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Abstrak :
Achalasia merupakan salah satu penyakit saluran pencernaan yang dapat terjadi pada masyarakat perkotaan. Pola diet tidak sehat diperkirakan menjadi faktor risiko terjadinya masalah pencernaan yang dapat berkembang menjadi Achalasia. Dampak dari Achalasia adalah asupan makanan yang sulit baik secara oral ataupun enteral. Salah satu usaha untuk menangani Achalasia adalah dengan tindakan operasi. Tatalaksana pra operasi untuk persiapan fisik klien adalah dengan meningkatkan asupan nutrisi ke dalam tubuh melalui pemberian terapi nutrisi parenteral. Tujuan karya ilmiah ini adalah untuk menganalisis intervensi keperawatan yaitu pemberian nutrisi parenteral pada klien dengan Achalasia. Penulisan ini menggunakan pendekatan studi kasus klinik. Intervensi yang dilakukan selama 17 hari perawatan pra operasi menunjukan bahwa terapi nutrisi parenteral melalui vena perifer mampu memberikan asupan nutrisi yang adekuat dan membuat klien menjadi lebih berenergi dari sebelumnya. Namun disamping itu, klien juga mengalami phlebitis sebanyak 3 kali selama masa perawatan. Rekomendasi studi kasus ini dalam mengoptimalkan asupan nutrisi parenteral pada klien dengan Achalasia adalah dengan melakukan perawatan akses vena perifer secara rutin dan memperhatikan faktor-faktor yang dapat memunculkan phlebitis.

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Achalasia is one of the gastrointestinal diseases that can occur in urban communities. Unhealthy diet patterns are estimated to be a risk factor for digestive problems that can develop into Achalasia. The impact of Achalasia is a difficult dietary intake both orally and enterally. One attempt to deal with Achalasia is by surgery. Preoperative management for the client 39;s physical preparation is by increasing the intake of nutrients into the body through the provision of parenteral nutrition therapy. The purpose of this scientific paper is to analyze the nursing intervention that is giving parenteral nutrition to the client with Achalasia. This writing uses a clinical case study approach. Interventions performed during the 17 days of preoperative treatment show that parenteral nutrition therapy through peripheral vein can provide adequate nutritional intake and make the client more energetic than before. In addition, clients also experience phlebitis 3 times during the treatment period. The recommendation of this case study in optimizing the intake of parenteral nutrition on clients with Achalasia is by routinely perform peripheral venous access treatments and notice the factors that causes phlebitis.

Abstrak :
We report a case of carcinoma of the esophagus in a 58 years old woman with achalasia, who has been diagnosed since 30 years ago, which initiated by surgical treatment (myotomy) and the symptoms recurred since 3 years ago. According to the progress of the disease, malignancy was strongly suspected due to prolonged stasis and mucosal irritation caused by achalasia (achalasia carcinoma sequence). Because of these contributing factors for the development of serious complications such as malignancy the diagnosis of achalasia must be systematically diagnosed and treated agressively. Surveillance endoscopy in patients with achalasia should be performed every 1-2 years.

Abstrak :
ABSTRAK
Analisis Praktik Residensi Keperawatan Medikal Bedah dan Studi Kasus Pemberian Asuhan Keperawatan Pada Pasien Akalasia Esofagus Dengan Pendekatan Model Adaptasi Roy Di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo Jakarta Abstrak Pendahuluan: Pelaksanaan praktek klinik selama masa residensi keperawatan peminatan digestif bertujuan untuk mampu menampilkan peran perawat spesialis sebagai pemberi asuhan keperawatan lanjut, pendidik, advokat, konselor, kolaborator, pembaharu dan peneliti. Peran pemberi asuhan keperawatan lanjut dilakukan dengan menggunakan Model Adaptasi Roy pada pasien Akalasia Esofagus dan 30 pasien lainnya. Perilaku maladaptif paling banyak adalah mode adaptasi fisiologis dengan diagnosa keperawatan ketidakseimbangan nutrisi kurang dari kebutuhan tubuh. Intervensi keperawatan berupa manajemen nutrisi ditujukan untuk meningkatkan adaptasi pasien dalam mencapai status nutrisi. Evidence Based Nursing dilakukan dengan menerapkan pemberian minuman maltodekstrin pada pasien pra operasi elektif pada dua pasien untuk mengatasi mual, muntah dan nyeri pasca operasi, diperoleh hasil keluhan mual dan muntah tidak ada sama sekali pada 0-24 jam pasca operasi, sedangkan keluhan nyeri ringan masih dirasakan pada satu pasien. Program inovasi kelompok berupa penerapan protokol ERAS yaitu pemberian maltodekstrin pra operasi, mengunyah permen karet pasca operasi dan mobilisasi dini 2 jam pasca operasi terbukti efektif mengatasi keluhan mual dan muntah pasca operasi, meningkatkan motilitas usus dan mencegah nyeri bahu pasca operasi. Kata kunci: akalasia esofagus, mengunyah permen karet, minuman maltodektrin pra operasi, mobilisasi dini, teori Adaptasi Roy, mual, muntah, motilitas usus dan nyeri pasca operasi

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ABSTRACT
Analysis of Medical Surgical Nursing Residency Practice and Case Study of Nursing Care Delivery on Achalasia Oesophagoes Using Roy Adaptation Model ApproachAbstractImplementation of clinical practice during the residency of digestive nursing aims to be able to showcase the role of specialist nurse as advanced nursing care provider, educator, advocator, counselor, collaborator, innovator and researcher. Role of specialist as advance nursing care provider was done by using Roy Adaptation Model on Achalasia Oesophagus and 30 other patients. Maladaptive behavior at most is a physiological adaptation mode with imbalanced nutrition: less than body requirement nursing diagnosis. Nursing outcome of nutrition management is aimed at improving patient adaptation in gaining nutrition status. Evidence Based Nursing was performed by applying preoperative oral carbohydrate loading to two patients undergoing laparoscopy cholesystectomy for relieving post operative nausea and vomiting. The innovation program was implementing ERAS protocol e.g preoperative oral carbohydrate loading, chewing gum and early mobilization proved effective as nursing intervention in pre and post operative management. Keywords: achalasia oesophagus, carbohydrate loading, chewing gum, early mobilization, Roy adaptation mode, post operative nausea and vomiting, pain and gut motility,

Abstrak :
Achalasia is defined as a motor disorder of I he esophageal smooth muscle in which the lower esophageal sphincter does not relax properly with swallowing and the normal peristalsis of the esophageal body is replaced by abnormal contractions. The definite etiology is unknown. The incident is infrequent. The diagnosis of achalasia was established by clinical, radiological investigation, and manometric data. The management of achalasia consists of conservative treatment, dilation and surgical treatment. Esophageal dilation is the technique used to stretch open the blocked portion of the esophagus. Balloon dilation is a form of definite treatment beside myotomy or Heller's operation. We hereby report a case managed by balloon dilation catheter after failure by means of conservative treatment.