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"Neonatus yang dirawat di rumah sakit sering mengalami nyeri yang disebabkan prosedur invasif. Karya ilmiah akhir ini bertujuan untuk menggambarkan penerapan teori model Konservasi Levine pada neonatus dengan gangguan rasa nyaman nyeri. Nyeri pada bayi perlu mendapatkan perhatian penting dari perawat dikarenakan dapat mempengaruhi pertumbuhan dan perkembangan bayi dimasa datang. Peningkatan kepedulian perawat melakukan menajemen non farmakologi salah satu caranya menggunakan poster. Hasil menunjukkan bahwa intervensi dengan pendekatan teori Konservasi Levine efektif meningkatkan kenyamanan pasien. Disarankan agar teori Konservasi Levine dapat diterapkan dalam pemberian asuhan keperawatan pada neonatus.

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Neonates who is hospitalized, experience pain frequenty that caused by invasif procedure. This scientific paper Aims to illustrate the application of levine conservation model theory to neonates with painful discomfort. Pain shoud become a nursing concern since it will have impact on baby rsquo;s growth and development in future. Increased care nurses do non-pharmacological management one way using posters. The result showed the intervention the evodance based on Levine Conservation theory effective to increase comfort. It suggested that levine Conservation Theory can apllied in the provision of nursing care to neonates. "

"Bayi baru lahir mengalami proses adaptasi dari intrauterin ke ekstrauterin, salah satunya dalam pemenuhan nutrisi. Bayi baru lahir memerlukan pemenuhan nutrisi adekuat untukmencapai pertumbuhan dan perkembangan optimal. Tujuan penulisan karya ilmiah akhir ini adalah memberikan gambaran tentang penerapan Model Adaptasi Sister Callista Roydalam asuhan keperawatan pada bayi baru lahir dalam pemenuhan nutrisi, juga memberikan gambaran langkah pemberian edukasi ASI pada Ibu. Desain yang digunakanadalah studi kasus. Pada kelima kasus kelolaan, masalah pemenuhan nutrisi yang terjadi meliputi defisit nutrisi, risiko defisit nutisi dan ketidakefektifan menyusui. Pendekatan Model Adaptasi Roy menggunakan prinsip pengkajian mode adaptasi fisiologis, konsep diri, peran dan interdepedensi dan pengkajian stimulus fokal, konstektual, dan residual yang dijadikan sebagai dasar dalam menyusun tujuan dan memberikan intervensi untuk pemenuhan nutrisi pada bayi baru lahir. Evaluasi yang didapatkan, masalah pemenuhan nutrisi satu kasus menunjukkan perilaku adapatif dan empat kasus lainnya menunjukkan perilaku inefektif. Pemenuhan nutrisi pada bayi baru lahir perlu dioptimalkan melalui edukasi ASI pada Ibu. Penyusunan Standar Prosedur Operasional Optimalisasi Edukasi ASI pada Ibu berdasarkan Model Adaptasi Roy telah dilakukan untuk meningkatkanefektivitas edukasi terhadap keterampilan Ibu dalam memberikan ASI.

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Newborns undergo an adaptation process from intrauterine to extrauterine, one of which is nutritional fulfillment. Newborn babies need adequate nutrition to achieve optimal

growth and development. The purpose of writing this final scientific paper is to provide an overview of how the application of the Sister Callista Roy Adaptation Model in the process of nursing care for newborns to fulfill nutrition, as well as to provide an overview of the steps for providing breastfeeding education to mothers. In five cases of management, nutritional fulfillment problems that occur include nutritional deficits, nutritional deficit risks and ineffectiveness of breastfeeding. Roy's Adaptation Model approach uses the principles of assessing physiological adaptation modes, self-concept, role and interdependence and assessing focal, contextual, and residual stimuli which are used as the basis for setting goals and providing interventions for nutritional fulfillment in newborns. The evaluation obtained, one case of nutritional fulfillment problems showed adaptive behavior and four other cases showed ineffective behavior. The fulfillment of nutrition in newborns needs to be optimized through breastfeeding education to mothers. The formulation of standard operating procedures for optimizing

breastfeeding education for mothers based on Roy's Adaptation Model has been carried out to increase the effectiveness of education on the skills of mothers in breastfeeding. "

