Askep Keperawatan Tb Paru

7/24/2019 Askep Keperawatan Tb Paru

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ASKEP KEPERAWATAN

Rabu, 07 Agustus 2013

ASKEP TBC

ASUHAN KEPERAWATAN PADA Tn. D.M

DENGAN TUBERK!S"S PARU D" "R"NA C2

RSU P#$%. DR. R.D. KANDU MANAD

Disusun Oleh:

DEPARTEMEN KESEHATAN RI

POLITEKNIK KESEHATAN DEPKES MANADO
http://dolvi-wwwners.blogspot.com/http://dolvi-wwwners.blogspot.com/


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JURUSAN KEPERAWATAN

PROGRAM STUDI KEPERAWATAN

2008


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!APRAN PENDAHU!UAN

&TUBERKU!S"S PARU'

1. P(ng(#t)an

Tube!"l"sis #$#l#h in%e!si &en'#!i( )enul# '#n $iseb#b!#n "leh )'*"b#*(eiu)

(ube*ul"sis+ su#(u b#sil aerobik (#h#n #s#) '#n, $i(ul#!#n )el#lui u$## -airborne./ P#$#

h#)&i se)u# !#sus in%e!si (ube*ul"sis $i$#(!#n )el#lui inh#l#si (i!el !u)#n '#n, !e*il

-se!i(# 1 ))./

2. Et)$*$g)

Pen'eb#b $#i &en'#!i( (ube*ul"sis u #$#l#h !u)#n -b#!(ei. '#n, h#n'# $#(

$ilih#( $en,#n )i"s!"&+ '#i(u )'*"b#*(eiu) (ube*ul"sis/ Mi*"b#!(ei #$#l#h b#!(ei aerob+

beben(u! b#(u '#n, )e)ben(u! s&"#/

3. Pat$%)s)$*$g)

Pen'eb#b (ube*ul"sis u (e3#$i !#en# !u)#n $ib#(u!!#n #(#u $ibesin!#n !elu#

)en3#$i dropletnu*lei $#l#) u$##/ P#(i!el in%e!si ini $#( )ene(#& $#l#) u$## beb#s sel#)#

12 3#)+ (e,#n(un, $# #$# (i$#!n'# sin# ul(#4i"le(+ 4en(il#si '#n, buu! $#n !ele)b#)#n/

D#l#) su#s#n# le)b#b $#n ,el#& !u)#n $#( (#h#n beh#i1h#i s#)i bebul#n1bul#n/ 56G

(i!el in%e!si ini (ehis#& "leh "#n, seh#(+ )#!# #!#n )ene)&el $# 3#l#n n#%#s #(#u u1

u/ Ku)#n #!#n $ih#$#&i &e(#)# !#li "leh neu("%il+ !e)u$i#n b#u "leh )#!"%#,/

Keb#n'#!#n (i!el ini #!#n )#(i #(#u $ibesih!#n "leh )#!"%#, !e7# $#i *#b#n, (#!e#

b"n*hi#l bes#)# ,e#!#n sili# $#l#) se!e(n'#/

5il# !u)#n )ene(#& $i 3#in,#n u+ )#!# #!#n be!e)b#n, bi#! $#l#) si("&l#s)#

)#!"%#,/ Disini !u)#n $#( (eb#7# )#su! !e ",#n (ubuh l#inn'#/ 5il#+ )#su!!e #(ei

&ul)"n#lis )#!# (e3#$i &en3#l##n !e seluuh b#,i#n u )en3#$i T5 )ilie/


4/39

D#i s##n, &i)e #!#n (i)bul &e#$#n,#n s#lu#n ,e(#h benin, )enu3u hilus $#n 3u,#

$ii!u(i &e)bes##n !elen3# ,e(#h benin, 4ius/ Se)u# &"ses ini )e)#!#n 7#!(u 18 )in,,u/

+. Man)%(stas) K*)n)

Ge3#l# !lini! (ube*ul"sis $#( $ib#,i $#l#) $u# ,"l"n,#n '#i(u ,e3#l# es&i#("i! $#n

,e3#l# sis(e)i!/

#/ Ge3#l# es&i#("i!

