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"Bensin bertimbal sudah dihapuskan di Indonesia sejak Tahun 2006, namun kualitas udara di Indonesia masih menunjukkan kadar timbal yang tinggi. Pajanan timbal yang terus-menerus ada dan anak-anak yang terus-menerus terpajan, pada akhirnya berpotensi menjadi ancaman. Penelitian ini bertujuan untuk mengetahui besaran risiko pajanan timbal udara ambien, dan efek kesehatan pada siswa sekolah dasar (SD) di Kelurahan Muncul, Kota Tangerang Selatan. Metode penelitian ini menggunakan pendekatan Public Health Assessment dengan menggabungkan metode analisis risiko kesehatan lingkungan dan Type-1 Health Study. Konsentrasi timbal udara ambien menggunakan data hasil pemantauan Pusarpedal Tahun 2011–2013. Data karakteristik siswa SD dikumpulkan dengan wawancara menggunakan kuesioner. Evaluasi efek kesehatan mengacu pada efek kritis dari pajanan timbal secara inhalasi, yaitu gangguan pernafasan, anemia, gangguan mental emosional dan hiperaktif, penurunan IQ, dan gangguan saraf. Hasil penelitian menunjukkan bahwa rata-rata konsentrasi timbal udara ambien yaitu 0,185 μg/m3 pada Tahun 2011, 0,052 μg/m3 pada Tahun 2012, dan 0,123 μg/m3 pada Tahun 2013. Besaran risiko pajanan timbal pada siswa SD di Kelurahan Muncul kurang dari 1 yang berarti belum berisiko. Proporsi penyakit yang paling sering dialami siswa SD yaitu gangguan pernafasan (44%), dan demam disertai gangguan pernafasan (26,2%). Proporsi efek kesehatan lain yang ditemui antara lain mengarah kepada tanda dan gejala gangguan saraf (7,1%), mengarah kepada tanda dan gejala gangguan mental emosional dan hiperaktif (56%), mengarah kepada tanda dan gejala anemia (67,9%), serta tanda dan gejala indikasi susah mengikuti pelajaran/terkait IQ (54,8%). Perlu dilakukan penelitian lanjutan, selain itu pemerintah juga perlu meninjau kegiatan penghasil timbal dengan melibatkan lintas sektor dan melakukan kajian baku mutu timbal udara ambien.

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Leaded gasoline has been prohibited in Indonesia since year 2006; however the ambient air quality is still indicating high level of lead. Regarding this, continuous lead exposure has become potential threat for children. The purpose of this study was to describe the risk level of exposure to ambient air lead and its effect to the health of elementary school students in Kelurahan Muncul, Kota Tangerang Selatan. The study method used was public health assessment with the combination of environmental health risk analysis and type 1 health study. The concentration of ambient air lead was obtained from observational data of Pusarpedal year 2011-2013. The characteristic of subjects was collected from interview data using questionnaire. Furthermore, the health effect measurement referred to the critical effect of inhaled lead exposure, namely respiratory distress, anemia, mental emotional and hyperactive disorders, IQ decline and neurological disorders. This study found the average number of ambient air lead concentration in 2011, 2012 and 2013 which was 0.185 ug/m3, 0.052 ug/m3 and 0.123 ug/m3 respectively. The risk level of exposure to ambient air lead among subjects was found less than one showing no risk. Nearly half of them were suffered from respiratory distress (44%) and fever accompanied respiratory distress (26.2%). Besides those, other health effects found among subjects were leaded to the symptoms and signs of anemia (67.9%), mental emotional and hyperactive disorders (56%), learning difficulties at school and IQ-related problem (54.8%) and also the symptoms and signs of neurological disorders (7.1%). These study findings emerge the need of government‟s action to review the lead-producing activity with the involvement of other sectors. Also, the findings suggested further research about ambient air quality lead."