"Masalah pernapasan merupakan masalah krusial pada bayi prematur dan memerlukan penanganan segera. Pemberian asuhan keperawatan pada bayi prematur dengan gangguan oksigenasi dapat dioptimalkan melalui intervensi fasilitated tucking. Efek positif dari fasilitated tucking adalah mempromosikan bayi dalam kestabilan fungsi fisiologis, sehingga membantu proses oksigenasi bayi menjadi lebih baik. Penggunaan Teori Konservasi Levine dapat diaplikasikan dalam penerapan asuhan keperawatan yang menerapkan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Lima kasus terpilih menunjukkan masalah keperawatan pemenuhan gangguan oksigenasi. Praktik keperawatan berbasis pembuktian yang dilakukan melalui fasilitated tucking terbukti efektif terhadap laju perubahan yang konstan terhadap parameter fisiologis yaitu nadi dan saturasi oksigen. Intervensi fasilitated tucking berbasis teori Konservasi Levine dapat diterapkan dalam pemberian asuhan keperawatan yang berkualitas pada bayi prematur dengan gangguan pemenuhan oksigenasi.

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Respiratory distress is the crucial problem in preterm infants and appropriate management soon. Providing nursing care for preterm infants with impaired oxygenation fulfillment can be optimalized by applying fasilitated tucking intervention. Positive effect of fasilitated tucking can promoth physiological function stability, therefore it helps oxygenation process better. Levine's Conservation Theory was used by appliying the principle of energy conservation, structural integrity conservation, personal integrity conservation, and social integrity conservation. Five cases were selected due to nursing problems in impaired oxygenation fulfillment. Evidenced done by doing fasilitated tucking effective for changes physiologic parameters constantly namely heart rate and oxygen saturation. Fasilitated tucking intervention with Levine's Conservation Theory can be applied for quality nursing intervention in preterm infants with impaired oxygenation fulfillment."

"Kesulitan menyusu merupakan masalah yang sering terjadi pada bayi prematur. Tujuan dari studi kasus ini adalah melakukan analisis optimalisasi pemenuhan kebutuhan nutrisi oral pada bayi prematur melalui edukasi perencanaan pulang pada orang tua dengan pendekatan Teori Konservasi Levine. Lima kasus terpilih menunjukkan terjadi masalah keperawatan defisit nutrisi dan menyusui tida efektif. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil pemberian asuhan keperawatan menunjukkan bahwa pengetahuan dan keterampilan ibu menyusui bayi meningkat sehingga pemenuhan kebutuhan nutrisi bayi terpenuhi dan meningkatkan berat badan bayi melalui edukasi perencanaan pulang. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi prematur yang mengalami kesulitan menyusu.

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Having difficulty in breastfeeding is a common problem on premature infants. The purpose of this study is to analyze the optimization of the oral fulfillment of nutritional needs in premature infants through discharge planning education for the parents using Levine rsquo s Conservation Theory. Five chosen cases shows the occurrences of nutritional deficit nursing problems. Levine rsquo s Conversation Theory approach is done using energy conservation principle, structural integrity conservation, personal integrity conservation, and social integrity conservation.

The research result from the intervention of discharge planning education with Levine rsquo s Conservation Theory could improve the mothers rsquo knowledge and skills so that the fulfillment of nutritional needs of the infants fulfilled and also increasing the infants rsquo weight. Nurse could make the intervention as a standard procedure for premature infants who experienced breastfeeding difficulty."