/ 5#(u! lebih $#i )in,,u

2/ 5#(u! $##h

/

N'ei $#$#

b/ Ge3#l# sis(e)i!

/ De)#)

2/ Ge3#l# sis(e)i! l#in: )#l#ise+ !ein,#( )#l#)+ #n"e!si# $#n be#( b#$#n )enuun/

-. P((#)saan /)agn$st)

#/ Kul(u s&u(u) : &"si(i% un(u! )'*"b#*(eiu) (ube*ul"sis

b/ 9iehl1Neelsen : &"si(i% un(u! b#sil1b#sil #s#) *e(

*/ Tes!uli( -PPD+ M#n("u+ P"("n,#n 4"lu)e. )enun3u!!#n : in%e!si )#s# l#lu $#n #$#n'# #n(i

b"$i+ (e(#&i (i$#! se*## be#(i )enun3u!!#n &en'#!i( #!(i%/

$/ ;"(" (h"# : )enun3u!!#n in%il(#si lesi #7#l $# #e# u #(#s/

e/ His("l",i #(#u !ulu( 3#in,#n: &"si(i% un(u! )'*"b#*(eiu) (ube*ul"sis/

%/ Pe)ei!s##n %un,si u: &enuun#n !#si(#s 4i(#l+ &enin,!#(#n u#n, )#(i+ &enin,!#(#n #si"

u$## esi$u $#n !#si(#s u ("(#l+ $#n &enuun#n s#(u##si $esi,en se!un$e (eh#$#&

in%il(#si &een!i) #(#u %ib"sis+ !ehil#n,#n 3#in,#n u $#n &en'#!i( &leu#l/

. P(nata*asanaan P(ng$batan


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Penil#i#n !ebeh#sil#n &en,"b#(#n $i$#s#!#n $# h#sil &e)ei!s##n b#!(ei"l",i $#n

!linis/ Kese)buh#n (ube*ul"sis u '#n, b#i! #!#n )e)&eh#(i!#n s&u(u) 5TA-1.+ #$#n'#

&eb#i!#n #$i"l",' $#n )en,hil#n,!#n ,e3#l#h/

7. K$*)as)

#/ 5#(u! $##h

b/ Pneu)"(h"#

*/ Luluh u

$/ G#,#l n#%#s

e/

G#,#l 3#n(un,

%/ E%usi &leu#


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4. P(n(ga5an

D#( $il#!u!#n $en,#n *## bul#n '#n, l#lu sebelu) )#su! u)#h s#!i(+ b#(u! $ise(#i ses#! n#%#s+

!ein,#( $in,in $# )#l#) h#i $#n !ele)#h#n (ubuh/ S##( $i!#3i !lien )en,eluh b#(u!

belen$i+ len$i !en(#l $#n be7#n# &u(ih+ $ise(#i ses#! n#%#s $#n #!(i4i(#s $ib#n(u "#n, l#in/

*/ Ri7#'#( Keseh#(#n D#hulu

Klien belu) &en#h $i#7#( $i u)#h s#!i( $#n b#u &e(#)# !#li $i#7#( $i u)#h s#!i(/


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$/ Ri7#'#( Keseh#(#n Kelu#,#

H#n'# sien '#n, )en$ei(# &en'#!i( se&e(i ini $i $#l#) !elu#,#/ Klien )e)ili!i s#(u "#n,

is(i $#n s#(u "#n, #n#!+ (in,,#l $i $#l#) s#(u u)#h+ 3enis u)#h &e)#nen )e)ili!i !#)#

(i$u 2+ $#&u $#n u#n, (#)u + 4en(il#si *u!u&+ &en*#h#'##n *u!u&/

Gen",#)

Ke(e#n,#n :

A : Pih#! #'#h

5 : Pih#! Ibu

: L#!i1l#!i


14/39

: Pee)&u#n

: P#sien

> : Su$#h )enin,,#l


15/39

3. P(nga)an Kasus K(*$*aan

#/ Pese&si Keseh#(#n@ M#n#3e)en Keseh#(#n

Klien )en,#n,,#& b#(u! '#n, $i#l#)i sel#)# !u#n, lebih bul#n sebelu) )#su! u)#h s#!i(

h#n'# b#(u! bi#s# $#n )en#n,,ul#n,in'# $en,#n )e)beli "b#( $i 7#un,/ Klien )e)&un'#i

i7#'#( )e"!"! $#n behen(i se(el#h s#!i(/

b/ P"l# Nu(isi Me(#b"li!

