gambaran penerapan teori Need For Help Wiedenbach?s dan Becaming A Mother Mercer dalam memberikan asuhan keperawatan pada klien primipara remaja preeklampsi berat dengan kelahiran bayi berat badan lahir rendah. Model Need For Help sangat tepat diterapkan pada fase akut, dimana pada fase ini klien mengalami perubahan yang signifikan sehingga perlu segera dapat mengatasi masalah fisik dan psikologis. Teori Model Keperawatan Becoming A Mother yang diterapkan pada fase pemeliharaan juga sangat membantu klien dalam menghadapi fase perubahan peran sebagai seorang ibu sehingga bounding attecment dapat tercipta dengan baik.

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ABSTRACT Adolescent pregnancy can impact maternal and fetal health including preeclampsia, anemia, infections, abortion and the birth of low birth weight babies. Save the Children Foundation reports that every year there are 13 million children of teenage mothers, or 11% of all deliveries in the world. A Maternity Nursing Specialist has a very strategic role to overcome the problem of primiparous adolescent mothers who face labor with severe preeclampsia and low birth weight infants birth complications by using the application of Wiedenbach?s Need for Help and Mercer?s Becoming a Mother Theoretical Model of Nursing. The purpose of this report is to provide an overview of the application of Wiedenbach?s Need for Help and Mercer?s Becoming a Mother Theory in providing nursing care to primiparous adolescent clients with severe preeclampsia and low birth weight infants birth. Need For Help Model was very suitable to be applied in the acute phase, which in this phase the client experienced a significant change so that she needs to be able to overcome the physical and psychological problems. Becoming a Mother Nursing Model Theory applied in the maintenance phase was also greatly assisted the clients in dealing with the phase of change in role as a mother so that the bounding and attachment can be created well.

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ABSTRAK
Angka kematian ibu (AKI) merupakan salah satu indikator penting dari derajat kesehatan masyarakat. AKI menggambarkan jumlah wanita meninggal dari suatu penyebab kematian terkait dengan gangguan kehamilan atau penanganannya selama kehamilan, melahirkan dan selama nifas. Kasus perdarahan sebagai penyebab utama kematian ibu dapat terjadi pada masa kehamilan, persalinan dan masa nifas. Salah satu penyebab perdarahan diantaranya adalah plasenta previa. Plasenta previa merupakan salah satu keadaan yang menjadi penyebab perdarahan yang memerlukan tindakan segera tenaga kesehatan terkait dengan kondisi ibu dan janin yang dikandungnya. Perawat sebagai salah satu tenaga kesehatan yang memberikan asuhan keperawatan secara komprehensif berperan dalam melakukan pemantauan secara berkesinambungan kondisi ibu dan janin serta proses persalinan yang akan dihadapi . Tujuan penulisan laporan KIA ini adalah menjelaskan tentang aplikasi konsep dan teori keperawatan dalam pemberian asuhan keperawatan pada ibu hamil dengan plasenta previa totalis,serta menjelaskan peran perawat maternitas sebagai pemberi asuhan keperawatan, educator, konselor, advokator, pengelola, kolaborator, agen pembaharu (innovator), komunikator dan koordinator serta peneliti dalam memberikan asuhan keperawatan pada ibu hamil dengan plasenta previa. Pemilihan konsep dan teori keperawatan berdasarkan kepada kontek klien yang dalam kondisi mengalami komplikasi yang berakibat kecemasan, dibutuhkan pendekatan perawat yang mampu memberikan asuhan secara komprehensif. Oleh karena itu konsep dan teori need for help Wiedenbach dan teori of caring Swanson tepat digunakan dalam pemberian 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 community health. MMR describes the number of women death caused by problems associated with 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 health professionals? immediate interventions related to the maternal and fetal condition. A nurse as one of health professionals who provides a comprehensive nursing care has a role in monitoring continuously the maternal and fetal condition as well as the labor and birth process. The purpose of this final scientific work was to explain about the application of the nursing concepts and theories in providing nursing care to pregnant women with placenta previa totalis, as well as to explain the role of maternity nurses as a caregiver, an educator, a counselor, an advocate, a manager, a collaborator, an innovator, a communicator and a coordinator as well as a researcher in providing nursing care to pregnant women with placenta previa. The selection of nursing concepts and theories was based on the context of the client experienced complications causing anxiety, nurses? approach that can provide comprehensive care was needed. Therefore, Wiedenbach need for help concept and theory and Swanson theory of caring were appropriate to be used in the provision of nursing care to pregnant women with placenta previa totalis. Hopefully the conditions of pregnant women 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 community health. MMR describes the number of women death caused by problems associated with 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 health professionals? immediate interventions related to the maternal and fetal condition. A nurse as one of health professionals who provides a comprehensive nursing care has a role in monitoring continuously the maternal and fetal condition as well as the labor and birth process. The purpose of this final scientific work was to explain about the application of the nursing concepts and theories in providing nursing care to pregnant women with placenta previa totalis, as well as to explain the role of maternity nurses as a caregiver, an educator, a counselor, an advocate, a manager, a collaborator, an innovator, a communicator and a coordinator as well as a researcher in providing nursing care to pregnant women with placenta previa. The selection of nursing concepts and theories was based on the context of the client experienced complications causing anxiety, nurses? approach that can provide comprehensive care was needed. Therefore, Wiedenbach need for help concept and theory and Swanson theory of caring were appropriate to be used in the provision of nursing care to pregnant women with placenta previa totalis. Hopefully the conditions of pregnant women with placenta previa totalis remain optimal, able to adapt physically and psychologically and ready to face the labor process.