"Pendahuluan: Penggunaan kafein lebih direkomendasikan dalam tatalaksana apnoe of prematurity (AOP) karena selain memberikan efektivitas yang tidak berbeda, namun juga memiliki keuntungan terapeutik lain dibandingkan teofilin atau aminofilin. Dalam kondisi ketersediaan kafein yang masih terbatas di Indonesia, RSAB Harapan Kita mengupayakan penggunaan sediaan kafein oral terhadap pasien bayi prematur yang dirawat di unit perawatan intensif neonatologi. Penelitian ini bertujuan untuk mengetahui capaian kadar kafein dalam plasma neonatus prematur yang mendapatkan kafein oral tersebut.Metode: Penelitian potong lintang ini mengumpulkan data rekam medis serta mengambil sampel darah untuk mengukur kadar kafein dalam darah neonatus prematur selama periode Maret – Agustus 2022 di RSAB Harapan Kita Jakarta dengan kriteria insklusi neonatus dengan usia gestasi 35 minggu atau kurang yang mendapat terapi kafein. Jenis kafein yang digunakan adalah caffeine base oral dengan dosis inisial 10mg/kgBB dan dilanjutkan dengan dosis rumatan 2,5 mg/kgBB/hari. Pengukuran kadar kafein dalam darah dilakukan setelah hari terapi kelima dengan menggunakan metode GCMS/MS.Hasil: Terdapat 33 subjek neonatus prematur yang diobservasi secara klinis serta dilakukan pemeriksaan kadar kafein dalam darah, dengan median usia gestasi 32 minggu (kisaran 25 – 34 minggu) dan rerata berat badan lahir 1296,8 (±307,8) gram. Sebanyak 97% subjek mencapai kisaran kadar terapeutik kafein pada keadaan steady state (4,49 – 20,63 mg/L). Subjek yang mengalami gejala AOP di hari terapi kafein ketujuh sebanyak 30,3%, mayoritas (27,2%) merupakan apnea tipe campuran. Efek samping yang paling banyak ditemui pada subjek penelitian ini adalah peningkatan diuresis.Kesimpulan: Mayoritas neonatus prematur yang mendapat caffeine base oral mencapai target kadar kafein darah 5 – 25 mg/L disertai penurunan kejadian AOP. Efek samping yang tersering adalah peningkatan diuresis namun tidak disertai kemaknaan klinis.

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Introduction: The use of caffeine is more recommended for the management of apnea of ​​prematurity (AOP) because, in addition to providing no difference in effectiveness, it also has other therapeutic advantages over theophylline or aminophylline. Because of the limited availability of caffeine in Indonesia, Harapan Kita National Women and Children Health Center seeks to use oral caffeine preparations for premature infants treated in the neonatology intensive care unit. This study aims to determine the achievement of caffeine levels in the plasma of premature neonates who received oral caffeine.

Methods: This cross sectional study collected medical records and took blood samples to measure blood caffeine levels of preterm infants born in the period March – August 2022 at RSAB Harapan Kita Jakarta who fulfilled the inclusion criteria of neonates with a gestational age of 35 weeks or less and received caffeine therapy. The type of caffeine used was an oral caffeine base with an initial dose of 10mg/kg and continued with a maintenance dose of 2.5 mg/kg/day. Measurement of caffeine levels in the blood was carried out after the fifth day of therapy using the GCMS/MS method.

Results: There were 33 preterm infants who were clinically observed and tested for caffeine levels in the blood, with a median gestational age of 32 weeks (range 25-34 weeks) and a mean birth weight of 1296.8 (±307.8) grams. A total of 97% of subjects reached the therapeutic range of caffeine levels at a steady state (4.49 – 20.63 mg/L). Subjects who experienced AOP symptoms on the seventh day of caffeine therapy were 30,3%, the majority (27,2%) were mixed type apnoe. The most common side effect found in the subjects of this study was an increase in diuresis.

Conclusion: Most of the preterm infants who received oral caffeine base achieved targeted blood caffeine levels of 5 – 25 mg/L with reduced incidence of AOP. The most common side effect was increased diuresis but there was no clinical significance."