"Menggigil pasca anesthesia merupakan komplikasi yang potensial bagi pasien pasca bedah yang dapat mengakibatkan Iiipoksemia karena peningkatan konsumsi oksigen jaringan dan peningkatan kadar C02 dalam darah. Hal ini berbahaya tenriama bagi pasien dengan riwayat penyakit jantung iskemi atau pasien-pasien dengan fungsi cadangan ventilasi yang terbatas. Teiah banyak upaya pencegahan maupun penanggulangan dilakukan untuk mengatasi menggigil pasca anestesia, obat yang lazim digunakan adalah petidin. Penelitian terbaru juga menunjukkan bahwa ketamin juga efektif untuk mencegah menggigil pasca anestesia.Penelitian ini bertujuan membuktikan apakah ketamin lebih efektif dibandingkan petidin untuk mencegah menggigil pasca anestesia inhalasi N20/02/isofluran, Penelitian ini bersifat uji klinis tersamar ganda yang membandingkan keefektifan ketamin intravena 0,5 mg/kb BB dengan petidin 0.35 mg/kg BB. Penelitian dilakukan di Instalasi Bedah Pusat RSCM dengan jumlah sampel 40, laki-laki dan perempuan, usia 16-65 tahun, status fisik ASA I-II. Kriteria penolakan adalah mempunyai riwayat alergi terhadap petidin dan ketamin, memiliki riwayat kejang, hipertensi dan penyakit jantung koroner, jika suhu tubuh sebelum induksi >38 °C atau <36°C dan bila pasien mengkonsumsi obat inhibitor monoamine oksidase. Kriteria pengeluaran jika operasi berlangsung >180 menit atau kurang dari 30 menit, mendapatkan darah atau komponen darah, memerlukan perawatan di ruang rawat intesif pasca pembedahan., mengalami komplikasi selamaanestesia seperti syok atau henti jantung dan bila intra operatif pasien mendapatkan obat klonidin, prostigmin, petidin dan ondansetron."

"Latar belakang: luka bakar berat dapat disertai dengan trauma inhalasi, yang akan memicu respons lokal dan sistemik, sehingga menyebabkan berbagai komplikasi, termasuk systemic inflammatory response syndrome (SIRS) dan sepsis. Berbagai kondisi ini menyebabkan hipermetabolime dan hiperkatabolisme, yang membutuhkan tatalaksana nutrisi adekuat untuk membantu proses penyembuhan pasien. Berbagai kelompok ahli telah memberikan rekomendasi tatalaksana nutrisi pada luka bakar berat dan sakit kritis. Namun, akibat keterbatasan sarana dan prasarana, tidak semua rekomendasi dapat dilaksanakan, sehingga tatalaksana nutrisi diberikan secara optimal. Metode: serial kasus ini terdiri atas empat pasien luka bakar berat, yang disebabkan oleh api, dan disertai trauma inhalasi, yang menyebabkan berbagai komplikasi, sepsis, multiple organ dysfunction syndrome (MODS) dan multiple organ failure (MOF). Tatalaksana nutrisi diberikan secara bertahap sesuai dengan keadaan pasien. Pemberian nutrisi diawali dengan nutrisi enteral dini (NED) dalam waktu 2448 jam setelah luka bakar, sebesar 10 kkal/kg BB, menggunakan drip intermiten. Selanjutnya, nutrisi diberikan sebesar 2025 kkal/kg BB pada fase akut dan 2530 kkal/kg BB/hari pada fase anabolik. Setelah pasien keluar dari intensive care unit (ICU), target kebutuhan energi menggunakan persamaan Xie, dengan protein 1,52,0 g/kg BB/hari, lemak 2530%, dan karbohidrat (KH) 5565%. Mikronutrien diberikan berupa multivitamin antioksidan, vitamin B, asam folat, dan vitamin D. Pasien dalam serial kasus ini juga mendapatkan nutrisi spesifik glutamin sebesar 0,3 g/kg BB/hari, selama 510 hari. Hasil: tiga pasien mengalami perbaikan klinis, kapasitas fungsional, dan laboratorium. Pasien selamat dan dipulangkan untuk rawat jalan. Masa rawat pasien yang selamat berturut-turut 33 hari, 70 hari, dan 43 hari. Seorang pasien mengalami perburukan dan MOF, hingga meninggal dunia setelah dirawat selama 23 hari di ICU. Kesimpulan: tatalaksana nutrisi optimal dapat menunjang penyembuhan luka serta menurunkan angka morbiditas dan mortalitas pasien luka bakar berat dengan trauma inhalasi dan sepsis.