Klien )#!#n seh#i+ $ii( TRT5+ ,i )#!#n bubu+ si#n, $#n )#l#) )#!#n n#si+ i!#n+ s#'u/

Klien )inu) #i &u(ih !u#n, lebih 2000 )l@ h#i/ 55 sebelu) )#su! u)#h s#!i( !,+ 55

se(el#h s#!i( 0 !,/ Men,#l#)i &enuun#n 55+ n#%su )#!#n )enuun+ I=;D $e("se F 20 ,((@

)n(+ H5 +C ,@ $l+ #lbu)in 2+2 ),@$l+ &"(ein ("(#l C+ ),@ $l+ GDS C ),@ $l/

*/ Eli)in#si

e)ih#n : !lien 5AK 1 seh#i+ (i$#! #$# !esuli(#n 5AK+ !"nsis(ensi uine

7#n# !unin, &e!#( $#n b#u !h#s+ 5AK )en,,un#!#n uin#l $#n $il#!u!#n $i (e)( (i$u/

en##n : !lien 5A5 seh#i $en,#n !"nsis(ensi le)be! 7#n# !unin,+ (i$#!

#$# !esuli(#n 5A5+ 5A5 )en,,un#!#n #l#( b#n(u $#n $il#!u!#n $i (e)( (i$u/

u)en : !lien )en,#(#!#n sein, be!ein,#( $in,in $# )#l#) h#i/


16/39

$/ A!(i4i(#s $#n L#(ih#n

A!(i4i(#s 0 2

M#n$i

5e!#i#n

Eli)in#si

M"bili#s#si

Pin$#h

A)bul#si

N#i! (#n,,#

Ke( : 0 : )#n$ii+ : $ib#n(u seb#,i#n+ 2 : $ib#n(u "#n, l#in+ : $ib#n(u "#n, l#in $#n #l#(+ :

(i$#! )#)&u/ Klien )en,#l#)i ses#! n#%#s+ %e!uensi &en#%#s#n 2@ )n(/ Jenis &en#%#s#n

("#!ul #b$")in#l/

e/ K",ni(i% Pese&(u#l

Klien )en,#(#!#n (i$#! )en,e(i (en(#n, &en'#!i(n'#+ !es#$##n *")&"s )en(is+ )ees&"n

(eh#$#& #n,s#n,#n n'ei+ &en$en,##n b#i!+ &en,lih#(#n b#i!+ &e)bi*###n (e##h $#(

bein(e#!si $en,#n "#n, l#in/

%/ P"l# Is(i#h#( $#n Ti$u

u) s#!i( : !lien beis(i#h#( $en,#n b#i!+ (i$u si#n, /001C/00 7i(#+ (i$u

)#l#) 20/0010/00 7i(#+ (i$#! &en#h )en,,un#!#n "b#( (i$u

$i!#3i : !lien (i$u si#n, &u!ul /001/00 7i(#+ (i$u )#l#) 20/0010/00

7i(#+ !lien sein, (eb#n,un se!#li1!#li 3i!# b#(u!/

,/ K"nse& Dii

i(#s : !lien be3enis !el#)in l#!i1l#!i $#n sen#n, $en,#n i$en(i(#sn'#

seb#,#i l#!i1l#!i/

# $ii : !lien )e#s# b#h7# i# beh#,# b#,i #n,,"(# !elu#,# '#n, l#in $#n

in,in se,e# *e( se)buh/

$ii : !lien (i$#! $#( )en3#l#n!#n (u,#sn'# seb#,#i &e(#ni !#en# s#!i(/b##n $ii : !lien )e#s# i# #$#l#h se"#n, #n,,"(# )#s'##!#( '#n, b#i! $#n