"Latar belakang Gagal tumbuh atau failure to thrive adalah kondisi keterlambatan pertumbuhan fisik pada anak, dimana terjadi kegagalan penambahan berat badan yang sesuai dengan grafik pertumbuhan normal, dibandingkan dengan tinggi badan. Beberapa kondisi menjadi faktor risiko terjadinya gangguan pertumbuhan terutama pada neonatus. Studi ini memberikan gambaran penerapan Model Adaptasi Roy dalam asuhan keperawatan pada lima kasus neonatus dengan risiko gangguan pertumbuhan.Presentasi kasus Kasus 1 neonatus laki-laki, dengan extremely preterm usia gestasi 27 minggu, berat badan lahir 870 gram, neonatus kurang bulan kecil masa kehamilan (NKB-KMK), RDS, TTN, septikemia, tersangka SNAD, neonatal jaundice, terpasang ventilator mode high frequency oscilation (HFO), terpasang orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 dengan GIR 4,7, kebutuhan kalori kurang dari target, interpretasi kurva Fenton dibawah persentil 50, berat badan menurun, usia enam hari 860 gram. Kasus 2 perempuan, extremely preterm usia gestasi 26 minggu, berat badan lahir 744 gram, NKB-KMK, RDS, tersangka SNAD, PDA, neonatal jaundice. Terpasang ventilator, sementara puasa, grafik Fenton berada dibawah persentil 50, kebutuhan kalori kurang dari target. Kasus 3 dan 4 neonatus berjenis kelamin perempuan, lahir dengan extremely preterm dan very preterm, terpasang ventilator, kebutuhan kalori kurang dari target, sementara dipuasakan karena kondisi belum stabil. Kasus 5 perempuan, usia gestasi 37 minggu, BBL 2610 gram, berat badan saat dikaji 2340 gram. Diagnosis medis gastroschizis post tutup defek hari ke 27, terpasang non invasif ventilasi, sementara puasa produksi OGT kehijauan, BB/PB berada di -3SD s/d <-2 SD (gizi kurang). Evaluasi respons adaptif dari kelima pasien didapatkan kebutuhan kalori terpenuhi sesuai target.Kesimpulan Hasil pengkajian perilaku dan stimulus mode fisiologis-fisik kelima kasus didapatkan empat kasus berisiko mengalami gangguan pertumbuhan dari kondisi neonatus lahir prematur, terpasang ventilator, penundaan pemberian makan karena kondisi klinis, risiko infeksi/sepsis serta kondisi medis lain yang mempengaruhi. Satu neonatus aterm gagal tumbuh karena gastroschizis post tutup defek, dengan produksi OGT kehijauan. Nutrisi optimal baik enteral maupun parenteral diperlukan pada kondisi neonatus tersebut untuk meningkatkan respons adaptif.

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Background Failure to thrive or failure to thrive is a condition of delayed physical growth in children, in which there is a failure to gain weight according to the normal growth chart, compared to height. Several conditions are risk factors for growth disorders, especially in neonates. This study provides an overview of the application of the Roy Adaptation Model in nursing care to five cases of neonates with a risk of growth retardation.

Case presentation Case 1 male neonate, with extremely preterm gestational age 27 weeks, birth weight 870 gram, small preterm neonate for gestational age (NKB-KMK), RDS, TTN, septicemia, TSK SNAD, neonatal jaundice, put on ventilator mode high frequency oscillation (HFO), installed orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 with GIR 4.7, caloric requirement less than target, interpretation of Fenton curve below 50th percentile, decreased body weight, age six days 860 gram. Cases of 2 women, extremely preterm, gestational age 26 weeks, birth weight 744 grams, NKB-KMK, RDS, suspected SNAD, PDA, neonatal jaundice. Installed on a ventilator, while fasting, the Fenton chart is below the 50th percentile, calorie needs are less than the target. Cases 3 and 4 female baby were born extremely preterm and very preterm, were attached to a ventilator, their caloric needs were less than the target, while they were fasted because their condition was not yet stable. Case 5 female, gestational age 37 weeks, BBL 2610 grams, body weight when studied 2340 grams. Medical diagnosis of gastroschizis post closed defect on day 27, installed non-invasive ventilation, while fasting green OGT production, BB/PB was in -3SD to <-2 SD (malnutrition). Evaluation of the adaptive response of the five patients found that the calorie needs were fulfilled according to the target.