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;Background: severe burn trauma combined with inhalation injury initiates local and systemic response, resulting in various complications such as systemic inflammatory response syndrome (SIRS) and sepsis. These conditions stimulate hypercatabolic process, leading to the increase of nutrition requirement. Adequate nutritional support is necessary in order to control both inflammatory and metabolic response, and also to improve healing process. To date, nutritional recommendations specific for severe burn trauma and critical illness have been established. However, many problems including patient?s condition and lack of resources exist, so optimal nutritional support that fits our settings was delivered. Method: this serial case focused on four severely burned patients caused by flame. Subjects with inhalation trauma and complications such as sepsis, multiple organ dysfunction syndrome (MODS), and multiple organ failure (MOF) were included in this study. Nutritional support was delivered according to clinical conditions, patient?s tolerance, and laboratory findings. Early enteral nutrition was initiated within 2448 hours post burns, starting from 10 kcal/kg BW/day with intermittent gravity drip method. Nutrition was gradually increased in order to reach the target of energy for critically ill patients, which is 2025 kcal/kg BW/day in acute phase or 2530 kcal/kg BW/day in anabolic recovery phase. Xie Equation was used to calculate target of total energy for burned patient. Protein requirement was 1.52.0 g/kg BW/day. Lipid and carbohydrate given were 2530% and 5565% from calorie intake, respectively. Micronutrient supplementation including antioxidants, vitamin B, folic acid, and vitamin D was also provided. Glutamin as specific nutrient was delivered by 0.3 g/kg BW/day in 510 days. Results: improvement of clinical condition, functional capacity, and laboratory parameters was observed in three patients, who could be discharged from hospital and asked to come back for outpatient care. Their lengths of stay were 33 days, 70 days, and 43 days, respectively. However, one patient experienced worsening of condition and died after 22 days of care in Intensive Care Unit (ICU). Conclusions: optimal nutritional support for severely burned patients with inhalation trauma and sepsis is necessary in order to improve healing process, as well as decrease morbidity and mortality."

"Kehamilan merupakan proses alami yang terjadi pada wanita. Selama kehamilan ibu akan mengeluh ketidaknyamanan, seperti mual dan muntah. Mual biasanya terjadi pagi hari, tetapi dapat pula timbul setiap saat dan malam hari. Gejala ini kurang lebih terjadi setelah 6 minggu dari hari pertama haid terkahir dan berlangsung selama kurang lebih 10 minggu. Apabila mual dan muntah terus berlanjut akan berdampak buruk bagi kesehatan ibu dan janin. Tujuan dari penelitian ini memberikan analisis asuhan keperawatan pada ibu hamil dengan masalah mual dan muntah. Salah satu intervensi keperawatan untuk mengatasi mual dan muntah adalah pemberian aromaterapi inhalasi lemon. Pemberian aromaterapi inhalasi lemon dilakukan selama 3 hari. Hasil eveluasi yang didapatkan adanya penurunan skor 12 menjadi skor 3 yaitu dalam 12 jam mual yang dirasakan ibu terjadi paling lama 1 jam dan ibu tidak mengalami muntah lagi, yang diukur dengan menggunakan kuesioner Rhodes Index Nausea, Vomitting, and Retching (INVR). Oleh karena itu, karya tulis ini menganjurkan adanya pemberian aromaterapi inhalasi lemon pada ibu hamil untuk mengurangi mual dan muntah. Keterbatasan intervensi pemberian aromaterpi inhalasi lemon baru diterapkan pada satu pasien.