!el# !elu#,# '#n, b#i!/

n : !lien be!e3# seb#,#i &e(#ni '#n, #3in $#n seb#,#i !el# !elu#,#

'#n, b#i! b#,i #n,,"(# !elu#,#n'#/

h/ P"l# K"&in, In("le#nsi S(es


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Klien )en,#(#!#n )en'e#h!#n se&enuhn'# !e$# Tuh#n $#n (i) )e$is (en(#n, !"n$isi

&en'#!i(n'#+ (in,!#( !e*e)#s#n in,#n $en,#n (#n$#1(#n$# !lien )en'e#h!#n !ese)buh#nn'#

$# Tuh#n ?#n, M#h# Es# $#n (i) )e$is+ N : 80@ )n(+ R : 22@ )n(+ e!s&esi 7#3#h (#)!

(en#n, !#en# !lien &e*#'# i# bis# $ise)buh!#n/ D#l#) )en,#(#si )#s#l#h !lien sein,

)e)in(# b#n(u#n "#n, l#in/

i/ P"l# Pe#n Hubun,#n

Hubun,#n !lien $en,#n #n,,"(# !elu#,# be3#l#n $en,#n b#i!/ Klien be!e3# seb#,#i se"#n,

&e(#ni+ su$#h )eni!#h/ Klien $#( bein(e#!si $en,#n "#n, l#in b#i!/

3/ P"l# Se!su#l Re&"$u!si

Klien su$#h )eni!#h+ )e)&un'#i "#n, #n#!+ is(i )#sih hi$u&/ Klien (i$#! l#,i )el#!u!#n

hubun,#n se!su#l !#en# !e#$##n '#n, se$#n, s#!i(/

!/ P"l# Nil#i $#n Ke&e*#'##n

Klien be#,#)# Kis(en P"(es(#n+ !lien &e*#'# $#n '#!i( $# T?ME/


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+. P((#)saan :)s)

TT=

TD : 0@80 ))H,

N : 80 @ )n(

R : 2 @ )n(

S5 : +"6

55 : 0 !,

He#$ (" T"e

1 Kel#

s&e!si : 7#n# #)bu( hi(#)+ !ebesih#n (e3#,#+ ben(u! !el# bul#(

#lsi : n'ei (e!#n (i$#! #$#

1 M#(#

s&e!si : s*le# (i$#! i!(eus+ !"n3un,(i4# #ne)is+ &u&il bul#(

#lsi : n'ei (e!#n (i$#! #$#

1 Hi$un,

s&e!si : ben(u! si)e(is+ se!e( (i$#! #$#

#lsi : n'ei (e!#n (i$#! #$#1 Mulu(

s&e!si : bibi (#)! !ein,+ ,i,i belub#n,+ )u!"s# le)b#b+ b#u )ulu( (i$#! #$#

1 Lehe

s&e!si : (i$#! #$# &e)bes##n !elen3# ('"i$

1 Th"#@ $#$#

s&e!si : si)e(is !ii $#n !#n#n

#lsi : s(e) %e)i(us !ii $#n !#n#n

e!usi : s"nu !ii $#n !#n#n

us!ul(#si : "n*hi >@ >+ 7heeBin, >@ >#

1 Ab$")en

s&e!si : $#(#

#lsi : le)#s+ n'ei (e!#n (i$#! #$#+ (i$#! #$# )#ss#


19/39

e!usi : (i$#! !e)bun,

us!ul(#si : bisin, usus n")#l

1 E!s(e)i(#s

(#s : #!#l h#n,#(+ (i$#! #$# "e$e)+ (#n,#n !#n#n (es#n, in%use $e("se F

20 ,((@ )n(

#7#h : #!#l h#n,#(+ (i$#! #$# "$e)

/ P((#)saan P(nunang

#/ Pe)ei!s##n l#b"#("iu) (,l/ 81812008

Jenis H#sil N")#l

H5

Ei("si(

Leu!"si(

T")b"si(

GDS

Ueu)