Conclusion The results of the assessment of the behavior and stimulus of the physiological-physical mode of five cases found that four cases were at risk of experiencing growth retardation from the condition of the neonate born prematurely, being placed on a ventilator, delaying feeding due to clinical conditions, risk of infection/sepsis and other affecting medical conditions. One term neonate failed to thrive because of a closed post gastroschizis defect, with greenish OGT production. Optimal nutrition, both enteral and parenteral, is needed in these neonatal conditions to increase adaptive responses."

"Latar belakang Gagal tumbuh atau failure to thrive adalah kondisi keterlambatan pertumbuhan fisik pada anak, dimana terjadi kegagalan penambahan berat badan yang sesuai dengan grafik pertumbuhan normal, dibandingkan dengan tinggi badan. Beberapa kondisi menjadi faktor risiko terjadinya gangguan pertumbuhan terutama pada neonatus. Studi ini memberikan gambaran penerapan Model Adaptasi Roy dalam asuhan keperawatan pada lima kasus neonatus dengan risiko gangguan pertumbuhan. Presentasi kasus Kasus 1 neonatus laki-laki, dengan extremely preterm usia gestasi 27 minggu, berat badan lahir 870 gram, neonatus kurang bulan kecil masa kehamilan (NKB-KMK), RDS, TTN, septikemia, tersangka SNAD, neonatal jaundice, terpasang ventilator mode high frequency oscilation (HFO), terpasang orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 dengan GIR 4,7, kebutuhan kalori kurang dari target, interpretasi kurva Fenton dibawah persentil 50, berat badan menurun, usia enam hari 860 gram. Kasus 2 perempuan, extremely preterm usia gestasi 26 minggu, berat badan lahir 744 gram, NKB-KMK, RDS, tersangka SNAD, PDA, neonatal jaundice. Terpasang ventilator, sementara puasa, grafik Fenton berada dibawah persentil 50, kebutuhan kalori kurang dari target. Kasus 3 dan 4 neonatus berjenis kelamin perempuan, lahir dengan extremely preterm dan very preterm, terpasang ventilator, kebutuhan kalori kurang dari target, sementara dipuasakan karena kondisi belum stabil. Kasus 5 perempuan, usia gestasi 37 minggu, BBL 2610 gram, berat badan saat dikaji 2340 gram. Diagnosis medis gastroschizis post tutup defek hari ke 27, terpasang non invasif ventilasi, sementara puasa produksi OGT kehijauan, BB/PB berada di -3SD s/d <-2 SD (gizi kurang). Evaluasi respons adaptif dari kelima pasien didapatkan kebutuhan kalori terpenuhi sesuai target.Kesimpulan Hasil pengkajian perilaku dan stimulus mode fisiologis-fisik kelima kasus didapatkan empat kasus berisiko mengalami gangguan pertumbuhan dari kondisi neonatus lahir prematur, terpasang ventilator, penundaan pemberian makan karena kondisi klinis, risiko infeksi/sepsis serta kondisi medis lain yang mempengaruhi. Satu neonatus aterm gagal tumbuh karena gastroschizis post tutup defek, dengan produksi OGT kehijauan. Nutrisi optimal baik enteral maupun parenteral diperlukan pada kondisi neonatus tersebut untuk meningkatkan respons adaptif.

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Background Failure to thrive or failure to thrive is a condition of delayed physical growth in children, in which there is a failure to gain weight according to the normal growth chart, compared to height. Several conditions are risk factors for growth disorders, especially in neonates. This study provides an overview of the application of the Roy Adaptation Model in nursing care to five cases of neonates with a risk of growth retardation. Case presentation Case 1 male neonate, with extremely preterm gestational age 27 weeks, birth weight 870 gram, small preterm neonate for gestational age (NKB-KMK), RDS, TTN, septicemia, TSK SNAD, neonatal jaundice, put on ventilator mode high frequency oscillation (HFO), installed orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 with GIR 4.7, caloric requirement less than target, interpretation of Fenton curve below 50th percentile, decreased body weight, age six days 860 gram. Cases of 2 women, extremely preterm, gestational age 26 weeks, birth weight 744 grams, NKB-KMK, RDS, suspected SNAD, PDA, neonatal jaundice. Installed on a ventilator, while fasting, the Fenton chart is below the 50th percentile, calorie needs are less than the target. Cases 3 and 4 female baby were born extremely preterm and very preterm, were attached to a ventilator, their caloric needs were less than the target, while they were fasted because their condition was not yet stable. Case 5 female, gestational age 37 weeks, BBL 2610 grams, body weight when studied 2340 grams. Medical diagnosis of gastroschizis post closed defect on day 27, installed non-invasive ventilation, while fasting green OGT production, BB/PB was in -3SD to <-2 SD (malnutrition). Evaluation of the adaptive response of the five patients found that the calorie needs were fulfilled according to the target.