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Pregnancy is a natural process that occurs in women. During pregnancy the mother will complain of discomfort, such as nausea and vomiting. Nausea usually occurs in the morning, but can also occur at any time of the night. These symptoms occur more or less after 6 weeks from the first day of the last menstrual period and last for approximately 10 weeks. If nausea and vomiting continue to have a negative impact on the health of the mother and fetus. The purpose of this study is to provide an analysis of nursing care in pregnant women with nausea and vomiting. One of the nursing interventions to treat nausea and vomiting is lemon inhalation aromatherapy. Lemon inhalation aromatherapy was administered for 3 days. The results of the evaluation obtained from a decrease in the score of 12 to a score of 3, namely in 12 hours felt by the mother which occurred at the longest 1 hour and the mother did not experience vomiting anymore, as measured using the Rhodes Index Nausea, Vomiting, and Retching (INVR) questionnaire. Therefore, this paper recommends the provision of lemon inhalation aromatherapy for pregnant women to reduce nausea and vomiting. The limitations of the lemon inhalation aromatherapy intervention were only applied to one patient."

"Seiring dengan target pemerintah dalam peningkatan produksi minyak dan gas di lepas pantai, maka penggunaan bahan kimia dalam kegiatan produksi minyak dan gas semakin meningkat, hal ini memunculkan kekhawatiran akan potensi permasalahan kesehatan pekerja, oleh karenanya perlu dilakukan kajian risiko kesehatan. Penelitian ini bertujuan untuk menganalisis tingkat risiko (risk rating/RR) kesehatan terkait pajanan dari kesebelas bahan kimia utama yang digunakan pekerja, pada proses produksi minyak dan gas di kapal FPSO XYZ tahun 2022. Metode Chemical Risk Assessment (CRA) yang digunakan adalah Stoffenmanager® 8 version 5.0 yang merupakan tools untuk menilai risiko kesehatan jalur pajanan inhalasi dan dermal dari penanganan enam bahan kimia oleh production technician di area kerja topside deck dan lima bahan kimia oleh utility operator di area kerja machinery deck. Hasil CRA menunjukkan bahwa tingkat risiko (RR) jalur inhalasi dimana satu bahan kimia kategori risiko tinggi (1,highest) delapan bahan kimia kategori risiko sedang (2, medium), dan dua bahan kimia risiko rendah (3, lowest). Sedangkan berdasarkan risk characterization ratio (RCR) pajanan inhalasi, ada dua bahan kimia yang diketahui nilai RCR task ≥ 1, yang berarti perkiraan konsentrasi emisi yang dihasilkan saat beraktivitas (task concentration estimation/TCE) terhadap potensi bahaya terhirup oleh production technician dan utility operator saat beraktivitas pada jarak yang dekat dengan sumber emisi, dikategorikan berbahaya atau risiko tidak dapat di tolerir (Unacceptable risk). Untuk tingkat risiko dermal efek lokal (skin local), sembilan bahan kimia masuk kategori risiko tinggi dan dua bahan kimia masuk kategori risiko sedang. Sedangkan tingkat risiko dermal efek sistemik (skin uptake), empat bahan kimia kategori risiko sedang, dan tujuh bahan kimia kategori risiko rendah. Hasil risk rating (RR) menentukan pula prioritas tindakan (Action Priority/AP) pengendalian risiko kesehatan. Rekomendasi pengendalian adalah menurunkan tingkat bahaya (HR) dengan melakukan penggantian bahan kimia (subtitusi) dengan bahan kimia yang lebih rendah tingkat bahayanya bagi kesehatan, dan untuk pajanan dermal (ER), otomatisasi proses penanganan, modifikasi teknik pekerjaan dengan membuat sistem penambahan bahan kimia secara gravitasi, menurunkan jumlah dosis pemakaian namun tetap efektif efisien (workplace-related modifiers), mengurangi waktu dan frekuensi penggunaan bahan kimia tersebut (activity time), penambahan ventilasi lokal (LEV) selain ventilasi mekanik, serta menggunakan baju khusus tahan kimia beserta sarung tangannya atau Chemsuit (control measures modifiers).