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ABSTRAK
Kesehatan reproduksi merupakan hal yang penting untuk diperhatikan dalam meningkatkan kesehatan perempuan. Ners spesialis keperawatan maternitas memiliki peran dalam mencapai upaya tersebut. Laporan ini merupakan hasil analisis yang komprehensif tentang pelaksanaan praktek residensi Ners spesialis keperawatan matemitas pada masa childbearing dan non. childbearing. Fokus pelaporan adalah pada kesesuaian penerapan teori keperawatanself care Orem dan social support Marjorie A. Schaffer pada kasus ibu postpartum dengan IUFD. Masalah keperawatan yang muncul dikaitkan dengan penyesuaian diri klien secara fisik dan psikologis terhadap perawatan masa nifas dengan IUFD. Selama masa perawatan. dan klien melalui proses berdukanya, diharapkan klien dapat melakukan perawata11 diri yang tepat secara bertahap dengan . dukungan sosial dari tenaga kesehatan dan keluarga. Kelima kasus kelolaan mengalami proses berduka namun dengan dukungan dari tenaga kesehatan dan keluarga, diharapkan klien dapat menggali potensi yang dimiliki untuk melakukan perawatan diri seoptimal mungkin secara bertahap. Perbedaan yang terjadi pada klien adalah kemampuan masing-masing klien untuk memenuhi self carenya berbeda-beda, tergantung da...-1 usia, dukun.gan sosial, tolera11si terhadap nyeri dan motivasi diri klien. Kompetensi yang dicapai selama praktek residensi ini dapat meningkatkan pengalaman dan ketrampilan ners spesialis keperawatan maternitas. ABSTRACT Reproductive health is an important thing to consider in improving women's health. A maternity nn .. sm· g "P"""ialist has .. o1 .. ., in achieu1nn- tr>s .. ff'n..t Thi'" ....... "' .... 1." "'""'""" .. ""hensl·"e "'n"'h'"'" .... .,.,lt ...... ""' .., """" ...... ...,.., ".LL.a.o .L.I. '"' ..Lv....... ... .., ... '"'.t'"' ... " t..JI """""' ......... .t' ... "' ? ......... u..~.; .., ... .., ... "'..,"'" ... "' of the implementation of a maternity nursing specialist during the childbearing and non­ childbearing period. This report focused on the suitability of the application of Orem' s self care and Marjorie A. Schaffer's social support nursing theory on cases of postpartum mothers with IUFD. Nursing problems that arose were associated with the client's physical and psychological adaptation to the treatment of postnatal \"\d.th IUFD. Du.....;tilg the treatment period a."J.d the client's grieving process, it is expected that the client can perform the appropriate self-care gradually with the social support from health professionals and family. Five managed cases experienced the grieving process, hopefully with the support of health professionals and families, the clients are expected to be able to explore their potential to perform an optimal self-care gradually. The differences were the ability of each client to meet her self-care, depending on her age, social support, pain tolerance and the client's self-motivation. Competences achieved during this residency practices can enhance the experience and skills of maternity nursing specialist.