Conclusion The results of the assessment of the behavior and stimulus of the physiological-physical mode of five cases found that four cases were at risk of experiencing growth retardation from the condition of the neonate born prematurely, being placed on a ventilator, delaying feeding due to clinical conditions, risk of infection/sepsis and other affecting medical conditions. One term neonate failed to thrive because of a closed post gastroschizis defect, with greenish OGT production. Optimal nutrition, both enteral and parenteral, is needed in these neonatal conditions to increase adaptive responses."

"Bayi prematur mempunyai banyak risiko gangguan kesehatan yang dapat dialami akibat fungsi dan sistem tubuh yang belum sempurna. Mandi merupakan tindakan non invasif yang dilakukan setiap hari dan dapat mengakibatkan stres pada bayi. Respon stres yang ditunjukkan oleh bayi prematur selama prosedur memandikan dapat berupa menangis, tremor, kehilangan suhu tubuh, dan perubahan tanda-tanda vital. Tujuan penelitian ini adalah memberikan gambaran penerapan Model Konservasi Levine pada asuhan keperawatan bayi prematur dengan risiko gangguan termoregulasi melalui teknik memandikan swaddled bath. Penelitian ini menggunakan metode studi kasus terhadap lima bayi prematur yang berisiko mengalami gangguan termoregulasi melalui pendekatan proses keperawatan. Gangguan termoregulasi dapat menghambat proses adaptasi bayi prematur dalam mencapai keutuhannya, sehingga diperlakukan intervensi berbasis Model Konservasi Levine melalui empat prinsip konservasi. Hasil penelitian menunjukkan bahwa Model Konservasi Levine dapat digunakan dalam asuhan keperawatan bayi prematur dengan masalah termoregulasi melalui penggunaan teknik memandikan swaddled bath.

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Premature babies have many risks of health problems that can be experienced due to immature body functions and systems. Bathing is a non-invasive action that is performed every day and can cause stress to the baby. The stress respone shown by premature babies during the bathing procedure can be in the form of crying, tremors, loss of body temperature, and changes in vital signs. The purpose of this study was to provide an overview of the application of the Levine Conservation Model in nursing care of premature infants with a risk of thermoregulation disorders through the swaddled bath technique. This research used a case study method of five premature babies who were at risk of experiencing thermoregulation disorders through the nursing process approach. Disorders of thermoregulation can hinder the adaptation process of premature babies in achieving their wholeness, so interventions based on the Levine Conservation Model are treated through four principles of conservation. The results of this study indicate that the Levine Conservation Model can be used in nursing care of premature infants with thermoregulation problems through the use of the swaddled bath technique."