6e#(inin

As#) u#(P"(ein ("(#l

Albu)in

+C ,@ $L

2+0 uL

C00 uL

20/000 uL

C ),@ $L

),@ $L

+ ),@ $L

8+ ),@ $LC+ ),@ $L

2+2 ),@ $L

1C ,@ $L

+201+0 uL

/00010/000 uL

0/00010/000

uL

010 ),@ $L

010 ),@ $L

0+1+ ),@ $L2+1C+0 ),@ $L

+18+ ),@ $L

+C1+ ),@ $L

b/ ;"(" (h"#

H#sil : (#)! T5 P#u

*/ S&u(u) 5TA

Pe)ei!s##n s&u(u) 5TA &"si(i% M'*"b#!(eiu) Tube!"l"sis

/ T(#a)

T,l/ 10812008

I=;D De("se F 20 ,((@ )n(


20/39

6e%ii)e 2 00 ), (#b

R#ni(i$ine 2 #)& in3

6"$ein 20 , (#b

Ri%#)&isin 0 ), (#b

INH C0 ), (#b

P9A 00 ), (#b

E(#)bu("l 2C ), (#b

5 (#b

Alu&uin"l 00 ), (#b 1010

C/ K*as)%)as) Data

DS : 1 !lien )en,eluh b#(u! belen$i

1 !lien )en,eluh ses#! n#%#s

1 !lien )en,eluh #!(i4i(#sn'# &elu b#n(u#n "#n, l#in

1 !lien )en,eluh )en,#l#)i &enuun#n n#%su )#!#n

1 !lien )en,eluh )en,#l#)i &enuun#n be#( b#$#n

1 !lien )en,#(#!#n (i$#! )en,e(i (en(#n, &en'#!i(n'#

DO : 1 TT=

TD : 0@80 ))H, N : 80 @ )n(

R : 2 @ )n( S5 : +"6

1 #us!ul(#si u "n*hi >@ >+ 7heeBin, >@ >

1 #!(i4i(#s $ib#n(u "#n, l#in

1 5A5 $#n 5AK $il#!u!#n $i (e)( (i$u

1 (es#n, in%use $i len,#n !#n#n $e("se F

1 55 sebelu) s#!i( : !,+ 55 sesu$#h s#!i( : 0 !,

1 &en$i$i!#n !lien (#)#( SD


21/39

ANA!"SA DATA

N

$

Data Daa Masa*a5 Masa*a5

: 1 !lien )en,eluh b#(u!

belen$i

1 !lien )en,eluh ses#!

n#%#s

: 1 TT=

TD : 0@80 ))H,

N : 80 @ )n(

R : 2 @ )n(

S5 : +"

61 #us!ul(#si u "n*hi >@

>

1 s&u(u) !en(#l

Pe#$#n,#n en!i)

u

Kelu#n'# e!su$u(

$#l#) #l4e"li

Penin,!#(#n &"$u!si

s&u(u)

Ke)#)&u#n b#(u!

)enuun

Te(#h#nn'# se!esi

J#l#n n#%#s (e,#n,,u

5esih#n 3#l#n

n#%#s (i$#! e%e!(i%

2 : 1 !lien )en,#(#!#n

#!(i4i(#sn'# $ib#n(u

: 1 5A5 $#n 5AK

$il#!u!#n $i (e)( (i$u

1 (es#n, I=;D

$e("se F $i len,#n !#n#n

P"ses &en'#!i(

Kele)#h#n (ubuh

Tes#n, in%use $i

len,#n !#n#n

A!(i4i(#s (eb#(#s

In("le#nsi #!(i4i(#s

: 1 !lien )en,eluh

)en,#l#)i &enuun#n n#%su

)#!#n

1 !lien )en,eluh

)en,#l#)i &enuun#n be#(

b#$#n

A$#n'# s&u(u) $#

s#lu#n &en#%#s#n $#n

$i b#,i#n )ulu(

5#(u! &"$u!(i%

Ke(i$#!sei)b#n,#

n nu(isi !u#n,

$#i !ebu(uh#n

(ubuh


22/39

N

$

Data Daa Masa*a5 Masa*a5

: 1 55 sebelu) s#!i( :

!,+ 55 sesu$#h s#!i( : 0 !,

Penin,!#(#n %e!uensi

&en#%#s#n

N#%su )#!#n )enuun

: 1!lien )en,#(#!#n (i$#!