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Along with the government's target to increase offshore oil and gas production,  the use of chemicals in oil and gas production activities tends to increase, this raises concerns about potential health problems for workers, therefore it is necessary to conduct a chemical health risk assessment. This study aims to analyze the health risk rating (RR) related to exposure to the eleven main chemicals used by workers in the oil and gas production process on the FPSO XYZ ship in 2022. The Chemical Risk Assessment (CRA) method that is used is Stoffenmanager® 8 version 5.0 which is a tool to assess the health risks of inhalation and dermal exposure lines from the handling of six chemicals by production technicians on the topside deck work area and five chemicals by utility operators on the machinery deck work area. The results of the CRA show that the risk level (RR) for the inhalation route is one chemical in the high-risk category (1,highest), eight chemicals in the medium risk category (2, medium), and two chemicals in the low-risk category (3, lowest). Meanwhile, based on the risk characterization ratio (RCR) of inhalation exposure, there are two chemicals whose RCR task value is ≥ 1, which means the estimated concentration of emissions produced during the activities (task concentration estimation/TCE) against the potential inhalation hazard by production technicians and utility operators when activities at a close distance to the emission source, are categorized as a dangerous or unacceptable risk. For the level of dermal risk of local effects (skin local), nine chemicals are in the high-risk category and two chemicals are in the medium risk category. While the level of risk of dermal systemic effects (skin uptake), four chemicals were in the moderate risk category, and seven chemicals were in the low-risk category. The results of the risk rating (RR) also determine the priority of action (Action Priority/AP) for controlling health risks. Control recommendations are to reduce the level of hazard (HR) by replacing chemicals (substitutions) with lower chemicals levels of danger to health, and for dermal exposure (ER), automation of handling processes, modification of work techniques by making chemical addition systems automatically. gravity, reducing the number of doses used but still being effective and efficient (workplace-related modifiers), reducing the time and frequency of using these chemicals (activity time), adding local ventilation (LEV) in addition to mechanical ventilation, and using special chemical resistant clothing and gloves or Chemical suit (control measures modifiers)."

"Analysis of alfa emitted radionuclide deposition at respiratory tract via inhalation process under difference air-ventilation system at radiometallurgy intallation..."

"Latar belakang. Emergence Delirium (ED) merupakan stadium dari disosiasi kesadaran pasca pembiusan dengan gejala khas berupa gelisah,mengamuk,tidak dapat dibujuk dan inkoherensi. Angka kejadian ED pada anak yang menjalani pembiusan umum di RSUPN Dr. Cipto Mangunkusumo 39,7%. Saat pulih stimulus auditorik menyebabkan sinaps talamus di Lateral amigdala sehingga menimbulkan respons takut berlebihan yang merupakan salah satu faktor terjadinya ED. Kebisingan di kamar operasi yang tinggi dapat dikurangi dengan penggunaan ear plug. Metode. Penelitian uji klinik acak tersamar ganda terhadap anak usia 1-5 tahun yang menjalani anestesia umum inhalasi di RSCM pada bulan September-Desember 2018. Sebanyak 107 subjek didapatkan dengan metode konsekutif yang dirandomisasi menjadi dua kelompok. Kelompok earplug (n=53) dilakukan pemasangan ear plug di akhir anestesia, sedangkan kontrol (n=54) tidak dilakukan pemasangan ear plug. Kejadian ED, waktu ekstubasi dicatat. ED dinilai dengan Pediatric Anesthesia Emergence Delirium (PAED). Analisis data menggunakan analisa multivariate regresi logistik dan analisa ANCOVA. Hasil. Kejadian ED pada kelompok ear plug sebesar 16,7% sedangkan kontrol 32,1% (OR = 0,402; IK 95% 0,152-1,062; p=0,066). Rerata waktu ekstubasi kelompok ear plug vs kontrol (5,76+3,23 menit) vs (6,54+ 3,67 menit) selisih rerata 0,825(0,530-2,180); p=0,230. Simpulan. Pemberian ear plug di akhir anestesia secara statistik tidak efektif namun secara klinis efektif menurunkan kejadian ED pasien anak yang menjalani anestesia umum inhalasi.