"Respiratory Distress Syndrome (RDS) masih merupakan penyumbang mortilitas tertinggi bagi neonatus yang gagal dalam melakukan adaptasi ektrauterin. Pemasangan Peripheral Intravenous Canulla (PIVC) merupakan tindakan invasif yang lazim digunakan sebagai akses untuk pemberian cairan, nutrisi maupun obat-obatan, namun demikian PIVC memiliki komplikasi seperti plebitis, ekstravasasi/ infiltrat, kebocoran akibat bergesernya kanula. Pemasangan spalk merupakan salah satu intervensi konservasi integritas struktural dalam Model Konservasi Levine dalam asuhan keperawatan guna mempertahankan pengeluaran energi pada bayi RDS dengan menghindarkan bayi dari dwell time yang pendek. Tujuan karya tulis ini adalah untuk memberikan gambaran asuhan keperawatan dengan Model Konservasi Levine terhadap neonatus dengan RDS yang terpasang PIVC menggunakan intervensi spalk. Desain: lima kasus kelolaan dengan menggunakan Model Konservasi Levine. Asuhan keperawatan diberikan selama tiga hari. Hasil: Empat prinsip konservasi telah diterapkan pada kelima kasus kelolaan dan menunjukkan respon organismik yang baik dengan dibuktikan oleh penurunan penggunaan alat bantu pernapasan dan dwell time PIVC lebih dari 72 jam sehingga tidak terdapat pemasangan akses PIVC berulang selama asuhan keperawatan diberikan. Simpulan: Melalui intervensi spalk ini adaptasi dapat tercapai dan keutuhan kesehatan terpenuhi. Model Konservasi Levine dapat direkomendasikan dalam penerapan kasus RDS pada neonatus yang terpasang PIVC.

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Respiratory Distress Syndrome (RDS) is still the highest contributor to mortality for neonates who fail to make extrauterine adaptations. Proper oxygen support as well as fulfillment of fluids and nutrients is needed in addition to treatment such as giving antibiotics, steroids or caffeine citrate. Installation of Peripheral Intravenous Canulla (PIVC) is an invasive procedure that is commonly used as access, however PIVC has complications such as phlebitis, extravasation/infiltrates, and leaks due to shifting of the cannula. Spalk installation is one of the structural integrity conservation interventions in the Levine Conservation Model in nursing care to maintain energy expenditure in RDS babies by preventing babies from short dwell times. The aim of this paper is to provide an overview of nursing care with the Levine Conservation Model for neonates with RDS attached to PIVC using spalk intervention. PIVC dwell time is more than 72 hours so there is no repeated PIVC access installation while nursing care is given. Through this spalk intervention, adaptation can be achieved and health integrity is fulfilled. The Levine Conservation Model can be recommended in the application of RDS cases in PIVC- attached neonates."

"Masalah pemenuhan nutrisi adalah masalah yang umum terjadi pada bayi prematur. Malnutrisi yang terjadi pada awal kehidupan dapat berdampak pada kelangsungan hidup bayi. Tujuan penulisan ini adalah memberikan gambaran penerapan Model Konservasi Levine pada asuhan nutrisi bayi prematur melalui penggunaan ASI. Penelitian dilakukan dengan metode studi kasus terhadap lima bayi prematur yang mengalami masalah nutrisi melalui pendekatan proses keperawatan. Masalah tersebut dapat menghambat proses adaptasi bayi prematur dalam mencapai keutuhannya sehingga intervensi yang dilakukan menggunakan Model Konservasi Levine melalui empat prinsip konservasi. Hasil penelitian menunjukkan bahwa Model Konservasi Levine dapat digunakan dalam asuhan nutrisi bayi prematur melalui penggunaan ASI. Keluarga berperan aktif dalam penyediaan ASI sehingga bayi dapat memperoleh asupan nutrisi yang sesuai. Model Konservasi Levine dapat diterapkan dalam optimalisasi asuhan nutrisi bayi prematur yang memiliki masalah nutrisi.

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Nutritional fulfillment problems is a common problem in preterm infants. Malnutrition that occurs early in life can later have an impact on the survival of the infants. The purpose of this study is to provide an overview of the application of Levine’s Conservation Model on the nutritional care of premature infants through the use of breast milk. The research was conducted by case study method on five preterm infants who experienced nutritional problems through the nursing process approach. This problems can obstruct the process of adaptation of premature infants in achieving wholeness so that interventions made using the Levine’s Conservation Model through four conservation principles. The results of nursing care show that Levine's Conservation Model can be used in nutritional care for preterm infants through the use of breast milk. The family plays an active role in providing breast milk so that the preterm infants can obtain the appropriate intake of nutrients. Levine's Conservation Model can be applied in optimizing the care of preterm infants who have nutrition problems."