)en,e(i (en(#n, &en'#!i(n'#

: 1 &en$i$i!#n !lien (#)#(

SD

Tin,!#( &en$i$i!#n

(#)#( SD

Ku#n, in%")#si

(en(#n, &en'#!i(n'#

Ku#n, &en,e(#hu#n

Ku#n,

&en,e(#hu#n

Pi"i(#s M#s#l#h :

/ 5esih#n 3#l#n n#%#s (i$#! e%e!(i% b@$ &"$u!si s&u(u) '#n, !en(#l

2/ In("le#nsi #!(i4i(#s b@$ !ele)#h#n (ubuh $#n &"ses &en,"b#(#n

/ Ke(i$#!sei)b#n,#n nu(isi b@$ &"$u!si s&u(u) '#n, !en(#l

/ Ku#n, &en,e(#hu#n (en(#n, &en'#!i(n'# b@$ !u#n,n'# in%")#si


23/39

ASUHAN KEPERAWATAN

Ke&e#7#(#n Tu3u#n In(e4ensi R#si"n#l I)&le)en(#si E4

#n n#%#s% b@$

u(u)

n,#n :

)en,eluh

n$i

)en,eluh

0@80))H,

0 @ )n(

@ )n(

+"6

(#si u

) !en(#l

5esih#n 3#l#nn#%#s !e)b#li

e%e!(i% se(el#h

$ibei!#n (in$#!#n

!e&e#7#(#n

sel#)# h#i

$en,#n !i(ei#

h#sil:

1 b#(u! belen$i

be!u#n, #(#u

hil#n,

1 se!e( en*e

1 (#n$#1(#n$# 4i(#l

$#l#) &u(us

n")#l

1 "n*hi 1@1

/ K#3i %un,si &en#%#s#n

se&e(i bun'i+

!e*e(#n $#n i#)#

se(i#& 3#) 0/00+

2/00+ 8/00 se(i#&

h#i

2/ Obse4#si (#n$#1(#n$#

4i(#l se(i#& 3#) 0/00+

2/00+ 8/00 se(i#&

h#i

/ A(u &"sisi !lien

$en,#n &"sisi se)i

%"7le se(i#& !#li !lien

)e#s# ses#! n#%#

/ A3#!#n (e!ni! n#%#s

/ Penuun#n %un,si

n#%#s $#(

)enun3u!!#n

!e(i$#!)#)&u#n

un(u! )e)besih!#n

3#l#n n#%#s/

2/ Pen'i)n,#n

n")#l TT=

)enun3u!!#n

&eub#h#n s(#(us

sien/

/ P"sisi )e)b#n(u

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24/39


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25/39


-0/00.

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26/39


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27/39


esu$#h s#!i( )#!#n#n $#n *#i#n/

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28/39


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29/39

CATATAN PERKEMBANGAN

H#i@ T,l/ D J#) I)&le)en(#si E4#lu#si

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30/39


I

I+ II+ III

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1 !lien )en,#(#!#n


31/39


III

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III

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su$#h bis# )#!#n


32/39


II

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se$i!i( (#&i sein,


33/39


8/0

0

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34/39


08/

0

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0

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36/39

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37/39

U6"AN AKH"R PRGRAM

ASUHAN KEPERAWATAN PADA Tn. D.M

DENGAN TUBERK!S"S PARU D" "R"NA C2

RSU P#$%. DR. R.D. KANDU MANAD

?#n, Disusun Oleh :

Hen$i Ke4in W"!#sPO C200C

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NIP/ 0 8


38/39

DA:TAR PUSTAKA

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ASKEP T56

ASKEP

202-.

M(ng(na) Sa9a
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