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Background. Emergence Delirium (ED) is classified as a transient postoperative disassociation state with characteristic such as agitation, irritable, umcompromising, uncooperatative, inconsolably crying. The incidence of ED in pediatric patients who underwent general anesthesia in RSUPN Dr. Cipto Mangunkusumo was 39,7%. During emergence state, auditoric stimulation induce Thalamic synaps in Lateral amigdala which leads to over respons of fearness (one of the risk factor of ED). A high noise level in operating room can be reduced with ear plug application to the patient.

Method. A double blind randomized clinical trial towards 1-5 years old pediatrics patients who underwent inhalation general anesthesia in RSCM from September-December 2018. One hundred and seven subjects were randomized after a consecutive sampling into two groups. Earplug group (n=53) with application of ear plug at the end of surgery, while in control group (n=54) without application of ear plug. The incidence of ED and time to extubation were recorded. ED was measured using Pediatric Anesthesia Emergence Delirium (PAED). All the data was analyzed using multivariate logistic regression and ANCOVA.

Result. Incidence of ED in ear plug group was 16.7% while in control group was 32.1% (OR = 0.402; CI 95% 0.152-1.062; p=0.066). Mean value of time to extubation in ear plug vs control group (5.76+3.23 minutes) vs (6.54+ 3.67 minutes) with mean difference of 0.825(0.530-2.180); p=0.230.

Conclusion. Ear plug application at the end of anesthesia was not statistically effective. However, it was clinically effective in reducing the incidence of ED in pediatric patient underwent inhalation anesthesia."

"Toluena dijumpai tersebar di lingkungan kita. Manusia terpapar logam ini dari berbagai sumber seperti udara, air, tanah dan makanan yang terkontaminasi. Terdapat beberapa penelitian yang menunjukkan bahwa toluena menyebabkan stres oksidatif dengan meningkatkan pembentukan reactive oxygen species dan menurunkan sistem anti-oksidan. Peroksidasi lipid meningkat karena terganggunya keseimbangan oksidan dan anti-oksidan, yang diukur dengan kadar malondialdehyde. Penelitian ini bertujuan mengetahui pengaruh pemberian berbagai pajanan toluena terhadap peroksidasi lipid. Tiga puluh ekor tikus wistar jantan dengan berat badan 200-250 gram dibagi dalam lima kelompok. Kelompok I sebagai kontrol, kelompok II sampai V berturut-turut mendapat toluena secara inhalasi, dosis 12.5 ppm, 25 ppm, 50 ppm, dan 100 ppm, yang dipajan selama 4 jam/hari. Setelah 14 hari berturut-turut, dilakukan pengukuran kadar malondialdehyde plasma dan darah tepi. Peningkatan kadar malondialdehyde pada kelompok IV, secara statistik tidak bermakna (p=0,118). Peningkatan tersebut sejalan dengan peningkatan pajanan toluena yang diberikan, kecuali kelompok V. Beberapa hasil darah tepi, yang tidak bermakna secara statistik yaitu HB, Hematokrit, leukosit, neutrofil, limfosit dan monosit. Sedangkan eritrosit, VER, HER, KHER, trombosit, dan eosinofil secara statistic menunjukkan adanya perbedaan bermakna.

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Toulene can be found in our environment. Humans are exposed to these metal from various sources such as air, water, soil, and contaminated food. There are several studies that show that toluene causes oxidative stress by increasing the formation of reactive oxygen species and decreasing the anti-oxidant system. Increased lipid peroxidation are due to the disruption of the balance of oxidants and antioxidants, as measured by levels of malondialdehyde. This study aims to determine the effect of various exposure of toluene towards lipid peroxidation. Thirty male wistar rats weighing 200-250 grams are divided into five groups. Group I as a control variable, group II to group V each gets toluene through inhalaton, with 12.5 ppm, 25 ppm, 50 ppm, dan 100 ppm doses, which are exposed for 4 hours/day. After 14 consecutive days, a measurement of the levels of malondialdehyde plasma and peripheral blood is done. Increase in levels of malondialdehyde in group IV is not statistically significant (p=0,118). This increase is in line with the increase of given toluene exposure, except for group V. Some of the results of peripheral blood, which was not statistically significant HB, hematocrit, leukocytes, neutrophil, lymphocytes and monocytes. While erythrocytes, MCV, MCH, MCHC, platelets and eosinophils statically shows significant difference."

"ABSTRAKPneumonia di Indonesia masih menjadi masalah utama dan angka kematian karenapneumonia masih tinggi. Salah satu masalah keperawatan pada pneumonia adalah gangguanbersihan jalan napas. Inhalasi nebuliser merupakan salah satu pengobatan untukmembersihkan jalan napas. Penelitian ini bertujuan untuk mengetahui faktor yangberhubungan dengan efektivitas proses unhalasi nebuliser. Desain yang digunakan adalahcross sectional dengan 142 sampel. Hasil penelitian dengan regresi logistik didapatkan 2faktor yang berhubungan signifikan yaitu dukungan keluarga (p=0,000) dan caring perawat(p=0,000). Rekomendasi untuk penelitian selanjutnya melihat efektivitas proses terapinebuliser pada pneumonia berdasarkan jenis alat yang digunakan dan dosis obat yangdiberikan.

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ABSTRACTPneumonia is still a major problem and mortality due to pneumonia is still high in Indonesia.One of the nursing problems in pneumonia is a disorder airway clearance. Inhalationnebulizer is one of treatment to clear the airway. This study aim to know factors related to theof the inhalation nebulizer therapy. The design used a cross sectional study with 142 samples.Logistic regression analysis of data found that 2 significant factors related with familysupport (p = 0.000) and caring (p = 0.000). Recommendations for future research look at theeffectiveness of the nebulizer therapy in pneumonia based on the type of equipment used and the doseof drug administered"

"ABSTRAKAnak dengan gangguan pernapasan sering mengalami ketidakefektifan bersihan jalan napas akibat sekret yang menumpuk. Pemberian asuhan keperawatan pada anak dengan gangguan oksigenasi dapat dioptimalkan melalui inhalasi menggunakan cairan salin hipertonik. Penggunaan model konservasi Levine dapat diaplikasikan dalam penerapan asuhan keperawatan yang menerapkan prinsip konservasi energi, konservasi integritas struktur, integritas personal dan integritas sosial. Perlunya berkolaborasi dengan tenaga kesehatan lain dalam pelaksanaan intervensi sebagai upaya memperbaiki kerusakan silia yaitu menerapkan konservasi integritas struktural. Dukungan sarana prasarana seperti alat nebuliser, pengadaan kemasan dan penyimpanan cairan salin hipertonik dapat meningkatkan kompetensi perawat spesialis dalam melakukan praktek pada anak dengan gangguan pemenuhan oksigenasi.

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ABSTRACTChildren who experience respiratory distress often encounter ineffective airway clearance caused by secret accumulation. Nursing care in children with oxygenation disturbance can be optimized through the use of hypertonic saline inhalation. The use of Levine?s conservation model applied in the implementation of nursing care facilitated children?s energy conservation, structural integrity conservation, personal integrity and social integrity. There was a need for collaboration with other health professionals in the implementation of the intervention as an effort to repair the damage of cilia, namely implementing structural integrity conservation. Infrastructure support such as nebuliser, packaging procurement and storage of hypertonic saline may improve the competence of specialist nurses in practice in children with impaired oxygenation fulfillment."